Sensorimotor performance in acute-subacute non-specific neck pain: a non-randomized prospective clinical trial with intervention

Renaud Hage, Christine Detrembleur, Frédéric Dierick, Jean-Michel Brismée, Nathalie Roussel, Laurent Pitance, Renaud Hage, Christine Detrembleur, Frédéric Dierick, Jean-Michel Brismée, Nathalie Roussel, Laurent Pitance

Abstract

Background: The assessment of cervical spine kinematic axial rotation performance is of great importance in the context of the study of neck sensorimotor control. However, studies addressing the influence of the level of provocation of spinal pain and the potential benefit of passive manual therapy mobilizations in patients with acute-subacute non-specific neck pain are lacking.

Methods: A non-randomized prospective clinical trial with an intervention design was conducted. We investigated: (1) the test-retest reliability of kinematic variables during a fast axial head rotation task standardized with the DidRen laser test device in 42 Healthy pain-free Control Participants (HCP) (24.3 years ±6.8); (2) the differences in kinematic variables between HCP and 38 patients with Acute-subacute Non-Specific neck Pain (ANSP) assigned to two different groups according to whether their pain was localized in the upper or lower spine (46.2 years ±16.3); and (3) the effect of passive manual therapy mobilizations on kinematic variables of the neck during fast axial head rotation.

Results: (1) Intra-class correlation coefficients ranged from moderate (0.57 (0.06-0.80)) to excellent (0.96 (0.91-0.98)). (2) Kinematic performance during fast axial rotations of the head was significantly altered in ANSP compared to HCP (age-adjusted) for one variable: the time between peaks of acceleration and deceleration (p<0.019). No significant difference was observed between ANSP with upper vs lower spinal pain localization. (3) After the intervention, there was a significant effect on several kinematic variables, e.g., ANSP improved peak speed (p<0.007) and performance of the DidRen laser test (p<0.001), with effect sizes ranging from small to medium.

Conclusion: (1) The DidRen laser test is reliable. (2) A significant reduction in time between acceleration and deceleration peaks was observed in ANSP compared to HCP, but with no significant effect of spinal pain location on kinematic variables was found. (3) We found that neck pain decreased after passive manual therapy mobilizations with improvements of several kinematic variables.

Trial registration: Registration Number: NCT04407637.

Keywords: Cervical rotation; acute non-specific neck pain; passive mobilizations; sensorimotor assessment.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart. Inclusion of 38 Patients (ANSP) and 42 Controls (HCP) with the three aims of the study presented: Reliability (test-retest reliability of kinematic variables), Validity (differences in kinematic variables between HCP and ANSP (upper vs lower spine pain localization: based on the manual examination, 38 ANSP were assigned to either the upper (C0-C2; n=17) or lower (C3 to C7; n=21) spine pain group)), and Intervention (effect of manual therapeutic interventions on kinematic variables assessed between the first and second DidRen laser tests). For blinding reasons, a first examiner supervised the completion of the questionnaires, the DidRen laser test, and the active cervical spine rotation test (range of motion). The questionnaires included the Neck Disability Index (NDI), the French version of the Bournemouth questionnaire (BQ), the Tampa scale of Kinesiophobia (TSK) (except for HCP), and the Numeric Pain Rating Scale (NPRS). A second examiner performed the cervical spine manual examination and the passive manual therapy mobilization sessions. Based on the manual examination, 12 HCP who experienced pain were excluded from the study; 42 HCP were then included
Fig. 2
Fig. 2
Installation of the DidRen laser test. A Head position in front of targets. B Schematic top view of the test setup with the three photosensitive sensors. C Helmet worn by participant with laser on top and DYSKIMOT on forehead
Fig. 3
Fig. 3
Typical plots of variables analyzed during a right rotation in a HCP from the younger adult group (age: 22 yrs., sex: female). We calculated the angular speed and acceleration of the head-neck complex from the beginning to the end of each rotation cycle. All values are expressed in absolute values. A (1) range of motion during the test (ROM test in °); (2) overshoot (°s-1); (3) stabilization time (s); (4) peak speed (°s-1); B (5) time to peak speed (s); (6) average speed (° s-1); (7) peak acceleration (°s-2); C (8) time to peak acceleration (s); (9) peak deceleration (°s-2); (10) time to peak deceleration (s); (11) time between peaks of acceleration and deceleration (s); (12) time from peak acceleration to end of rotation (s); D (13) angle at maximum speed (°)

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