Cervical movement performance in individuals with traumatic neck pain: a cross-sectional validity and reliability study of the cervical reaction acuity test

Musculoskelet Sci Pract. 2026 Jun 15;85:103599. doi: 10.1016/j.msksp.2026.103599. Online ahead of print.

ABSTRACT

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.

PMID:42314365 | DOI:10.1016/j.msksp.2026.103599