Cervical proprioception and spatiotemporal gait parameters in adults with chronic neck pain
DOI:
https://doi.org/10.47197/retos.v69.116308Keywords:
Adult, chronic pain, neck pain, gait, proprioceptionAbstract
Objective: To evaluate the association between cervical proprioception and spatiotemporal gait parameters in adults with chronic neck pain.
Methods: This was an analytical cross-sectional study with a sample of 37 adults with chronic neck pain. Cervical proprioception was measured using the Joint Position Error Test. Spatiotemporal gait parameters, including gait velocity and asymmetry, stride length, and cadence, were measured using the Project Automation Framework (PAF) of the Qualisys® Track Manager (QTM) motion capture system.
Results: Seventy-three percent of participants were women, and the median age was 32 years (interquartile range, 26 to 47). The overall joint positioning error mean was 11.1 ± 2.9 degrees, and 97.3% had impaired neck proprioception. Gait speed had a mean of 1.1 ± 0.1 m/s, gait asymmetry had a median of 3.4 (interquartile range: 2 to 6.9), stride length was 1.3 ± 0.1 meters, and cadence was 98.9 ± 8.5 steps per minute. No association was found between cervical proprioception and speed, asymmetry, stride length, or cadence (p>0.05).
Discussion: Although there are few similar studies, their results differ, possibly due to variations in the instruments used, methodological design, and population characteristics.
Conclusions: This study suggests that cervical proprioception is not associated with spatiotemporal gait parameters such as speed, asymmetry, stride length, and cadence in adults with chronic neck pain.
References
Abualait, T., & Ahsan, M. (2022). Comparison of gender, age, and body mass index for spatiotemporal parameters of bilateral gait pattern. F1000Research, 10, 266. https://doi.org/10.12688/f1000research.51700.2
Akoglu, H. (2018). User’s guide to correlation coefficients. Turkish Journal of Emergency Medicine, 18(3), 91-93. https://doi.org/10.1016/j.tjem.2018.08.001
AlDahas, A., Devecchi, V., Deane, J. A., & Falla, D. (2023). Measurement properties of cervical joint posi-tion error in people with and without chronic neck pain. PloS One, 18(10), e0292798. https://doi.org/10.1371/journal.pone.0292798
AlDahas, A., Heneghan, N. R., Althobaiti, S., Deane, J. A., Rushton, A., & Falla, D. (2024). Measurement properties of cervical joint position error in people with and without neck pain: A systematic review and narrative synthesis. BMC Musculoskeletal Disorders, 25, 44. https://doi.org/10.1186/s12891-023-07111-4
Alshehri, S. H. S., Reddy, R. S., ALMohiza, M. A., Alshahrani, M. S., Alkhamis, B. A., Alnakhli, H. H., Koura, G. M., Gautam, A. P., Mukherjee, D., Alqhtani, R. S., Al Adal, S. Y., Alyami, A. M., & Alyazedi, F. M. (2025). Influence of cervical muscle strength and pain severity on functional balance and limits of stability in elderly individuals with chronic nonspecific neck pain: A cross-sectional study. BMC Geriatrics, 25(1), 18. https://doi.org/10.1186/s12877-024-05670-2
Andrade Ortega, J. A., Delgado Martínez, A. D., & Almécija Ruiz, R. (2010). Validation of the Spanish ver-sion of the Neck Disability Index. Spine, 35(4), E114-118. https://doi.org/10.1097/BRS.0b013e3181afea5d
Andrews, A. W., Vallabhajosula, S., Boise, S., & Bohannon, R. W. (2023). Normal gait speed varies by age and sex but not by geographical region: A systematic review. Journal of Physiotherapy, 69(1), 47-52. https://doi.org/10.1016/j.jphys.2022.11.005
Ayan, H., Kara, B., & Erbayraktar, R. (2023). Investigation of Gait Symmetry, Cervical Proprioception and Functionality in Individuals with Chronic Idiopathic Neck Pain. Annals of the Rheumatic Diseases, 82(Suppl 1), 1933-1933. https://doi.org/10.1136/annrheumdis-2023-eular.3020
Badakva, A. M., М, Б. А., Miller, N. V., В, М. Н., Zobova, L. N., & Н, З. Л. (2023). Integration of Vestibular, Visual and Proprioceptive Inputs in the Cerebral Cortex during Movement Control. Fiziologiâ Čeloveka, 49(2), Article 2. https://doi.org/10.31857/S0131164622600422
