METHODS: Forty-three participants (23 asymptomatic and 20 with CNP) underwent neck proprioception testing, returning to a NHP and THP in both sitting and standing positions (six trials for each test). A laser pointer was secured on the participant's forehead and inertial measurement unit (IMU) sensors were placed beneath the laser pointer and at the level of the spinous process of the seventh cervical vertebra. Both the absolute and the constant JPE were assessed.
FINDINGS: For the asymptomatic participants, good reliability (ICC: 0.79) was found only for right rotation of the THP task in sitting. In standing, good reliability (ICC: 0.77) was only found in flexion for the THP task. In standing, good reliability (ICC: 0.77) was only found for right rotation of the THP for the absolute JPE and left rotation (ICC: 0.85) for the constant error of the NHP task. In those with CNP, when tested in sitting, good reliability was found for flexion (ICC: 0.8) for the absolute JPE and good reliability (ICC range: 0.8-0.84) was found for flexion, extension, and right rotation for the constant JPE. In standing, good reliability (ICC range: 0.81-0.88) was found for flexion, and rotation for the absolute JPE. The constant JPE showed good reliability (ICC: 0.85) for right rotation and excellent reliability (ICC: 0.93) for flexion. Validity was weak to strong (r range: 0.26-0.83) and moderate to very strong (r range: 0.47-0.93) for absolute and constant error respectively, when tested in sitting. In standing, the validity was weak to very strong (0.38-0.96) for the absolute JPE and moderate to very strong (r range: 0.54-0.92) for the constant JPE.
CONCLUSION: The reliability of the measure of JPE when tested in sitting and standing in both groups showed good reliability, but not for all movements. The results of the current study also showed that the laser pointer correlated well with the Noraxon IMUs, but not for all movements. The results of the current study support the use of the JPE using a laser pointer in clinical and research settings.
OBJECTIVE: To assess the responsiveness of the measure of cervical JPE after a 4-week home-based neck proprioceptive training intervention in people with CNP.
DESIGN: An observational study to assess the responsiveness of the measure of cervical JPE.
METHODS: The JPE test was assessed in people with CNP before and after 4 weeks of neck proprioception training. JPE was assessed as participants performed neck joint position sense tests for flexion, extension, right rotation, and left rotation in sitting and standing which were performed in a random order. Both the absolute and constant JPE were assessed. The intervention consisted of neck repositioning exercises as well as movement sense exercises. Cohen's d effect size was used to assess the internal responsiveness of the JPE test. The Pearson's correlation was used to assess the change of scores of the laser pointer and measures from inertial measurement units (IMUs) (external responsiveness).
RESULTS: After 4 weeks of proprioception training, JPE assessed in sitting reduced from 2.69◦-3.57◦ to 1.88◦-1.98◦ for flexion, extension, and right rotation with large effect sizes (Cohen's d range: 1.25-2.00). For left rotation, JPE reduced from 3.23◦ to 1.9◦, and the effect size was close to being large (Cohen's d: 0.79). When assessed in standing, JPE reduced from 3.49◦-4.52◦ to 1.5◦-2.33◦ with large effect sizes (Cohen's d range: 0.89-1.25) for flexion, extension, right rotation, and left rotation. Large effect sizes were not observed for the constant JPE when assessed in either sitting or standing. The assessment of the external responsiveness revealed weak correlations between the change of scores obtained from the laser pointer and the IMUs for all movements, apart from the constant JPE in sitting for left rotation, which showed a strong correlation (r = 0.7).
CONCLUSION: The results of this study showed that the measure of the JPE has sufficient internal responsiveness, however, the external responsiveness was inadequate. Further research is advised.
METHODS: This systematic review was registered prospectively on Prospero (CRD42020188715). It was designed using the COSMIN guidelines and reported in line with the PRISMA checklist. Two reviewers independently searched Medline, Embase, SportDiscus, and CINAHL Plus databases from inception to the 24th July 2022 with an update of the search conducted until 14th of October 2023. The COSMIN risk of bias checklist was used to assess the risk of bias in each study. The updated criteria for good measurement properties were used to rate individual studies and then the overall pooled results. The level of evidence was rated by two reviewers independently using a modified GRADE approach.
RESULTS: Fifteen studies were included in this review, 13 reporting absolute JPE and 2 reporting constant JPE. The measurement properties assessed were reliability, measurement error, and validity. The measurement of JPE showed sufficient reliability and validity, however, the level of evidence was low/very low for both measurement properties, apart from convergent validity of the constant JPE, which was high.
CONCLUSION: The measure of cervical JPE showed sufficient reliability and validity but with low/very low levels of evidence. Further studies are required to investigate the reliability and validity of this test as well as the responsiveness of the measure.