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The Validity and Reliability of Immersive VR Device in Measuring Craniocervical Range of Motion.


 Background

Craniocervical range of motion (CROM) is a crucial index for assessing the neck's function. Its accurate evaluation could assist in detecting certain disorders, optimizing the therapy, and tracking intervention progress. In recent years, as VR technology has advanced rapidly, it has been widely applied in the medical field as it can simulate the real world. However, whether the novel immersive VR device could achieve a good performance in evaluating CROM remains explored.
Methods

This research aims to verify intra- and inter-rater reliability and validity of an immersive virtual reality (VR) device in measuring craniocervical range of motion (CROM) and compare its performance with the universal goniometer. Forty-two healthy adults without neck disorders were recruited for CROM measurement using an immersive VR device and a universal goniometer. We considered all six aspects of freedom, including flexion, extension, right/left lateral flexion, and right/left rotation. Two raters participated in the examination. The first rater was required to repeat measurements twice with a five-minute interval using an immersive VR device to evaluate intra-rater reliability while also measuring the same subject with the same subject universal goniometer. To ascertain inter-rater reliability, the second rater conducted the third examination using the immersive VR device. A two-way random effect model was employed in calculating intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)).
Results

The immersive VR device revealed excellent reliability of intra-rater (ICC from 0.885 for right rotation to 0.978 for extension) and inter-rater (ICC from 0.770 for left rotation to 0.920 for left lateral flexion). By analyzing Bland-Altman plot, a small mean difference (≤1.64°) was revealed between the immersive VR device and universal goniometer. They demonstrated an excellent agreement in measuring CROM (r values from 0.833 to 0.964).
Conclusions

In healthy subjects, the immersive VR device provided excellent intra-rater and inter-rater reliability and a high agreement with the universal goniometer. Whether VR devices could achieve a similar performance between patients with neck disorders still requires future investigation.