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Moser N, Popovic MR, Kalsi-Ryan S. Effectiveness of personalized rehabilitation in adults suffering from persistent concussion symptoms as compared to usual care: a randomized control trial protocol. BMC Neurol 2024; 24:239. [PMID: 38987676 PMCID: PMC11234705 DOI: 10.1186/s12883-024-03700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/31/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Symptoms reported by patients who sustain a concussion are non-specific. As such, clinicians are better able to manage patients when a standardized clinical exam is performed to sub-type the driver(s) of symptoms. Aerobic exercise and multimodal rehabilitation have consistently shown to be a possibly effective means to manage this population; however, the optimal training prescription is unclear. Thus, there is a need to further examine the effectiveness of personalized rehabilitative treatments. Our primary aim is to evaluate the response to personalized therapy on recovery, as measured by The Rivermead Post-concussion Symptoms Questionnaire (RPQ) when compared to an active control. METHODS We will conduct a multi-center 12-week case-crossover randomized controlled trial. 50 participants will be recruited from out-patient University Health Network clinics and community-based clinical practices around the greater Toronto area. Participants will be randomized at baseline to Group A: a personalized care program followed by an active control or Group B: an active control followed by a personalized care program. Participants will be included should they be 21 years of age and older and have symptoms that have persisted beyond 4 weeks but less than 1 year. Participants will undergo 6-weeks of care in their respective streams. After 6-weeks, participants will undergo a re-examination. They will then crossover and undertake the alternative treatment for 6 weeks. At the end of 12 weeks, participants will undertake the endpoint examinations. The primary outcome will be the Rivermead Postconcussion Questionnaire (RPQ). The secondary outcomes will be changes in standardized clinical examination, Neck Disability Index (NDI), Patient Health Questionnaire (PHQ-9) and an electroencephalography (EEG) via NeuroCatch™. The statistical analysis to be performed is composed of an adjusted model using an analysis of variance, specifically using an unpaired t-test to test for associations between variables and outcomes. DISCUSSION Given the recommendations from reviews on the topic of rehabilitation for adults with persistent concussion symptoms, we are undertaking a controlled trial. The documented high costs for patients seeking care for persistent symptoms necessitate the need to evaluate the effectiveness of a personalized rehabilitative program compared to the current standard of care. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT06069700.
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Affiliation(s)
- Nicholas Moser
- KITE Research Institute-University Health Network, Toronto, ON, Canada.
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Nicholas, Canada.
| | - Milos R Popovic
- KITE Research Institute-University Health Network, Toronto, ON, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Nicholas, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Sukhvinder Kalsi-Ryan
- KITE Research Institute-University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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Särkilahti N, Hirvonen M, Lavapuro J, Takatalo J, Löyttyniemi E, Tenovuo O. Sensorimotor tests in patients with neck pain and its associated disorders: a systematic review and meta-analysis. Sci Rep 2024; 14:12764. [PMID: 38834665 DOI: 10.1038/s41598-024-63545-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
This systematic review aimed to synthesize the current evidence regarding neck sensorimotor testing in individuals with neck pain, assess the differences between neck pain groups and healthy controls, and recognize factors that might affect test results. We performed the data search using PubMed, Embase, PsycINFO, CINAHL, and Scopus databases. We used a two-step screening process to identify studies. Furthermore, we screened the reference lists for additional studies. Hedges g was used to present the difference between neck pain groups and asymptomatic individuals. We assessed the quality of the studies using the QUADAS tool. The final review included 34 studies, of which 25 were related to the joint position error test, four to the smooth pursuit neck torsion test and six to the balance test. Our meta-analysis showed poorer joint-position sense, oculomotor function, and wider postural sway in individuals with neck pain than healthy controls. The size of the difference between the groups seemed to be influenced by the intensity of the pain and the presence of dizziness. Therefore, it might be helpful in future studies to differentiate patients with neck pain into subgroups based on their symptom and demographic profiles to assess other factors that significantly affect cervical sensorimotor control.
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Affiliation(s)
- Niklas Särkilahti
- Department of Clinical Neurosciences, Faculty of Medicine, University of Turku, Turku, Finland.
- Neurocenter, Turku University Hospital, Turku, Finland.
| | - Milka Hirvonen
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Joona Lavapuro
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Jani Takatalo
- Medical Research Center Oulu, University of Oulu, Oulu, Finland
- Loisto Terveys, Oulu, Finland
| | - Eliisa Löyttyniemi
- The Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
| | - Olli Tenovuo
- Department of Clinical Neurosciences, Faculty of Medicine, University of Turku, Turku, Finland
- Turku Brain Injury Centre, Turku University Hospital, Turku, Finland
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Ragnarsdottir H, Peterson G, Gislason MK, Oddsdottir GL, Peolsson A. The effect of a neck-specific exercise program on cervical kinesthesia for patients with chronic whiplash-associated disorders: a case-control study. BMC Musculoskelet Disord 2024; 25:346. [PMID: 38693515 PMCID: PMC11064421 DOI: 10.1186/s12891-024-07427-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/09/2024] [Indexed: 05/03/2024] Open
Abstract
INTRODUCTION Cervical kinesthesia is an important part of movement control and of great importance for daily function. Previous research on kinesthesia in whiplash-associated disorders (WAD) has focused on grades I-II. More research is needed on WAD grade III. The aim of this study was to investigate cervical kinesthesia in individuals with WAD grades II-III before and after a neck-specific exercise intervention and compare them to healthy controls. METHODS A prospective, case-control study with a treatment arm (n = 30) and a healthy control arm (n = 30) was conducted in Sweden. The WAD group received a neck-specific exercise program for 12 weeks. The primary outcome to evaluate kinesthesia was neck movement control (the Fly test). Secondary outcomes were neck disability, dizziness and neck pain intensity before and after the Fly test. Outcomes were measured at baseline and post-treatment. The control arm underwent measurements at baseline except for the dizziness questionnaire. A linear mixed model was used to evaluate difference between groups (WAD and control) and over time, with difficulty level in the Fly test and gender as factors. RESULTS Between-group analysis showed statistically significant differences in three out of five kinesthetic metrics (p = 0.002 to 0.008), but not for the WAD-group follow-up versus healthy control baseline measurements. Results showed significant improvements for the WAD-group over time for three out of five kinaesthesia metrics (p < 0.001 to 0.008) and for neck disability (p < 0.001) and pain (p = 0.005), but not for dizziness (p = 0.70). CONCLUSIONS The exercise program shows promising results in improving kinesthesia and reducing neck pain and disability in the chronic WAD phase. Future research might benefit from focusing on adding kinesthetic exercises to the exercise protocol and evaluating its beneficial effects on dizziness or further improvement in kinesthesia. IMPACT STATEMENT Kinesthesia can be improved in chronic WAD patients without the use of specific kinesthetic exercises. TRIAL REGISTRATION ClinicalTrials.gov (NCT03664934), first registration approved 11/09/2018.
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Affiliation(s)
- Harpa Ragnarsdottir
- Research Centre of Movement Science, Department of Physiotherapy, University of Iceland, Stapi v/Hringbraut 31, Reykjavik, 101, IS, Iceland
- Elja Physiotherapy, Hafnafjordur, Iceland
| | - Gunnel Peterson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Magnus K Gislason
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland
| | - Gudny L Oddsdottir
- Research Centre of Movement Science, Department of Physiotherapy, University of Iceland, Stapi v/Hringbraut 31, Reykjavik, 101, IS, Iceland
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Clinical Medicine, Linköping University, Linköping, Sweden.
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Chen X, Cha L, Xuan Z, Zhang W. The effect of joint position sense therapy on chronic shoulder pain with central sensitization. Medicine (Baltimore) 2024; 103:e37786. [PMID: 38608097 PMCID: PMC11018202 DOI: 10.1097/md.0000000000037786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Chronic shoulder pain is a common musculoskeletal problem associated with unreleased pain and functional dysfunction that can evolve into central sensitization. Some forms of manual therapy may exacerbate pain and central sensitization. This study investigated the impact of joint position sense therapy (JPST), a moderate joint proprioception training technique, on central sensitization, shoulder functional dysfunction, and pain in patients with chronic shoulder pain compared with more intense exercises or aggressive manual therapies. METHODS We assessed the pressure pain threshold (PPT) in 30 patients with and 30 patients without chronic shoulder pain. The assessment focused on 4 muscle sites: deltoid, upper trapezius, brachioradialis, and tibialis anterior. Thirty patients with chronic shoulder pain were randomly divided into the JPST and control groups. The JPST group underwent additional shoulder joint position-sense training. The efficiency outcomes were the disabilities of the arm, shoulder, and hand questionnaire, visual analog scale (VAS), and PPT, evaluated at baseline and after the intervention. RESULTS Significant differences were observed in the PPT values at the brachioradialis (P < .05), deltoid (P < .01), and trapezius (P < .001) among the non-chronic and chronic groups, but not in the tibialis anterior muscle (P > .05). Although both control and JPST interventions effectively improved the disabilities of the arm, shoulder, and hand questionnaire score, pain intensity, and PPT values in the upper limb, the outcomes in the JPST group were significantly different from those in the control group. CONCLUSIONS Generalized hyperalgesia changes limited to the upper limbs were observed in patients with chronic shoulder pain. JPST has beneficial effects on pain control and functional dysfunction in patients with chronic shoulder pain.
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Affiliation(s)
- Xin Chen
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University Medical School, Shanghai, China
| | - Lisi Cha
- Department of Rehabilitation Therapy, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Zhi Xuan
- Department of Rehabilitation Therapy, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
| | - Weiming Zhang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University Medical School, Shanghai, China
- Department of Rehabilitation Therapy, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
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Majcen Rosker Z, Rosker J. Cervicocephalic kinaesthesia reveals novel subgroups of motor control impairments in patients with neck pain. Sci Rep 2024; 14:8383. [PMID: 38600120 PMCID: PMC11006834 DOI: 10.1038/s41598-024-57326-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
Cervical-spine sensorimotor control is associated with chronicity and recurrence of neck pain (NP). Tests used to measure sensorimotor impairments lack consistency in studied parameters. Interpretation is often based on either a handful or numerous parameters, without considering their possible interrelation. Different aspects of motor-control could be studied with different parameters, but this has not yet been addressed. The aim of this study was to determine if different parameters of cervical position (JPE) and movement (Butterfly) sense tests represent distinct components of motor-control strategies in patients with chronic NP. Principal component analysis performed on 135 patients revealed three direction-specific (repositioning from flexion, extension or rotations) and one parameter-specific (variability of repositioning) component for JPE, two difficulty-specific (easy or medium and difficult trajectory) and one movement-specific (undershooting a target) component for Butterfly test. Here we report that these components could be related to central (neck repositioning and control of cervical movement) and peripheral sensorimotor adaptations (variability of repositioning) present in NP. New technologies allow extraction of greater number of parameters of which hand-picking could lead to information loss. This study adds towards better identification of diverse groups of parameters offering potentially clinically relevant information and improved functional diagnostics for patients with NP.
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Affiliation(s)
| | - Jernej Rosker
- Faculty of Health Sciences, University of Primorska, Koper, Slovenia.
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Nast I, Scheermesser M, Ernst M, Sommer B, Schmid P, Weisenhorn M, E B, Gomez D, Iten P, von Wartburg A, Frey W, Lünenburger L, Bauer C. Usability of a visual feedback system to assess and improve movement disorders related to neck pain: Perceptions of physical therapists and patients. Heliyon 2024; 10:e26931. [PMID: 38434337 PMCID: PMC10907800 DOI: 10.1016/j.heliyon.2024.e26931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
A prototype visual feedback system has been developed to assess and improve movement disorders related to neck pain. The aim of this study was to assess the usability of the prototype in a rehabilitation setting. Twelve physical therapists integrated the device into their regular therapy programs for 24 neck pain patients with movement disorders. Each patient performed three individual therapy sessions with the device under physical therapist supervision. Usability was assessed by the physical therapists and patients using therapy diaries, the System Usability Scale, and focus group or personal interviews. Based on an overall usability rating of marginally acceptable, the visual feedback system was generally found to be a device with the potential to assess and train neck pain patients but needs improvement. To become a useful adjunct to regular physical therapy, improvements in the hardware and software, and further system developments are required.
