Assessing pose and balance problems in patients with neck pain
- Conditions
- Normal individuals without any musculoskeletal painSegmental and somatic dysfunction,
- Registration Number
- CTRI/2022/07/044222
- Lead Sponsor
- Manipal Academy of Higher Education
- Brief Summary
Neck pain is a common prevailing musculoskeletal disorder affecting various age groups. Neck pain is listed as one among the most burdensome chronic musculoskeletal problem globally.Though many etiological factors exist for neck pain, but the etiology is often illusive. The presentation of neck pain is usually non-specific or mechanical neck pain.Non-specific neck pain is defined “as pain in the posterior and lateral aspect of the neck between the superior nuchal line and the spinous process of the first thoracic vertebra with no signs or symptoms of major structural pathology and no or minor to major interference with activities of daily life as well as with the absence of neurological signs and specific pathologies; such as: traumatic sprain and fracture, tumour, infectious or inflammatory cervical spondylolysis, etcâ€.
Chronic non-specific neck pain is associated with disability, deficits in muscular strength and range of motion, increased pain sensitivity and impaired proprioception. Proprioception is an interoceptive sense that provides informative inputs to central nervous system for motor planning. Cervical spine plays a major role in balance and proprioception as the information from cervical spine has direct access to the center for balance and proprioception. Patients with neck pain experience somatosensory deficits due to multiple causes including sensitivity of receptors , alteration of cortical representation and modulation of cervical afferent inputs.Also, muscles of cervical region mainly suboccipital and deep flexor muscles have high density of muscle spindle that contribute to neck proprioception and impairment in information from these muscles affect postural sway.
Studies have shown that neck pain associated with whiplash injuries and idiopathic neck pain have impact on balance and proprioception. Also, a systematic review on standing balance in patients with idiopathic neck pain and whiplash injuries has stated that they present with poorer balance than the normal population. Whiplash induced trauma damages the key systems of postural control mainly the vestibular and neck receptors for the central nervous system, causing impairments in postural control.On contrary to whiplash injuries there is no inciting trauma in idiopathic neck pain, where the suggested mechanism is likely to be the impaired peripheral mechanoceptors, but a much more precise mechanism to be attributed for this can be proprioceptive dysfunction from spinal and supraspinal causes.Though studies have been done on the assessment of balance and proprioception in patients with neck pain, there is a lack of evidence on the usage of objective assessment to quantify the level of impairment in balance and postural sway.
Biodex Balance SD is an instrument used to quantify the balance and postural sway in individuals with a high reliability of 0.94 for Overall Stability Index. It is an instrument equipped with circular platform with which measures both static and dynamic balance. The platform is capable of moving in all 4 directions and adopting 12 static positions and the ability to move in 20 degrees in each direction makes it capable of measuring Antero-Posterior Stability Index and Medio-Lateral Stability Index. Measurement of these indices will quantify the balance and postural sway which will provide a better insight to the dynamic and static balance issues in patients with neck pain.
Existing literature suggests that, there exists a scarcity in the objective assessment of balance and postural sway done in patients with non-specific neck pain. Studies were done on postural and balance impairment with force different objective measures, but a system dedicated to balance assessment has not been used in the previous studies. Hence, this study aims at analyzing the standing balance and postural sway in patients with non-specific neck pain using Biodex Balance SD.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 126
Inclusion criteria for neck pain 1.Pain isolated to neck/cervical region 2.Non-specific neck pain for more than 6 months Inclusion criteria for Healthy individuals 1.Individuals with absence of musculoskeletal pain in 6 months.
1.Patients with serious neck pathologies (cervical myelopathy, neoplastic conditions, upper cervical ligamentous instability, vertebral artery insufficiency, inflammatory or systemic diseases) 2.Patients with history of Cervicogenic headache 3.Patients with Radiculopathy symptoms 4.Any recent Trauma to upper extremity or neck including History of Whiplash Injury 5.Previous surgery to neck or shoulder.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Balance System TM SD- Biodex Medical Systems Baseline assessment (0 weeks- at time of enrollment)
- Secondary Outcome Measures
Name Time Method Pain Disability
Trial Locations
- Locations (1)
Manipal Hospitals Bangalore
🇮🇳Bangalore, KARNATAKA, India
Manipal Hospitals Bangalore🇮🇳Bangalore, KARNATAKA, IndiaNITHIN PRAKASHPrincipal investigator9915803047nithinprakash8891@gmail.com