Disturbance of neck proprioception and feed-forward motor control following static neck flexion in healthy young adults

Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review

Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work.

Does Forward Head Posture Influence Somatosensory Evoked Potentials and Somatosensory Processing in Asymptomatic Young Adults?

The current investigation used somatosensory evoked potentials (SEPs) to assess differences in sensorimotor integration and somatosensory processing variables between asymptomatic individuals with and without forward head posture (FHP). We assessed different neural regions of the somatosensory pathway, including the amplitudes of the peripheral N9, spinal N13, brainstem P14, peak-to-peak amplitudes of parietal N20 and P27, and frontal N30 potentials. Central conduction time (N13-N20) was measured as the difference in peak latencies of N13 and N20. We measured these variables in 60 participants with FHP defined as a craniovertebral angle (CVA) < 50° and 60 control participants matched for age, gender, and body mass index (BMI) with normal FHP defined as CVA > 55°. Differences in variable measures were examined using the parametric t-test. Pearson's correlation was used to evaluate the relationship between the CVA and sensorimotor integration and SEP measurements. A generalized linear model (GLM) was used to compare the SEP measures between groups, with adjustment for educational level, marital status, BMI, and working hours per week. There were statistically significant differences between the FHP group and control group for all sensorimotor integration and SEP processing variables, including the amplitudes of spinal N13 (p < 0.005), brainstem P14 (p < 0.005), peak-to-peak amplitudes of parietal N20 and P27 (p < 0.005), frontal N30 potentials (p < 0.005), and the conduction time N13-N20 (p = 0.004). The CVA significantly correlated with all measured neurophysiological variables indicating that as FHP increased, sensorimotor integration and SEP processing became less efficient. FHP group correlations were: N9 (r = -0.44, p < 0.001); N13 (r = -0.67, p < 0.001); P14 (r = -0.58, p < 0.001); N20 (r = -0.49, p = 0.001); P27 (r = -0.58, p < 0.001); N30 potentials (r = -0.64, p < 0.001); and N13-N20 (r = -0.61, p < 0.001). GLM identified that increased working hours adversely affected the SEP measures (p < 0.005), while each 1° increase in the CVA was associated with improved SEP amplitudes and more efficient central conduction time (N13-N20; p < 0.005). Less efficient sensorimotor integration and SEP processing may be related to previous scientific reports of altered sensorimotor control and athletic skill measures in populations with FHP. Future investigations should seek to replicate our findings in different spine disorders and symptomatic populations in an effort to understand how improving forward head posture might benefit functional outcomes of patient care.

Does Smartphone Use Really Impact Cervical Rotation and Cervical Proprioception in Asymptomatic Individuals?

Background and objective Smartphone use has increased exponentially over the last two years worldwide. The outbreak of the coronavirus disease 2019 (COVID-19) pandemic led to significantly higher dependence on the smartphone for information exchange and communication among the general public. Currently, India has hundreds of millions of smartphone users, and their numbers are on the rise. This has raised concerns regarding the adverse effects of smartphone use on mental and musculoskeletal health. In light of this, this study aimed to determine and evaluate the musculoskeletal consequences of smartphone use. Method A total of 102 participants (50 adolescents and 52 adults) who were smartphone users and are asymptomatic for cervical spine-related disorders were included based on convenience sampling. The components assessed were cervical rotation using tape measurement and cervical proprioception using the head repositioning accuracy test. Frequency distribution tables and text were used to report the results. Results The results of this research indicated reduced cervical rotation range and cervical proprioception deficits in both adolescent and adult smartphone users. Furthermore, no correlation was found between cervical rotation (right and left) and cervical proprioception (right and left rotation). Conclusion Though the results showed that both the individual components - cervical rotation and cervical proprioception - were significantly affected, there was no correlation between the components, which indicates that these asymptomatic individuals who are marginally excessive smartphone users are at increased risk for reduced cervical mobility and deficits in cervical proprioception.

Impairments in trunk muscles performance and proprioception in older adults with hyperkyphosis

BACKGROUND AND OBJECTIVES

Thoracic hyperkyphosis is one of the most common postural deformities in the geriatric population. This study investigated whether trunk proprioception, muscle strength, and endurance differ between older adults with hyperkyphosis and the age-matched control group. This study also aimed to explore the association of kyphotic posture with muscle performance, position sense, and force sense.

