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JKM > Volume 38(1); 2017 > Article
Yim, Kim, Park, and Park: A review on measuring cervical range of motion using an inertial measurement unit



The purpose of this study was to review the article using an IMU(Inertial Measurement Unit) for measuring the cervical range of motion and to evaluate the feasibility of using an IMU for measuring the cervical range of motion.


Scopus was used to search for the articles relating to the inclusion criteria. Which is measuring the cervical range of motion using an IMU. A total of 15 articles were selected through discussion. Degree and the reliability of the cervical range of motion and the validity of the data within the articles were extracted.


The measurement of the cervical range of motion using an IMU were 92.25º to 138.2º, 122.4º to 154.9º, 73.75º to 93.1º on the sagittal plane, transverse plane, and coronal plane respectively. 38 of the 43 values showed good reliability. They were larger than 0.75. 5 of the 43 values showed reliability less than 0.75. They were measured by smart phone. 16 of the 21 values showed good validity. The remaining 5 were measured by smart phone. The lower reliability and validity of smart phone were related to the protocol. The IMU can measure the coupling motion and may be used in various situations.


The IMU may become a gold standard for measuring the cervical range of motion. The IMU measured not only the cervical range of motion but also the coupling motion. Furthermore, IMU may be used in various situations. Therefore, IMU must be considered a valuable measurement device.

Fig. 1
A Review of Measurement on Cervical ROM using an IMU
Fig. 2
(a) wireless IMU from Kim et al4) (b) Wired IMU based CUELA system From Schiefer et al21).
Fig. 3
the Android phone based equipment set up from Quek et al14).
Fig. 4
Position of the iPhone for the measurement of right lateral flexion from Tousignant et al13).
Fig. 5
(a) A participant wearing the Oculus Rift performing the task. (b) A yellow field goal post at the center viewpoint of the participant from Xu et al22).
Table 1
Measurement on Cervical ROM using an IMU.
Study N Sagittal Plane Transverse Plane Coronal Plane
Total Extension Flexion Total Left Right Total Left Right
Pancani et al12 12 106* 54 52 145 80
Schiefer et al21 20 117* 54.33 62.67 141* 70 71 76.33* 39.33 37
Xu et al22 10 69.8 99.5 16.2
Alqhtani et al15 18 128.1* 66.4 61.7 154.9* 80.5 74.4 83.6* 42.1 41.5
Quek et al14 21 131.3* 79.3 52.0 122.4* 65.3 57.1 93.8* 48.8 45.0
Kim et al4 18 116.70 57.23 58.48 143.29 69.67 73.62 89.42 44.15 45.28
Peter et al1 12 92.25 125.75 73.75
Jan et al2 10 63.2 75.0 40.1
Miyaoka et al23 14 112.9* 61.2 51.7 86.6* 43.9 42.7
Duc et al28 10 122 144 88
Tousignant et al13 28 138.2* 82.2 56.0 147.8* 75.4 72.4 93.1* 47.5 45.6

Unit: degree; N: number of subjects.

* These values were calculated by adding two separate values.

Table 2
Reliability of Measurement on Cervical ROM using an IMU.
Study N Sagittal Plane Transverse Plane Coronal Plane
Total Extension Flexion Total Left Right Total Left Right
Pancani et al12) 12 0.88 0.92 0.65 0.91
Schiefer et al21) 20 0.89 0.83 0.79 0.83 0.93 0.95
Alqhtani et al15) 18 0.98 0.98 0.99 0.97 0.98 0.98
Quek et al14) 16 0.82 0.86 0.05 0.33 0.85 0.90
Kim et al4) 18 0.98 0.97 0.98 0.99 0.99 0.99 0.97 0.97 0.98
Peter et al1) 12 0.85 0.95 0.86
Duc et al28) 10 0.87 0.98 1.00
Tousignant et al13) 28 0.84 0.78 0.66 0.74 0.78 0.77

Intraclass Correlation Coefficient(ICC). N: number of subjects.

Table 3
Validity of Measurement on Cervical ROM using an IMU.
Study Gold standard Validity N Sagittal Plane Transverse Plane Coronal Plane
Total Extension Flexion Total Left Right Total Left Right
Pancani et al12) The camera’s system ICC 12 0.98 1.00 0.96
Pryce et al20) video Pearson r 13 0.78 0.92 0.95
Quek et al14) 3DMA ICC 21 0.92 0.98 0.53 0.53 0.95 0.96
Tousignant et al13) CROM ICC 28 0.58 0.76 0.43 0.55 0.70 0.85

N: number of subjects. 3DMA: three dimensional motion analysis (Eyeglasses-like instrument has three inclinometers placed at three different positions), CROM: Cervical Range of Motion Device.