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Affiliation(s)
- I. Nast
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - M. Scheermesser
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - M.J. Ernst
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - B. Sommer
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - P. Schmid
- Zurich University of Applied Sciences, School of Engineering, Institute of Signal Processing and Wireless Communications, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - M. Weisenhorn
- Zurich University of Applied Sciences, School of Engineering, Institute of Signal Processing and Wireless Communications, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - Bärtschi E
- Balgrist University Hospital, Forchstrasse 340, 8008, Zürich, Switzerland
| | - D. Gomez
- Cantonal Hospital, Winterthur Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - P. Iten
- Cantonal Hospital, Winterthur Brauerstrasse 15, 8401, Winterthur, Switzerland
- Physiowerk Aadorf, Hauptstrasse 47, 8355, Aadorf, Switzerland
| | - A. von Wartburg
- Hocoma AG, Industriestrasse 4, 8604, Volketswil, Switzerland
| | - W.O. Frey
- Balgrist University Hospital, Forchstrasse 340, 8008, Zürich, Switzerland
- Clinic Hirslanden, Klinik Hirslanden, Dr. med. Walter O. Frey, Witellikerstrasse 40, 8032, Zürich, Switzerland
| | - L. Lünenburger
- Hocoma AG, Industriestrasse 4, 8604, Volketswil, Switzerland
| | - C.M. Bauer
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
- Lake Lucerne Institute, Seestrasse 18, 6354, Vitznau, Switzerland
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Lim W. Joint position sense error in the hip and knee without reference to the joint angle. J Back Musculoskelet Rehabil 2024; 37:513-519. [PMID: 38073373 DOI: 10.3233/bmr-230129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
BACKGROUND Joint position reproduction measures the angle acuity of reference angle reproduction using an indicator angle. However, reference angles are often not available. OBJECTIVE This study aimed to examine joint position sense at three different targeted joint angles, which were estimated from the maximum range of motion (maxROM) without a reference angle at each targeted joint angle. METHODS The maxROM was measured in straight leg raise (SLR) and active knee extension (AKE) positions. In both positions, a targeted joint angle at 75% of the maxROM was assessed first, followed by that at 50% and 25% of the maxROM. A one-sample t-test was used to analyze differences between the targeted and reproduced angles in both positions. RESULTS All reproduced angles significantly differed from the targeted angle in both SLR and AKE positions except for the reproduced angle measured at 75% maxROM. Overall, position errors in the AKE position were higher than those in the SLR position. CONCLUSIONS Estimating the angle based on the maxROM without a matched reference angle may lead to significant discrepancies in comparison with the targeted joint angle. In clinical settings, if accurate reproduction of motions is required to improve proprioception, providing a reference angle might be helpful.
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Affiliation(s)
- Wootaek Lim
- Department of Physical Therapy, College of Health and Welfare, Woosong University, Daejeon, Korea
- Department of Digital Bio-Health Convergence, College of Health and Welfare, Woosong University, Daejeon, Korea
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Sohani SM, Akbari M, Nahrani MH. Romberg Neck Torsion :A New Specific Test for Cervicogenic Dizziness. Indian J Otolaryngol Head Neck Surg 2023; 75:2960-2965. [PMID: 37974751 PMCID: PMC10645657 DOI: 10.1007/s12070-023-03902-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/25/2023] [Indexed: 11/19/2023] Open
Abstract
AIMS Previous studies have shown that Cervical myofascial pain syndrome with dizziness (CMPS-D ) is one of the most common causes of cervicogenic dizziness and is associated with challenge in diagnosis and treatment. this study aimed to investigate the Romberg neck torsion test in patients with CMPS-D and healthy controls. MATERIALS AND METHODS Cross-sectional, observational study. twenty patients with CMPS-D were compared with twenty healthy controls. the Romberg (neutral position and neck torsion) and smooth pursuit neck torsion tests were performed in patients with CMPS-D and healthy controls. RESULTS The results confirmed that there are significant differences in the Romberg neck torsion test between subjects with CMPS-D and healthy controls (p < 0.05). in addition, There was a significant correlation between Romberg neck torsion and smooth pursuit neck torsion results (p < 0.05). CONCLUSION The results of Romberg neck torsion test in CMPS-D subjects were different from those in healthy controls, which was attributed to neck pain and changes in cervical proprioception input. Romberg neck torsion is a new method for assessing cervicogenic dizziness.
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Affiliation(s)
- Soheil Mansour Sohani
- Department of physical therapy, school of rehabilitation sciences, Iran university of medical sciences, Tehran, Iran
| | - Mehdi Akbari
- Department of audiology, school of rehabilitation sciences, Iran university of medical sciences, Tehran, Iran
| | - Morteza Hamidi Nahrani
- Department of audiology, school of rehabilitation sciences, Hamadan university of medical sciences, Hamadan, Iran
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Rahnama L, Saberi M, Kashfi P, Rahnama M, Karimi N, Geil MD. Effects of Two Exercise Programs on Neck Proprioception in Patients with Chronic Neck Pain: A Preliminary Randomized Clinical Trial. Med Sci (Basel) 2023; 11:56. [PMID: 37755160 PMCID: PMC10535186 DOI: 10.3390/medsci11030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare the effects of specific neck muscle training and general neck-shoulder exercises on neck proprioception, pain, and disability in patients with chronic non-specific neck pain. METHODS Twenty-five patients with chronic non-specific neck pain were recruited into this preliminary single-blinded randomized clinical trial. They were randomly assigned to either a specific neck exercise (n = 13, mean aged 24 years) or a general neck exercise group (n = 12, mean aged 25 years). Specific neck exercises included eye-head coordination and isometric deep neck muscle exercises. General neck exercises included neck and shoulder free range of motion and shoulder shrug. Pain, disability, and neck proprioception, which was determined using the joint repositioning error, were measured at baseline and after eight weeks of training in both groups. RESULTS Both training groups showed significant improvements in joint repositioning error (p < 0.001, F = 24.144, ES = 0.8), pain (p < 0.001, F = 61.118, ES = 0.31), and disability (p = 0.015, F = 6.937, ES = 0.60). However, the specific neck exercise group showed larger variability in joint repositioning error (p = 0.006, F = 0.20, F critical = 0.36). CONCLUSIONS Either specific neck exercise or a general neck-shoulder range of motion exercise could be effective in improving neck proprioception. Therefore, exercises could be recommended based on patient comfort and patients' specific limitations.
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Affiliation(s)
- Leila Rahnama
- School of Kinesiology, Nutrition & Food Science, California State University, Los Angeles, CA 90032, USA
| | - Manizheh Saberi
- Department of Physiotherapy, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran;
- Department of physiotherapy, National University of Medical Sciences, 28001 Madrid, Spain
| | - Pegah Kashfi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13871, Iran (N.K.)
| | - Mahsa Rahnama
- School of Medicine, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Noureddin Karimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13871, Iran (N.K.)
| | - Mark D. Geil
- Wellstar College of Health Professions and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
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Poesl M, Carvalho GF, Adamczyk WM, Schüßler B, Richter M, Luedtke K, Szikszay TM. Widespread Proprioceptive Acuity Impairment in Chronic Back Pain: A Cross-sectional Study. Arch Phys Med Rehabil 2023; 104:1439-1446. [PMID: 36935031 DOI: 10.1016/j.apmr.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE To investigate whether proprioceptive accuracy measured with the Joint Position Sense (JPS) in patients with chronic neck and low back pain is impaired exclusively in affected areas or also in distant areas, not affected by pain. DESIGN Cross-sectional study. SETTING Interdisciplinary outpatient rehabilitation clinic for back and neck pain. PARTICIPANTS Patients with chronic neck pain (n=30), patients with chronic low back pain (n=30), and age- and sex-matched asymptomatic control subjects (n=30; N=90). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patients and asymptomatic control subjects completed a test procedure for the JPS of the cervical spine, lumbar spine, and ankle in a randomized order. Between group differences were analyzed with the univariate analysis of variance and associations of the JPS with clinical features using the Pearson's correlation coefficient. RESULTS Both patients with chronic neck pain (P<.001) and patients with chronic low back pain (P<.01) differed significantly from asymptomatic controls in the JPS of the cervical spine, lumbar spine and ankle joint, regardless of the painful area. No difference was shown between patient groups (P>.05). An association of the JPS with clinical characteristics, however, could not be shown. CONCLUSION These results suggest widespread impairment of proprioceptive accuracy in patients with chronic and low back pain and a role for central sensorimotor processes in musculoskeletal pain conditions.
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Affiliation(s)
| | - Gabriela F Carvalho
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Universität zu Lübeck, Lübeck, Germany
| | - Waclaw M Adamczyk
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Beate Schüßler
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Universität zu Lübeck, Lübeck, Germany
| | | | - Kerstin Luedtke
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Universität zu Lübeck, Lübeck, Germany; Center of Brain, Behavior and Metabolism (CBBM), Universität zu Lübeck, Lübeck, Germany
| | - Tibor M Szikszay
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), Universität zu Lübeck, Lübeck, Germany; Center of Brain, Behavior and Metabolism (CBBM), Universität zu Lübeck, Lübeck, Germany.
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Paredes Sanchez J, Titmus M, Lawson-Smith H, Di Pietro F. Tactile acuity improves during acute experimental pain of the limb. Pain Rep 2023; 8:e1091. [PMID: 38225958 PMCID: PMC10789456 DOI: 10.1097/pr9.0000000000001091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/18/2023] [Accepted: 05/26/2023] [Indexed: 01/17/2024] Open
Abstract
Introduction Chronic pain is associated with poor tactile acuity, commonly measured with the 2-point discrimination (TPD) test. Although poor tactile acuity across chronic pain conditions is well established, less is known in acute pain. Objective Recent conflicting findings in experimentally induced neck and back pain led us to conduct a TPD investigation in experimentally induced limb pain. We hypothesised altered TPD during experimental upper limb pain, but we did not speculate on the direction of the change. Methods Thirty healthy subjects immersed their dominant hand in a circulating cold-water bath at 7°C (cold pressor test [CPT]). Two-point discrimination was measured at baseline (pre-CPT), during pain (during-CPT), and after withdrawal from the water (post-CPT) in 3 different sites: (1) the dominant forearm, (2) dominant arm and (3) contralateral forearm. Results Repeated-measures analysis of variance revealed a significant main effect of time (F(2,56) = 4.45, P = 0.02, η p 2 = 0.14) on TPD; in all 3 sites, TPD values decreased (ie, tactile acuity improved) during pain. Interestingly, the contralateral forearm followed a similar pattern to the dominant (ie, painful) forearm, and furthermore was the only site that exhibited any correlation with pain, albeit in an intriguing direction (r = 0.57, P = 0.001), ie, the greater the pain the worse the tactile acuity. Conclusion The improvements in tactile acuity during experimentally induced limb pain may reflect a protective response. The changes in the corresponding site in the contralateral limb may reflect a protective spinal cross talk. Such a response, together with the interesting relationship between tactile acuity and pain, warrant further inquiry.
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Affiliation(s)
| | - Morgan Titmus
- Curtin Medical School, Curtin University, Western Australia, Australia
| | | | - Flavia Di Pietro
- Curtin Medical School, Curtin University, Western Australia, Australia
- Curtin Health and Innovation Research Institute (CHIRI), Curtin University, Western Australia, Australia
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Menevşe Ö, Kepenek-Varol B, Gültekin M, Bilgin S. Cervical proprioception in Parkinson's disease and its correlation with manual dexterity function. J Mov Disord 2023; 16:295-306. [PMID: 37394236 PMCID: PMC10548074 DOI: 10.14802/jmd.23039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/26/2023] [Accepted: 06/30/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVE Cervical proprioception plays a crucial role in posture and movement control. This study aimed to determine the relationships of cervical proprioception, cervical muscle strength and endurance with manual dexterity and hand strength in individuals with idiopathic Parkinson's disease (PD). METHODS Twenty individuals with PD (mean age: 63.9 years) and 20 healthy individuals as a control group (mean age: 61.9 years) were recruited. Cervical joint position error (JPE), static endurance of neck muscles, activation of deep cervical flexor muscles (Craniocervical Flexion Test, CCFT), manual dexterity (Purdue Pegboard Test, PPT), cognitive and motor tasks of the PPT, finger tapping test (FTT), pinch strength, and grip strength were assessed. RESULTS Cervical JPE was significantly higher in individuals with PD than in controls (p < 0.05). The strength and endurance of the cervical muscles were significantly decreased in individuals with PD (p < 0.05). Cervical JPE measurements were negatively correlated with PPT, cognitive and motor tasks of the PPT in individuals with PD (all p < 0.05). The endurance of cervical flexor muscles was negatively correlated with PPT and cognitive PPT scores in the PD group (p < 0.05). In addition, a significant positive correlation was found between cervical flexor endurance and hand strength in the PD group (p < 0.05). CONCLUSION Cervical proprioception and the strength and endurance of cervical muscles decrease in individuals with PD compared to healthy individuals. Impairment of cervical proprioception appears to be associated with poorer upper extremity performance. Detailed evaluation of the cervical region in PD may help determine the factors affecting upper extremity function.
