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Rahnama M.1, Karimi N.2, Rahnama L.2, Abdollahi I.2, Arab-Khazaeli Z.2, Bagherzadeh F.2, Saberi M.1
1Shiraz University of Medical Sciences, Shiraz, Iran, 2University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Background: Chronic neck pain (CNP) and forward head posture (FHP) are two prevalent neck problems with several sensorimotor and musculoskeletal complications such as proprioceptive disruption and altered muscles function. It is claimed that FHP has negative impact on proprioceptive receptors due to deviation in cervical alignment. On the other hand, CNP may disrupt mechanoreceptors function by pain inhibitory reflexes. However, whether FHP has more deteriorative impact on neck proprioception or CNP, has not yet been investigated.
Purpose: The purpose of the present study was to investigate the cervical position sense accuracy in individuals with CNP and compare to individuals with FHP.
Methods: Twenty five female college students with FHP and 25 matched females sustaining CNP voluntarily participated in this study. Cranio-vertebral angle (CVA) was measured to identify individuals with FHP. CVA lesser than 49 degrees was recognized as FHP. Participants with CNP were included if they had neck pain at the time of study in addition to a positive history of neck pain in the year prior to the study while the FHP group were excluded if they reported any pain in their neck area during that year. Cervical position senses were measured by performing head repositioning error (HRE) test. Independent t-test was used to compare the HRE between the two groups. In order to evaluate the association between pain and CVA with HRE, Spearman correlation was conducted. The level of significance was set at alpha 0.05.
Results: There were no significant differences between two groups in terms of age and body mass index (BMI). The FHP group aged 31.88±2.65 years and the CNP group aged 33±5.96 years. BMIs were 23.69±3.32 and 24.31±2.98 in FHP and CNP groups respectively. A significant (p=0.02) higher HRE in participants with CNP (5.43±1.32) were observed compare to FHP (4.28±1.95). A moderate positive correlation was revealed for CVA and HRE (p=0.03, r=0.43). No significant relationship was found between pain and HRE.
Conclusion(s): The results of this study showed higher HRE in participants with CNP compare to individuals with FHP indicating more cervical proprioceptive disruption in CNP. Additionally, a moderate association between HRE and CVA indicates the more sever FHP is, the less accurate, the cervical joint position sense is .
Implications: The results show that pain has high deteriorative impact on cervical position sense. Therefore in managing chronic neck pain, proprioceptive re-education should be considered. This result may be of interest for those researchers investigating effects of pain and postural deviations on cervical position sense.
Funding acknowledgements: No funding source
Topic: Musculoskeletal: spine
Ethics approval: Ethical Approval NO: IR.USWR.REC.1393.192 (Ethics Board of University of Social Welfare and Rehabilitation Sciences)
All authors, affiliations and abstracts have been published as submitted.