Table 4
Devices only for a measurement about movement.
Study Device Fix Size Communication
Pancani et al12) OPAL, APDM, Inc., Portland, Oregon, USA Straps Dermatological patches N/A N/A
Pryce et al20) Microstrain mXRS, Lord Sensing Systems; Williston, Vermont USA N/A 47g, 58mm × 43mm × 22mm Wireless
Schiefer et al21) CUELA SYSTEM (CUELA, IFA, Sankt Augustin, Germany) Velcro straps N/A. Only in picture. Wired
Alqhtani et al15) 3A Sensor String; ThetaMetrix, Waterlooville, UK double-sided tape N/A Wired
Cuesta-Vargas et al25) Inertiacube3, InterSense Inc., MA 26.2mm×39.2mm×14.8mm N/A
Kim et al4) Model EBIMU24G, E2BOX, Seoul, Republic Korea Velcro straps 7.85g, 32mm × 21mm × 6.5mm Wireless
Peter et al1) model 3DM-GX3-25; Microstrain, VT, USA double-sided toupee tape 18g 44mm × 25mm × 11mm Wired
Jan et al2) IC3. Intersense, Bedford, MA, USA N/A Wireless
Miyaoka et al23) ADXL-250, Analog Devices Inc., Norwood, MA, USA the glasses and suspenders with the two sensor elements N/A N/A
Duc et al28) The weaable system (Physilog®, BioAGM, CH) dermatological patches N/A wireless
Boissy et al26) MotionPod, Movea Inc, Grenoble, France 33mm × 21mm × 15mm Wireless
Table 5
Mean (SD. Standard deviation) values for the ROM reached performing extension, flexion, axial rotation and lateral flexion with orthoses.
Max ROM (deg) Trials without orthoses HR SSS A support SSS 6 supports VA
Extension 54 (13) 50 (12) 43 (7) 35 (10) ** 35 (7) **
Flexion 52 (9) 28 (13) ** 36 (13) * 36 (12) * 27 (10) **
Axial rotation 145 (12) 116 (21) 101 (30) ** 96 (33) ** 77 (30) **
Lateral flexion 80 (12) 70 (13) 67 (11) 60 (18) * 61 (15) *

HR: Headmaster. SSS-A support: SSS with the A support. SSS-6 supports: SSSwith six supports. VA: Vista. (*) Level of significance for the difference with “trials without orthosis” is P < 0.05. (**) Level of significance for the difference with “trials without orthosis” is P < 0.01.

Table 6
Angular displacement of the thrust (deg), Mean ± SD.
Rotation Side bending
Pre - training 9.0 ± 8.0 7.9 ± 3.6
Post - training 13.1 ± 8.3 6.6 ± 2.1


1. Peter ST, Michael DJ, Jonathan MW. Do inertial sensors represent a viable method to reliablymeasure cervical spine range of motion? Manual Therapy. 2012; 17:92–96.

2. Jan MJ, Julia T, Peter C, Gwendolen J. Wireless orientation sensors: Their suitability to measure head movement for neck pain assessment. Manual Therapy. 2007; 12:380–385.

3. Michele S, Gwendolen J, Bill V, Justin K, Ross D. Physical and psychological factors predict outcome following whiplash injury. Pain. 2005; 114:141–148.

4. Kim H, Shin SH, Kim JK, Park YJ, Oh HS, Park YB. Cervical Coupling Motion Characteristics in Healthy People Using a Wireless Inertial Measurement Unit. Evidence-Based Complementary and Alternative Medicine. 2013; 8

5. Kim H, Park YB. Development of a motion analysis system and clinical indices for evaluating cervical rotations. Master’s Theses. 2014.

6. Frisch GD, D’Aulerio L, O’Rourke J. Mechanism of head and neck response to G(x) impact acceleration: A math modeling approach. Aviation Space and Environmental Medicine. 1977; 48:223–230.

7. Hallman DM, Gupta N, Mathiassen SE, Holtermann A. Association between objectively measured sitting time and neck–shoulder pain among blue-collar workers. International Archives of Occupational and Environmental Health. 2015; 88:8. 1031–1042.

8. Kouchakzadeh A, Beigzadeh Y. Permitted working hours with a motorised backpack sprayer. Biosystems Engineering. 2015; 136:1–7.

9. Lo Martire R, Gladh K, Westman A, Lindholm P, Nilsson J, Äng BO. Neck muscle activity in skydivers during parachute opening shock. Scandinavian Journal of Medicine and Science in Sports. 2016; 26:3. 307–316.

