Original articleAssociation between cervicocephalic kinesthetic sensibility and frequency of subclinical neck pain
Introduction
Neck pain is a major problem in modern society (National Institute of Occupational Safety and Health (NIOSH), 1997; Lee et al., 2005b), which frequently becomes chronic and/or recurring (Hoving et al., 2004). Sedentary office workers (such as bank employees) face a particularly high risk of developing neck pain, because when they work their neck and shoulders are generally static (Ariens et al., 2000, Ariens et al., 2001). Subjects experiencing minor symptoms or subclinical neck pain have been found to show changes in their neck's range of motion (ROM), muscle endurance, and proprioception (Lee et al., 2005a). To prevent further progress, it is crucial to detect early signs of subclinical neck pain in order to allow prompt intervention.
Recently, increasing attention has been paid to the role that proprioception plays in neck pain (Sterling et al., 2003; Treleaven et al., 2005; Feipel et al., 2006). The cervicocephalic kinesthetic sensibility test (a frequently adapted method of determining neck proprioception) has been used to examine each subject's ability to return their head to a predetermined position without visual cues after they have moved (Revel et al., 1991; Loudon et al., 1997). The ability to do this has been reported to be impaired in patients with chronic neck pain (Revel et al., 1991; Heikkila and Astrom, 1996; Loudon et al., 1997; Feipel et al., 2006). Meanwhile, it has also been found that a proprioceptive training program (including head repositioning) can reduce the symptoms affecting the neck (Revel et al., 1994; Taimela et al., 2000). Since previous studies showed that proprioception is critical to the maintenance of joint stability under dynamic conditions (Ferrell et al., 1985), impairment of proprioception might be a predisposing factor in the development of clinical pain (Sharma et al., 1997; Vilensky, 2003; Panjabi, 2006).
Pain intensity has been a major focus for clinical research on neck pain (Revel et al., 1991; Heikkila and Astrom, 1996; Chiu et al., 2005). However, the subjective intensity of neck pain may not be easily quantified, especially if it occurs only intermittently, or is subclinical. As a result, previous studies have not consistently shown any association between pain intensity and cervicocephalic kinesthetic sensibility (Heikkila and Wenngren, 1998; Rix and Bagust, 2001; Armstrong et al., 2005). An alternative approach to the study of this type of subclinical neck pain is to quantify the temporal aspect of pain and examine if it is related to any change of neck proprioception. We therefore conducted this study, which evaluates repositioning errors, to determine whether the frequency, duration, and intensity of neck pain are associated with cervicocephalic kinesthetic sensibility.
Section snippets
Participants
Subjects were recruited via an invitation to participate, which was published in the newsletter produced by the National Federation of Bank's Employees Unions. One hundred and twenty-seven bank employees with or without neck pain (38 males and 89 females) volunteered for the study (Table 1). Exclusion criteria included the following: specific diagnosis of the cervical spine; traumatic spinal injury; vestibular impairment (demonstrated by vertigo, dizziness, or motor imbalance); diseases of
Demographics and pain characteristics
Table 1 summarizes the demographic data and pain characteristics of 127 subjects recruited into the study. The mean age (and standard deviation) of the studied subjects was 41.8 (8.5) years. In all, 70% of subjects reported that the pain they experienced occurred less than daily. Over half of the study subjects (50.4%) reported that their pain lasted longer than 1 h on average. About 87% of the subjects reported that the intensity of their pain was “minimal” or “mild”. The subjects demonstrated
Discussion
The present study revealed that individuals with higher pain frequency could not reproduce the NHP as accurately when repositioning their head. This finding supports the results of previous research (Revel et al., 1991; Heikkila and Astrom, 1996; Loudon et al., 1997; Feipel et al., 2006) and provides further evidence for a relationship between proprioceptive deficit and pain frequency. However, given the cross-sectional nature of our study, it cannot be determined whether the decrease observed
Conclusion
The present study has provided further evidence that pain frequency, not the intensity or duration of pain, is associated with neck proprioception in individuals with subclinical neck pain. The examination of proprioception in repositioning to the neutral head position may be indicated for patients of increased frequency of neck pain.
Acknowledgments
The study was supported by the Institute of Occupational Safety and Health, Council of Labor Affairs, Taiwan (IOSH90-H331 and IOSH91-H122).
References (49)
- et al.
Head and neck position sense in whiplash patients and healthy individuals and the effect of the cranio-cervical flexion action
Clinical Biomechanics
(2005) - et al.
Experimental muscle pain produces central modulation of proprioceptive signals arising from jaw muscle spindles
Pain
(2000) - et al.
Reproducibility and instrument validity of a new ultrasonography-based system for measuring cervical spine kinematics
Clinical Biomechanics
(2000) - et al.
The influence of joint afferent discharge on locomotion, proprioception and activity in conscious cats
Brain Research
(1985) - et al.
Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury
Archives of Physical Medicine and Rehabilitation
(1998) - et al.
Prognostic factors for neck pain in general practice
Pain
(2004) - et al.
Influences on the gamma-muscle spindle system from muscle afferents stimulated by KCl and lactic acid
Neuroscience Research
(1993) - et al.
Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients
Manual Therapy
(2004) - et al.
Test–retest reliability of cervicocephalic kinesthetic sensibility in three cardinal planes
Manual Therapy
(2006) - et al.
Discharge behavior of feline gamma-motoneurones following induction of an artificial myositis
Pain
(1991)
Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism
Manual Therapy
Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study
Archives of Physical Medicine and Rehabilitation
Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain
Archives of Physical Medicine and Rehabilitation
Development of motor system dysfunction following whiplash injury
Pain
A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work—1: neck and shoulder muscle recruitment patterns
Manual Therapy
Cervicocephalic kinesthetic sensibility in young and middle-aged adults with or without a history of mild neck pain
Manual Therapy
Measurement of cervical range of motion pattern during cyclic neck movement by an ultrasound-based motion system
Manual Therapy
Physical risk factors for neck pain
Scandinavian Journal of Work, Environment & Health
Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study
Occupational and Environmental Medicine
A randomized controlled trial on the efficacy of exercise for patients with chronic neck pain
Spine
Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task
Spine
Head repositioning accuracy in patients with whiplash-associated disorders
Spine
Textbook of medical physiology
Cervicocephalic kinesthetic sensibility in patients with whiplash injury
Scandinavian Journal of Rehabilitation Medicine
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