SYSTEMATIC REVIEW AND META-ANALYSIS OF SENSORIMOTOR TESTS IN PATIENTS WITH NECK PAIN AND ITS ASSOCIATED DISORDERS

N. Särkilahti¹, M. Hirvonen², J. Lavapuro², J. Takatalo³, E. Löyttyniemi⁴, O. Tenovuo²

¹University of Turku, Doctoral Programme in Clinical Research, Turku, Finland, ²University of Turku, Faculty of Medicine, Turku, Finland, ³Oulu University Hospital, Loisto Terveys, Medical Research Center, Oulu, Finland, ⁴University of Turku, Department of Biostatistics, Turku, Finland

Background: Neck pain is a huge common complaint, resulting in significant social, psychological, and economic burden^1,2. There is evidence that proprioceptive changes occur in acute and chronic neck pain^3-8and therefore sensorimotor control tests and exercises are commonly used in patients with neck pain. Although several studies have suggested that sensorimotor characteristics differ between individuals with or without neck pain, or between patient groups with various types of neck pain, there is an inconsistency between the studies^5-7,9-19.

Purpose: The objectives of this systematic review were to synthesize the current evidence regarding neck pain patient’s sensorimotor testing, the ability to make a difference between different neck pain patient groups and healthy controls by testing, and to recognize factors that might affect test results.

Methods: We performed the data search using PubMed, Embase, PsycINFO, CINAHL, and Scopus databases, based on three groups of keywords: neck pain, sensorimotor tests, and reliability and validity of the clinical tests. Furthermore, we screened the reference lists for additional studies.This review was registered in the PROSPERO database (registration number: CRD42020207504).
We used a two-step screening process to identify studies. Initially, the two evaluators (NS and MH) independently reviewed the titles and abstracts of the studies and graded the studies as´potentially relevant´or´insignificant’. In the second phase, the evaluators independently performed a full-text review of the studies identified as´potentially relevant´and graded them as´relevant´or´insignificant´.
We included all neck sensorimotor tests in the review but analyzed only those for which a meta-analysis was possible. In addition, we did a further analysis of the effects of demographic factors on sensorimotor test results.We assessed the quality of the studies using the QUADAS tool.

Results: According to our preliminary results sensorimotor control was most assessed by the joint position sense tests, oculomotor tests, and balance tests. Almost three-quarters of the subjects were women. According to our meta-analysis, sensorimotor control differs between patients with neck pain and healthy controls. Furthermore, we found a small difference between patients with WAD and non-traumatic neck pain. The sensorimotor control appears to be affected in particular by the intensity of the pain as well as by the presence of dizziness symptom.

Conclusions: To evaluate sensorimotor control as a phenomenon, we should be able to determine which variables can affect the test results. According to our review, especially pain intensity and dizziness appear to affect the results of sensorimotor tests. However, there is still little information on the effects of various factors on sensorimotor control. Therefore, it still seems that the reference standard is missing.

Implications: The use of sensorimotor tests is indicated in patients with severe neck pain and/or dizziness.

Funding acknowledgements: Niklas Särkilahti. Source of Financial Support: Finnish Association of Physiotherapists

Keywords:
Neck Pain
Sensorimotor control
Proprioception

Topics:
Musculoskeletal: spine
Musculoskeletal
Disability & rehabilitation

Did this work require ethics approval? No

Reason: No ethics approval is not required due to the research method (systematic review)