Examining the Effect of Lateralization Imagery Training on EEG Brain Oscillations, Pain Intensity, Proprioception, Kinesiophobia and Body Awareness in Individuals With Chronic Neck Pain
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 34
- 试验地点
- 2
- 主要终点
- Cognitive Status Assessment (Montreal Cognitive Assessment: MoCA)
研究概览
简要总结
In this study, it was planned to investigate the effectiveness of lateralization and imagery training in individuals with chronic neck pain. A total of 34 individuals, 17 with chronic neck pain and 17 healthy individuals between the ages of 18-65, will be included in the study. Individuals in each group will be treated with lateralization and imagery training for 4 weeks. Before treatment, individuals' cognitive states will be evaluated with neuropsychological tests (Montreal Cognitive Assessment, Stroop test). Then, after completing the Motor Imagery Evaluation, Neck Pain Task Force Scale, Pain Severity, Kinesiophobia Evaluation, Neck Disability Evaluation, Proprioception Sense Test, Body Awareness Evaluation (Fremantle Neck Awareness Questionnaire) and Evaluation of Compliance with the Treatment Program, EEG recording of the individuals will be performed. EEG recording will be performed and analyzed with Spontaneous EEG, Oddball Paradigm and Lateralization paradigm. After four weeks of treatment, all pre-treatment tests will be repeated and then the individuals will be taken again for EEG recording. Brain oscillations will be examined through EEG analysis before and after treatment, and the extent to which brain activities have changed and the possible effect of the treatment on brain activities will be investigated.
详细描述
Chronic neck pain is one of the debilitating conditions that can impair the ability to perform regular daily activities, reduce productivity, and negatively impact quality of life. Approximately two-thirds of people in developed countries experience neck pain. At any given time, approximately 14% to 16% of the adult population globally experiences neck pain, with an average lifetime prevalence of 48.5%. Chronic pain is categorized as pain that lasts more than three months.
It is very important to understand neuroplasticity to know how acute pain turns into chronic pain. Local inflammation of injured tissue increases the sensitivity of peripheral sensory neurons (nociceptors), resulting in recurrent abnormal afferent input to the central nervous system. Chronic pain causes abnormal cortical reorganization and abnormal neural circuit formation in subcortical structures through neuroplastic changes in the brain. Due to chronic pain; Deterioration in body schema perception, weaknesses in perceiving somatosensory differences, deterioration in movement quality and difficulties in performing complex movements occur. Cervical afferent input to the upper centers may change for these reasons, thus cervical proprioception may be impaired.
One of the main problems of patients with neck pain is that impairment of cervical proprioception leads to impairment of cervical sensorimotor control. A study revealed that the focus of studies should be on special programs that address different aspects of sensorimotor control disorders, such as training aimed at improving proprioception and muscle coordination.
Motor imagery (MI) approach is a method created to reduce pain and improve function, especially in chronic painful situations. It is known that imagination and active movement pass through and occur through similar neural pathways. In MI, it is seen that similar regions are activated during imagination in the same way that the regions that occur during real movement and are activated in the motor cortex. In this method, premotor cortex activation is achieved without primary motor cortex activation. Movement signals are produced in cortical areas before movement is performed.
Lateralization Imagery Training (LIE) is a form of implicit motor imagery that involves determining as accurately and quickly as possible whether an image of a body part belongs to the left or right side. It has been assumed that LIE performance differences reflect changes in central nervous system functioning, errors in judgment, and changes in bodily representations. It has been shown that LIE is a complex mental task that includes cognitive, sensory, motor and behavioral processes and can be associated with them. A study showed that there was a strong correlation between LIE and proprioception.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Inclusion criteria
- •Between the ages of 18-65, having neck pain lasting more than 3 months,
- •Speaks and understands the Turkish language at a sufficient level,
- •Able to use telephone and computer,
- •Being literate,
- •Scored 21 or more on the Montreal Cognitive Assessment (MoCA) scale, which evaluates the cognitive status of individuals,
- •Reporting pain intensity as 30 mm or more on the Visual Analogue Scale (VAS),
- •Individuals with level 3 according to the Neck Pain Task Force Scale will be included.
- •Inclusion criteria for healthy group / Asymptomatic Individuals
- •Asymptomatic between the ages of 18-65,
- •Individuals matched with the study group in terms of body mass index and age
- •Do not feel neck or back pain that prevents them from normal activities,
- •Those who have not previously received medical intervention or treatment for their neck problem,
- •Being literate,
- •Individuals who score 21 or above on the Montreal Cognitive Assessment (MoCA) scale, which evaluates the cognitive status of individuals, will be included.
排除标准
- •Have received physiotherapy treatment due to neck pain in the last 6 months,
- •Those who have had neck surgery,
- •Suspicion of malignant or systemic disease,
- •Having a neurological disease or injury,
- •Individuals with vertigo, nausea, visual disturbances will not be included.
