Assessing Cervical Sensorimotor Control With VR in Chronic Neck Pain

Cervical Sensorimotor Control Assessment Using a Virtual Reality System in Individuals With and Without Chronic Neck Pain

To develop a cervical SMC VR assessment system incorporating different SMC tests and to compare cervical SMC performance using this self-developed VR assessment system in individuals with and without CNP

Study Overview

• Status: Completed
• Conditions: Neck Pain; Virtual Reality; Sensorimotor

• Study Type: Observational
• Enrollment (Actual): 70

Contacts and Locations

Study Locations

• Taiwan
  • Taiwan
    • Tainan, Taiwan, Taiwan, 701
      • National Cheng Kung University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Patients with CNP will be recruited from the affiliated hospital, local outpatient clinics, local communities and around the campus.

Healthy adults will be recruited from the local communities near the university in the Tainan city.

Description

Inclusion Criteria:

1. For patients with chronic neck pain:

   • Pain was unilateral or bilateral between the superior nuchal line and 1st thoracic vertebra,
   • Neck pain persisting for 3 months and above,
   • Average pain intensity of last pain episode was between 2 and 8 based on the numerical rating scale (NRS)

2. Healthy asymptomatic adults:

   • Do not have any complaints of current pain and impairments of neuromusculoskeletal systems within the last 6 months

Exclusion Criteria:

• acute or the first onset of neck pain
• previous fracture or surgery of the spine
• diagnosed cardiopulmonary diseases, for example, chronic obstructive pulmonary disease, pulmonary tuberculosis, asthma, chronic bronchitis, pulmonary emphysema
• diagnosed gastrointestinal and abdominal conditions which may interfere daily activities within the past 6 months
• medical conditions that may affect balance and study procedures (e.g. neurological diseases, vestibular disorders, malignant tumors)
• metabolic diseases such as anemia and diabetes
• smoking, plan to pregnant or in pregnancy
• psychological disorders (affect questionnaire responses)
• unable to walk independently
• Corrected visual abnormalities or individuals unable to wear contact lenses for vision correction due to the potential interference of wearing VR head-mounted display with glasses

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Chronic neck pain group; Pain was unilateral or bilateral between the superior nuchal line and 1st thoracic vertebra; Neck pain persisting for 3 months and above; Average pain intensity of last pain episode was between 2 and 8 based on the numerical rating scale (NRS).
Healthy adults group; Do not have any complaints of current pain and impairments of neuromusculoskeletal systems within the last 6 months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cervical Range of Motion (ROM)	Participants will follow the instructions that appeared in the VR HMD to perform active maximal neck flexion, extension, side bending and rotation. The maximal ROM in each direction will be calculated and obtained based on the IMU sensors embedded in the HMD.	One day
Joint Position Error (JPE)	There will be a virtual target displayed in the VR HMD. Participant will be instructed to remember this position, then close their eyes and move the head away from the target center, and then return to the initial starting position. Difference between the starting position and final position in distance (mm) will be calculated.	One day
Figure of Eight (FOE)	The participant will be instructed to control the red dot moving along the path of the figure-of-eight as accurately as possible by moving their head.	One day
Subjective Visual Vertical (SVV)	A tilted white rod will be presented at different angles for 1-degree interval from 45 to 135 degrees randomly on the display as described above. The rod will be precisely controlled by using left and right arrow keys of a keyboard. Participants will be instructed to reposition the white rod so that the white rod will be positioned vertically while keeping the head and neck as still as possible.	One day
Head Tile Response (HTR)	A tilted white rod will be presented at different angles for 1-degree interval from 45 to 135 degrees randomly on the display as described above. Participants will be instructed to tilt their heads laterally so that the line will be re-positioned vertically.	One day
Saccades	Two virtual white targets at 90 degrees of visual angle positioned 0.82 m apart from the participant will be displayed in the VR HMD. Participants will be asked to shift their gaze quickly between two targets without moving their heads for 10 secs.	One day
Smooth Pursuit Neck Torsion (SPNT)	A virtual red-dot target is displayed in the VR HMD. The target will move in a horizontal plane with a sinusoidal pattern (30 degrees per second) from left to right and back 10 times with a visual angle of 40 degrees. Participants will be requested to follow the moving target with their eyes and keep their heads still.	One day
Postural Sway (PS)	Participants will be asked to follow the instructions that appeared in the VR HMD and stand still for 30 seconds in EO or EC condition and in neck neutral or neck torsion 45-degree position	One day

Collaborators and Investigators

• Sponsor: National Cheng Kung University
• Collaborators: National Science and Technology Council

Study record dates

Study Major Dates

• Study Start (Actual): February 17, 2025
• Primary Completion (Actual): December 31, 2025
• Study Completion (Actual): March 31, 2026

Study Registration Dates

• First Submitted: June 19, 2024
• First Submitted That Met QC Criteria: June 19, 2024
• First Posted (Actual): June 25, 2024

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Virtual Reality; Sensorimotor control; cervical; Chronic neck Pain
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neck Pain
• Other Study ID Numbers: NCKU_VR

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No