Burton, W., Ma, Y., Manor, B., Hausdorff, J. M., Kowalski, M. H., Bain, P. A., & Wayne, P. M. (2023). The impact of neck pain on gait health: A systematic review and meta-analysis. BMC Musculoskele-tal Disorders, 24(1), 618. https://doi.org/10.1186/s12891-023-06721-2
Bytyçi, I., & Henein, M. Y. (2021). Stride Length Predicts Adverse Clinical Events in Older Adults: A Sys-tematic Review and Meta-Analysis. Journal of Clinical Medicine, 10(12), 2670. https://doi.org/10.3390/jcm10122670
Cabral, S. (2018). Gait Symmetry Measures and Their Relevance to Gait Retraining. En Handbook of Human Motion (Vol. 1, pp. 429-447). Springer, Cham. https://doi.org/10.1007/978-3-319-14418-4_201
Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., Kerns, R., Von Korff, M., Porter, L., & Helmick, C. (2018). Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults—United States, 2016. Morbidity and Mortality Weekly Report, 67(36), 1001-1006. https://doi.org/10.15585/mmwr.mm6736a2
Danion, F., Varraine, E., Bonnard, M., & Pailhous, J. (2003). Stride variability in human gait: The effect of stride frequency and stride length. Gait & Posture, 18(1), 69-77. https://doi.org/10.1016/s0966-6362(03)00030-4
de Vries, J., Ischebeck, B. K., Voogt, L. P., van der Geest, J. N., Janssen, M., Frens, M. A., & Kleinrensink, G. J. (2015). Joint position sense error in people with neck pain: A systematic review. Manual Ther-apy, 20(6), 736-744. https://doi.org/10.1016/j.math.2015.04.015
Fairbank, J. C., Couper, J., Davies, J. B., & O’Brien, J. P. (1980). The Oswestry low back pain disability questionnaire. Physiotherapy, 66(8), 271-273.
GBD 2021 Neck Pain Collaborators. (2024). Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. The Lancet. Rheumatology, 6(3), e142-e155. https://doi.org/10.1016/S2665-9913(23)00321-1
Huerta, M. Á., Salazar, A., & Moral-Munoz, J. A. (2025). Trends in chronic neck and low back pain preva-lence in Spain (2006-2020): Differences by sex, age, and social class. Eur Spine J, 34(4), 1331-1340. https://doi.org/10.1007/s00586-025-08676-5
Jaén-Carrillo, D., García-Pinillos, F., Chicano-Gutiérrez, J. M., Pérez-Castilla, A., Soto-Hermoso, V., Moli-na-Molina, A., & Ruiz-Alias, S. A. (2023). Level of Agreement between the MotionMetrix System and an Optoelectronic Motion Capture System for Walking and Running Gait Measurements. Sensors (Basel, Switzerland), 23(10), 4576. https://doi.org/10.3390/s23104576
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A.-A., & Safiri, S. (2022). Neck pain: Global epidemiology, trends and risk factors. BMC Musculo-skeletal Disorders, 23, 26. https://doi.org/10.1186/s12891-021-04957-4
Kim, D., Lewis, C. L., & Gill, S. V. (2021). Effects of obesity and foot arch height on gait mechanics: A cross-sectional study. PLOS ONE, 16(11), e0260398. https://doi.org/10.1371/journal.pone.0260398
Kirmizi, M., Simsek, I. E., Elvan, A., Akcali, O., & Angin, S. (2019). Gait speed and gait asymmetry in indi-viduals with chronic idiopathic neck pain. Musculoskeletal Science & Practice, 41, 23-27. https://doi.org/10.1016/j.msksp.2019.03.001
Kırmızı, M., Şimşek, İ. E., Elvan, A., Akçalı, Ö., & Angın, S. (2020). Investigating spatiotemporal gait pa-rameters and gait stability in individuals with chronic idiopathic neck pain. Journal of Exercise Therapy and Rehabilitation, 6(3), Article 3.
Kumar, R., Bogia, P., Singh, V., & Reddy, T. O. (2025). The running gait analysis technology: A compre-hensive systematic literature review. Journal of Orthopaedics, 62, 75-83. https://doi.org/10.1016/j.jor.2024.10.013
Laskowski, E. R., Newcomer-Aney, K., & Smith, J. (2000). Proprioception. Physical Medicine and Reha-bilitation Clinics of North America, 11(2), 323-340, vi.
Lockhart, T. E., Soangra, R., Chung, C., Frames, C., Fino, P., & Zhang, J. (2014). Development of automat-ed gait assessment algorithm using three inertial sensors and its reliability. Biomedical Sciences Instrumentation, 50, 297-306.
