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The active cervical range of motion (aROM) is assessed by clinicians to inform their decision-making. Even with the ability of neck motion to discriminate injured from non-injured subjects, the mechanisms to explain recovery or persistence of WAD remain unclear. There are few studies of ROM examinations with precision tools using kinematics as predictive factors of recovery rate. The present paper will evaluate the performance of an artificial neural network (ANN) using kinematic variables to predict the overall change of aROM after a period of rehabilitation in WAD patients. To achieve this goal the neck kinematics of a cohort of 1082 WAD patients (55.1% females), with mean age 37.68 (SD 12.88) years old, from across Spain were used. Prediction variables were the kinematics recorded by the EBI® 5 in routine biomechanical assessments of these patients. These include normalized ROM, speed to peak and ROM coefficient of variation. The improvement of aROM was represented by the Neck Functional Holistic Analysis Score (NFHAS). A supervised multi-layer feed-forward ANN was created to predict the change in NFHAS. The selected architecture of the ANN showed a mean squared error of 308.07–272.75 confidence interval for a 95% in the Monte Carlo cross validation. The performance of the ANN was tested with a subsample of patients not used in the training. This comparison resulted in a medium correlation with R = 0.5. The trained neural network to predict the expected difference in NFHAS between baseline and follow up showed modest results. While the overall performance is moderately correlated, the error of this prediction is still too large to use the method in clinical practice. The addition of other clinically relevant factors could further improve prediction performance.

Background Traumatic cervical spine injuries are amongst the traffic injuries that can cause most harm to a person. Classifying subtypes of clinical presentations has been a method used in other pathologies to diagnose more efficiently and to address the appropriate treatment and the prognosis. The management of patients suffering from cervical injuries could be improved by classifying the severity of the impairment. This will allow clinicians to propose better treatment modalities according to the severity of the injury. Materials and methods The present study is a retrospective cohort study performed with the clinical data from 772 patients stored at Fisi-(ON) Health Group. All the patients treated for cervical spine injuries are evaluated using the EBI-5 ® system, which is based on inertial measurement unit (IMU) technology. The normalized range of motion of each patient was incorporated into a single index, the Neck Functional Holistic Analysis Score (NFHAS). Results Clustering analysis of the patients according to their NFHAS resulted in five groups. The Kruskal-Wallis H test showed that there were statistically relevant differences in the ROM values and NFHAS of the patients depending on the cluster they were assigned to: FE X 2 (4) = 551.59, p = 0.0005; LB ROM X 2 (4) = 484.58, p = 0.0005; RT ROM X 2 (4) = 557.14, p = 0.0005; NFHAS X 2 (4) = 737.41, p = 0.0005. Effect size with ηp 2 for the comparison of groups were: FE = 0.76, LB = 0.68, RT = 0.76 and NFHAS = 0.96.

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The cervical spine is one of the most frequently injured joints in a car accident. References for the range of motion (ROM) that should be expected in a person are needed to stage the injuries. The two main objectives of this paper are to clinically validate a measuring device for the cervical spine, and to assess if the use of different ROM reference values will render different results from the American Medical Association (AMA) ROM guidelines. The present study is divided into 2 phases, a validation phase with 55 subjects and a case-control phase with 80 subjects. A BTS (Bioengineering Technology and System) system and the EBI-5 (estudio biomecánico integral) system were used for the present investigation. The intraclass correlation agreement value between both measuring devices is considered very good with a Cronbach alpha up to 0.9 in every dimension. Correlations (r) between variables are very high, not showing any values lower than 0.887. All comparisons between using AMA ROM guidelines or normative values presented significant differences (p < 0.05). The EBI-5 system has exhibited good accuracy being paired to a photogrammetric system. The use of guidelines adjusted to age constitute an alternative to the use of the AMA cervical ROM guidelines. Professionals should use age-normalized guidelines as an alternative to the AMA guidelines.