Effects of Local Treatment With and Without Sensorimotor and Balance Exercises in Neck Pain
- Conditions
- Neck Pain
- Interventions
- Other: LNT plus sensorimotor exercisesOther: LNT plus balance exercisesOther: LNT plus sensorimotor/balance exercisesOther: Local neck treatment (LNT)
- Registration Number
- NCT03149302
- Lead Sponsor
- Chiang Mai University
- Brief Summary
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.
- Detailed Description
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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 168
- 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)
- 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
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description LNT plus sensorimotor exercises LNT plus sensorimotor exercises Local neck treatment plus a tailored sensorimotor exercise program. LNT plus balance exercises LNT plus balance exercises Local neck treatment plus balance training program. LNT plus sensorimotor/balance exercises LNT plus sensorimotor/balance exercises A combination of local neck treatment, sensorimotor control exercise, and balance exercise. Local neck treatment (LNT) Local neck treatment (LNT) Cervical mobilization and specific therapeutic exercises
- Primary Outcome Measures
Name Time Method Cervical joint position error Change from baseline at immediate, and 3, 6, 12 months follow-ups The ability to perform an active movement (extension and rotation to the left and right) and return to the starting head position as accurately as possible, using a target on the wall and a laser-pointer attached to a lightweight headband.
Postural sway area Change from baseline at immediate, and 3, 6, 12 months follow-ups 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.
Postural sway displacement Change from baseline at immediate, and 3, 6, 12 months follow-ups The sway displacement 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.
- Secondary Outcome Measures
Name Time Method Pain location Change from baseline at immediate, and 3, 6, 12 months follow-ups Pain location using a digital device (iPad Air 2) and sketching software (SketchBook Pro).
Global perceived benefit of treatment Change from baseline at immediate, and 3, 6, 12 months follow-ups Participant rated perceived benefit of treatment, using a six-point ordinal Likert scale.
Dizziness intensity Change from baseline at immediate, and 3, 6, 12 months follow-ups an average dizziness intensity over the past week on VAS 0-10
Neck pain disability Change from baseline at immediate, and 3, 6, 12 months follow-ups How neck pain affects a patient's daily life and to assess the self-rated disability, using NDI.
Gait speed Change from baseline at immediate, and 3, 6, 12 months follow-ups Walk barefoot over 10 meters at a comfortable speed and then with head turns from side to side.
Neck pain intensity Change from baseline at immediate, and 3, 6, 12 months follow-ups an average intensity of neck pain experienced in the past week on VAS 0-10.
Pain extent Change from baseline at immediate, and 3, 6, 12 months follow-ups Pain extent using a digital device (iPad Air 2) and sketching software (SketchBook Pro).
Cervical range of motion Change from baseline at immediate, and 3, 6, 12 months follow-ups Cervical range of motion in flexion, extension, left-right lateral flexion and left-right rotation, using CROM.
Functional ability status Change from baseline at immediate, and 3, 6, 12 months follow-ups Participants' functional status using the patient-specific functional scale (PSFS).
Health-related quality Change from baseline at immediate, and 3, 6, 12 months follow-ups Participants' health-related quality of life, using Short Form-36.
Trial Locations
- Locations (1)
Department of Physical Therapy, Faculty of Associated Medical Sciences
🇹🇭Chiang Mai, Thailand