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Preiss S, Beinert K, Taube W. Immediate effects of visuomotor tracking with the head on cervical sensorimotor function and pain in chronic neck pain patients. J Back Musculoskelet Rehabil 2024; 37:127-136. [PMID: 37599520 DOI: 10.3233/bmr-220431] [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: 08/22/2023]
Abstract
BACKGROUND Working in awkward and sustained postures is, besides psychosocial risk factors, the most reported physical risk factor for neck pain. Accurate proprioception is fundamental to correcting awkward head-to-trunk positions, but impaired proprioceptive performance has been found in patients with chronic neck pain. OBJECTIVE The aim was to compare the effectiveness of two different interventions in a workplace set-up on sensorimotor performance and pain sensitivity in people with chronic neck pain. METHODS A total of 25 patients with chronic neck pain participated in this double-blind study. Patients were randomly allocated to the visuomotor tracking task group or the video group (watching a massage video, imagining themselves being massaged). The primary outcomes were cervical joint position sense acuity and pressure pain threshold of the cervical spine, evaluated by a blinded assessor. RESULTS There were significant time by group interactions for cervical joint position sense acuity (F1;23: 4.38; p= 0.048) and pressure pain threshold (F1;23: 5.78; p= 0.025), with the tracking task group being more accurate in cervical joint position sense testing and less pain sensitive for pressure pain threshold. CONCLUSIONS The visuomotor tracking task improves cervical joint position sense acuity and reduces pressure pain threshold immediately after intervention in people with chronic neck pain.
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Affiliation(s)
- Sandra Preiss
- Department of Medicine, Movement and Sports Science, University of Fribourg, Fribourg, Switzerland
| | - Konstantin Beinert
- Faculty of Sport, German University of Health and Sport, Mannheim, Germany
| | - Wolfgang Taube
- Department of Medicine, Movement and Sports Science, University of Fribourg, Fribourg, Switzerland
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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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Watching Your Neck: The Influence of Real-Time Visual Feedback on Cervical Joint Position Sense in Chronic Neck Pain. Motor Control 2021; 25:631-643. [PMID: 34510021 DOI: 10.1123/mc.2019-0111] [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: 11/21/2019] [Revised: 04/30/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022]
Abstract
Patients with neck pain demonstrate a variety of sensorimotor impairments, such as decreased cervical joint position sense (CJPS) acuity, which might also be associated with an impaired internal body representation. The present study evaluated the effect of real-time visual feedback of the individual's own neck on CJPS compared to observing a book. Twenty-three patients with neck pain participated in the experiment and received the interventions in randomized order on separate days in a within-subject pretest-posttest design. Before and immediately after each intervention, CJPS was measured by a therapist blinded to the intervention. The results demonstrate a significantly different development of CJPS (p = .04), with increased CJPS acuity after observing one's own neck and decreased acuity after observing a book. Real-time visual feedback of the neck improved CJPS acuity in patients with neck pain without active movements of the neck, indicating the importance of central nervous system processing for CJPS acuity.
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Rampazo ÉP, da Silva VR, de Andrade ALM, Back CGN, Madeleine PM, Arendt-Nielsen L, Liebano RE. Sensory, Motor, and Psychosocial Characteristics of Individuals With Chronic Neck Pain: A Case-Control Study. Phys Ther 2021; 101:pzab104. [PMID: 33774667 DOI: 10.1093/ptj/pzab104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Given the complex and unclear etiology of neck pain, it is important to understand the differences in central sensitization as well as psychosocial factors in individuals with chronic neck pain and healthy controls. The purpose of this study was to benchmark differences in central sensitization, psychosocial factors, and range of motion between people with nonspecific chronic neck pain and healthy controls and to analyze the correlation between pain intensity, neck disability, and psychosocial factors in people with chronic neck pain. METHODS Thirty individuals with chronic neck pain and 30 healthy controls were included in this case-control study. Outcome measures were as follows: central sensitization (pressure pain threshold, temporal summation, and conditioned pain modulation), psychosocial factors (depressive symptoms, pain catastrophizing, and quality of life), and active cervical range of motion. RESULTS People with neck pain had lower local pressure pain threshold, a decrease in conditioned pain modulation, more depressive symptoms, greater pain catastrophizing, lower quality of life, and reduced range of motion for neck rotation when compared with healthy controls. In people with neck pain, moderate correlations were observed between pain intensity and quality of life (ρ = -0.479), disability and pain catastrophizing (ρ = 0.379), and disability and quality of life (ρ = -0.456). CONCLUSIONS People with neck pain have local hyperalgesia, impaired conditioning pain modulation, depressive symptoms, pain catastrophizing, low quality of life, and reduced active range of motion during neck rotation, which should be taken into account during assessment and treatment. IMPACT This study shows that important outcomes, such as central sensitization and psychosocial factors, should be considered during assessment and treatment of individuals with nonspecific chronic neck pain. In addition, pain intensity and neck disability are correlated with psychosocial factors.
