Journal of Biomedical Physics and Engineering

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Staff Members

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

News

A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

Document Type : Original Article

Authors

1 Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

3 Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.
Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.
Materials and Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.
Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.
Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

Keywords

References
  1. Guez M, Hildingsson C, Nilsson M, Toolanen G. The prevalence of neck pain: a population-based study from northern Sweden. Acta Orthop Scand. 2002;73:455-9. doi.org/10.1080/00016470216329. PubMed PMID: 12358121.
  2. Makela M, Heliovaara M, Sievers K, Impivaara O, Knekt P, Aromaa A. Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol. 1991;134:1356-67. PubMed PMID: 1755449.
  3. Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine (Phila Pa 1976). 1994;19:1307-9. doi.org/10.1097/00007632-199406000-00001. PubMed PMID: 8066508.
  4. Sjolander P, Michaelson P, Jaric S, Djupsjobacka M. Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity. Man Ther. 2008;13:122-31. doi.org/10.1016/j.math.2006.10.002. PubMed PMID: 17197230.
  5. Tsang SM, Szeto GP, Lee RY. Movement coordination and differential kinematics of the cervical and thoracic spines in people with chronic neck pain. Clin Biomech (Bristol, Avon). 2013;28:610-7. doi.org/10.1016/j.clinbiomech.2013.05.009. PubMed PMID: 23777907.
  6. Woodhouse A, Vasseljen O. Altered motor control patterns in whiplash and chronic neck pain. BMC Musculoskelet Disord. 2008;9:90. doi.org/10.1186/1471-2474-9-90. PubMed PMID: 18570647. PubMed PMCID: 2446396.
  7. Sarig Bahat H, Chen X, Reznik D, Kodesh E, Treleaven J. Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain. Man Ther. 2015;20:295-302. doi.org/10.1016/j.math.2014.10.002. PubMed PMID: 25456272.
  8. Liu JX, Thornell LE, Pedrosa-Domellof F. Muscle spindles in the deep muscles of the human neck: a morphological and immunocytochemical study. J Histochem Cytochem. 2003;51:175-86. doi.org/10.1177/002215540305100206. PubMed PMID: 12533526.
  9. Kulkarni V, Chandy MJ, Babu KS. Quantitative study of muscle spindles in suboccipital muscles of human foetuses. Neurol India. 2001;49:355-9. PubMed PMID: 11799407.
  10. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Man Ther. 2008;13:2-11. doi.org/10.1016/j.math.2007.06.003. PubMed PMID: 17702636.
  11. Bove M, Courtine G, Schieppati M. Neck muscle vibration and spatial orientation during stepping in place in humans. J Neurophysiol. 2002;88:2232-41. doi.org/10.1152/jn.00198.2002. PubMed PMID: 12424265.
  12. Kavounoudias A, Gilhodes JC, Roll R, Roll JP. From balance regulation to body orientation: two goals for muscle proprioceptive information processing? Exp Brain Res. 1999;124:80-8. doi.org/10.1007/s002210050602. PubMed PMID: 9928792.
  13. Silva AG, Cruz AL. Standing balance in patients with whiplash-associated neck pain and idiopathic neck pain when compared with asymptomatic participants: A systematic review. Physiother Theory Pract. 2013;29:1-18. doi.org/10.3109/09593985.2012.677111. PubMed PMID: 22515180.
  14. Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14:696-701. doi.org/10.1016/j.math.2009.05.004. PubMed PMID: 19632880.
  15. Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res. 2007;25:404-12. doi.org/10.1002/jor.20220. PubMed PMID: 17143898.
  16. Revel M, Minguet M, Gregoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil. 1994;75:895-9. doi.org/10.1016/0003-9993(94)90115-5. PubMed PMID: 8053797.
  17. McCaskey MA, Schuster-Amft C, Wirth B, Suica Z, de Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review. BMC Musculoskelet Disord. 2014;15:382. doi.org/10.1186/1471-2474-15-382. PubMed PMID: 25409985.