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Affiliation(s)
- Özlem Menevşe
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Büşra Kepenek-Varol
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Murat Gültekin
- Department of Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
- Department of Neurology, Faculty of Medicine, İstanbul Atlas University, İstanbul, Turkey
| | - Sevil Bilgin
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Bocos-Corredor E, Pérez-Fernández T, Perez-Dominguez R, Liébana S, Armijo-Olivo S, Raya R, Martin-Pintado-Zugasti A. Potential Use of Wearable Inertial Sensors to Assess and Train Deep Cervical Flexors: A Feasibility Study with Real Time Synchronization of Kinematic and Pressure Data during the Craniocervical Flexion Test. SENSORS (BASEL, SWITZERLAND) 2023; 23:3911. [PMID: 37112252 PMCID: PMC10141233 DOI: 10.3390/s23083911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 06/19/2023]
Abstract
The aim of the study was to develop a novel real-time, computer-based synchronization system to continuously record pressure and craniocervical flexion ROM (range of motion) during the CCFT (craniocervical flexion test) in order to assess its feasibility for measuring and discriminating the values of ROM between different pressure levels. This was a descriptive, observational, cross-sectional, feasibility study. Participants performed a full-range craniocervical flexion and the CCFT. During the CCFT, a pressure sensor and a wireless inertial sensor simultaneously registered data of pressure and ROM. A web application was developed using HTML and NodeJS technologies. Forty-five participants successfully finished the study protocol (20 males, 25 females; 32 (11.48) years). ANOVAs showed large effect significant interactions between pressure levels and the percentage of full craniocervical flexion ROM when considering the 6 pressure reference levels of the CCFT (p < 0.001; η2 = 0.697), 11 pressure levels separated by 1 mmHg (p < 0.001; η2 = 0.683), and 21 pressure levels separated by 0.5 mmHg (p < 0.001; η2 = 0.671). The novel time synchronizing system seems a feasible option to provide real-time monitoring of both pressure and ROM, which could serve as reference targets to further investigate the potential use of inertial sensor technology to assess or train deep cervical flexors.
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Affiliation(s)
- Elena Bocos-Corredor
- Departamento de Fisioterapia, Facultad de Medicina, CEU San Pablo University, 28668 Madrid, Spain
| | - Tomás Pérez-Fernández
- Departamento de Fisioterapia, Facultad de Medicina, CEU San Pablo University, 28668 Madrid, Spain
| | - Raquel Perez-Dominguez
- Departamento de Tecnologías de la Información, Escuela Politécnica Superior, CEU San Pablo University, 28668 Madrid, Spain
| | - Sonia Liébana
- Departamento de Fisioterapia, Facultad de Medicina, CEU San Pablo University, 28668 Madrid, Spain
| | - Susan Armijo-Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences, 53604 Osnabrück, Germany
| | - Rafael Raya
- Departamento de Tecnologías de la Información, Escuela Politécnica Superior, CEU San Pablo University, 28668 Madrid, Spain
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Reliability and Validity of A Novel Device for Evaluating the Cervical Proprioception. Pain Ther 2023; 12:671-682. [PMID: 36867364 PMCID: PMC10199988 DOI: 10.1007/s40122-023-00487-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/06/2023] [Indexed: 03/04/2023] Open
Abstract
INTRODUCTION In clinical practice, cervical proprioception is usually evaluated by calculating the cervical joint position error (JPE) with laser pointer devices (LPD) or cervical range-of-motion (CROM) instruments. As technology continues to improve, more and more advanced tools are used to evaluate cervical proprioception. The purpose of this study was to analyze the reliability and validity of the WitMotion sensor (WS) device in evaluating cervical proprioception, and to explore a cheaper, more convenient, and more practical testing tool. METHODS Twenty-eight healthy participants (16 women, 12 men; age 25-66 years) were recruited and evaluated for cervical joint position error with a WS and LPD by two independent observers. All participants repositioned their head to the target position and the deviation of repositioning was calculated using these two instruments. The intra- and inter-rater reliability of the instrument were determined by calculating the intraclass correlation coefficients (ICC), and the validity was analyzed by calculating the ICC and the Spearman's correlation. RESULTS The intra-rater reliability of the WS (ICCs = 0.682-0.774) was higher than that of the LPD (ICCs = 0.512-0.719) for measuring JPE of cervical flexion, right lateral flexion, and left rotation. However, the LPD (ICCs = 0.767-0.796) outperformed the WS (ICCs = 0.507-0.661) in cervical extension, left lateral flexion, and right rotation. For the inter-rater reliability, the ICC values obtained by the WS and the LPD were above 0.70 for all cervical movements except cervical extension and left lateral flexion (ICCs = 0.580-0.679). For the validity, the ICC values were moderate to good (ICCs > 0.614) for measuring JPE in all movements with the WS and the LPD. CONCLUSIONS Based on the high ICC values of reliability and validity, the novel device can be an alternative tool to evaluate cervical proprioception in clinical practice. TRIAL REGISTRATION This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100047228).
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Consorti G, Castagna C, Tramontano M, Longobardi M, Castagna P, Di Lernia D, Lunghi C. Reconceptualizing Somatic Dysfunction in the Light of a Neuroaesthetic Enactive Paradigm. Healthcare (Basel) 2023; 11:healthcare11040479. [PMID: 36833014 PMCID: PMC9957393 DOI: 10.3390/healthcare11040479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/27/2022] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Background: Palpatory findings are considered a central element of osteopathic practice, especially when associated with a patient's altered regulative functions than with named somatic dysfunctions. Although osteopathic theories for somatic dysfunction could be plausible, the clinical applicability of the concept is debated, especially because it is largely related to simple cause-effect models of osteopathic care. In contrast to a linear kind of diagnosis of a "tissue as a producer of symptoms", this perspective article aims to provide a conceptual and operational framework in which the somatic dysfunction evaluation process is seen as a neuroaesthetic (en)active encounter between osteopath and patient. Subsections relevant to the subject: To summarize all concepts of the hypothesis, the enactive neuroaesthetics principles are proposed as a critical foundation for the osteopathic assessment and treatment of the person, specifically addressing a new paradigm for somatic dysfunction. Conclusions, and future directions: The present perspective article represents a proposition to blend technical rationality informed by neurocognitive and social sciences, and professional artistry clinical experience informed by traditional tenets, to overcome the controversy around somatic dysfunction, rather than dismissing the concept.
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Affiliation(s)
- Giacomo Consorti
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
- Correspondence:
| | - Carmine Castagna
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Marco Tramontano
- Fondazione Santa Lucia Istituto di Ricovero e Cura a Carattere Scientifico, 00179 Rome, Italy
- Centre Pour l’Etude, la Recherche et la Diffusion Osteopathiques, 00199 Rome, Italy
| | | | - Paolo Castagna
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Daniele Di Lernia
- Human Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy
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Is Neck Pain Related to Sagittal Head and Neck Posture?: A Systematic Review and Meta-analysis. Indian J Orthop 2023; 57:371-403. [PMID: 36825268 PMCID: PMC9941407 DOI: 10.1007/s43465-023-00820-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023]
Abstract
Background Neck pain (NP) is common in all age groups and adversely affects the patients' entire lifestyle. There exists inconclusive evidence relating faulty craniocervical posture with pain-related disability. This review aims to determine whether sagittal head and neck posture differs in NP and pain-free subjects, to critically appraise the correlation of posture with NP. Methods Of 3796 articles identified at primary search from CINAHL, PubMed, Google Scholar, EMBASE, 26 were included based on eligibility criteria. Mean pooled difference (MPD) and effect size (ES) were calculated to establish relationship among studies, to assess postural correlation with NP measures [Visual Analogue Scale (VAS), Numeric Pain Rating Scale (NPRS), neck disability index (NDI), Northwick Park NP Questionnaire (NPQ)] and for age- and gender-wise variation. Risk of bias was assessed using Newcastle-Ottawa Quality Assessment Scale. Results Craniovertebral angle (CVA) had a significant MPD of - 2.93(95% CI - 4.95 to - 0.91). Sagittal head angle (SHA) and forward head posture (FHP) had an insignificant MPD of 1.15 (95% CI - 1.16 to 3.46) and - 0.26 (95% CI - 1.89 to 1.36), respectively. Age- and gender-wise CVA difference was found to be 2.36° and 2.57°, respectively. ES was significant for correlation between CVA and pain intensity [NPRS: - 0.44 (95% CI - 0.61 to - 0.26); VAS: - 0.31 (95% CI - 0.46 to - 0.16)], and between CVA and disability [NDI: - 0.18 (95% CI - 0.31 to - 0.05); NPQ: - 0.47 (95% CI - 0.61 to - 0.320)]. Conclusion CVA differs for age, gender, and pain vs pain-free subjects, and correlates negatively with NP measures. Other surrogate measures (SHA, cranial and cervical angles, FHP) warrant further research. PROSPERO Registration PROSPERO 2021 CRD42021275485.
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Kinematic analysis of sensorimotor control during the craniocervical flexion movement in patients with neck pain and asymptomatic individuals: a cross-sectional study. J Neuroeng Rehabil 2023; 20:8. [PMID: 36650553 PMCID: PMC9843978 DOI: 10.1186/s12984-023-01133-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/07/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Patients with craniocervical pain have shown reduced performance in the craniocervical flexion test (CCFT). However, there is limited evidence of other possible kinematic alterations not assessed in the context of the CCFT. Previous studies on other functional or planar movements have reported alterations in sensorimotor control (e.g., range of motion [ROM], velocity, or smoothness) in subjects with neck pain. The objective of this study was to explore the association between sensorimotor control variables associated with craniocervical flexion movement and different characteristics related to pain, age, disability, and fear of movement in individuals with non-traumatic chronic neck pain and asymptomatic controls. METHODS This was an observational, cross-sectional study in patients with non-traumatic neck pain and asymptomatic participants. Regression models were used to assess whether descriptive characteristics of the sample, including: (a) age, (b) intensity of pain, (c) neck disability, (d) chronicity of pain, and (e) fear of movement could explain sensorimotor control variables such as ROM, velocity, jerk, head repositioning accuracy, and conjunct motion. All these variables were recorded by means of light inertial measurement unit sensors during the performance of three maximal repetitions of full range craniocervical flexion in the supine position. RESULTS A total of 211 individuals were screened and 192 participants finished the protocol and were included in the analyses. Participants had an average age of 34.55 ± 13.93 years and included 124 patients with non-traumatic neck pain and 68 asymptomatic subjects. Kinesiophobia partially explained lower craniocervical flexion ROM (p = .01) and lower peak velocity in flexion (P < .001). Age partially explained increased craniocervical extension ROM (P < .001) and lower peak velocity in flexion (P = .03). Chronicity partially explained increased lateral flexion conjunct motion (P = .008). All models showed low values of explained variance (< 32%) and low absolute values of regression coefficients. CONCLUSIONS This study did not find a clear relationship between population characteristics and sensorimotor control variables associated with the craniocervical flexion movement. Kinesiophobia might have some association with reduced ROM in craniocervical flexion, but further research in this field is needed in large samples of patients with higher levels of kinesiophobia pain or disability.
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Argus M, Pääsuke M. Musculoskeletal disorders and functional characteristics of the neck and shoulder: Comparison between office workers using a laptop or desktop computer. Work 2023; 75:1289-1299. [PMID: 36683484 DOI: 10.3233/wor-220080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Using a laptop for work is gaining rapid popularity, but there is little evidence of how it influences musculoskeletal disorders (MSDs) and functional characteristics of the neck and shoulder area. OBJECTIVE This study aimed to compare the prevalence of upper body MSDs and functional characteristics of the neck between office workers using a laptop or desktop computer. METHODS A total of 110 office workers with a mean age of 41±10 years participated. 45 office workers (73% female) used a laptop and 65 office workers (86% female) used desktop computers. The prevalence of MSDs was recorded using the Nordic Musculoskeletal Questionnaire. Active range of motion (AROM), maximal voluntary isometric contraction (MVC) force, joint position error (JPE), and pain-pressure threshold (PPT) of the neck and shoulder area were measured. RESULTS Laptop users experienced significantly more MSDs in the right shoulder area on the day of participation (p < 0.001, OR = 4.47), during the previous 7 days (p < 0.01, OR = 3.74), and at 6 months (p < 0.01, OR = 3.57). Laptop users also experienced significantly more MSDs in the left shoulder during the previous 7 days (p < 0.05, OR = 2.44). There were no statistically significant differences in any of the functional characteristics of the neck and shoulder area between the groups. CONCLUSION Using the laptop computer for office work may pose a higher risk of developing MSDs in the right shoulder area, but might not have long-term effects on the functional characteristics of the neck and shoulder area.
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Affiliation(s)
- Martin Argus
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
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Sensory Interaction Balance and Limits of Stability in Neck Pain: Comparison of Traumatic and Non-traumatic Patients. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1172228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background and Purpose: A variety of sensory-motor changes are reported in both the traumatic and non-traumatic neck pain. However, it is still unclear whether there is a significant difference between individuals with traumatic neck pain and those with non-traumatic in terms of postural control. The aim of this cross-sectional study was to investigate whether there was a difference between individuals with traumatic pain and non-traumatic neck pain in terms of postural control and disability.