10. Brecl JG, Pelykh O, Košutzká Z, Pirtošek Z, Trošt M, Ilmberger J, et al. Postural stability under globus pallidus internus stimulation for dystonia. Clinical Neurophysiology. 2015; 126:12. 2299–2305.

11. Omkar SN, Vanjare AM, Suhith H, Kumar SGH. Motion analysis for short and long jump. International Journal of Performance Analysis in Sport. 2012; 12:1. 132–143.

12. Pancani S, Rowson J, Tindale W, Heron N, Langley J, McCarthy AD, et al. Assessment of the Sheffield Support Snood, an innovative cervical orthosis designed for people affected by neck muscle weakness. Clinical Biomechanics. 2016; 32:201–206.

13. Yannick TL, Nicolas B, Alexandre MD, Carol-Anne V. Reliability and criterion validity of two applications of the iPhone™ to measure cervical range of motion in healthy participants. Journal of Neuro Engineering and Rehabilitation. 2013; 10:69.

14. Quek J, Brauer SG, Treleaven J, Pua YH, Mentiplay B, Clark RA. Validity and intra-rater reliability of an Android phone application to measure cervical range-of-motion. Journal of Neuro Engineering and Rehabilitation. 2014; 11:65.

15. Alqhtani RS, Jones MD, Theobald PS, Williams JM. Reliability of an accelerometer-based system for quantifying multiregional spinal range of motion. Journal of Manipulative and Physiological Therapeutics. 2015; 38:4. 275–281.

16. Higgins MJ, Tierney RT, Caswell S, Driban JB, Mansell J, Clegg S. An in-vivo model of functional head impact testing in non-helmeted athletes. Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology. 2009; 223:3. 117–123.

17. Cazzola D, Preatoni E, Stokes KA, England ME, Trewartha G. A modified prebind engagement process reduces biomechanical loading on front row players during scrummaging: A cross-sectional study of 11 elite teams. British Journal of Sports Medicine. 2014; 49:8. 541–546.

18. Kang YS, Moorhouse K, Herriott R, Bolte JH. Comparison of Cervical Vertebrae Rotations for PMHS and BioRID II in Rear Impacts. Traffic Injury Prevention. 2013; 14: SUPPL1. S136–S147.

19. Khurelbaatar T, Kim K, Lee S, Kim YH. Consistent accuracy in whole-body joint kinetics during gait using wearable inertial motion sensors and in-shoe pressure sensors. Gait and Posture. 2015; 42:1. 65–69.

20. Pryce R, McDonald N. Prehospital Spinal Immobilization: Effect of Effort on Kinematics of Voluntary Head-neck Motion Assessed using Accelerometry. Prehospital and Disaster Medicine. 2015; 31:1. 36–42.

21. Schiefer C, Kraus T, Ellegast RP, Ochsmann E. A technical support tool for joint range of motion determination in functional diagnostics - An inter-rater study. Journal of Occupational Medicine and Toxicology. 2015; 10:16.

22. Xu X, Chen KB, Lin JH, Radwin RG. The accuracy of the Oculus Rift virtual reality head-mounted display during cervical spine mobility measurement. Journal of Biomechanics. 2015; 48:4. 721–724.

23. Miyaoka S, Hirano H, Ashida I, Miyaoka Y, Yamada Y. Analysis of head movements coupled with trunk drift in healthy subjects. Medical and Biological Engineering and Computing. 2005; 43:3. 395–402.

24. Milani P, Coccetta CA, Rabini A, Sciarra T, Massazza G, Ferriero G. Mobile smartphone applications for body position measurement in rehabilitation: A review of goniometric tools. PM and R. 2014; 6:11. 1038–1043.

25. Cuesta-Vargas AI, Williams J. Inertial sensor real-time feedback enhances the learning of cervical spine manipulation: A prospective study. European Spine Journal. 2014; 23:11. 2314–2320.

26. Boissy P, Shrier I, Brière S, Mellete J, Fecteau L, Matheson GO, et al. Effectiveness of cervical spine stabilization techniques. Clinical Journal of Sport Medicine. 2011; 21:2. 80–88.

27. Fleiss JL. Design and analysis of clinical experiments. New York: Wiley Classical Library;1999.

28. Duc C, Salvia P, Lubansu A, Feipel V, Aminian K. A wearable inertial system to assess the cervical spine mobility: Comparison with an optoelectronic-based motion capture evaluation. Medical Engineering and Physics. 2014; 36:1. 49–56.

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