Madsalae, T., Thongprong, T., Chaikeeree, N., & Boonsinsukh, R. (2024). Changes in gait performances during walking with head movements in older adults with chronic neck pain. Frontiers in Medi-cine, 11, 1324375. https://doi.org/10.3389/fmed.2024.1324375
Marzieh M. Ardestani, Christopher Ferrigno, Mehran Moazen, & Markus A. Wimmer. (2016). From normal to fast walking: Impact of cadence and stride length on lower extremity joint moments. Gait & Posture, 46, 118-125. https://doi.org/10.1016/j.gaitpost.2016.02.005
McCambridge, J., Witton, J., & Elbourne, D. R. (2014). Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. Journal of Clinical Epidemiology, 67(3), 267-277. https://doi.org/10.1016/j.jclinepi.2013.08.015
McGrath, R. L., Ziegler, M. L., Pires-Fernandes, M., Knarr, B. A., Higginson, J. S., & Sergi, F. (2019). The effect of stride length on lower extremity joint kinetics at various gait speeds. PLOS ONE, 14(2), e0200862. https://doi.org/10.1371/journal.pone.0200862
Ministerio de Salud, Instituto Nacional de Salud. (2004). La medición de la talla y el peso. Guía para el personal de la salud del primer nivel de atención. Ministerio de Salud, Instituto Nacional de Sa-lud. https://www.gob.pe/institucion/ins/noticias/1132261-ministerio-de-salud-aprueba-guia-de-actividad-fisica-segun-curso-de-vida
Ministerio de Salud, Instituto Nacional de Salud. (2012). Guía técnica para la valoración nutricional antropométrica de la persona adulta. Ministerio de Salud, Instituto Nacional de Salud. https://www.gob.pe/institucion/minsa/informes-publicaciones/314114-guia-tecnica-para-la-valoracion-nutricional-antropometrica-de-la-persona-adulta
Mirelman, A., Shema, S., Maidan, I., & Hausdorff, J. M. (2018). Chapter 7—Gait. En B. L. Day & S. R. Lord (Eds.), Handbook of Clinical Neurology (Vol. 159, pp. 119-134). Elsevier. https://doi.org/10.1016/B978-0-444-63916-5.00007-0
Murray, M. P., Kory, R. C., Clarkson, B. H., & Sepic, S. B. (1966). Comparison of free and fast speed walk-ing patterns of normal men. American Journal of Physical Medicine, 45(1), 8-23.
Nakazato, T., Quezada, P., Gutiérrez, C., & Romaní, F. (2024). Chronic Neck Pain Prevalence Before and After COVID-19 Restrictions and Its Relationship With Digital Device Screen Viewing: A Popula-tion Study. Annals of Rehabilitation Medicine, 48(2), 124-134. https://doi.org/10.5535/arm.230030
Papageorgiou, S. N. (2022). On correlation coefficients and their interpretation. Journal of Orthodon-tics, 49(3), 359-361. https://doi.org/10.1177/14653125221076142
Patterson, K. K., Nadkarni, N. K., Black, S. E., & McIlroy, W. E. (2012). Gait symmetry and velocity differ in their relationship to age. Gait & Posture, 35(4), 590-594. https://doi.org/10.1016/j.gaitpost.2011.11.030
Peel, N. M., Alapatt, L. J., Jones, L. V., & Hubbard, R. E. (2019). The Association Between Gait Speed and Cognitive Status in Community-Dwelling Older People: A Systematic Review and Meta-analysis. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 74(6), 943-948. https://doi.org/10.1093/gerona/gly140
Peng, B., Yang, L., Li, Y., Liu, T., & Liu, Y. (2021). Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain and Therapy, 10(1), 143-164. https://doi.org/10.1007/s40122-020-00230-z
Prochazka, A. (2021). Proprioception: Clinical relevance and neurophysiology. Current Opinion in Physiology, 23, 100440. https://doi.org/10.1016/j.cophys.2021.05.003
Proske, U., & Gandevia, S. C. (2012). The Proprioceptive Senses: Their Roles in Signaling Body Shape, Body Position and Movement, and Muscle Force. Physiological Reviews, 92(4), 1651-1697. https://doi.org/10.1152/physrev.00048.2011
Qu, N., Tian, H., De Martino, E., & Zhang, B. (2022). Neck Pain: Do We Know Enough About the Sen-sorimotor Control System? Frontiers in Computational Neuroscience, 16, 946514. https://doi.org/10.3389/fncom.2022.946514
Qualisys AB. (2022a). Qualisys Gait module. https://www.qualisys.com/analysis/gait/#features
Qualisys AB. (2022b). Qualisys Track Manager User Manual. https://docs.qualisys.com/qtm/
Rahman, S., Kidwai, A., Rakhamimova, E., Elias, M., Caldwell, W., & Bergese, S. D. (2023). Clinical Diag-nosis and Treatment of Chronic Pain. Diagnostics, 13(24), 3689. https://doi.org/10.3390/diagnostics13243689
Raizah, A., Reddy, R. S., Alshahrani, M. S., Gautam, A. P., Alkhamis, B. A., Kakaraparthi, V. N., Ahmad, I., Kandakurti, P. K., & ALMohiza, M. A. (2023). A Cross-Sectional Study on Mediating Effect of Chronic Pain on the Relationship between Cervical Proprioception and Functional Balance in Elderly Individuals with Chronic Neck Pain: Mediation Analysis Study. Journal of Clinical Medi-cine, 12(9), 3140. https://doi.org/10.3390/jcm12093140
Riskowski, J. L., Mikesky, A. E., Bahamonde, R. E., Alvey, T. V., & Burr, D. B. (2005). Proprioception, gait kinematics, and rate of loading during walking: Are they related? Journal of Musculoskeletal & Neuronal Interactions, 5(4), 379-387.