Methods: Ninety-two patients with chronic neck pain were grouped according to the onset of pain. Clinical test of sensory interaction balance (CTSIB) and limits of stability (LOS) test were used for postural control assessment. The Numeric Rating Scale and Neck Pain Disability Index (NPDI) were used to measure pain intensity and disability, respectively. Mann-Whitney U test was used to compare groups.
Results: There were no significant differences between groups in terms of LOS, CTSIB and NPDI scores (p > 0.05).
Conclusion: The results of this study suggest that postural control and disability do not differ between patients with traumatic and non-traumatic neck pain. Therefore, from a clinical perspective, postural control and disability should be evaluated without considering trauma history in patients with neck pain.
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Romero-Franco N, Oliva-Pascual-Vaca Á, Fernández-Domínguez JC. Concurrent validity and reliability of a smartphone-based application for the head repositioning and cervical range of motion. BIOMED ENG-BIOMED TE 2022; 68:125-132. [PMID: 36473075 DOI: 10.1515/bmt-2021-0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
Abstract
Objectives
To evaluate the validity and reliability of a smartphone-based application against inertial sensors to measure head repositioning (by using joint position sense –JPS) and cervical range of motion (ROM).
Methods
JPS and cervical ROM were evaluated for neck flexion, extension and both-sides lateral flexion in thirty-one volunteers. Participants were simultaneously evaluated with inertial sensors and the smartphone application. A total of 248 angles were compared for concurrent validity. Inter-tester and intra-tester reliability were evaluated through scoring of images with the smartphone application by two testers, and re-scoring images by the same tester.
Results
Very high correlation was observed between both methods for ROM in all neck movements and JPS in left-side lateral flexion (r>0.9), and high for JPS in the rest of movements (r>0.8). Bland-Altman plots always demonstrated absolute agreement. Inter-and intra-tester reliability was perfect for JPS and ROM in all the neck movements (ICC>0.81).
Conclusions
This smartphone-based application is valid and reliable for evaluating head repositioning and cervical ROM compared with inertial sensors in healthy and young adults. Health professionals could use it in an easier and portable way in field conditions.
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Affiliation(s)
- Natalia Romero-Franco
- Nursing and Physiotherapy Department , University of the Balearic Islands, Palma de Mallorca , Spain
- Health Research Institute of the Balearic Islands (IdISBa) , Palma de Mallorca , Spain
| | | | - Juan Carlos Fernández-Domínguez
- Nursing and Physiotherapy Department , University of the Balearic Islands, Palma de Mallorca , Spain
- Health Research Institute of the Balearic Islands (IdISBa) , Palma de Mallorca , Spain
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Reference values, minimum repetitions for stable measures, and test-retest reliability in the torsion and conventional cervical joint position sense tests in asymptomatic individuals. Musculoskelet Sci Pract 2022; 62:102681. [PMID: 36334580 DOI: 10.1016/j.msksp.2022.102681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/17/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine reference values, including the appropriate number of repetitions, and test-retest reliability of the torsion and conventional cervical joint position sense (JPS) tests. METHODS Phase 1) Cross-sectional design to determine reference values and the appropriate number of repetitions; Phase 2) repeated-measures concordance design (test-retest reliability). Sixty-eight healthy participants performed 10 repetitions of randomized rotation left and right for both cervical JPS tests using a laser projected onto a target. Thirty participants returned for the same evaluation process one week later. RESULTS The age-stratified reference values for the torsion JPS test showed greater absolute error as age increased. Stable levels of performance were obtained with 6-7 repetitions for both tests. Moderate to good reliability was found with 7 or more repetitions for left rotation [Torsion JPS test, Intraclass Correlation Coefficient (ICC; 95% CI) = 0.85 (0.68-0.93); Conventional JPS test, ICC = 0.78 (0.53-0.89)], and 6-7 or more repetitions for right rotation [Torsion JPS test, 6 repetitions, ICC = 0.79 (0.56-0.90); Conventional JPS test, 7 repetitions, ICC = 0.82 (0.61-0.91)]. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) stabilized at 7 repetitions in both tests [Torsion JPS test (SEM ≤ 1.0°; MDC90 ≤ 2.4°; MDC95 ≤ 2.9°); Conventional JPS test (SEM ≤ 1.2°; MDC90 ≤ 2.8°; MDC95 ≤ 3.3°)]. CONCLUSIONS The reference values generated for the torsion JPS test may help identify the presence of impairments cervical proprioception. At least 7 repetitions optimize stability, reliability and responsiveness in the torsion and conventional cervical JPS tests.
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Reddy RS, Tedla JS, Dixit S, Raizah A, Al-Otaibi ML, Gular K, Ahmad I, Sirajudeen MS. Cervical Joint Position Sense and Its Correlations with Postural Stability in Subjects with Fibromyalgia Syndrome. Life (Basel) 2022; 12:life12111817. [PMID: 36362972 PMCID: PMC9697665 DOI: 10.3390/life12111817] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/05/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
Cervical joint position sense (JPS) and postural stability are vital to maintaining balance and preventing falls in fibromyalgia syndrome (FMS). Impaired cervical JPS may influence postural stability, and understanding the relationship between them can aid in formulating treatment strategies in individuals with FMS. This study aims to (1) assess cervical JPS and postural stability between FMS and control group and (2) determine the correlation between cervical JPS and postural stability in the FMS group. This cross-sectional study recruited 92 FMS patients (mean age: 51.52 ± 7.7 yrs.) and 92 healthy controls (mean age: 49.36 ± 6.9 yrs.). A cervical range of motion (CROM) unit was utilized to assess cervical JPS. The postural stability was assessed using an IsoFree force platform, and anterior-posterior (A/P) and medial-lateral (M/L) directions of sway and ellipse area were measured. Cervical JPS and postural stability tests were assessed and compared between FMS and control groups. Cervical JPS was significantly impaired in FMS compared to the control group (p < 0.001). The JPS errors in FMS group were larger in flexion (FMS = 5.5°, control = 2.4°), extension (FMS = 6.4°, control = 3.0°), and rotation in left (FMS = 5.4°, control = 2.2°) and right directions (FMS = 5.1°, control = 2.8°). FMS individuals demonstrated statistically significant impaired postural stability compared to control in both the dominant and non-dominant legs tested (p < 0.001). The cervical JPS test showed moderate to strong positive correlations with postural stability variables. Statistically significant correlations were observed in all the JPS directions tested with all the postural stability variables (A/P and M/L sway and ellipse area). The correlation coefficients ranged between r = 0.37 (moderate) to 0.75 (strong). Cervical JPS and postural stability are impaired in FMS individuals. A moderate to strong relationship existed between JPS and postural stability. Individuals with FMS who had a greater magnitude of cervical JPS errors exhibited more severe postural control deficits. Therefore, cervical JPS and postural stability tests should be incorporated into routine clinical practice when assessing or formulating treatment strategies for patients with FMS.
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Affiliation(s)
- Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
- Correspondence: ; Tel.: +966-503587903
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Abdullah Raizah
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohammed Lafi Al-Otaibi
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Kumar Gular
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohamed Sherif Sirajudeen
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
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Proprioceptive Cervicogenic Dizziness: A Narrative Review of Pathogenesis, Diagnosis, and Treatment. J Clin Med 2022; 11:jcm11216293. [DOI: 10.3390/jcm11216293] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 01/17/2023] Open
Abstract
Basic science and clinical evidence suggest that cervical spine disorders can lead to dizziness. The cervical spine has highly developed proprioceptive receptors, whose input information is integrated with the visual and vestibular systems in the central nervous system, acting on the neck and eye muscles to maintain the coordinative motion of the head, eyes, neck, and body through various reflex activities. When the cervical proprioceptive input changes due to the mismatch or conflict between vestibular, visual, and proprioceptive inputs, cervicogenic dizziness may occur. The diagnosis of cervicogenic dizziness can be determined based on clinical features, diagnostic tests, and the exclusion of other possible sources of dizziness. The cervical torsion test appears to be the best diagnostic method for cervicogenic dizziness. Based on the available evidence, we first developed the diagnostic criteria for cervicogenic dizziness. Treatment for cervicogenic dizziness is similar to that for neck pain, and manual therapy is most widely recommended.
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Davenport M, Condon B, Lamoureux C, Phipps Johnson JL, Chen J, Rippee MA, Zentz J. The University of Kansas Health System Outpatient Clinical Concussion Comprehensive Protocol: An Interdisciplinary Approach. Health Serv Insights 2022; 15:11786329221114759. [PMID: 36034733 PMCID: PMC9411741 DOI: 10.1177/11786329221114759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: The concussion team at The University of Kansas Health System outpatient rehabilitation spine center is comprised of experienced multi-disciplinary experts including physical therapists and a speech language pathologist. The team set forth with a purpose of creating and organizing an internal physical therapy clinical recommendation protocol for initial evaluations and subsequent treatments for the concussed patient. The aim of this paper is to share these recommendation protocols with other therapy teams and provide a foundational layout for treating the patient with post-concussion symptoms in an outpatient physical therapy clinical setting. Study design: Clinical recommendation protocol provides guidance for patients ages 10+ from initial evaluation through discharge with emphasis on evidence-based research in the areas of: oculomotor, cervical, vestibular, post-concussion migraine influence, mood disorders(such as anxiety and depression), exertion, and cognitive communicative dysfunction. Results: Finding a written, comprehensive clinical resource protocol for post-concussion outpatient evaluation(s) and treatment strategies can be difficult. This document serves as a resource for other outpatient concussion rehabilitation clinics, providing rationale, and objective measurement tools, for assessing and treating concussion patients. To the authors’ knowledge, no other research has produced a practical, efficient evaluation tool to be utilized at bed side, condensing evidence-based research into an easy-to-use form. Conclusion: The University of Kansas Health System outpatient concussion rehabilitation center developed clinical recommendation protocols for concussion care. The intent was to standardize assessment and treatment for concussion patients and to share these objective measurement tools and procedures, focused on a team approach of concussion providers, as a clinical outline for both the novice and seasoned clinician specializing in the field of concussion work in an outpatient rehabilitation setting.
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Affiliation(s)
- Maria Davenport
- Department of Rehabilitation Services, The University of Kansas Health System, Kansas City, KS, USA
| | - Bill Condon
- Department of Rehabilitation Services, The University of Kansas Health System, Kansas City, KS, USA
| | - Claude Lamoureux
- Department of Rehabilitation Services, The University of Kansas Health System, Kansas City, KS, USA
| | - Jamie L Phipps Johnson
- Department of Rehabilitation Services, The University of Kansas Health System, Kansas City, KS, USA
| | - Jamie Chen
- Center for Concussion Management, The University of Kansas Health System, Kansas City, KS, USA
| | - Michael A Rippee
- Department of Neurology, The University of Kansas Health System, Kansas City, KS, USA
| | - Jennifer Zentz
- Director of Ambulatory Operations, UT Southwestern Medical Center, Dallas, TX, USA
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De Vestel C, Vereeck L, Van Rompaey V, Reid SA, De Hertogh W. Clinical characteristics and diagnostic aspects of cervicogenic dizziness in patients with chronic dizziness: A cross-sectional study. Musculoskelet Sci Pract 2022; 60:102559. [PMID: 35364427 DOI: 10.1016/j.msksp.2022.102559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/20/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Chronic dizziness can significantly affect quality of life, but identifying the underlying cause remains challenging. This study focuses on proprioceptive cervicogenic dizziness (CGD) and aims: (1) to compare clinical test results between patients with CGD, dizzy patients without CGD, and healthy controls; and (2) to evaluate the diagnostic value of the clinical tests for CGD in patients with chronic dizziness. METHODS Sixty patients with chronic dizziness (18 with CGD and 42 without CGD), and 43 healthy controls underwent clinical tests evaluating neck function (mobility, proprioception, muscle function and disability), balance control, and the presence of visually induced dizziness. Data were analysed through one-way ANOVA, chi-square, independent samples t-test, and logistic regression analyses. RESULTS Patients with CGD had significantly more neck pain-related disability (Neck Bournemouth questionnaire (NBQ), p = 0.006), but better static (Static Balance, p = 0.001) and dynamic balance (Tandem Gait, p = 0.049), compared to dizzy patients without CGD. Univariable analyses revealed that increased NBQ (OR 1.05 [1.01; 1.09], p = 0.017), Joint Position Error (JPE) after extension (OR 1.52 [1.00; 2.32], p = 0.050), and Tandem Gait scores (OR 1.09 [1.01; 1.18], p = 0.046) were individually associated with higher odds of having CGD. Their optimal cut-off level (based on the maximum Youden index) had high sensitivity but low specificity for CGD. The multivariable model, including NBQ and Tandem Gait, had fair discriminative ability (AUC = 0.74, 95% CI [0.61; 0.87]). CONCLUSION The combined use of the NBQ and Tandem Gait tests had the highest discriminative ability to detect CGD in patients with chronic dizziness.
