{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:18:03Z","timestamp":1787811483603,"version":"build-2784847793"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Sports Act. Living"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study investigated phase-specific performance, movement smoothness, and turning kinematics during the Timed Up and Go (TUG) test in older adults with and without chronic neck pain (CNP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eighty-five older adults [CNP,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925; control (CON),\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960] completed an instrumented TUG (iTUG) using wearable inertial sensors. Total TUG duration, spatiotemporal gait parameters (gait velocity, stride length, and cadence), and phase durations (sit-to-stand, walking forward, turning, walking back, and turn-to-sit) were extracted. Trunk movement smoothness was quantified using the Log Dimensionless Jerk based on acceleration (LDLJa), and peak trunk angular velocities during turning and turn-to-sit were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the CON group, participants with CNP required significantly longer to complete the TUG, particularly during the turning, walking-back, and turn-to-sit phases, despite similar gait velocity, stride length, and cadence. The CNP group also demonstrated lower LDLJa values, indicating reduced movement smoothness, together with lower peak trunk angular velocities during turning and turn-to-sit. LDLJa was positively correlated with turning angular velocity in both groups, indicating that smoother movement was associated with faster, more coordinated turning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Older adults with CNP exhibited impaired functional mobility characterized by prolonged TUG performance and reduced movement smoothness despite preserved basic spatiotemporal gait parameters. These impairments were most evident during dynamic postural transitions, suggesting that phase-specific iTUG metrics and LDLJa provide complementary information on movement quality beyond conventional TUG outcomes and may enhance the clinical assessment of mobility impairment in older adults with CNP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fspor.2026.1909320","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:33:38Z","timestamp":1787808818000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Movement smoothness and turning deficits during the timed up and go in older adults with chronic neck pain"],"prefix":"10.3389","volume":"8","author":[{"given":"Thanya","family":"Madsalae","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Faculty of Physical Therapy, Srinakharinwirot University","place":["Nakhonnayok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanapat","family":"Thongprong","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Physical Therapy, Srinakharinwirot University","place":["Nakhonnayok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithinun","family":"Chaikeeree","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Physical Therapy, Srinakharinwirot University","place":["Nakhonnayok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumpa","family":"Boonsinsukh","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Physical Therapy, Srinakharinwirot University","place":["Nakhonnayok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6885","DOI":"10.2147\/JPR.S551730","article-title":"Assessment of the burden of chronic neck and\/or shoulder pain on quality of life among Saudi adults: a cross-sectional study","volume":"18","author":"Jareebi","year":"2025","journal-title":"J Pain Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1111\/papr.13033","article-title":"Epidemiology of neck pain and its impact on quality of life","volume":"21","author":"Hey","year":"2021","journal-title":"Pain Pract"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1324375","DOI":"10.3389\/fmed.2024.1324375","article-title":"Changes in gait performances during walking with head movements in older adults with chronic neck pain","volume":"11","author":"Madsalae","year":"2024","journal-title":"Front Med (Lausanne)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1016\/j.math.2007.02.002","article-title":"The influence of neck pain on balance and gait parameters in community-dwelling older people","volume":"40","author":"Poole","year":"2008","journal-title":"J Rehabil Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1016\/j.gaitpost.2014.01.009","article-title":"New insights into neck-pain-related postural control using measures of signal frequency and complexity in older adults","volume":"39","author":"Quek","year":"2014","journal-title":"Gait Posture"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1688","DOI":"10.1523\/JNEUROSCI.05-07-01688.1985","article-title":"The coordination of arm movements: an experimentally confirmed mathematical model","volume":"5","author":"Flash","year":"1985","journal-title":"J Neurosci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1269772","DOI":"10.3389\/fnhum.2024.1269772","article-title":"Slowing gait during turning: how volition of modifying walking speed affects the gait pattern in healthy adults","volume":"18","author":"Madrid","year":"2024","journal-title":"Front Hum Neurosci"},{"key":"B8","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.gaitpost.2022.11.010","article-title":"Spatiotemporal parameters during turning gait maneuvers of different amplitudes in young and elderly healthy adults: a descriptive and comparative study","volume":"99","author":"Madrid","year":"2023","journal-title":"Gait Posture"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1878271","DOI":"10.3389\/fnagi.2026.1878271","article-title":"Spatiotemporal gait parameters during turning differ in Parkinson\u2019s disease patients with and without freezing of gait","volume":"18","author":"Madrid","year":"2026","journal-title":"Front Aging Neurosci"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2126","DOI":"10.1109\/TBME.2011.2179545","article-title":"A robust and sensitive metric for quantifying movement smoothness","volume":"59","author":"Balasubramanian","year":"2012","journal-title":"IEEE Trans Biomed Eng"},{"key":"B11","doi-asserted-by":"publisher","first-page":"558771","DOI":"10.3389\/fbioe.2020.558771","article-title":"Estimating movement smoothness from inertial measurement units","volume":"8","author":"Melendez-Calderon","year":"2021","journal-title":"Front Bioeng Biotechnol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"540","DOI":"10.3389\/fphys.2020.00540","article-title":"SPARC Metrics provide mobility smoothness assessment in oldest-old with and without a history of falls: a case control study","volume":"11","author":"Figueiredo","year":"2020","journal-title":"Front Physiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"13440","DOI":"10.3390\/ijerph192013440","article-title":"Evaluation of gait smoothness in patients with stroke undergoing