Roren, A., Mayoux-Benhamou, M.-A., Fayad, F., Poiraudeau, S., Lantz, D., & Revel, M. (2009). Comparison of visual and ultrasound based techniques to measure head repositioning in healthy and neck-pain subjects. Manual Therapy, 14(3), 270-277. https://doi.org/10.1016/j.math.2008.03.002
Rosmaninho, I., Ribeirinho-Soares, P., & Nunes, J. P. L. (2021). Walking Speed and Mortality: An Updated Systematic Review. Southern Medical Journal, 114(11), 697-702. https://doi.org/10.14423/SMJ.0000000000001318
Rössler, R., Wagner, J., Knaier, R., Rommers, N., Kressig, R. W., Schmidt-Trucksäss, A., & Hinrichs, T. (2024). Spatiotemporal gait characteristics across the adult lifespan: Reference values from a healthy population - Analysis of the COmPLETE cohort study. Gait & Posture, 109, 101-108. https://doi.org/10.1016/j.gaitpost.2024.01.005
Rowe, E., Beauchamp, M. K., & Astephen Wilson, J. (2021). Age and sex differences in normative gait patterns. Gait & Posture, 88, 109-115. https://doi.org/10.1016/j.gaitpost.2021.05.014
Ruiz-Malagón, E. J., García-Pinillos, F., Molina-Molina, A., Soto-Hermoso, V. M., & Ruiz-Alias, S. A. (2023). RunScribe Sacral Gait LabTM Validation for Measuring Pelvic Kinematics during Human Loco-motion at Different Speeds. Sensors (Basel, Switzerland), 23(5), 2604. https://doi.org/10.3390/s23052604
Saltychev, M., Pylkäs, K., Karklins, A., & Juhola, J. (2024). Psychometric properties of neck disability index—A systematic review and meta-analysis. Disability and Rehabilitation, 1-17. https://doi.org/10.1080/09638288.2024.2304644
Särkilahti, N., Hirvonen, M., Lavapuro, J., Takatalo, J., Löyttyniemi, E., & Tenovuo, O. (2024). Sensorimo-tor tests in patients with neck pain and its associated disorders: A systematic review and meta-analysis. Scientific Reports, 14(1), 12764. https://doi.org/10.1038/s41598-024-63545-3
Senden, R., Meijer, K., Heyligers, I. C., Savelberg, H. H. C. M., & Grimm, B. (2012). Importance of correct-ing for individual differences in the clinical diagnosis of gait disorders. Physiotherapy, 98(4), 320-324. https://doi.org/10.1016/j.physio.2011.06.002
Slaght, J., Sénéchal, M., Hrubeniuk, T. J., Mayo, A., & Bouchard, D. R. (2017). Walking Cadence to Exercise at Moderate Intensity for Adults: A Systematic Review. Journal of Sports Medicine (Hindawi Publishing Corporation), 2017, 4641203. https://doi.org/10.1155/2017/4641203
Stanton, T. R., Leake, H. B., Chalmers, K. J., & Moseley, G. L. (2016). Evidence of Impaired Proprioception in Chronic, Idiopathic Neck Pain: Systematic Review and Meta-Analysis. Physical Therapy, 96(6), 876-887. https://doi.org/10.2522/ptj.20150241
Steingrímsdóttir, Ó. A., Landmark, T., Macfarlane, G. J., & Nielsen, C. S. (2017). Defining chronic pain in epidemiological studies: A systematic review and meta-analysis. Pain, 158(11), 2092-2107. https://doi.org/10.1097/j.pain.0000000000001009
Subbarayalu, A. V., & Ameer, M. A. (2017). Relationships among head posture, pain intensity, disability and deep cervical flexor muscle performance in subjects with postural neck pain. Journal of Taibah University Medical Sciences, 12(6), 541-547. https://doi.org/10.1016/j.jtumed.2017.07.001
Tramonti, C., Griguoli, F., Di Martino, S., Lamola, G., Falossi, F., Palattella, G., Raffaetà, G., Chisari, C., & Parchi, P. (2024). The Effect of Proprioceptive Insoles on Gait Kinematics in Healthy Partici-pants. JPO: Journal of Prosthetics and Orthotics, 36(4), 273. https://doi.org/10.1097/JPO.0000000000000500