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Affiliation(s)
- Charlotte De Vestel
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, 2610, Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp (M(2)OCEAN), Antwerp University Hospital, Edegem, 2650, Antwerp, Belgium.
| | - Luc Vereeck
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, 2610, Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp (M(2)OCEAN), Antwerp University Hospital, Edegem, 2650, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, 2650, Antwerp, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, 2610, Antwerp, Belgium
| | - Susan A Reid
- Discipline of Physiotherapy, Faculty of Health Sciences, School of Allied Health, Australian Catholic University, New South Wales, 2060, North Sydney, Australia
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, 2610, Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp (M(2)OCEAN), Antwerp University Hospital, Edegem, 2650, Antwerp, Belgium
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Effects of clinical pilates exercises in patients with chronic nonspecific neck pain: a randomized clinical trial. Ir J Med Sci 2022:10.1007/s11845-022-03101-y. [PMID: 35857170 DOI: 10.1007/s11845-022-03101-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Neck pain is a common musculoskeletal problem in adults. Clinical pilates exercises can be beneficial managing the pain and improving the risk factors. AIMS The aim of this study was to investigate the effects of clinical pilates exercises on pain and disability, deep neck flexor endurance (DNFE), posture, cervical range of motion (CROM), and proprioception in patients with chronic nonspecific neck pain. METHODS Fifty patients with chronic nonspecific neck pain were randomized into two groups. The clinical pilates exercise group (CPEG) received clinical pilates exercises for 6 weeks. The control group (CG) received posture education. Pain and disability, DNFE, forward head angle (FHA) and forward shoulder angle (FSA) degrees, CROM, and joint position error (JPE) were measured before and after 6 weeks. RESULTS Clinical pilates exercises improved pain, Neck Disability Index (NDI), DNFE, posture, CROM (except extension), and JPE (p < 0.05). We found significant differences between CPEG and CG in the comparisons for the change of pain, NDI, DNFE, FSA, CROM (except extension), and JPE (except left rotation) (p < 0.05). NDI, FSA, and rotational JPE also improved in CG (p < 0.05). However, these improvements were significantly better in CPEG than CG (p < 0.05) except JPE in left rotation (p = 0.118). CONCLUSION In patients with chronic nonspecific neck pain, clinical pilates exercise is a safe and effective method to improve pain and disability, DNFE, posture, ROM, and proprioception. CLINICAL TRIAL REGISTRATION NCT03782584 retrospectively registered December 20 2018.
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Qu N, Tian H, De Martino E, Zhang B. Neck Pain: Do We Know Enough About the Sensorimotor Control System? Front Comput Neurosci 2022; 16:946514. [PMID: 35910451 PMCID: PMC9337601 DOI: 10.3389/fncom.2022.946514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Neck pain is a worldwide health problem. Clarifying the etiology and providing effective interventions are challenging for the multifactorial nature of neck pain. As an essential component of cervical spine function, the sensorimotor control system has been extensively studied in both healthy and pathological conditions. Proprioceptive signals generated from cervical structures are crucial to normal cervical functions, and abnormal proprioception caused by neck pain leads to alterations in neural plasticity, cervical muscle recruitment and cervical kinematics. The long-term sensorimotor disturbance and maladaptive neural plasticity are supposed to contribute to the recurrence and chronicity of neck pain. Therefore, multiple clinical evaluations and treatments aiming at restoring the sensorimotor control system and neural plasticity have been proposed. This paper provides a short review on neck pain from perspectives of proprioception, sensorimotor control system, neural plasticity and potential interventions. Future research may need to clarify the molecular mechanism underlying proprioception and pain. The existing assessment methods of cervical proprioceptive impairment and corresponding treatments may need to be systematically reevaluated and standardized. Additionally, new precise motor parameters reflecting sensorimotor deficit and more effective interventions targeting the sensorimotor control system or neural plasticity are encouraged to be proposed.
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Affiliation(s)
- Ning Qu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - HaoChun Tian
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Enrico De Martino
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Aerospace Medicine and Rehabilitation Laboratory, Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bin Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Bin Zhang,
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Röijezon U, Jull G, Blandford C, Daniels A, Michaelson P, Karvelis P, Treleaven J. Proprioceptive Disturbance in Chronic Neck Pain: Discriminate Validity and Reliability of Performance of the Clinical Cervical Movement Sense Test. FRONTIERS IN PAIN RESEARCH 2022; 3:908414. [PMID: 35875476 PMCID: PMC9299354 DOI: 10.3389/fpain.2022.908414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022] Open
Abstract
Chronic neck pain is associated with sensorimotor dysfunctions, which may develop symptoms, affect daily activities, and prevent recovery. Feasible, reliable, and valid objective methods for the assessment of sensorimotor functions are important to identify movement impairments and guide interventions. The aim of this study was to investigate the discriminative validity of a clinical cervical movement sense test, using a laser pointer and an automatic video-based scoring system. Individuals with chronic neck pain of idiopathic onset (INP), traumatic onset (TNP), and healthy controls (CON) were tested. Associations between movement sense and neck disability were examined and the repeatability of the test was investigated. A total of 106 participants (26 INP, 28 TNP, and 52 CON) were included in a cross-sectional study. Acuity, Speed, Time, and NormAcuity (i.e., normalized acuity by dividing acuity with movement time) were used as outcome measures. ANOVAs were used for group comparisons and Pearson correlations for associations between movement sense variables and neck disability index (NDI). Notably, 60 of the participants (30 CON, 17 INP, and 13 TNP) performed the test on a second occasion to explore test-retest reliability. Results revealed a reduced NormAcuity for both INP and TNP compared with CON (p < 0.05). The neck pain groups had similar Acuity but longer Time compared with CON. Among TNP, there was a fair positive correlation between Acuity and NDI, while there was a negative correlation between Acuity and NDI among INP. Reliability measures showed good to excellent ICC values between tests, but standard error of measurements (SEM) and minimal detectable change (MDC) scores were high. The results showed that NormAcuity is a valuable measure to identify disturbed cervical movement sense among INP and TNP. While Acuity was similar between the groups, different strategies, such as longer Time, to perform the task among neck patient groups were used. Few differences were identified between the neck pain groups, but altered strategies may exist. Reliability was acceptable, and the test is feasible to perform in the clinic. However, the technical complexity of the automated image analysis is a concern. Future developments will provide more feasible solutions.
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Affiliation(s)
- Ulrik Röijezon
- Division of Health, Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
- *Correspondence: Ulrik Röijezon
| | - Gwendolen Jull
- Division of Health, Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Christian Blandford
- Division of Health, Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Anna Daniels
- Division of Health, Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Peter Michaelson
- Division of Health, Medicine and Rehabilitation, Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Petros Karvelis
- Department of Informatics and Telecommunications, University of Ioannina, Arta, Greece
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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Miranda IF, Neto ESW, Dhein W, Brodt GA, Loss JF. Neck Strength in Coronal and Sagittal Head Movement in Military Pilots and Aircrew With Chronic Neck Pain: A Systematic Review With Meta-Analysis. J Manipulative Physiol Ther 2022; 45:448-458. [PMID: 36336484 DOI: 10.1016/j.jmpt.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 07/21/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This systematic review aimed to assess whether there is a difference in neck strength between military pilots and aircrew with and without chronic neck pain. METHODS The PubMed, Embase, and Scopus databases were searched. Two independent reviewers selected relevant full articles comparing neck strength between military pilots and aircrew with and without chronic neck pain. Two independent reviewers extracted the data from the full articles selected. A meta-analysis was used to assess standardized mean differences in neck strength based on a random-effects model. RESULTS The search returned 3554 results; 5 articles were included in the study. Military pilots and aircrew with chronic neck pain showed no difference in neck strength from military pilots and aircrew without chronic neck pain for flexion and extension, but did show a neck strength reduction for right and left lateral flexion -0.29 (95% confidence interval, -0.52 to -0.06; I² = 3%) and -0.23 (95% confidence interval, -0.45 to 0.00; I² = 0%), respectively. CONCLUSION Based on this meta-analysis with a 3a level of evidence, military pilots and aircrew with chronic neck pain have reduced neck strength for coronal head movement, but not sagittal movement compared with military pilots and aircrew without chronic neck pain.
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Affiliation(s)
- Iã Ferreira Miranda
- Department of Physical Education, Physiotherapy, and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Edgar Santiago Wagner Neto
- Department of Physical Education, Physiotherapy, and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - William Dhein
- Faculty of Serra Gaúcha, Caxias do Sul, Rio Grande do Sul, Brazil
| | - Guilherme A Brodt
- University of Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil
| | - Jefferson F Loss
- Department of Physical Education, Physiotherapy, and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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MacDermid JC, Walton DM. Development and validation of the ND10 to measure neck-related functional disability. BMC Musculoskelet Disord 2022; 23:605. [PMID: 35739498 PMCID: PMC9219202 DOI: 10.1186/s12891-022-05556-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous neck-specific patient-reported outcome measures (PROMs) have tended to measure both symptoms and disability. This multi-staged study developed and evaluated a neck-specific PROM focusing on functional disability. Methods This study integrated findings from systematic reviews on neck-specific outcome measures, patient interviews, qualitative studies on neck disability, and iterative item testing to develop a 10-item measure of neck-related disability (ND10). Content validity was assessed by classifying items using the International Classification of Functioning, Disability and Health (ICF) and perspective linking. Patients (n = 78) with neck pain completed cognitive interviews, exploring items of the Neck Disability Index (NDI) and ND10, and completed structured questions related to literacy and relevance. Test–retest reliability and internal consistency were evaluated using intraclass correlation coefficients, Bland Altman graphs, and Cronbach’s alpha. Concurrent convergent validity was evaluated by comparing the ND10 to the NDI, Single Assessment Numeric Evaluation (SANE), and Disabilities of the Arm, Shoulder and Hand (DASH). Known group validity was determined by comparing ND10 scores from patients, who rated their neck as more or less than 1/2 of “normal” on the SANE, using t-tests. Results The ND10 requires respondents to make rational judgements about their neck-related body function and disability. It has high internal consistency (0.94) and re-test reliability (0.87; SEM = 3.2/100; MDC = 7.5); and no re-test bias (mean re-test difference of 0.6). It followed expected correlation patterns, being highly correlated with related multi-item PROMs (r = 0.85–0.91), and moderately correlated to the single-item SANE. More patients agreed that the ND10 was easily readable than did so for the NDI (84% vs 68%; p < 0.05). All the PROMs distinguished the patients who perceived themselves as being abnormal/normal defined by a dichotomized SANE (p < 0.01). Conclusion The ND10 is reliable and valid for measuring neck-related functional disability. Longitudinal and cross-cultural translation studies are needed to support future use. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05556-7.
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Affiliation(s)
- Joy C MacDermid
- Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. .,School of Physical Therapy, Western University, London, ON, Canada.
| | - David M Walton
- School of Physical Therapy, Western University, London, ON, Canada
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31
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English DJ, Zacharias A, Green RA, Weerakkody N. Reliability of Cervicocephalic Proprioception Assessment: A Systematic Review. J Manipulative Physiol Ther 2022; 45:346-357. [PMID: 36270904 DOI: 10.1016/j.jmpt.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to determine the reliability and, where possible, the validity of cervicocephalic proprioceptive (CCP) tests in healthy adults and clinical populations. METHODS A systematic search, utilizing 7 databases from the earliest possible date to April 14, 2021, identified studies that measured reliability of CCP tests. Studies were screened for eligibility, and included studies were appraised using Quality Appraisal Tool for Studies of Diagnostic Reliability (QAREL) and Quality Assessment and Diagnostic Accuracy Studies-2 Tool (QUADAS-2) tools. Validity outcomes were assessed for included studies. RESULTS Of 34 included studies, 29 investigated reliability for sense of position tests, 10 involved sense of movement tests, and 1 used a sense of force test. The head to neutral test was reliable and valid when 6 or more repetitions were performed within the test, discriminating between those with and without neck pain. Head tracking tests were reliable with 6 repetitions, and 1 study found discriminative validity in a whiplash population. Studies that found discriminative validity in sense of position reported mean joint position error generally >4.5° in the neck pain group and <4.5° in the asymptomatic group. No sense of force test was applied to a clinical population. Convergent validity analysis showed that these proprioceptive tests have low correlations with each other. CONCLUSION The reliability and validity of CCP tests for sense of position and movement are dependent upon equipment and repetitions. Six repetitions are generally required for good reliability, and joint position error >4.5° is likely to indicate impairment in sense of position.