结局指标
主要结局
Cognitive Status Assessment (Montreal Cognitive Assessment: MoCA)
时间窗: Baseline
It will be used to evaluate the cognitive status of individuals and to exclude participants from the study. It is a test that aims to evaluate participants in 7 cognitive aspects such as attention, concentration, memory, language, calculation, spatial-visual skills, reasoning and orientation. It takes approximately ten minutes. The highest score that can be obtained from the test is 30. The cognitive level of the participant who scores 21 points or above is considered normal. Turkish validity-reliability study was conducted by Özdilek and Kenangil in 2014.
Stroop test (quick)
时间窗: Baseline, and up to 4 weeks
It is a cognitive control test consisting of three parts developed by J. R. Stroop in 1935. The Stroop task and related tests are considered the gold standard of attention measurements in the literature. In the first part of the test, subjects are presented with color names and asked to read them as quickly as possible. In the second part, you are asked to say the colors of dot clusters printed with colored ink as quickly as possible. In the third part, the students are asked to read the words written in ink of a different color than the name of the presented color as quickly (and loudly) as possible. The Turkish validity and reliability study was conducted by Karakaş et al. in 1999.
Motor Imagery Assessment
时间窗: Baseline
Made using the Movement Imagery Questionnaire-3. The Turkish validity and reliability study of the questionnaire was conducted by Dilek et al. It was made by. It consists of 3 subscales and a total of 12 items that evaluate external visual imagery, internal visual imagery, and kinesthetic imagery. Each of the 12 tasks in the survey is first performed physically, then the participant returns to the starting position and imagery is performed according to the desired type of imagery. Scoring is made between 1 and 7, with "1 point: very difficult to see/feel, 7 points: very easy to see/feel." When calculating the score, internal visual imagery, external visual imagery and kinesthetic imagery scores are added separately, divided by 4 and averaged to obtain the score of each subscale.
Pain Intensity
时间窗: Baseline, and up to 4 weeks
Individuals' pain intensity will be evaluated subjectively with the Visual Analog Scale (VAS). This scale consists of a 10 cm linear line. The starting point of the line is 0, no pain; The endpoint of 10 is the worst pain ever experienced in life; 5 indicates moderate pain. People will be asked to numerically rate the severity of their pain on the scale.
Kinesiophobia Assessment
时间窗: Baseline, and up to 4 weeks
Fear of movement will be evaluated with the TAMPA kinesiophobia scale (TKÖ). TAS is a questionnaire consisting of 17 questions developed by Korietal in 1991 for musculoskeletal pain. This scale includes parameters for injury/re-injury and fear avoidance in activities related to . In this scale, each question was scored as (1 = disagree, 4 = strongly agree). While scoring, items 4, 8, 12 and 16 are reversed and then the total score is obtained. The person receives a total score between 17-68. The Turkish reliability of the Tampa Kinesiophobia Scale was conducted by Yılmaz et al.
Evaluation of Neck Disability
时间窗: Baseline, and up to 4 weeks
The extent to which individuals' chronic neck pain affects their daily living activities will be evaluated with the Neck Disability Index (NEI). The Turkish validity and reliability of the index was determined by Telci et al. The index, which evaluates subjective symptoms and activities of daily living, consists of a total of 10 sections (pain intensity, personal care, lifting, reading, headache, concentration, work life, driving, sleep and leisure activities). There are 6 options for each section, ranging from 0 to 5 points. The total score varies between 0 and 50 (0: no disability; 50: maximum disability), and an increase in the total score indicates that the disability increases. In the evaluation in our study, the percentage of each score will be calculated to obtain an equal score distribution in case the patients do not answer some questions. 8 percent and below is considered "no excuse".
Proprioception Sense Test
时间窗: Baseline, and up to 4 weeks
Cervical joint position error will be measured using the Dualer IQ digital inclinometer (J-Tech Medical, Midvale, UT, USA). Digital inclinometer spine assessment protocols are well established and approved by the American Medical Association. Digital inclinometer allows clinicians to evaluate range of motion and proprioception using dynamic inclinometry similar to that used in other goniometric protocols. Digital inclinometer has demonstrated test-retest reliability for measuring spinal range of motion.
Body Awareness Assessment
时间窗: Baseline, and up to 4 weeks
Individuals' neck awareness will be assessed with the Fremantle Neck Awareness Questionnaire. Developed by Benedict Wand, its Turkish validity and reliability were confirmed by Onan et al. Likert type assessing individual-specific altered perception (0 = I never/never feel like this, 1= I rarely feel like this, 2 = Sometimes, or some of the time I feel like this, 3 = I often feel like this, 4 = I always or most of the time feel like this) It is a simple survey. The survey asks individuals 9 questions, such as how they perceive their neck in relation to their body and how they perceive their body position.
EEG power in alpha, theta, beta band
时间窗: Baseline, and up to 4 weeks
Evaluation of brain oscillations with EEG analysis.
次要结局
未报告次要终点
研究者
Aysegul Bostan
Lecturer
Bahçeşehir University