Effects of Local Treatment With and Without Sensorimotor and Balance Exercises in Neck Pain

Chiang Mai University168 enrolled

Overview

The sensorimotor disturbance and postural instability have been demonstrated to be associated with neck pain. Specific therapeutic exercise and manual therapy for the cervical spine are effective interventions for improving dizziness symptoms, neck impairments, functional ability and quality of life. However, the effects of these interventions on the actual impairment of joint position sense and balance remain uncertain. Adaptive changes in the sensorimotor and postural control systems may need to be specifically addressed.

The sensorimotor (joint position sense and oculomotor control) and postural stability (balance) disturbances have been demonstrated to be associated with neck pain. Specific therapeutic exercise directed to neuromuscular impairments and manual therapy for the cervical spine are effective interventions for improving dizziness symptoms, neck impairments, functional ability and quality of life. However, the effects of these interventions on the actual impairment of joint position sense and balance remain uncertain. Adaptive changes in the sensorimotor and postural control systems may need to be specifically addressed. Currently, it is not known whether the clinician has to train every impairment or can choose between sensorimotor training and balance training in the rehabilitation of neck pain. Different training approaches may have specific influences on the different outcomes and their outcomes will be important to inform the optimal and efficient management of persons with chronic neck pain.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

168

Conditions

Neck Pain

Interventions

Local neck treatment (LNT)OTHER

The local neck treatment consists of cervical mobilization and specific therapeutic exercises (30 minutes). The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

LNT plus sensorimotor exercisesOTHER

The local neck treatment (30 minutes) plus the sensorimotor exercise program (15 minutes). The sensorimotor exercises include cervical joint position sense and oculomotor training. The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

LNT plus balance exercisesOTHER

The local neck treatment (30 minutes) plus the balance exercise program (15 minutes).The balance program includes with static balance and progress to dynamic balance and gait. The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * insidious neck pain for at least 3 months * an average neck pain intensity over the past week ≥ 30 mm on a 100 mm visual analog scale (VAS) * a score of neck pain and disability ≥ 10/ 100 on the Neck Disability Index-Thai version * an absolute error of cervical joint position error \> 4.5° * an inability to stand in tandem stance with eyes closed for 30 seconds * cervical segmental joint dysfunction (pain provoked \>2/10 with abnormal tissue resistance) Exclusion Criteria: * a previous history of neck and head injury or surgery * known or suspected vestibular pathology * vertigo or dizziness caused by underlying pathology in the ear, brain, or sensory nerve pathways (e.g. benign paroxysmal positional vertigo and BPPV) * vascular disorders (e.g. a migraine and hypertension) * any musculoskeletal or neurological conditions that could affect a balance * inflammatory joint disease * systemic conditions * cognitive impairment * taking four or more medications * received physiotherapy treatment for their neck disorder in the past 12 months

Locations (1)

Department of Physical Therapy, Faculty of Associated Medical Sciences

Chiang Mai, Thailand

Outcomes

Primary Outcomes

Postural sway area

The sway area during narrow stance on firm and soft surfaces with eyes open and eyes closed and during neck torsion maneuver (head turned 45 degrees to the left and right) on firm and soft surfaces, using a swaymeter device.