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Affiliation(s)
- Daniel J English
- Department of Pharmacy and Biomedical Sciences, La Trobe University, Bendigo, Victoria, Australia.
| | - Anita Zacharias
- Department of Pharmacy and Biomedical Sciences, La Trobe University, Bendigo, Victoria, Australia
| | - Rodney A Green
- Department of Pharmacy and Biomedical Sciences, La Trobe University, Bendigo, Victoria, Australia
| | - Nivan Weerakkody
- Department of Pharmacy and Biomedical Sciences, La Trobe University, Bendigo, Victoria, Australia
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Cid MM, Calixtre LB, da Silva Grüninger BL, Sousa FS, Oliveira AB. Reliability of the Joint Position Sense Error Test for Women With Neck Pain and Asymptomatic Men and Women. J Manipulative Physiol Ther 2022; 45:329-336. [PMID: 36192261 DOI: 10.1016/j.jmpt.2022.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/25/2022] [Accepted: 08/24/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the intra-rater between-days reliability of the joint position sense error (JPSE) test in asymptomatic men and women, as well as in women with neck pain. METHODS Fourteen asymptomatic men and 27 women (14 asymptomatic and 13 with neck pain) participated. The JPSE test was performed during right and left cervical rotation (10 trials for each side) in 2 sessions, with at least 7 days between them. The head repositioning error during the JPSE test (in degrees) was measured and used to calculate the intra-rater between-days reliability of the test, evaluated through the intraclass correlation coefficient and Bland-Altman analyses. Independent t tests were calculated to compare the head repositioning errors of asymptomatic women and men. The minimal detectable change was also calculated. RESULTS The neck pain group showed higher intraclass correlation coefficient values (0.866 and 0.773, good reliability) compared to the asymptomatic men (0.478 and 0.403, poor reliability) and to the asymptomatic women (-0.161 and 0.504, poor and moderate reliability, respectively) for both right and left cervical rotation, respectively. Considering Bland-Altman analyses, the neck pain group showed better agreement between the measurements for right cervical rotation than the asymptomatic groups. CONCLUSION The results indicate that the methodology used to perform the JPSE test in this study may be a reliable way to assess the proprioception of women with neck pain in clinical settings.
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Affiliation(s)
- Marina Machado Cid
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Letícia Bojikian Calixtre
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Bruno Leonardo da Silva Grüninger
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Franciana Silva Sousa
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Beatriz Oliveira
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
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Igbokwe EO, Taube W, Beinert K. A Comparison of the Effects of Stochastic Resonance Therapy, Whole-Body Vibration and Balance Training on Pain Perception and Sensorimotor Function in Patients with Chronic Non-Specific Neck Pain: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34430. [PMID: 35656706 PMCID: PMC9270712 DOI: 10.2196/34430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Neck pain is a prevalent pathological condition, and together with low back pain, it presents as the leading cause of years lived with disability worldwide in 2015 and continues to contribute substantially to the global burden of disease. Objective This study will investigate and compare the effects of stochastic resonance therapy (SRT), whole-body vibration (WBV), and balance training (BLT) in the management of chronic nonspecific neck pain. Methods In total, 45 participants with chronic neck pain will be randomly allocated into SRT, WBV, and BLT groups. Pain intensity, pressure pain threshold, neck disability, and cervical joint position sense will be measured before, immediately after, and 15 minutes after the first intervention session and after 4 weeks of intervention. A follow-up postintervention measurement would be taken after 4 weeks. The SRT group will train on an SRT device (SRT Zeptor Medical plus noise, Zeptoring). The WBV group will train on a Galileo vibration device (Novotec Medical), while the BLT group will perform balance exercises. All participants shall train 3 times a week for a period of 4 weeks. Mixed ANOVA will be used to determine the main and effects of interactions within (before intervention, post intervention 1, post intervention 2, post intervention 3, and follow-up) and between (SRT, WBV, and BLT) factors on the study outcome variables. Results Recruitment of participants started in May 2021, and as of May 2022, a total of 20 patients have been enrolled in the study. All participants are expected to have completed the trial by the end of 2022, and data analysis will commence thereafter. Conclusions The outcome of this study will shed closer light on the effects of SRT, WBV, and BLT on pain and function in patients with chronic neck pain. Trial Registration German Clinical Trials Register DRKS00023881; https://tinyurl.com/ycxuhj37 International Registered Report Identifier (IRRID) DERR1-10.2196/34430
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Affiliation(s)
- Emmanuel Osinachi Igbokwe
- University of Fribourg, Faculty of Science and Medicine, Department of Neurosciences and Movement Science, Fribourg, CH.,Reha Center Michaeliskarree, Jahnstr. 42, Hof, DE
| | - Wolfgang Taube
- University of Fribourg, Faculty of Science and Medicine, Department of Neurosciences and Movement Science, Fribourg, CH
| | - Konstantin Beinert
- Department of Physiotherapy, Deutsche Hochschule fuer Gesundheit und Sport, Mannheim, DE
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Alalawi A, Devecchi V, Gallina A, Luque-Suarez A, Falla D. Assessment of Neuromuscular and Psychological Function in People with Recurrent Neck Pain during a Period of Remission: Cross-Sectional and Longitudinal Analyses. J Clin Med 2022; 11:jcm11072042. [PMID: 35407650 PMCID: PMC8999485 DOI: 10.3390/jcm11072042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 12/19/2022] Open
Abstract
The aim of this study was to examine for the presence of differences in neuromuscular and psychological function in individuals with recurrent neck pain (RNP) or chronic neck pain (CNP) following a whiplash trauma compared to healthy controls. A secondary aim was to examine whether neuromuscular characteristics together with psychological features in people with RNP were predictive of future painful episodes. Multiple features were assessed including neck disability, kinesiophobia, quality of life, cervical kinematics, proprioception, activity of superficial neck flexor muscles, maximum neck flexion and extension strength, and perceived exertion during submaximal contractions. Overall, those with RNP (n = 22) and CNP (n = 8) presented with higher neck disability, greater kinesiophobia, lower quality of life, slower and irregular neck movements, and less neck strength compared to controls (n = 15). Prediction analysis in the RNP group revealed that a higher number of previous pain episodes within the last 12 months along with lower neck flexion strength were predictors of higher neck disability at a 6-month follow-up. This preliminary study shows that participants with RNP presented with some degree of altered neuromuscular features and poorer psychological function with respect to healthy controls and these features were similar to those with CNP. Neck flexor weakness was predictive of future neck disability.
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Affiliation(s)
- Ahmed Alalawi
- Physical Therapy Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; (V.D.); (A.G.)
| | - Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; (V.D.); (A.G.)
| | - Alessio Gallina
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; (V.D.); (A.G.)
| | - Alejandro Luque-Suarez
- Department of Physiotherapy, Universidad de Malaga, 29016 Malaga, Spain;
- Instituto de la Investigacion Biomedica de Malaga (IBIMA), 29010 Malaga, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK; (V.D.); (A.G.)
- Correspondence: ; Tel.: +44-(0)121-415-4220
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Kantak SS, Johnson T, Zarzycki R. Linking Pain and Motor Control: Conceptualization of Movement Deficits in Patients With Painful Conditions. Phys Ther 2022; 102:6497839. [PMID: 35079833 DOI: 10.1093/ptj/pzab289] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 09/13/2021] [Accepted: 12/10/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED When people experience or expect pain, they move differently. Pain-altered movement strategies, collectively described here as pain-related movement dysfunction (PRMD), may persist well after pain resolves and, ultimately, may result in altered kinematics and kinetics, future reinjury, and disability. Although PRMD may manifest as abnormal movements that are often evident in clinical assessment, the underlying mechanisms are complex, engaging sensory-perceptual, cognitive, psychological, and motor processes. Motor control theories provide a conceptual framework to determine, assess, and target processes that contribute to normal and abnormal movement and thus are important for physical therapy and rehabilitation practice. Contemporary understanding of motor control has evolved from reflex-based understanding to a more complex task-dependent interaction between cognitive and motor systems, each with distinct neuroanatomic substrates. Though experts have recognized the importance of motor control in the management of painful conditions, there is no comprehensive framework that explicates the processes engaged in the control of goal-directed actions, particularly in the presence of pain. This Perspective outlines sensory-perceptual, cognitive, psychological, and motor processes in the contemporary model of motor control, describing the neural substrates underlying each process and highlighting how pain and anticipation of pain influence motor control processes and consequently contribute to PRMD. Finally, potential lines of future inquiry-grounded in the contemporary model of motor control-are outlined to advance understanding and improve the assessment and treatment of PRMD. IMPACT This Perspective proposes that approaching PRMD from a contemporary motor control perspective will uncover key mechanisms, identify treatment targets, inform assessments, and innovate treatments across sensory-perceptual, cognitive, and motor domains, all of which have the potential to improve movement and functional outcomes in patients with painful conditions.
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Affiliation(s)
- Shailesh S Kantak
- Neuroplasticity and Motor Behavior Laboratory, Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA.,Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
| | - Tessa Johnson
- Neuroplasticity and Motor Behavior Laboratory, Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA
| | - Ryan Zarzycki
- Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
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Poor cervical proprioception as a risk factor for concussion in professional male rugby union players. Phys Ther Sport 2022; 55:211-217. [DOI: 10.1016/j.ptsp.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/24/2022]
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Wang X, Qu N, Wang Y, Dong J, Jiao J, Wu M. Effects of experimental pain on the cervical spine reposition errors. BMC Musculoskelet Disord 2022; 23:259. [PMID: 35300653 PMCID: PMC8932173 DOI: 10.1186/s12891-022-05170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/28/2022] [Indexed: 12/04/2022] Open
Abstract
Background Healthy subjects showed normal variance of cervical spine reposition errors of approximately 2 degrees. Effects of experimental pain on cervical spine reposition errors were unknown; thus, the purpose of this study was to investigate the effects of experimental pain on cervical spine reposition errors. Methods A repeated measured study design was applied. Thirty healthy subjects (12 males) were recruited. Reposition errors were extracted from upright cervical positions before and after cervical flexion movement in healthy subjects before and during experimental neck pain. Cervical spine reposition errors were calculated based on anatomical landmarks of each cervical joint. Reposition errors were extracted in degrees as constant errors and absolute errors for further statistical analysis. Repeated measures analysis of variance (RM-ANOVA) was applied to analyse experimental pain effects on either constant errors or absolute errors of different cervical joints. Results The cervical spine showed non-significant difference in reposition errors regarding the constant errors (P>0.05) while larger reposition errors regarding the absolute errors during experimental pain compared to before experimental pain (P<0.001). In addition, the pain level joint (C4/C5) and its adjacent joints (C3/C4 and C5/C6) indicated larger reposition errors regarding absolute errors (P=0.035, P=0.329 and P=0.103, respectively). Conclusions This study firstly investigated the cervical spine reposition errors in experimental neck pain and further found the joints adjacent to the pain level showed larger errors compared to the distant joints regarding absolute errors. It may imply that the larger reposition errors in specific cervical joint indicate probable injury or pain existed adjacent to the joints. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05170-7.
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Affiliation(s)
- Xu Wang
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China
| | - Ning Qu
- The Department of Orthopaedics, The first Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Yang Wang
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China
| | - Jian Dong
- The Department of Rehabilitation, China- Japan Union Hospital of Jilin University, Changchun, 130021, China
| | - Jianhang Jiao
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China
| | - Minfei Wu
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China.
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Reddy RS, Tedla JS, Alshahrani MS, Asiri F, Kakaraparthi VN. Comparison and correlation of cervical proprioception and muscle endurance in general joint hypermobility participants with and without non-specific neck pain-a cross-sectional study. PeerJ 2022; 10:e13097. [PMID: 35295560 PMCID: PMC8919848 DOI: 10.7717/peerj.13097] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/20/2022] [Indexed: 01/12/2023] Open
Abstract
Background Cervical proprioception and muscle endurance are essential for maintaining cervical functional joint stability. Proprioception and muscle endurance may be impaired in those with general joint hypermobility (GJH). Examining these aspects is crucial. This study's aims are to (1) compare the cervical joint position error (JPE) and muscle endurance holding capacities in GJH individuals with and without non-specific neck pain (NSNP) (2) to assess the relationship between hypermobility Beighton scores, cervical JPE's, and muscle endurance in GJH individuals with and without NSNP. Methods In this cross-sectional comparative study, 33 GJH participants with NSNP (mean age 21.7 ± 1.8 years) and 35 asymptomatic participants GJH (mean age 22.42 ± 1.7 years) participated. Beighton's score of ≥4 of 9 tests was used as criteria to diagnose GJH. Cervical JPEs were estimated in degrees using a cervical range of motion device, and muscle endurance (flexor and extensor) were estimated in seconds using a stopwatch. Results GJH participants with NSNP showed significantly larger cervical JPEs (p < 0.001) and decreased muscle endurance holding times (p < 0.001) compared to asymptomatic participants. Beighton hypermobility scores showed a significant moderate positive correlation with cervical JPEs (flexion: r = 0.43, p = 0.013), left rotation: r = 0.47, p = 0.005, right rotation: r = 0.57, p = 0.001) in NSNP individuals. Also, Beighton hypermobility scores showed a moderate negative correlation with muscle endurance in NSNP (flexor muscles: r = -0.40, p = 0.020, extensor muscles: r = -0.41, p = 0.020, and asymptomatic individuals (flexor muscles: -0.34, p = 0.045, extensor muscles: r = -0.45, p = 0.007). Conclusion GJH individuals with NSNP showed increased cervical JPEs and reduced muscle endurance compared to asymptomatic. Individuals with GJH with higher Beighton scores demonstrated increased cervical JPEs and reduced neck muscle endurance holding ability. In clinical practice, therapists should be aware of these findings, incorporate proprioceptive and muscle endurance assessments, and formulate rehabilitation strategies for NSNP individuals with GJM.
