Evaluation of Cervical Position and Movement Sense Using a Novel Computer Vision-Based Software

NCT07181798 | Not Yet Recruiting

• 1 other identifier: NEVSEHIRHBVU-KMYO-MG-001
• Study Type: observational
• Target: 74
• Locations: 1 country
• Sites: 1

Brief Summary

This observational study evaluates cervical proprioception using a computer vision-based system developed with OpenCV and MediaPipe. Healthy adults will perform a series of head movements while their nose tip is tracked by a camera. The primary objective is to assess the accuracy of neck position and movement perception. Data will be analyzed to determine the reliability of the tracking system. The study is non-invasive, involves no interventions, and poses minimal risk to participants. Findings may support the development of accessible diagnostic tools for clinical and research applications.

Conditions

Cervical Proprioception

Keywords

Proprioception; Computer-Assisted Image Interpretation

Outcome Measures

Primary Outcomes (4)

• Cervical Joint Position Sense (Head Relocation Error)

  With the help of algorithms, the initial position of the participant's nose tip on the screen will be recorded. Following flexion, extension, or rotation movements, the final position will be obtained, and the difference between the initial and final positions will be calculated in pixels and reported as the error score. While the primary output will be in pixels, this difference can also be expressed in degrees with the necessary conversions. Rotational movements performed during the measurement will be simultaneously recorded using the CROM device, and the values from the screen will be compared with those from the CROM to assess criterion validity, which provides the error magnitude directly in degrees. Measurements performed on the same group at two different time points will be analyzed using the Intraclass Correlation Coefficient (ICC), the Standard Error of Measurement (SEM), and Bland-Altman methods.

  The test will be repeated at 1-hour intervals.

• Cervical Movement Sense - Patterned Tracking

  During the test, an F8 or ZZ shaped pattern will be displayed on the screen, and the participant will trace the pattern starting from the center using their nose tip. The algorithm will track the nose tip's position in each camera frame throughout the test: if the nose tip remains within the shape, the error score will be 0; if it moves outside, the distance to the nearest point of the shape will be calculated in pixels and recorded as the instantaneous error score. At the end of the test, all instantaneous error scores will be summed to obtain the total error score. The start and finish times of the test will also be recorded to determine the total test duration. Total error scores from measurements performed on the same group at different time points will be analyzed using the Intraclass Correlation Coefficient (ICC), the Standard Error of Measurement (SEM), and Bland-Altman methods.

  The test will be repeated at 1-hour intervals.

• Cervical Movement Sense - Target Tracking:

  During the test, a rectangle will appear on the screen and move at a constant speed along the ZZ or F8 paths. The participant will attempt to keep their nose tip inside this moving rectangle. Since the speed is fixed, the test duration is the same for all participants. Scoring Methods Time-Based Score: The total time the nose tip remains inside the rectangle is divided by the total test duration. The resulting ratio ranges from 0 to 1: 1 → Best score (nose tip always inside) 0 → Worst score (nose tip never inside) Distance-Based Score: For each frame, the algorithm calculates the distance from the nose tip to the rectangle: Inside = 0 Outside = distance in pixels to the nearest edge At the end, all distances are summed to obtain the total deviation score. Both scores from measurements performed on the same group at different time points will be analyzed using the Intraclass Correlation Coefficient (ICC), the Standard Error of Measurement (SEM), and Bland-Altman methods.

  The test will be repeated at 1-week intervals.

• Sensorimotor Control Assessment

  The test duration is 60 seconds. During this time, individual points will appear on the screen at random locations. The participant's task is to move their nose tip over these points. When the nose tip correctly reaches a point: The point will disappear, A new point will appear at a different location on the screen. At the end of the test, the number of points the participant successfully matched with their nose tip within the 60 seconds will be counted, and this value will be recorded as the test score. The test score obtained from measurements performed on the same group at different time points will be analyzed using the Intraclass Correlation Coefficient (ICC), the Standard Error of Measurement (SEM), and Bland-Altman methods.

  The test will be repeated at 1-hour intervals.

Study Arms (1)

Healthy Volunteer Cohort

A single cohort of 74 healthy adult volunteers will undergo an observational test-retest reliability study of four cervical proprioception assessments using computer-vision tracking. No medical interventions will be administered. Two distinct assessment protocols control for learning effects and follow literature-based retest intervals: Protocol A (n=37): Cervical Movement Sense Target Tracking at baseline and again after one week to assess longer-term reliability. Protocol B (n=37): Head Relocation Test in 32 participants at baseline and again after one hour. Cervical Movement Sense Patterned Tracking and Cervical Proprioceptive Function Test in all 37 participants at baseline and again after one hour to minimize short-term learning effects. Separate participant groups prevent cross-test learning, and retest intervals (1 hour vs. 1 week) align with prior studies.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population will consist of healthy adult volunteers aged 18 years and older, without any history of neck pain, spinal disorders, or other conditions affecting cervical mobility. Participants will be recruited from the general population.

