Seeing the site of treatment improves habitual pain but not cervical joint position sense immediately after manual therapy in chronic neck pain patients

Objective The main objective of this trial was to assess whether action observation (AO) training and motor imagery (MI) produced changes in the cervical joint position sense (CJPS) both at the end of the intervention and 10 min postintervention compared with a placebo intervention in patients with nonspecific chronic neck pain (NSCNP). Methods A single-blind placebo clinical trial was designed. A total of 30 patients with NSCNP were randomly assigned to the AO group, MI group or placebo observation (PO) group. CJPS in flexion, extension and rotation movements in both planes were the main variables. Results The results obtained in the vertical plane showed that the AO group obtained greater improvements than the PO group in the CJPS in terms of cervical extension movement both at the end of the intervention and 10 min postintervention (p = .001, d = 1.81 and p = .004, d = 1.74, respectively), and also in cervical flexion movement, although only at 10 min after the intervention (p = .035, d = 0.72). In addition, the AO group obtained greater improvements than the MI group in the CJPS only at the end of the intervention in cervical extension movement (p = .041, d = 1.17). Regarding the left rotation cervical movement, both the MI and AO groups were superior to the PO group in both planes at the end of the intervention (p < .05, d > 0.80). Conclusions Although both AO and MI could be a useful strategy for CJPS improvement, the AO group showed the strongest results. The therapeutic potential of the application of mental practice in a clinical context in the early stages of rehabilitation of NSCNP should be considered.

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Watching Your Neck: The Influence of Real-Time Visual Feedback on Cervical Joint Position Sense in Chronic Neck Pain

Motor Control ◽

10.1123/mc.2019-0111 ◽

2021 ◽

Vol 25 (4) ◽

pp. 631-643

Author(s):

Konstantin Beinert ◽

Katharina Deutsch ◽

Sebastian Löscher ◽

Martin Diers

Keyword(s):

Central Nervous System ◽

Neck Pain ◽

Real Time ◽

Visual Feedback ◽

Body Representation ◽

Chronic Neck Pain ◽

Position Sense ◽

Joint Position Sense ◽

Joint Position ◽

Internal Body

Patients with neck pain demonstrate a variety of sensorimotor impairments, such as decreased cervical joint position sense (CJPS) acuity, which might also be associated with an impaired internal body representation. The present study evaluated the effect of real-time visual feedback of the individual’s own neck on CJPS compared to observing a book. Twenty-three patients with neck pain participated in the experiment and received the interventions in randomized order on separate days in a within-subject pretest–posttest design. Before and immediately after each intervention, CJPS was measured by a therapist blinded to the intervention. The results demonstrate a significantly different development of CJPS (p = .04), with increased CJPS acuity after observing one’s own neck and decreased acuity after observing a book. Real-time visual feedback of the neck improved CJPS acuity in patients with neck pain without active movements of the neck, indicating the importance of central nervous system processing for CJPS acuity.

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Peer Review #3 of "Mental practice in isolation improves cervical joint position sense in patients with chronic neck pain: a randomized single-blind placebo trial (v0.2)"

10.7287/peerj.7681v0.2/reviews/3 ◽

2019 ◽

Author(s):

VP Nicholson

Keyword(s):

Neck Pain ◽

Peer Review ◽

Chronic Neck Pain ◽

Position Sense ◽

Joint Position Sense ◽

Mental Practice ◽

Joint Position ◽

Placebo Trial ◽

Single Blind

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Influence of Cervical Spine Manipulation on Neck Joint Position Sense error in patients with chronic neck pain.

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2016.14.405 ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Iã Ferreira Miranda ◽

Daniel Facchini ◽

Eliane Fátima Manfio

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Spinal Manipulation ◽

Prediction Rule ◽

Chronic Neck Pain ◽

Position Sense ◽

Joint Position Sense ◽

Joint Position ◽

Post Intervention ◽

Cervical Spine Manipulation

Introduction: Cervical joint dysfunction may interfere with the sensorimotor afferent response, interfering with neck neck Joint Position Sense error (JPS). Objective: The aim of this study was to evaluate the influence of Cervical Spine Manipulation (CSM) on neck JPS error in patients with chronic neck pain. Method: 21 patients with chronic neck pain were divided into 2 groups: Spinal Manipulation Group (MG) or Sham Group (SG) who received 4 sessions of CSM and Sham CSM respectively. JPS was assessed in three different time frames: 1) pre-intervention; 2) Right after the first intervention (post-intervention 1); and 3) After a chronic intervention (post-intervention 2). The outcome measured in this study was the head reposition accuracy test with the Revel’s Test. Results: The JPS showed no significant differences between pre- and post-intervention 1 and 2 for any of the assessed groups. Conclusion: We conclude that, for this sample, neither the CSM nor the Sham CSM statistically changed the JPS error for neither groups. We believe that the changes in JPS after CSM were concealed because the ability of other sensory system information to compensate for inadequacies in any other component. Therefore, more studies have to be done with a stronger methodological rigor, clinical prediction rule for spinal manipulation, bigger sample and a blind assessment.

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