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Affiliation(s)
- Ravi Shankar Reddy
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Jaya Shanker Tedla
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | | | - Faisal Asiri
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
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Franov E, Straub M, Bauer CM, Ernst MJ. Head kinematics in patients with neck pain compared to asymptomatic controls: a systematic review. BMC Musculoskelet Disord 2022; 23:156. [PMID: 35172799 PMCID: PMC8848642 DOI: 10.1186/s12891-022-05097-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/08/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neck pain is one of the most common musculoskeletal disorders encountered by healthcare providers. A precise assessment of functional deficits, including sensorimotor control impairment, is regarded necessary for tailored exercise programmes. Sensorimotor control can be measured by kinematic characteristics, such as velocity, acceleration, smoothness, and temporal measures, or by assessing movement accuracy. This systematic review aims to identify movement tasks and distinct outcome variables used to measure kinematics and movement accuracy in patients with neck pain and present their results in comparison to asymptomatic controls. METHODS Electronic searches were conducted in MEDLINE, PEDro, Cochrane Library and CINAHL databases from inception to August 2020. Risk of bias of included studies was assessed. Movement tasks and specific outcome parameters used were collated. The level of evidence for potential group differences in each outcome variable between patients with neck pain and controls was evaluated. RESULTS Twenty-seven studies examining head kinematics and movement accuracy during head-aiming, functional and unconstrained movement tasks of the head were included. Average Risk of Bias of included studies was moderate. In total, 23 different outcome variables were assessed. A strong level of evidence for an increased movement time and for an increased number of errors during head aiming tasks was found. Moderate evidence was found in traumatic neck pain for a decreased mean velocity, peak acceleration, and reaction time, and for point deviation and time on target during head aiming tasks. Moderate evidence was found for decreased acceleration during unconstrained movements, too. Results on the remaining movement task and outcome variables showed only limited, very limited or even conflicting level of evidence for patients with neck pain to differ from controls. CONCLUSIONS Sensorimotor control in NP in the way of kinematic and movement accuracy characteristics of head motion was examined in head aiming, functional or unconstrained movement tasks. The results from this review indicate that for some characteristics that describe sensorimotor control, patients with NP differ from healthy controls. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42020139083.
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Affiliation(s)
- Esther Franov
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8400, Winterthur, Switzerland
| | - Matthias Straub
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8400, Winterthur, Switzerland
| | - Christoph M Bauer
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8400, Winterthur, Switzerland
| | - Markus J Ernst
- Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, 8400, Winterthur, Switzerland.
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Erdoğanoğlu Y, Bayraklı B. Short-Term Changes in Chronic Neck Pain After the Use of Elastic Adhesive Tape. J Chiropr Med 2022; 20:70-76. [PMID: 34987323 DOI: 10.1016/j.jcm.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 04/21/2020] [Accepted: 04/05/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives The aim of the study was to examine the short-term changes of elastic adhesive tape application on pain intensity and the range of motion (ROM), cervical region proprioception sense, and cervical flexor endurance of patients with chronic neck pain. Methods Thirty-four patients (male: 26, female: 8) between ages 20 and 55 with chronic neck pain having the complaints for at least 6 months were included in the study. Demographic information, pain intensity, cervical ROM, cervical flexor endurance, and cervical proprioception sense of the patients were evaluated. Results were examined 2 times. The first evaluation was conducted prior to elastic adhesive tape application and the second one was conducted 24 hours after the procedure. Results The mean age of the patients was 39.56 ± 17.09 years, average height was 165.65 ± 9.83 cm, average weight was 71.44 ± 15.79 kg, and average body mass index was 26.24 ± 6.62. A statistically significant difference was found between the measurement results of pain intensity, ROM of the joint in flexion, extension, right and left rotation, and cervical flexor endurance before and 24 hours after the application of elastic adhesive tape (P < .05). When the proprioception sense was examined, there was a significant difference between the results before elastic adhesive tape application and 24 hours after the same application in deviation angles except for right rotation (P < .05). Conclusion The results of this study revealed short-term changes following the use of elastic adhesive tape on cervical flexor endurance, pain, and cervical proprioception sense for patients with chronic pain.
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Affiliation(s)
- Yıldız Erdoğanoğlu
- Department of Physical Treatment and Rehabilitation, Faculty of Health Sciences, Antalya Bilim University, Antalya, Turkey
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Mendes-Fernandes T, Puente-González AS, Márquez-Vera MA, Vila-Chã C, Méndez-Sánchez R. Effects of Global Postural Reeducation versus Specific Therapeutic Neck Exercises on Pain, Disability, Postural Control, and Neuromuscular Efficiency in Women with Chronic Nonspecific Neck Pain: Study Protocol for a Randomized, Parallel, Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010704. [PMID: 34682453 PMCID: PMC8535440 DOI: 10.3390/ijerph182010704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/02/2021] [Accepted: 10/08/2021] [Indexed: 12/15/2022]
Abstract
Background: Chronic nonspecific neck pain is the most frequent form of neck pain. It is more prevalent in women, and a costly public health issue. It is commonly associated with biomechanical, functional, proprioceptive, and postural impairments. The aim of this trial is to compare the effects of global postural exercises versus specific therapeutic exercises on neck pain, disability, mobility, pressure pain threshold, kinesiophobia, pain catastrophizing, postural control, and neuromuscular efficiency in women with chronic nonspecific neck pain. Methods and analysis: This study is a randomized, parallel-group and single blinded clinical trial. Sixty-two women with nonspecific chronic neck pain were recruited from the community of Guarda, Portugal, and randomly assigned to one of two intervention groups: (1) global postural reeducation (GPR group), (2) specific therapeutic exercises (STE group). The intervention was carried out over 4 weeks, with two sessions per week (eight sessions), and applied by a physiotherapist and paired with a daily individual at-home-exercise program. Primary outcomes are neck pain intensity and disability (Numerical Pain Rating Scale, Neck Disability Index). Secondary outcomes are cervical mobility and pressure pain threshold (CROM, algometry), attitude to pain (kinesiophobia, pain catastrophizing), standing postural control (Center of Pressure (COP) displacements), and neuromuscular efficiency (electromyography). There are four points of evaluation where the outcomes were assessed twice before the intervention, 1 week apart, and the two post-intervention assessments will be carried out after four and eight sessions. The objective was to increase scientific knowledge of different exercise modalities, such as global postural reeducation, in musculoskeletal disorders. Trial registration: ClínicalTrials.gov (NCT04402463), prospectively registered (data 22 May 2020).
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Affiliation(s)
- Tânia Mendes-Fernandes
- Centro EMA, 6300-537 Guarda, Portugal;
- Doctoral Programme in Health, Disability, Dependency and Welfare, University of Salamanca, 37007 Salamanca, Spain;
| | - Ana Silvia Puente-González
- Department of Nursing and Physical Therapy, University of Salamanca, C/Donante de Sangre s/n, 37007 Salamanca, Spain;
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Manuel Antonio Márquez-Vera
- Doctoral Programme in Health, Disability, Dependency and Welfare, University of Salamanca, 37007 Salamanca, Spain;
- Department of Nursing and Physical Therapy, University of Salamanca, C/Donante de Sangre s/n, 37007 Salamanca, Spain;
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Physiotherapy Unit, Universitary Hospital of Salamanca, 37007 Salamanca, Spain
| | - Carolina Vila-Chã
- Polytechnic Institute of Guarda, 6300-559 Guarda, Portugal;
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Roberto Méndez-Sánchez
- Department of Nursing and Physical Therapy, University of Salamanca, C/Donante de Sangre s/n, 37007 Salamanca, Spain;
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Correspondence:
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Szczygieł E, Gigoń A, Chudyba IC, Joanna G, Edward G. Evaluation attempt of own body sensing amongst persons with and without scoliosis. J Back Musculoskelet Rehabil 2021; 34:425-430. [PMID: 33459696 DOI: 10.3233/bmr-191761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a common structural spine deformity affecting 2%-4% of adolescents. Due to the unknown cause of idiopathic scoliosis, its therapy is a long-term and often unsatisfactory process. In the literature, it is often suggested that problems related to the feeling of one's own body are caused by AIS. OBJECTIVE The aim of this study was to assess the feeling of one's own body among children with and without scoliosis on the example of feeling the head position, pelvis shape and balance. METHOD The research included 62 children: 30 with scoliosis and 25 without diagnosed scoliosis with an age range between 11 to 19 years. The minimum scoliosis value was 7∘ and the maximum was 53∘. The average value was 25∘. During the study, three functional tests were used: Cervical Joint Position Error Test (CJPET), Clinical Test of Sensory Integration on Balance (CTSIB) and Body proportion demonstration test (BPDT). RESULTS The results of the tests showed statistically significant differences (CJPET p= 3.54*10-14, CTSIB p= 0.0376, BPDT p= 0.0127). However, none of the studies showed a correlation between the results of people with scoliosis and the value of their Cobb angles.
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Affiliation(s)
- Elżbieta Szczygieł
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | - Agata Gigoń
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | | | - Golec Joanna
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | - Golec Edward
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
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Additive effect of "Brahma Mudra" on pain, proprioception and functional abilities in non-specific mechanical neck pain. J Bodyw Mov Ther 2021; 27:717-722. [PMID: 34391312 DOI: 10.1016/j.jbmt.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/20/2021] [Accepted: 06/08/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Being the second highest musculoskeletal problem irrespective of age, gender and occupation, the etiology of neck pain is predominantly mechanical in nature. This can lead to dysfunction with time and recurrence. Altered joint position sense (JPS) from soft tissues can alter the cervical biomechanics by compromising the cephalo spatial orientation, which depends on the visual, vestibular and proprioceptive cues. This study was done to observe the additive effect of "Brahma mudra" (BM) a yogic tool on non-specific mechanical neck pain and its clinical implication on pain, proprioception and functional abilities. METHODS It was a quasi-experimental pre -post study design involving 30 individuals from a software firm between the age group of 18-45 years. The conventional treatment group received standard physiotherapy regime and in the BM group BM was incorporated in addition to standard physiotherapy regime. Independent sample student t-test/Mann Whitney test were used to compare continuous variables between two groups. Paired sample test/Wilcoxon signed rank test were used for within groups. RESULTS There was a significant reduction in pain, improved functional abilities and proprioception in BM group when compared to conventional treatment group with 0.01 level of statistical significance. CONCLUSION It may be concluded that practice of BM had an added effect to conventional standard physiotherapy regime in reduction of pain, improvement of proprioception and functional abilities among individuals with chronic non-specific mechanical neck pain.
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Salehi R, Rasouli O, Saadat M, Mehravar M, Negahban H, Shaterzadeh Yazdi MJ. Cervical movement kinematic analysis in patients with chronic neck pain: A comparative study with healthy subjects. Musculoskelet Sci Pract 2021; 53:102377. [PMID: 33895488 DOI: 10.1016/j.msksp.2021.102377] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/10/2021] [Accepted: 04/11/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Several studies have investigated cervical kinematic performance in patients with chronic neck pain, especially with fast movements. A recent systematic review recommended further study of cervical spine kinematics cervical motions in individuals with neck pain. OBJECTIVES This study aimed to examine cervical spine kinematics of naturally paced cervical motions in patients with chronic neck pain compared with a group of asymptomatic participants. Also, the relationships between cervical kinematic measures with neck pain intensity and disability were determined. METHOD Kinematic performance was measured in 20 individuals with chronic nonspecific neck pain and 20 healthy controls. Data were captured using a 7-camera motion analysis system. Parameters were range of cervical motion, peak velocity, duration of movement, and jerk index (smoothness of movement). Pain intensity and Neck Disability Index were also measured. RESULTS Duration of movements, peak velocities, and jerk indexes were significantly different between the two groups (p < 0.05). Pain intensity was significantly associated with duration of movement, range of motion, peak velocity, and smoothness predominantly in extension (r range = 0.4 to 0.6, p < 0.05). CONCLUSION This study's findings indicated altered cervical kinematic performance during naturally paced motions (particularly reduced smoothness of movement)in patients with chronic nonspecific neck pain compared to asymptomatic participants. Also, pain intensity was moderately associated with most kinematic measures, especially in extension. This study's results can help to understand better the impairments associated with chronic nonspecific neck pain.