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Affiliation(s)
- É P Rampazo
- Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil
| | - V R da Silva
- Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil
| | - A L M de Andrade
- Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil
| | - C G N Back
- Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil
| | - P M Madeleine
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - L Arendt-Nielsen
- Center for Sensory-Motor Interaction, Department of Health Science and Technology School of Medicine, Aalborg University, Aalborg, Denmark
| | - Richard Eloin Liebano
- Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), Rod. Washington Luis, km 235, São Carlos/SP Brazil, CEP: 13565-905
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Comparing Central Pain Processing in Individuals With Non-Traumatic Neck Pain and Healthy Individuals: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2020; 21:1101-1124. [DOI: 10.1016/j.jpain.2020.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/16/2020] [Accepted: 02/23/2020] [Indexed: 12/29/2022]
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Di Lernia D, Lacerenza M, Ainley V, Riva G. Altered Interoceptive Perception and the Effects of Interoceptive Analgesia in Musculoskeletal, Primary, and Neuropathic Chronic Pain Conditions. J Pers Med 2020; 10:E201. [PMID: 33138185 PMCID: PMC7712753 DOI: 10.3390/jpm10040201] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic pain (CP) severely disrupts the daily life of millions. Interoception (i.e., sensing the physiological condition of the body) plays a pivotal role in the aetiology and maintenance of CP. As pain is inherently an interoceptive signal, interoceptive frameworks provide important, but underutilized, approaches to this condition. Here we first investigated three facets of interoceptive perception in CP, compared with pain-free controls. We then introduce a novel interoceptive treatment and demonstrate its capacity to reduce pain severity in CP, potentially providing complementary analgesic treatments. Study 1 measured interoceptive accuracy, confidence and sensibility in patients (N = 60) with primary, secondary musculoskeletal, and neuropathic CP. Compared with matched controls, CP participants exhibited significantly lower interoceptive accuracy and interoceptive confidence. Pain severity was predicted positively by interoceptive accuracy, anxiety and depression, and negatively by interoceptive confidence. Study 2 tested a promising new interoceptive treatment for CP, in a single-blind between-subjects design (N = 51) with primary, secondary musculoskeletal, and neuropathic CP patients. The treatment specifically activates the C-Tactile system, by means of controlled stimulation of interoceptive unmyelinated afferents, at 3 cm/s with a force of 2.5 mN. This treatment led to significant pain reduction (mean 23%) in the CP treatment group after only 11 min, while CP controls who received comparable but non-interoceptive stimulation reported no change in pain intensity. These studies highlight the importance of interoceptive approaches to CP and demonstrate the potential of this novel method of C-Tactile stimulation to provide complementary analgesic treatments.
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Affiliation(s)
- Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy;
- Humane Technology Lab., Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy
| | - Marco Lacerenza
- Neurology and Pain Center, Humanitas San Pio X Clinic, 20159 Milan, Italy;
| | - Vivien Ainley
- Lab of Action and Body, Royal Holloway University of London, Egham TW20 0EX, UK;
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy;
- Humane Technology Lab., Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco, 2, 20149 Milan, Italy
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Turkmen C, Kose N, Bilgin S, Cetin H, Dulger E, Altin B, Aksoy S. Effects of local vibration and cervical stabilization exercises on balance, joint position sense, and isometric muscle performance in young adults: A randomized controlled study. ISOKINET EXERC SCI 2020. [DOI: 10.3233/ies-193243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND: Cervical stabilization exercises and local vibration may improve proprioception and balance and prevent musculoskeletal problems. OBJECTIVE: To compare the effects of local vibration and cervical stabilization exercises on balance, cervical joint position sense, and muscle performance in healthy participants. METHODS: Forty-eight healthy male participants without neck pain were included. The participants were randomly divided into three groups: a home exercise program lasting eight weeks to the cervical stabilization group; 60 s of vibration to the neck muscles of the local vibration group and a control group. Balance, joint position sense, and muscle performance were evaluated twice in all subjects, before and after the intervention. RESULTS: Joint position sense error values were decreased in both the local vibration and cervical stabilization groups. Balance was improved (p< 0.001) in the local vibration group while improvement in muscle performance parameters was only seen in the cervical stabilization group (p< 0.05). CONCLUSIONS: The methods used in the present study may be used for improving the proprioceptive and vestibular components of balance in individuals with musculoskeletal problems such as cervical disc herniation, cervical spondylosis, or neck pain. However, given the limitations, much more research is needed to firmly establish these recommendations.
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Affiliation(s)
- Ceyhun Turkmen
- Neurosurgery Rehabilitation Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Nezire Kose
- Neurosurgery Rehabilitation Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Sevil Bilgin
- Neurosurgery Rehabilitation Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hatice Cetin
- Neurosurgery Rehabilitation Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Esra Dulger
- Neurosurgery Rehabilitation Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Busra Altin
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Songul Aksoy
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
- Dizziness and Balance Disorders Research and Application Center, Hacettepe University, Ankara, Turkey
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