METHODS

Ninety-seven elderly volunteers (61 with hyperkyphosis and 36 normal controls) participated in this cross-sectional study. The kyphosis degree, trunk position sense, force sense, back muscle strength, and endurance were assessed in all participants.

RESULTS

The results showed lower back extensor strength and endurance, also higher force and position sense error in the hyperkyphotic group than the control group. In addition, the findings revealed that back extensor strength and endurance, as well as trunk position sense, were associated with kyphotic posture in older adults.

DISCUSSION AND IMPLICATIONS

This study suggests that back extensor strength and endurance and trunk position sense and force sense are potentially modifiable impairments associated with thoracic kyphosis in older adults with hyperkyphosis. It seems monitoring these potentially contributing factors would be helpful in the assessment and treatment of hyperkyphotic older individuals.

Investigation of Joint Position Sense and Balance in Individuals With Chronic Idiopathic Neck Pain: A Cross-Sectional Study

OBJECTIVE

The aim of this study was to determine the relationship between joint position sense and static and dynamic balance in female patients with chronic neck pain compared with healthy controls.

METHODS

The study sample comprised 25 female patients with chronic neck pain and 25 healthy (asymptomatic) female controls. Pain severity with the visual analog scale, joint position sense with the laser pointer method, static balance with the Single-Leg Balance Test, and dynamic balance with the Y Balance Test were assessed.

RESULTS

The deviation in cervical joint position sense was greater in extension (P < .001), right rotation (P < .001), and left lateral rotation (P < .05) in the patients with chronic neck pain compared with the healthy controls. The results of the patients with chronic neck pain were worse than the healthy controls in the Single-Leg Balance Test with both eyes open (P < .05) and eyes closed (P < .05). The patients with chronic neck pain had worse dynamic balance only in the anterior direction reach of the left leg (P < .05).

CONCLUSION

Cervical joint position sense and static balance were worse in female patients with chronic idiopathic neck pain when compared with asymptomatic controls. Dynamic balance in all other directions except for the anterior direction was not negatively affected in individuals with chronic idiopathic neck pain.

Neck and back muscle chains hypomobility in women with migraine

OBJECTIVE

To compare the mobility of neck and back flexor and extensor muscle chains in women with migraine, chronic migraine and headache-free.

METHODS

This is a cross-sectional study. The muscle chain test was performed based on the theoretical assumptions of the Busquet method, in women with migraine (MG, n = 24), chronic migraine (CMG, n = 36) and headache-free (CG, n = 27). The evaluation of neck and back mobility was performed by an examiner expert in the Busquet method with the aid of cervical range of motion (CROM®) device (neck muscles) and the Tiltmeter® application (back muscles).

RESULTS

Compared to woman headache-free, women with migraine (MD = -12° [CI95% = -19°, -5°] and chronic migraine (MD = -15° [CI95% = -21°, -8°] present reduced mobility in the neck extensor muscle chain. Also, in the back extensor muscle chain, migraine vs headache-free (MD = -9° [CI95% = -15°, -2°]) and chronic migraine vs headache-free (MD = -10° [CI95% = -16°, -4°]) and in the back flexor muscle chain, migraine vs headache-free (MD = -6° [CI95% = -10°, -0.1°]) and chronic migraine vs headache-free (MD = -7 [CI95% = -11°, -2°]), with an effect sizes varying between 1.19 e 2.38. No difference was found between groups for neck flexor muscle chain.

CONCLUSION

Women with migraine and chronic migraine have hypomobility of the neck and back extensor muscle chains, and of the back flexor chain.

Perception of musculoskeletal pain in the state of confinement: associated factors

OBJECTIVE

to describe the perception of musculoskeletal pain in the population and how the state of confinement (adopted as a measure to control contagion by COVID-19) has interfered with it, as well as identifying the sociodemographic, occupational, physical, and psychosocial factors involved.

METHOD

an observational, cross-sectional and analytical study, with simple random probabilistic sampling, aimed at residents in Spain over 18 years old during the confinement period. An ad hoc survey was conducted, consisting in 59 items.

RESULTS

a total of 3,247 surveys were answered. Persistent musculoskeletal pain or significant episodes thereof increased 22.2% during confinement. The main location was the spine (49.5%). The related factors were decreased physical activity, increased seated position, and use of electronic devices. The psychological impact of confinement was also related to the perception of musculoskeletal pain.