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Affiliation(s)
- Reza Salehi
- Rehabilitation Research Center, Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Omid Rasouli
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Maryam Saadat
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mohammad Mehravar
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Mazaheri M, Abichandani D, Kingma I, Treleaven J, Falla D. A meta-analysis and systematic review of changes in joint position sense and static standing balance in patients with whiplash-associated disorder. PLoS One 2021; 16:e0249659. [PMID: 33831060 PMCID: PMC8031393 DOI: 10.1371/journal.pone.0249659] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/23/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To synthesise and analyse the current evidence regarding changes in joint position sense (JPS) and standing balance in people with whiplash-associated disorder (WAD) taking the presence or absence of dizziness into account. DATA SOURCES PubMed, CINAHL Plus, Web of Science, Embase, MEDLINE and APA PsycINFO were searched by two independent reviewers from inception until August 2020 and reference lists of all included studies were also reviewed. STUDY SELECTION Only cross-sectional studies that measured JPS and/or standing balance between people with WAD vs. healthy controls (HC) or people with WAD complaining of dizziness (WADD) vs. those not complaining of dizziness (WADND) were selected. DATA EXTRACTION Relevant data were extracted using specific checklists and quality assessment was performed using Downs and Black Scale (modified version). DATA SYNTHESIS Twenty-six studies were included. For JPS, data were synthesized for absolute error in the primary plane of movement for separate movement directions. For standing balance, data were synthesized for traditional time- and frequency domain sway parameters considering the conditions of eyes open (EO) and eyes closed (EC) separately. For meta-analysis, reduced JPS was observed in people with WAD compared to HC when the head was repositioned to a neutral head position (NHP) from rotation (standardised mean difference [SMD] = 0.43 [95%: 0.24-0.62]) and extension (0.33 [95%CI: 0.08-0.58]) or when the head was moved toward 50° rotation from a NHP (0.50 [0.05-0.96]). Similarly, people with WADD had reduced JPS compared to people with WADND when the head was repositioned to a NHP from rotation (0.52 [0.22-0.82]). Larger sway velocity and amplitude was found in people with WAD compared to HC for both EO (0.62 [0.37-0.88] and 0.78 [0.56-0.99], respectively) and EC (0.69 [0.46-0.91] and 0.80 [0.58-1.02]) conditions. CONCLUSION The observed changes of JPS and standing balance confirms deficits in sensorimotor control in people with WAD and especially in those with dizziness.
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Affiliation(s)
- Masood Mazaheri
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Deepa Abichandani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Lecturer in Physiotherapy, Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Idsart Kingma
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Julia Treleaven
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- * E-mail:
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Majcen Rosker Z, Kristjansson E, Vodicar M, Rosker J. Postural balance and oculomotor control are influenced by neck kinaesthetic functions in elite ice hockey players. Gait Posture 2021; 85:145-150. [PMID: 33578306 DOI: 10.1016/j.gaitpost.2021.01.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/19/2021] [Accepted: 01/28/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Research indicates that neck kinaesthetic awareness plays an important role in oculomotor and balance control, however the relationship has not been studied in athletes. As performance in ice hockey demands visual perception acuity during skating, while constantly shifting between unilateral and bilateral stances in sports specific posture more in-depth relationship should be studied. RESEARCH QUESTION What is the relationship between neck kinaesthetic awareness, postural balance and eye movement control in professional ice hockey players and non-trained individuals? METHODS In this observational study, centre-of-pressure was measured using force plate in twenty-eight hockey players and thirty non-trained participants during different stances in eyes-opened and eyes-closed conditions. Butterfly test and Head-to-Neutral Relocation test were performed to assess neck kinaesthesia. Horizontal smooth pursuit eye movements were measured using video-oculography. Linear regression was used to determine the relationship between neck kinaesthesia, body sway and oculomotor control. RESULTS Time-on-target in Butterfly test was able to predict low to medium proportions of variance in amplitude and velocity parameters for single leg stances in hockey players (R2 = .220-.698). Head-to-Neutral Relocation test was able to predict low to medium proportion of variance in average eye movement velocity during first 100 milliseconds of smooth pursuit initiation for both groups (R2 = .262-.541). SIGNIFICANCE Findings from our study suggest that cervical spine afferent input plays an important role in maintaining unilateral postural balance in hockey players, with less evidence presented in controls. Sports specific posture or upper body loading could lead to adaptations in neck proprioception, not frequently considered when searching for balance related injury risk factors or performance deficits. Our study suggests, that in addition to balance control, neck kinaesthesia can also affect oculomotor performance which was present in both groups. This is especially evident when initiating changes in eye movement direction.
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Affiliation(s)
- Ziva Majcen Rosker
- Faculty of Sport, University of Ljubljana, Gortanova 22, SI 1000, Ljubljana, Slovenia.
| | | | - Miha Vodicar
- Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Njegoseva 4, SI 1000, Ljubljana, Slovenia.
| | - Jernej Rosker
- Faculty of Health Sciences, University of Primorska, Koper, Polje 42, SI 6310, Izola, Slovenia.
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Ozen T, Tonga E, Polat MG, Bayraktar D, Akar S. Cervical proprioception accuracy is impaired in patients with axial spondyloarthritis. Musculoskelet Sci Pract 2021; 51:102304. [PMID: 33227676 DOI: 10.1016/j.msksp.2020.102304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Proprioception is the awareness of body parts and includes joint position sense, kinesthesia, and sense of force. Cervical spine is one of the major affected areas in axial spondyloarthritis (axSpA), and is an essential region for proprioceptive receptors. OBJECTIVE To investigate the cervical joint proprioceptive accuracy by using cervical joint positioning error (JPE) method in patients with axSpA and healthy controls. DESIGN Cross-sectional study. METHODS JPE was calculated for cervical motions in the directions of flexion, extension, rotations, and lateral flexions. Time since diagnosis, symptom duration, spinal mobility, functional status, quality of life, disease activity, and pain were evaluated in axSpA patients. Cervical JPE of axSpA patients was also compared according to radiographic status, biologic use, and existence of cervical syndesmophytes. RESULTS Eighty-two axSpA patients (52 males) and 71 healthy subjects (53 males) were evaluated. Cervical JPE was higher in patients with axSpA compared to healthy subjects (p < 0.001), except left lateral flexion (p = 0.10). Cervical proprioceptive accuracy for extension and left rotation was better in biologics+ subgroup compared to biologic- subgroup (p < 0.05). No other differences were detected related to radiographic status nor existence of cervical syndesmophytes (p > 0.05). CONCLUSION Cervical proprioception accuracy is impaired in patients with axSpA. It seems that controlling disease activity by using appropriate medication may have a positive effect on cervical proprioception accuracy.
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Affiliation(s)
- Tugce Ozen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
| | - Eda Tonga
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Mine Gulden Polat
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Deniz Bayraktar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Servet Akar
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
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Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther 2021; 10:143-164. [PMID: 33464539 PMCID: PMC8119582 DOI: 10.1007/s40122-020-00230-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
Neck pain is very common, but most of the causes are unknown, making diagnosis and treatment extremely challenging. Current studies have found that one of the main problems in patients with neck pain is the impairment of cervical proprioception, which subsequently leads to cervical sensorimotor control disturbances. Cervical spine has a very delicate proprioceptive system that plays a crucial role in controlling posture and balance. Cervical proprioceptive impairment in neck pain occurs through a variety of mechanisms. Experimental neck muscle pain induced by injection of hypertonic saline results in inhibition of the activation of painful muscle; chronic neck pain causes structural and functional impairment of cervical muscles; excessive activation of mechanoreceptors in degenerative cervical discs and facet joints produces a large number of erroneous sensory signals. Clinical examinations to assess the link between structural pathology and neck pain have been unsuccessful, opening the way for the development of function-based tests. To date, eight neck sensorimotor control tests have been reported to evaluate patients with chronic neck pain. Although some tests may involve different subsystems (such as oculomotor system and vestibular system), all tests measure sensorimotor control in the neck, and the most commonly used is cervical joint position error (JPE) test. Current studies support the effectiveness of exercises targeting different aspects of sensorimotor function, in particular retraining aimed at improving cervical proprioception and muscle coordination. Based on the available evidence, it is recommended that patients with neck pain should be assessed and managed for cervical proprioceptive impairment and sensorimotor control disturbances.
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Affiliation(s)
- Baogan Peng
- Department of Spinal Surgery, The Third Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing, China.
| | - Liang Yang
- Department of Spinal Surgery, The Third Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Yongchao Li
- Department of Spinal Surgery, The Third Medical Center, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Tanghua Liu
- Department of Algology, Lizhuang Tongji Hospital, Yibin, Sichuan, China
| | - Yanqing Liu
- Department of Algology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Fraix M, Badran S, Graham V, Redman-Bentley D, Hurwitz EL, Quan VL, Yim M, Hudson-McKinney M, Seffinger MA. Osteopathic manipulative treatment in individuals with vertigo and somatic dysfunction: a randomized, controlled, comparative feasibility study. J Osteopath Med 2021; 121:71-83. [PMID: 33125033 DOI: 10.7556/jaoa.2020.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Context There is a paucity of research assessing the efficacy of osteopathic manipulative treatment (OMT) in patients with vertigo. Objective To assess the feasibility of conducting a randomized, controlled trial comparing OMT and vestibular rehabilitation therapy (VRT), alone or in combination, in patients with vertigo and somatic dysfunction. Methods Volunteers with vertigo who were also diagnosed with somatic dysfunction (SD) were prospectively enrolled in a blinded, randomized, controlled cohort comparative effectiveness study and assigned to 1 of 4 groups: OMT alone, VRT alone, a combination of OMT and VRT (OMT/VRT), or a nonintervention control group. Participants between 18 and 79 years of age were included if they had experienced symptoms of vertigo for at least 3 months' duration, demonstrated somatic dysfunction, and could participate in computerized dynamic posturography (CDP) testing, tolerate manual therapy and exercises, and communicate effectively in English or Spanish. A total of 3 treatments lasting 45 minutes each were administered 1 week apart to each participant. OMT in this study consisted of counterstrain, myofascial release, balanced ligamentous tension, soft tissue, HVLA, and articulatory techniques. Comparisons were made between composite scores (CS) assessed with computerized dynamic posturography (CDP), dizziness handicap inventory (DHI), optometric evaluation, and osteopathic structural examinations collected before the first treatment, after the third/final treatment, and 3 months after the final treatment. (ClinicalTrials.gov number NCT01529151). Results A total of 23 patients were included in the study: 7 in the OMT group, 5 in the VRT group, 6 in the OMT/VRT group, and 5 in the control group. The OMT/VRT group demonstrated significant improvement in DHI score (P=0.0284) and CS (P=0.0475) between pre- and 3-month posttreatment measures. For total severity, improvements were significant in the OMT group both from pretreatment to immediate posttreatment measures (P=0.0114) and from pretreatment to 3-month posttreatment measures (P=0.0233). There was a statistical difference between the OMT and control groups from pretreatment to 3-month posttreatment DHI scores (P=0.0332). Also, there was a statistical difference in DHI score between VRT and control from pre- to 3-month posttreatment scores (P=0.0338). OMT/VRT statistically and clinically improved visual acuity in patients' right eyes from pre- to posttreatment (P=0.0325). In all participants, vergence dysfunction was prevalent (5; 21.7%) in addition to vertical heterophoria (15; 65.2%). Conclusion A combination of OMT and VRT significantly reduced vertigo and improved balance 3 months after treatment (P<0.05). There was a high prevalence in vergence and vertical heterophoria, which are not typical screening measurements used by physical therapists and physicians to assess vertigo patients. With a small sample size, this study demonstrated the feasibility of an interdisciplinary team evaluating and treating patients with vertigo in a community setting. A larger study is needed to assess the efficacy of OMT/VRT in vertigo patients.
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Affiliation(s)
- Marcel Fraix
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific , Pomona , CA , USA
| | - Sondos Badran
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific , Pomona , CA , USA
| | | | - Donna Redman-Bentley
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific , Pomona , CA , USA
| | | | - Valerie L Quan
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific , Pomona , CA , USA
| | - Michelle Yim
- The Dignity Health California Hospital Medical Center , Los Angeles , CA , USA
| | - Mary Hudson-McKinney
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific , Pomona , CA , USA
| | - Michael A Seffinger
- Western University of Health Sciences College of Osteopathic Medicine of the Pacific , Pomona , CA , USA
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Balance and Physical Functioning in Patients After Head and Neck Cancer Post–Neck Dissection Surgery: A Case Series. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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