Treede, R.-D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., Cohen, M., Evers, S., Finnerup, N. B., First, M. B., Giamberardino, M. A., Kaasa, S., Korwisi, B., Kosek, E., Lavand’homme, P., Nicholas, M., Perrot, S., Scholz, J., Schug, S., … Wang, S.-J. (2019). Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain, 160(1), 19-27. https://doi.org/10.1097/j.pain.0000000000001384
Treleaven, J. (2008). Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual Therapy, 13(1), 2-11. https://doi.org/10.1016/j.math.2007.06.003
Tudor-Locke, C., Han, H., Aguiar, E. J., Barreira, T. V., Jr, J. M. S., Kang, M., & Rowe, D. A. (2018). How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: a nar-rative review. Br J Sports Med, 52, 776-788. https://doi.org/10.1136/bjsports-2017-097628
Tuthill, J. C., & Azim, E. (2018). Proprioception. Current Biology, 28(5), R194-R203. https://doi.org/10.1016/j.cub.2018.01.064
Vernon, H., & Mior, S. (1991). The Neck Disability Index: A study of reliability and validity. Journal of Manipulative and Physiological Therapeutics, 14(7), 409-415.
Veronese, N., Stubbs, B., Volpato, S., Zuliani, G., Maggi, S., Cesari, M., Lipnicki, D. M., Smith, L., Schofield, P., Firth, J., Vancampfort, D., Koyanagi, A., Pilotto, A., & Cereda, E. (2018). Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies. Journal of the American Medical Directors Association, 19(11), 981-988.e7. https://doi.org/10.1016/j.jamda.2018.06.007
Viteckova, S., Kutilek, P., Svoboda, Z., Krupicka, R., Kauler, J., & Szabo, Z. (2018). Gait symmetry measures: A review of current and prospective methods. Biomedical Signal Processing and Control, 42, 89-100. https://doi.org/10.1016/j.bspc.2018.01.013
Wannaprom, N., Treleaven, J., Jull, G., & Uthaikhup, S. (2018). Neck muscle vibration produces diverse responses in balance and gait speed between individuals with and without neck pain. Musculo-skeletal Science & Practice, 35, 25-29. https://doi.org/10.1016/j.msksp.2018.02.001
Weir, C. B., & Jan, A. (2025). BMI Classification Percentile And Cut Off Points. En StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK541070/
Wibault, J., Vaillant, J., Vuillerme, N., Dedering, Å., & Peolsson, A. (2013). Using the cervical range of mo-tion (CROM) device to assess head repositioning accuracy in individuals with cervical radicu-lopathy in comparison to neck- healthy individuals. Manual Therapy, 18(5), 403-409. https://doi.org/10.1016/j.math.2013.02.004
Wohlrab, M., Klenk, J., Delgado-Ortiz, L., Chambers, M., Rochester, L., Zuchowski, M., Schwab, M., Beck-er, C., & Jaeger, S. U. (2022). The value of walking: A systematic review on mobility and healthcare costs. European Review of Aging and Physical Activity, 19(1), 31. https://doi.org/10.1186/s11556-022-00310-3
Yoshimoto, K., & Shinya, M. (2022). Use of the Azure Kinect to measure foot clearance during obstacle crossing: A validation study. PloS One, 17(3), e0265215. https://doi.org/10.1371/journal.pone.0265215
Zhang, F., Wang, H., Bai, Y., Huang, L., Zhong, Y., & Li, Y. (2025). Gait Speed and All-Cause Mortality in Whole-Spectrum Chronic Kidney Disease: A Systematic Review and Meta-Analysis Included 6217 Participants. Journal of Cachexia, Sarcopenia and Muscle, 16(1), e13739. https://doi.org/10.1002/jcsm.13739
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