Comparison of the Effects of Muscle Energy Technique and Mobilization Techniques on Cervical Proprioception and Motor Control in Patients With Cervical Spondylosis: A Randomized Controlled Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cervical Spondylosis
- Sponsor
- Eastern Mediterranean University
- Enrollment
- 76
- Locations
- 1
- Primary Endpoint
- Neck pain intensity
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
Proprioceptive sensitivity decreases in individuals with neck pain compared to those without neck pain. While organizing the treatment program of patients with neck pain, evaluation of cervical proprioception and its addition to the treatment have gained importance.
The aim of the study was to examine the effects of muscle energy technique applied to patients with chronic neck pain on cervical proprioception and motor control and to compare the results of muscle energy technique application with cervical mobilization techniques.
Detailed Description
Cervical spondylosis (SS) is defined as chronic disc degeneration due to aging caused by degenerative changes in the muscles, tendons, joints or bones of the neck or shoulder. The etiology of cervical spondylosis includes various factors such as bad posture, anxiety, depression, neck strain, and overload in sports or occupational activities. Proprioception is defined as sensory feedback that contributes to muscle sensation, postural balance and joint stability. It is possible that loss of cervical proprioception and motor control affect segmental stability. This increases the risk of injury following minor trauma. It has been reported that proprioceptive sensitivity is worse in individuals with neck pain compared to those without neck pain, and the degree of the disorder is related to the severity of pain. Some evidence-based studies have shown that manual techniques improve proprioception and motor control. It has been shown that Muscle Energy Technique (MET), which has gained popularity in recent years, increases cervical joint mobility and reduces pain in patients with chronic neck pain. MET is a form a manual therapy which uses a muscle's own energy in the form of gentle isometric contractions to relax the muscles via autogenic or reciprocal inhibition mechanism. It has been reported that MET stimulates joint proprioceptors, creates a different movement activity in the area of proprioceptive disorder and allows the central nervous system to normalize proprioceptive and motor coordination in this segment. The effect of MET on cervical proprioception in patients with cervical spondylosis has not been investigated yet. Active participation of the patient in movement is extremely important in proprioceptive feedback, motor control and motor learning. For this reason, it is thought that investigating the effect of MET, which includes active muscle contractions of the patient, on proprioceptive sense and comparing the results with passive applications (manipulation or mobilization) will be useful in determining the optimal treatment method in cervical spondylosis.
Investigators
Buse Sezerel
Principal Investigator
Eastern Mediterranean University
Eligibility Criteria
Inclusion Criteria
- •Presence of neck pain of Visual Analog Pain Scale (VAS) ≥ 2 in at least one direction lasting more than three months
- •Not having received conservative treatment in the last 6 months
- •Exclusion criteria
- •Pain or numbness that spreads to the arms
- •Having a cervical region surgery
- •Having musculoskeletal problems such as shoulder impingement or thoracic outlet syndrome
- •Having a contraindication to cervical mobilization (VBI, myelopathy, inflammatory arthropathy, malignancy, etc.)
- •Using analgesic drugs
- •People who cannot adapt to study
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Neck pain intensity
Time Frame: 4 week
Visual analog scale (VAS) was used to neck pain intensity during resting and activity.
Cervical region movement sensation
Time Frame: 4 week
The laser pointer was fixed on the individual's head. The person sat on a chair 1 m away from the ZZ pattern, which was transferred to a 13 cm high A4 paper with 23.4 horizontal and 26.6 long diagonal stripes fixed to the wall. The pattern has five thin additional lines every 5 mm from the baseline to differentiate the five deviation zones. The test was recorded with a camera 50 cm from the center of the pattern. Individuals will be asked to follow the bands of the pattern as accurately and as quickly as possible, starting from the center of the pattern, and the test was considered complete when it returns to its starting position. After the test, video files were examined at 1/8 of the normal speed, to be used in analysis; time, error frequency and error size were calculated.
Neutral head position test (NBPT)
Time Frame: 4 week
NBPT as assessed using the CROM (cervical range of motion) device, which is a special goniometer for the neck. NBPT was started when the cervical region is in a neutral position, the individual was asked to turn his head completely to the left or right and return to the neutral position in a controlled manner. The angular difference was recorded in degrees.
Target head position test (HBPT)
Time Frame: 4 week
CROM device was used for HBPT evaluation. The researcher passively moved the person's head to the pre-determined target position, 50% of the maximum range of motion. The head was held in the target position for 3 seconds (sec), then the person was asked to move the head to the neutral position first and then actively move it back to the target position. The angular difference was recorded in degrees.
Secondary Outcomes
- Cervical flexor muscle endurance(4 week)
- Neck pain related disability(4 week)
- Craniocervical Flexion Test (CCFT)(4 week)
- Cervical extensor muscle endurance(4 week)
- Static balance(4 week)
- Dynamic balance(4 week)