  18. Adamovich SV, Fluet GG, Tunik E, Merians AS. Sensorimotor training in virtual reality: a review. NeuroRehabilitation. 2009;25:29-44. PubMed PMID: 19713617. PubMed PMCID: 2819065.
  19. Holden MK. Virtual environments for motor rehabilitation: review. Cyberpsychol Behav. 2005;8:187-211; discussion 212-9. doi.org/10.1089/cpb.2005.8.187. PubMed PMID: 15971970.
  20. Malloy KM, Milling LS. The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev. 2010;30:1011-8. doi.org/10.1016/j.cpr.2010.07.001. PubMed PMID: 20691523.
  21. Miller AC, Hickman LC, Lemasters GK. A distraction technique for control of burn pain. J Burn Care Rehabil. 1992;13:576-80. doi.org/10.1097/00004630-199209000-00012. PubMed PMID: 1452593.
  22. Li A, Montano Z, Chen VJ, Gold JI. Virtual reality and pain management: current trends and future directions. Pain Manag. 2011;1:147-57. doi.org/10.2217/pmt.10.15. PubMed PMID: 21779307. PubMed PMCID: 3138477.
  23. Mahrer NE, Gold JI. The use of virtual reality for pain control: a review. Curr Pain Headache Rep. 2009;13:100-9. doi.org/10.1007/s11916-009-0019-8. PubMed PMID: 19272275.
  24. Wiederhold BK, Gao K, Sulea C, Wiederhold MD. Virtual reality as a distraction technique in chronic pain patients. Cyberpsychol Behav Soc Netw. 2014;17:346-52. doi.org/10.1089/cyber.2014.0207. PubMed PMID: 24892196. PubMed PMCID: 4043365.
  25. Burdea GC. Virtual rehabilitation--benefits and challenges. Methods Inf Med. 2003;42:519-23. PubMed PMID: 14654886.
  26. Sarig Bahat H, Takasaki H, Chen X, Bet-Or Y, Treleaven J. Cervical kinematic training with and without interactive VR training for chronic neck pain - a randomized clinical trial. Man Ther. 2015;20:68-78. doi.org/10.1016/j.math.2014.06.008. PubMed PMID: 25066503.
  27. Jansen-Kosterink SM, Huis In ‘t Veld RM, Schonauer C, Kaufmann H, Hermens HJ, Vollenbroek-Hutten MM. A Serious Exergame for Patients Suffering from Chronic Musculoskeletal Back and Neck Pain: A Pilot Study. Games Health J. 2013;2:299-307. doi.org/10.1089/g4h.2013.0043. PubMed PMID: 24761327. PubMed PMCID: 3833375.
  28. Pool JJ, Ostelo RW, Hoving JL, Bouter LM, de Vet HC. Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain. Spine (Phila Pa 1976). 2007;32:3047-51. doi.org/10.1097/BRS.0b013e31815cf75b. PubMed PMID: 18091500.
  29. Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14:409-15. PubMed PMID: 1834753.
  30. Mousavi SJ, Parnianpour M, Montazeri A, Mehdian H, Karimi A, Abedi M, et al. Translation and validation study of the Iranian versions of the Neck Disability Index and the Neck Pain and Disability Scale. Spine (Phila Pa 1976). 2007;32:E825-31. doi.org/10.1097/BRS.0b013e31815ce6dd. PubMed PMID: 18091478.
  31. Arami J, Rezasoltani A, Khalkhali Zaavieh M, Rahnama L. The effect of two exercise therapy programs (proprioceptive and endurance training) to treat patients with chronic non-specific neck pain. Journal of Babol University of Medical Sciences. 2012;14:77-84.
  32. Roijezon U, Bjorklund M, Bergenheim M, Djupsjobacka M. A novel method for neck coordination exercise--a pilot study on persons with chronic non-specific neck pain. J Neuroeng Rehabil. 2008;5:36. doi.org/10.1186/1743-0003-5-36. PubMed PMID: 19105826. PubMed PMCID: 2625342.
  33. Harel NY, Song KH, Tang X, Strittmatter SM. Nogo receptor deletion and multimodal exercise improve distinct aspects of recovery in cervical spinal cord injury. J Neurotrauma. 2010;27:2055-66. doi.org/10.1089/neu.2010.1491. PubMed PMID: 20809785. PubMed PMCID: 2978056.
  34. Gold JI, Belmont KA, Thomas DA. The neurobiology of virtual reality pain attenuation. Cyberpsychol Behav. 2007;10:536-44. doi.org/10.1089/cpb.2007.9993. PubMed PMID: 17711362.
  35. Humphreys B, Irgens P. The effect of a rehabilitation exercise program on head repositioning accuracy and reported levels of pain in chronic neck pain subjects. Journal of Whiplash & Related Disorders. 2002;1:99-112. doi.org/10.3109/j180v01n01_09.
Journal of Biomedical Physics and Engineering
Volume 9, Issue 3 - Serial Number 3
33
June 2019
Pages 355-366
Files
Share
How to cite
Statistics