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Cervical movement performance in individuals with traumatic neck pain: a cross-sectional validity and reliability study of the cervical reaction acuity test
Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.ORCID iD: 0000-0003-0704-6047
School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
Luleå University of Technology, Department of Health, Education and Technology, Health, Medicine and Rehabilitation.ORCID iD: 0000-0003-0112-4657
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2026 (English)In: Musculoskeletal Science and Practice, ISSN 2468-7812, Vol. 85, no October 2026, article id 103599Article in journal (Refereed) Published
Abstract [en]

Background

Traumatic neck pain is prevalent and often linked to sensorimotor impairments, including reduced cervical movement velocity, prolonged task completion time and delayed reaction times. The cervical reaction acuity (CRA) test provides a virtual reality (VR) based objective assessment of a combination of these deficits.

Objectives

To evaluate the CRA test in terms of discriminant and construct validity, associations among CRA-variables, and test-retest reliability.

Design

Cross-sectional and test-retest reliability study.

Method

Adults aged 18–65 years with chronic traumatic neck pain (CTNP) (n = 42) and asymptomatic controls (CON) (n = 38) completed the VR-based CRA test (measuring peak velocity, reaction time, and task completion time) twice, one week apart. Discriminant validity was examined through group comparisons and sensitivity and specificity analyses. Construct validity was examined through correlations with patient-reported outcomes. Associations among CRA variables were examined using correlational analyses. Test-retest reliability (CTNP n = 41, CON n = 29) was examined via intraclass correlation coefficients (ICC), standard error of measurement and minimal detectable change.

Results

Participants with CTNP showed significantly lower peak velocity and longer task completion times than CON. Reaction time did not differ between groups. Peak velocity had the best discriminative ability (sensitivity 83%, specificity 71%), while task completion time showed lower sensitivity (45%) but higher specificity (90%). Correlations with self-reported measures were low to moderate. ICC ranged from 0.54 to 0.94 (95% CI 0.23–0.97).

Conclusion

The CRA test assesses cervical movement performance, with reliability ranging from poor to excellent. Individuals with CTNP demonstrate slower cervical movement velocity and prolonged task completion times than CON.

Place, publisher, year, edition, pages
Elsevier, 2026. Vol. 85, no October 2026, article id 103599
Keywords [en]
Neck pain, Reaction time, Sensorimotor control, Velocity, Virtual reality
National Category
Physiotherapy
Research subject
Physiotherapy and Health Promotion
Identifiers
URN: urn:nbn:se:ltu:diva-118799DOI: 10.1016/j.msksp.2026.103599OAI: oai:DiVA.org:ltu-118799DiVA, id: diva2:2078853
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Full text license: CC BY

Available from: 2026-06-24 Created: 2026-06-24 Last updated: 2026-06-24

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Forsberg, KarinMichaelson, PeterRöijezon, Ulrik

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3940414243444542 of 91
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