You may qualify if:

• Healthy individuals over 18 years of age
• No neck pain

You may not qualify if:

• Neck or spinal symptoms
• History of cervical/spinal trauma or surgery
• Chronic conditions affecting mobility
• Visual or vestibular impairments

Sponsors & Collaborators

• Nevsehir Haci Bektas Veli University: lead
• Health Institutes of Türkiye: collaborator

Study Sites (1)

Nevşehir Hacı Bektaş Veli University

Nevşehir, Kozakli, 50600, Turkey (Türkiye)

Location

Related Publications (14)

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  PMID: 33464539 BACKGROUND

• Sarig-Bahat H, Weiss PL, Laufer Y. Cervical motion assessment using virtual reality. Spine (Phila Pa 1976). 2009 May 1;34(10):1018-24. doi: 10.1097/BRS.0b013e31819b3254.

  PMID: 19404177 BACKGROUND

• Pinsault N, Fleury A, Virone G, Bouvier B, Vaillant J, Vuillerme N. Test-retest reliability of cervicocephalic relocation test to neutral head position. Physiother Theory Pract. 2008 Sep-Oct;24(5):380-91. doi: 10.1080/09593980701884824.

  PMID: 18821444 BACKGROUND

• Strimpakos N, Sakellari V, Gioftsos G, Kapreli E, Oldham J. Cervical joint position sense: an intra- and inter-examiner reliability study. Gait Posture. 2006 Jan;23(1):22-31. doi: 10.1016/j.gaitpost.2004.11.019.

  PMID: 16311191 BACKGROUND

• Werner IM, Ernst MJ, Treleaven J, Crawford RJ. Intra and interrater reliability and clinical feasibility of a simple measure of cervical movement sense in patients with neck pain. BMC Musculoskelet Disord. 2018 Oct 5;19(1):358. doi: 10.1186/s12891-018-2287-0.

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• Kristjansson E, Oddsdottir GL. "The Fly": a new clinical assessment and treatment method for deficits of movement control in the cervical spine: reliability and validity. Spine (Phila Pa 1976). 2010 Nov 1;35(23):E1298-305. doi: 10.1097/BRS.0b013e3181e7fc0a.

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• Kristjansson E, Hardardottir L, Asmundardottir M, Gudmundsson K. A new clinical test for cervicocephalic kinesthetic sensibility: "the fly". Arch Phys Med Rehabil. 2004 Mar;85(3):490-5. doi: 10.1016/s0003-9993(03)00619-1.

  PMID: 15031839 BACKGROUND

• Hage R, Ancenay E. Identification of a relationship between cervical spine function and rotational movement control. Ann Phys Rehabil Med. 2009 Nov;52(9):653-67. doi: 10.1016/j.rehab.2009.04.003. Epub 2009 Sep 10. English, French.

  PMID: 19783494 BACKGROUND

• Goncalves C, Silva AG. Reliability, measurement error and construct validity of four proprioceptive tests in patients with chronic idiopathic neck pain. Musculoskelet Sci Pract. 2019 Oct;43:103-109. doi: 10.1016/j.msksp.2019.07.010. Epub 2019 Jul 28.

  PMID: 31376618 BACKGROUND

• English DJ, Zacharias A, Green RA, Weerakkody N. Reliability of Cervicocephalic Proprioception Assessment: A Systematic Review. J Manipulative Physiol Ther. 2022 Jun;45(5):346-357. doi: 10.1016/j.jmpt.2022.08.005. Epub 2022 Oct 19.

  PMID: 36270904 BACKGROUND

• Sarig Bahat H, Sprecher E, Sela I, Treleaven J. Neck motion kinematics: an inter-tester reliability study using an interactive neck VR assessment in asymptomatic individuals. Eur Spine J. 2016 Jul;25(7):2139-48. doi: 10.1007/s00586-016-4388-5. Epub 2016 Jan 30.

  PMID: 26831536 BACKGROUND

Study Officials

• ismail Saraçoğlu, Associate Professor

  Kütahya University of Health Sciences

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Mustafa GÜVEN, Master of Science

CONTACT

0 384 471 45 75; mguven1389@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer and PhD Student, Principal Investigator

Study Record Dates

• First Submitted: May 18, 2025
• First Posted: September 18, 2025
• Study Start: September 1, 2025
• Primary Completion: December 1, 2025
• Study Completion: April 1, 2026
• Last Updated: September 24, 2025

Record last verified: 2025-09

Locations

TU (1)