CONCLUSION

the state of confinement causes an increase in the perception of musculoskeletal pain. The identification of a particularly sensitive population profile, as well as that of the related factors, allows establishing multidisciplinary approaches in health promotion.

Flexion Dysfunction of Atlanto-Occipital Joint Associated with Cervical Spondylosis

Objective

To investigate the association between atlanto‐occipital radiographic alignment in flexion and cervical spondylosis (CS).

Methods

This is a retrospective case‐control study. CS patients were recruited from our hospital, and the age/gender/body mass index (BMI)‐matched healthy controls were selected from the subjects in health examinations at the same hospital between January 2015 and May 2019. A total of 464 subjects was included in the study. There are 282 males and 182 females. The ages of patients were 20 to 67 years, and the mean age was 33.9 years. CS patients were considered the case group. Based on surgical treatments, they were subdivided into non‐operation group and operation group. The operation group and non‐operation group had 45 and 187 patients, respectively, while 232 subjects were included in the control group. The angle between McGregor's line and C₁ line (O‐C₁ angle) was evaluated on images taken in flexion (F‐OC) and neutral positions (N‐OC) independently. The relationship between the FOC (FOC=F‐OC—N‐OC) and Neck Disability Index (NDI) was examined, and the involvement of the FOC in the onset of CS was analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut‐off for detecting an increased risk of CS.

Results

The median follow‐up time was 51.6 months (25–115 months). The case groups, especially the operation group, tended to be older (55.8 ± 11.2 vs 41.6 ± 13.8 vs 23.5 ± 5.5 years, P < 0.001), have a higher NDI score (12.2 ± 4.5 vs 6.2 ± 2.1 vs 3.2 ± 1.2, P < 0.001), and longer medical history (10.5 ± 9.5 vs 6.8 ± 11.2 years, P < 0.001). One‐way analysis of variance showed statistically significant differences in FOC between the control and case groups (1.4° ± 1.2° vs 3.6° ± 1.9° vs 7.2° ± 2.0°, P < 0.001). Besides, a post‐hoc Tukey test showed a lower FOC in the operation group compared with that in the non‐operation group (1.4° ± 1.2° vs 3.6° ± 1.9°, P < 0.001). Using FOC as a radiological predictive model to predict CS, the cut‐off value was 4.2°. Using FOC as a radiological predictive model to predict CS, the area under the curve (AUC) was 0.86 (95% CI: 0.78–0.92, P < 0.001). In the univariable risk analysis model, conditional logistic regression showed that the FOC level was an independent factor with an important role in the risk of CS. The odds rose to 8.2 times when FOC reached the level under 4.2° (OR = 8.2; 95% CI: 6.4–10.0; P < 0.001). There existed a significant negative correlation between FOC levels and NDI (r = −0.451, P = 0.016).

Conclusions

Stiff O‐C₁, which is defined as FOC ≤ 4.2°, represented decreased flexion dysfunction of atlanto‐occipital joint and is closely associated with high risk for the occurrence of CS. This finding could show a possible relationship between upper and lower cervical spine and help spine surgeons to understand the pathological process of CS and implement appropriate management.

The effect of calling duration on cervical joint repositioning error angle and discomfort in university students

BACKGROUND

The time spent on mobile phone during daytime is increasing with the rapid life-style in young population for different purposes such as texting, calling etc. and the younger population is more dependent on networking with them.

OBJECTIVE

The aim of the present study was to compare joint repositioning error angle in the cervical region between groups with regard to their daily calling duration on smartphone and to determine the relationship between daily calling duration and potential cervical pain and disability.

METHODS

Sixty-three university students were included in the study. Participants were divided concerning to their durations of daily calling durations on smartphones. The joint-repositioning-error sense, craniovertebral angle, cervicothoracic muscle strength, and endurance of neck flexors were measured and potential pain and disability levels were assessed.

RESULTS

University students who spending twenty minutes or more for calling on smartphone daily had significantly higher joint repositioning error sense. Additionally, it was determined that there was fair relationship between the daily calling time on smartphone and potential neck pain and disability.

CONCLUSIONS

The prolonged calling duration on smartphone could affect cervical joint repositioning error sense in university students. This might be related to potential discomfort on cervical region in the further period.