Abstract
BackgroundNeck pain is associated with several alterations in neck motion and motor control. Previous studies have investigated single constructs of neck motor control, while few have applied a comprehensive set of tests to investigate cervical motor control. This comparative cross- sectional study aimed to investigate different motor control constructs in neck pain patients and healthy controls.MethodsA total of 166 subjects participated in the study, 91 healthy controls (HC) and 75 neck pain patients (NP) with long-lasting moderate to severe neck pain. Neck flexibility, proprioception, head steadiness, trajectory movement control, and postural sway were assessed using a 3D motion tracking system (Liberty). The different constructs of neck motion and motor control were based on tests used in previous studies.ResultsNeck flexibility was lower in NP compared to HC, indicated by reduced cervical ROM and conjunct motion. Movement velocity was slower in NP compared to HC. Tests of head steadiness showed a stiffer movement pattern in NP compared to HC, indicated by lower head angular velocity. NP patients departed less from a predictable trajectory movement pattern (figure of eight) compared to healthy controls, but there was no difference for unpredictable movement patterns (the Fly test). No differences were found for postural sway in standing with eyes open and eyes closed. However, NP patients had significantly larger postural sway when standing on a balance pad. Proprioception did not differ between the groups. Largest effect sizes (ES) were found for neck flexibility (ES range: 0.2- 0.8) and head steadiness (ES range: 1.3- 2.0). Neck flexibility was the only construct that showed a significant association with current neck pain, while peak velocity was the only variable that showed a significant association with kinesiophobia.ConclusionsNP patients showed an overall stiffer and more rigid neck motor control pattern compared to HC, indicated by lower neck flexibility, slower movement velocity, increased head steadiness and more rigid trajectory head motion patterns. Only neck flexibility showed a significant association with clinical features in NP patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0517-2) contains supplementary material, which is available to authorized users.
Highlights
Neck pain is associated with several alterations in neck motion and motor control
The groups were similar in age and BMI, but there were a higher proportion of women in the healthy controls (HC) group (Table 2)
The neck pain patients (NP) subjects showed a moderate disability measured by the Neck Disability Index (NDI), a moderate kinesiophobia measured by the Tampa Scale of Kinesiophobia (TSK), and a moderate pain catastrophizing measured by the Pain Catastrophizing Scale (PCS)
Summary
Previous studies have investigated single constructs of neck motor control, while few have applied a comprehensive set of tests to investigate cervical motor control. This comparative cross- sectional study aimed to investigate different motor control constructs in neck pain patients and healthy controls. Few studies have utilized a comprehensive set of neck movement and motor control tests to contrast patients and healthy subjects. The aim of this study was to compare neck motion and motor control in neck pain patients with moderate to severe neck pain and healthy subjects with tests representing five different constructs: neck flexibility, proprioception, trajectory movement control, head steadiness, and postural sway. Secondary aim was to evaluate the association between clinical features such as pain, disability, and kinesiophobia and the constructs of motor control and neck motion
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