rehabilitation: comparison between two metrics","volume":"19","author":"Germanotta","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1007\/s40520-023-02403-0","article-title":"Instrumental evaluation of gait smoothness and history of falling in older persons: results from an exploratory case-control study","volume":"35","author":"Zucchelli","year":"2023","journal-title":"Aging Clin Exp Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"E1415","DOI":"10.1097\/BRS.0b013e31820e68ac","article-title":"Validation of Thai versions of the Neck Disability Index and Neck Pain and Disability Scale in patients with neck pain","volume":"36","author":"Uthaikhup","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"400","DOI":"10.2519\/jospt.2009.2930","article-title":"Neck disability Index: measurement properties and clinical application","volume":"39","author":"MacDermid","year":"2009","journal-title":"J Orthop Sports Phys Ther"},{"key":"B17","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1001\/archotol.1990.01870040046011","article-title":"The development of the dizziness handicap inventory","volume":"116","author":"Jacobson","year":"1990","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"B18","volume-title":"User Guide Mobility Lab","year":"2016"},{"key":"B19","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1109\/TNSRE.2010.2047606","article-title":"iTUG, a sensitive and reliable measure of mobility","volume":"18","author":"Salarian","year":"2010","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.3390\/s25041233","article-title":"Smooth moves: comparing log dimensionless jerk metrics from body center of mass trajectory and wearable sensor acceleration during walking","volume":"25","author":"Brasiliano","year":"2025","journal-title":"Sensors"},{"key":"B21","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"1988"},{"key":"B22","doi-asserted-by":"publisher","first-page":"364","DOI":"10.2519\/jospt.2009.2834","article-title":"Sensorimotor function and dizziness in neck pain: implications for assessment and management","volume":"39","author":"Kristjansson","year":"2009","journal-title":"J Orthop Sports Phys Ther"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1012880","DOI":"10.3389\/fmed.2022.1012880","article-title":"Can the balance evaluation systems test be used to identify system-specific postural control impairments in older adults with chronic neck pain?","volume":"9","author":"Madsalae","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1007\/s40122-020-00230-z","article-title":"Cervical proprioception impairment in neck pain: a systematic review and meta-analysis","volume":"21","author":"Peng","year":"2021","journal-title":"Spine J"},{"key":"B25","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.gaitpost.2017.11.016","article-title":"An exploratory study examining factors underpinning postural instability in older adults with idiopathic neck pain","volume":"60","author":"Quek","year":"2018","journal-title":"Gait Posture"},{"key":"B26","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1186\/s12891-023-06721-2","article-title":"The impact of neck pain on gait health: a systematic review and meta-analysis","volume":"24","author":"Burton","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"B27","doi-asserted-by":"publisher","first-page":"9","DOI":"10.33393\/aop.2025.3289","article-title":"Discriminative ability, responsiveness, and interpretability of smoothness index of gait in people with multiple sclerosis","volume":"15","author":"Castiglia","year":"2025","journal-title":"Arch Physiother"},{"key":"B28","doi-asserted-by":"publisher","first-page":"268","DOI":"10.2519\/jospt.2017.6768","article-title":"People with chronic neck pain walk with a stiffer spine","volume":"47","author":"Falla","year":"2017","journal-title":"J Orthop Sports Phys Ther"},{"key":"B29","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.gaitpost.2018.10.036","article-title":"Walking smoothness is associated with gait and balance in older adults","volume":"68","author":"Hillel","year":"2019","journal-title":"Gait Posture"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e96675","DOI":"10.1371\/journal.pone.0096675","article-title":"Objective assessment of fall risk in Parkinson\u2019s disease using a body-fixed sensor worn for 3 days","volume":"9","author":"Weiss","year":"2014","journal-title":"PLoS One"},{"key":"B31","doi-asserted-by":"publisher","first-page":"7460","DOI":"10.1007\/s00415-024-12711-8","article-title":"Impact of proprioceptive cervical dizziness in chronic neck pain syndromes on gait and stance during active head-turn challenges","volume":"271","author":"Huppert","year":"2024","journal-title":"J Neurol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"864.e9","DOI":"10.1016\/j.jamda.2016.06.025","article-title":"Transition between the timed up and go turn to sit subtasks: is timing everything?","volume":"17","author":"Weiss","year":"2016","journal-title":"J Am Med Dir Assoc"},{"key":"B33","doi-asserted-by":"publisher","first-page":"774448","DOI":"10.3389\/fnins.2021.774448","article-title":"Contribution of cervical proprioception, vision, and vestibular feedback on reducing dynamic head\u2013trunk orientation error in the yaw direction","volume":"15","author":"Mooti","year":"2022","journal-title":"Front Neurosci"},{"key":"B34","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1136\/jnnp.2009.173740","article-title":"The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease","volume":"81","author":"Zampieri","year":"2010","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B35","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1471-2318-14-14","article-title":"Is the timed up and go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis","volume":"14","author":"Barry","year":"2014","journal-title":"BMC Geriatr"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.2147\/CIA.S86001","article-title":"Assessment of the risk of falling with the use of the timed up and go test in the elderly","volume":"10","author":"Zasadzka","year":"2015","journal-title":"Clin Interv Aging"},{"key":"B37","doi-asserted-by":"publisher","first-page":"2339","DOI":"10.3390\/s22062339","article-title":"High specificity of single inertial sensor-supplemented timed up and go test for assessing fall risk in elderly nursing home residents","volume":"22","author":"Dierick","year":"2022","journal-title":"Sensors (Basel)"}],"container-title":["Frontiers in Sports and Active Living"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fspor.2026.1909320\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:33:39Z","timestamp":1787808819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fspor.2026.1909320\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":37,"alternative-id":["10.3389\/fspor.2026.1909320"],"URL":"https:\/\/doi.org\/10.3389\/fspor.2026.1909320","relation":{},"ISSN":["2624-9367"],"issn-type":[{"value":"2624-9367","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"article-number":"1909320"}}