Abstract

ObjectiveThe 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).MethodsA 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.ResultsThe 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).ConclusionsAlthough 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.

Highlights

  • Neck pain is a common musculoskeletal disorder with a high prevalence in the population and is the fourth leading disability-generating condition (Vos et al, 2013)

  • The results obtained in the vertical plane showed that the action observation (AO) group obtained greater improvements than the placebo observation (PO) group in cervical joint position sense (CJPS) of the cervical extension movement both at the end of the intervention and at 10 min postintervention, as well as in the cervical flexion movement, only at 10 min after the intervention

  • The results obtained in the vertical plane showed that both the AO and motor imagery (MI) groups obtained greater improvements than the PO group in CJPS of the cervical left rotation movement at the end of the intervention

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Summary

Introduction

Neck pain is a common musculoskeletal disorder with a high prevalence in the population and is the fourth leading disability-generating condition (Vos et al, 2013). Chronic neck pain is often considered nonspecific (NSCNP), due to the difficulty in identifying the origin of the pain, when imaging tests provide no relevant information for establishing an accurate pathological diagnosis (Bogduk, 2011). This clinical condition is thought to have a multidimensional nature due to the combination of a complex pathogenesis, the presence of maladaptive processes of central neuroplasticity and in pain processing, as well as the relevance of psychological aspects involved in the NSCNP such as anxiety or pain catastrophism (Binder, 2007; Dimitriadis et al, 2015; Muñoz García et al, 2016). Hodges & Tucker (2011) suggested that maladaptive processes of central plasticity could lead to impaired motor planning and movement execution as a pain response and could affect motor control and movement acuity in this region

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