de Zoete RMJ1,2,3,4, Osmotherly PG2,3,4, Rivett DA2,3,4, Snodgrass SJ2,3,4
1Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia, 2The University of Newcastle, School of Health Sciences, Callaghan, Australia, 3Hunter Medical Research Institute, Newcastle, Australia, 4Centre for Brain and Mental Health Research, The University of Newcastle, Callaghan, Australia
Background: Cervical sensorimotor control outcomes have been suggested important in the assessment of individuals with chronic idiopathic neck pain, despite a lack of consistent supporting evidence. Longitudinal evidence of changes in cervical sensorimotor control over time is lacking, and it is unclear whether characteristics of neck pain might be related to potential changes in sensorimotor control. Several cross-sectional studies have reported weak correlations between cervical sensorimotor control and neck pain intensity, neck pain duration, and neck disability. Clinicians might believe a sensorimotor control intervention could improve neck pain, however, it is currently unclear whether sensorimotor skills are related to the characteristics of neck pain.
Purpose: To investigate whether cervical sensorimotor control changes over time in individuals with chronic idiopathic neck pain, and whether characteristics of chronic idiopathic neck pain are associated with changes in cervical sensorimotor control.
Methods: Longitudinal observational study: Fifty participants with chronic idiopathic neck pain and 50 gender and age matched healthy controls completed seven cervical sensorimotor control tests. The seven tests (14 test conditions) were: joint position error, postural balance, subjective visual vertical, head tilt response, The Fly®, smooth pursuit neck torsion, and head steadiness. Neck pain characteristics included pain intensity (Visual Analogue Scale 0-100mm with four-week recall), pain duration, and Neck Disability Index score. Individuals with neck pain were assessed four times (baseline, four-weeks, eight-weeks, and six-months), and healthy individuals were assessed twice (baseline, six-months). Linear mixed regression models were used to investigate whether any factors were associated with changes in sensorimotor control.
Results: Neck pain intensity changed significantly over the six-month period (p=0.05), and seven out of 14 cervical sensorimotor control outcomes changed significantly in individuals with chronic idiopathic neck pain. Neck pain intensity was associated with one of 14 sensorimotor control test conditions (balance with torsion and eyes open, p=.035) at only one of four time points (four-weeks), and neck disability was associated with balance with eyes open (p=.039) (only at baseline) and high load head steadiness (p=.004) (only at eight-weeks). Other factors, including gender, age, body mass index, and physical activity levels, showed no associations with cervical sensorimotor control outcomes.
Conclusion(s): Cervical sensorimotor control did not change consistently with changes in pain or disability over a six-month period in individuals with chronic idiopathic neck pain. The very few associations between the different test conditions and neck pain characteristics were weak at best, hence these are likely to be chance findings.
Implications: Clinically, cervical sensorimotor control tests that do not respond to changes in neck pain characteristics may not be meaningful. As these tests might not provide relevant information regarding the improvement/deterioration of idiopathic neck pain, the meaningfulness of these outcomes in this population is questionable. Thus, the clinical utility of the currently available cervical sensorimotor control tests in individuals with chronic idiopathic neck pain is arguably low.
Keywords: Neck pain, Sensorimotor control, Chronic pain
Funding acknowledgements: This work was supported by Felicity and Michael Thomson through the Hunter Medical Research Institute, grant no. G160129.
Purpose: To investigate whether cervical sensorimotor control changes over time in individuals with chronic idiopathic neck pain, and whether characteristics of chronic idiopathic neck pain are associated with changes in cervical sensorimotor control.
Methods: Longitudinal observational study: Fifty participants with chronic idiopathic neck pain and 50 gender and age matched healthy controls completed seven cervical sensorimotor control tests. The seven tests (14 test conditions) were: joint position error, postural balance, subjective visual vertical, head tilt response, The Fly®, smooth pursuit neck torsion, and head steadiness. Neck pain characteristics included pain intensity (Visual Analogue Scale 0-100mm with four-week recall), pain duration, and Neck Disability Index score. Individuals with neck pain were assessed four times (baseline, four-weeks, eight-weeks, and six-months), and healthy individuals were assessed twice (baseline, six-months). Linear mixed regression models were used to investigate whether any factors were associated with changes in sensorimotor control.
Results: Neck pain intensity changed significantly over the six-month period (p=0.05), and seven out of 14 cervical sensorimotor control outcomes changed significantly in individuals with chronic idiopathic neck pain. Neck pain intensity was associated with one of 14 sensorimotor control test conditions (balance with torsion and eyes open, p=.035) at only one of four time points (four-weeks), and neck disability was associated with balance with eyes open (p=.039) (only at baseline) and high load head steadiness (p=.004) (only at eight-weeks). Other factors, including gender, age, body mass index, and physical activity levels, showed no associations with cervical sensorimotor control outcomes.
Conclusion(s): Cervical sensorimotor control did not change consistently with changes in pain or disability over a six-month period in individuals with chronic idiopathic neck pain. The very few associations between the different test conditions and neck pain characteristics were weak at best, hence these are likely to be chance findings.
Implications: Clinically, cervical sensorimotor control tests that do not respond to changes in neck pain characteristics may not be meaningful. As these tests might not provide relevant information regarding the improvement/deterioration of idiopathic neck pain, the meaningfulness of these outcomes in this population is questionable. Thus, the clinical utility of the currently available cervical sensorimotor control tests in individuals with chronic idiopathic neck pain is arguably low.
Keywords: Neck pain, Sensorimotor control, Chronic pain
Funding acknowledgements: This work was supported by Felicity and Michael Thomson through the Hunter Medical Research Institute, grant no. G160129.
Topic: Musculoskeletal: spine
Ethics approval required: Yes
Institution: The University of Newcastle
Ethics committee: Human Research Ethics Committee
Ethics number: H-2016-0099
All authors, affiliations and abstracts have been published as submitted.
