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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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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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Torkamani MH, Mokhtarinia HR, Vahedi M, Gabel CP. Relationships between cervical sagittal posture, muscle endurance, joint position sense, range of motion and level of smartphone addiction. BMC Musculoskelet Disord 2023; 24:61. [PMID: 36690958 PMCID: PMC9869316 DOI: 10.1186/s12891-023-06168-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Frequent smartphone use in a pathological way forces the user to adopt a compromised posture. This gradually results in changes to both the postural and musculoskeletal systems. This study's objectives were evaluation of head posture, muscle endurance, neck range of motion (ROM) and joint position sense in two separate smartphone user groups, one 'Addicted', the other 'Non-Addicted'. METHODS A sample of convenience (n = 60) was recruited from medical students (age 24.57 ± 4.38, 53.3% male) with a history of smartphones use > 2 h/day for 1-year. Based on the cut-off values of the smartphone addiction scale-short version (SAS-SV), participants were entered into each group (cut-off for male ≥ 31, female ≥ 33). Neck muscle endurance time, joint position error and cervical ROM, along with forward head posture parameters of craniovertebral angle (CVA), shoulder angle (SA), sagittal head angle (SHA) and forward head distance (FHD)) were evaluated. A Mann-Whitney test and Spearman correlation coefficient were used to determine the difference between groups and the correlations between variables. RESULTS The difference between 'Addicted' and 'Non-Addicted' groups was confirmed by the values for SAS-SV scores (25.23 ± 5.5 versus 43.9 ± 6.61) (p < 0.001). There were statistically significant differences between groups for the CVA and FHD parameters (p < 0.001). Further, the neck extensor muscle endurance (97 ± 3.79 versus 74.86 ± 2.23 s), was significantly different between groups (p = 0.010) but not after Bonferroni correction. There was no notable difference in the neck flexor muscle endurance, joint position error, SA, and SHA parameters between groups (p > 0.05). CONCLUSIONS There is a positive correlation between smartphone addiction and both decreased extensor muscle endurance and changes in neck postural alignment.
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Affiliation(s)
- Maryam Heidary Torkamani
- grid.472458.80000 0004 0612 774XDepartment of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Kodakyar Ave.Daneshjo Blvd, Evin, Tehran, 1985713834 PC Iran
| | - Hamid Reza Mokhtarinia
- grid.472458.80000 0004 0612 774XDepartment of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Kodakyar Ave.Daneshjo Blvd, Evin, Tehran, 1985713834 PC Iran
| | - Mohsen Vahedi
- grid.472458.80000 0004 0612 774XDepartment of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran
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Diaz-Saez MC, Gil-Martínez A, Iglesias González I, Kim Lee J, Del-Castillo Pardo de-Vera JL, Cebrián Carretero JL, Beltran-Alacreu H. A novel mobile application to determine mandibular and tongue laterality discrimination in women with chronic temporomandibular disorder. Med Oral Patol Oral Cir Bucal 2020; 25:e775-e783. [PMID: 32701931 PMCID: PMC7648923 DOI: 10.4317/medoral.23785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/19/2020] [Indexed: 11/17/2022] Open
Abstract
Background Chronic pain from temporomandibular disorders (TMDs) is caused by a somatosensory disturbance due to sustained activation of central nervous system nociceptive pathways, which can induce changes in neuroplasticity in the thalamus, basal ganglia and limbic system, as well as disturbances in the somatosensory, prefrontal and orbitofrontal cortex and cognitive impairment. The main objective of this study was to determine the discrimination capacity of mandibular and tongue laterality between women with chronic TMDs and asymptomatic women.
Material and Methods This descriptive-comparative study examined 2 groups with a total of 30 women. All participants were between the ages of 23 and 66 years and were assigned to the chronic TMD group or the asymptomatic group according to the inclusion criteria.
We employed a mobile application developed specifically for this study to measure the accuracy and reaction time (RT) of mandibular and tongue laterality discrimination.
Results The chronic TMD group had a lower success rate in laterality discrimination (mean mandibular accuracy of 40% and mean tongue accuracy of 67%) than the asymptomatic group (mean mandibular accuracy of 61% and mean tongue accuracy of 90%). These results showed statistically significant differences between the groups for mandibular laterality discrimination (d, 1.14; p<0.01) and tongue laterality discrimination (d, 0.79; p=0.03). The asymptomatic group had faster RTs than the chronic TMD group. The data revealed statistically significant differences for the right mandibular RT (d, 0.89; p=0.02) and right tongue RT (d, 0.83; p=0.03). However, there were no significant differences for left mandibular and left tongue RT.
Conclusions We found that the women with chronic TMDs had a lower success rate and slower RTs in the discrimination of mandibular laterality when compared with the asymptomatic women. Key words:Mobile application, tongue, chronic temporomandibular disorder, pain, lateral discrimination, cortical representation, reaction time.
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Affiliation(s)
- M-C Diaz-Saez
- Physiotherapy Department Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Calle La Salle 10, 28023 Madrid, Spain
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Morales Tejera D, Fernandez-Carnero J, Suso-Martí L, Cano-de-la-Cuerda R, Lerín-Calvo A, Remón-Ramiro L, La Touche R. Comparative study of observed actions, motor imagery and control therapeutic exercise on the conditioned pain modulation in the cervical spine: a randomized controlled trial. Somatosens Mot Res 2020; 37:138-148. [PMID: 32340585 DOI: 10.1080/08990220.2020.1756244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Aim: The aim of this study was to compare the effects of cervical exercise, motor imagery (MI) and action observation (AO) of cervical exercise actions on conditioned pain modulation and pressure pain thresholds. The second objective was to assess the effects of these interventions on cervical motor activity (ranges of motion and muscle endurance), attention, and the ability to generate motor images.Study design: Single-blinded randomized controlled trial.Materials and methods: Fifty-four healthy subjects were randomly assigned to each group. Response conditioned pain modulation, pressure pain threshold, were the main variables. The secondary outcome measures included, cervical range of motion, Neck flexor endurance test, mental movement representation associated and psychosocial variables.Results: All groups showed significant differences in time factor for all evaluated variables (p < .01) except pressure pain threshold over the tibial region. The post hoc analysis revealed significant within-group differences in the AE and AO groups in conditioned pain modulation (p < .05), with medium effect size in time [AE (d -0.61); AO (d -0.74)].Conclusion: The results showed that within-group changes in conditioned pain modulation, cervical muscle endurance, and attention where founded only in the AE and AO groups. Variations in pain thresholds at pressure in the trapezium area were also obtained in the three groups. Changes in the ranges of flexion-extension and rotation movement were presented exclusively in the exercise group, and in the capacity to generate motor images only in the AO group. However, there was no difference in the pressure pain threshold over the tibial region.
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Affiliation(s)
- David Morales Tejera
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Josue Fernandez-Carnero
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.,Grupo Multidisciplinar de Investigación y Tratamiento del Dolor. Grupo de Excelencia Investigadora, URJC-Banco de Santander, Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Departament of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Alfredo Lerín-Calvo
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | - Lorena Remón-Ramiro
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | - Roy La Touche
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, España
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