Change in a clinical measure of cervical movement sense following four weeks of kinematic training

Background: Training targeted towards improving cervical movement accuracy is an effective strategy in the management of neck pain. Relatively complex measures have been validated to measure this in research although a simple clinical measure using a head mounted laser tracing a standardised pattern has been shown to be reliable. It is not known if this method demonstrate clinically meaningful change to training. Objective: To assess change responsiveness of the clinical cervical movement sense (CCMS) test following home kinematic training (KT). Study design: Pre-post treatment observational study. Methods: The CCMS measure was assessed in 56 patients with chronic neck pain (41 intervention, 15 control) at baseline and 4 weeks post intervention by blinded assessors. Task completion time and error number were assessed reviewing video of the performances. Change pre-post intervention was compared between groups. Results: There was a significantly greater mean improvement in the intervention (−9.2 ± 9.3) seconds) for completion time and combined time and error (−13.3 ± 16) compared to the control group for time (−2.0 ± 9.8) and combined time and error (−1.8 ± 14) with moderate to high effect sizes (Cohen's d 0.76). There was a non-significant trend for decreased number of errors in the intervention (−4.1 ± 9.0) compared to control group (0.2 ± 8.3). Conclusion: Completion time of the CCMS test appears to be able to demonstrate meaningful change following four weeks of KT. This further supports its clinical utility as a measure of cervical movement accuracy and provides direction for future clinical use.