Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial

Verónica Pérez-Cabezas, Carmen Ruiz-Molinero, Jose Jesús Jimenez-Rejano, Gema Chamorro-Moriana, Gloria Gonzalez-Medina, Raquel Chillon-Martinez, Verónica Pérez-Cabezas, Carmen Ruiz-Molinero, Jose Jesús Jimenez-Rejano, Gema Chamorro-Moriana, Gloria Gonzalez-Medina, Raquel Chillon-Martinez

Abstract

Objectives: Proprioceptive training is popularly applied as a therapeutic exercise method in physiotherapy. Its effects on pain and range of motion are only poorly evaluated. Therefore, this study assesses the effectiveness of proprioceptive training with an Eye-Cervical Re-education Program to decrease pain and increase the joint range in chronic neck pain patients. Material and Methods.

Design: A randomized, no-blinded, controlled clinical trial. Setting. Physiotherapy consultation. Participants. 44 people were divided into two groups. Interventions. All patients were treated with a multimodal physiotherapy intervention. The experimental group was supplemented with an exercise program that included eye-cervical proprioception. Outcomes. The primary outcomes included pain pressure thresholds (upper trapezius, levator scapulae, and splenius capitis) and cervical range of motion. The secondary outcomes included pain measured by the Visual Analogical Scale and the McGillSpv Questionnaire.

Results: The proprioception treatment was effective in reducing the pain pressure threshold in the right upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius (.

Conclusions: The Eye-Cervical Re-education Program is effective at relieving pain pressure thresholds in the upper trapezius, right levator scapula, and left splenius capitis and especially effective for increasing the cervical range of motion. This trial is registered with NCT03197285 (retrospective registration).

Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this article.

Copyright © 2020 Verónica Pérez-Cabezas et al.

Figures

Figure 1
Figure 1
CONSORT flow diagram.

References

    1. Van Hecke O., Torrance N., Smith B. H. Chronic pain epidemiology and its clinical relevance. British Journal of Anaesthesia. 2013;111(1):13–18. doi: 10.1093/bja/aet123.
    1. Kääriä S., Laaksonen M., Rahkonen O., Lahelma E., Leino-Arjas P. Risk factors of chronic neck pain: a prospective study among middle-aged employees. European Journal of Pain. 2012;16(6):911–920. doi: 10.1002/j.1532-2149.2011.00065.x.
    1. Goode A. P., Freburger J., Carey T. Prevalence, practice patterns, and evidence for chronic neck pain. Arthritis Care & Research. 2010;62(11):1594–1601. doi: 10.1002/acr.20270.
    1. Andersen L. L., Hansen K., Mortensen O. S., Zebis M. K. Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain. BMC Musculoskeletal Disorders. 2011;12(1):p. 169. doi: 10.1186/1471-2474-12-169.
    1. Andersen L. L., Andersen C. H., Sundstrup E., Jakobsen M. D., Mortensen O. S., Zebis M. K. Central adaptation of pain perception in response to rehabilitation of musculoskeletal pain: randomized controlled trial. Pain Physician. 2012;15(5):385–394. doi: 10.1016/j.spinee.2014.02.010.
    1. Jørgensen R., Ris I., Juhl C., Falla D., Juul-Kristensen B. Responsiveness of clinical tests for people with neck pain. BMC Musculoskeletal Disorders. 2017;18(1):p. 548. doi: 10.1186/s12891-017-1918-1.
    1. Pan F., Arshad R., Zander T., Reitmaier S., Schroll A., Schmidt H. The effect of age and sex on the cervical range of motion—a systematic review and meta-analysis. Journal of Biomechanics. 2018;75:13–27. doi: 10.1016/j.jbiomech.2018.04.047.
    1. Dieterich A. V., Andrade R. J., Le Sant G., et al. Shear wave elastography reveals different degrees of passive and active stiffness of the neck extensor muscles. European Journal of Applied Physiology. 2017;117(1):171–178. doi: 10.1007/s00421-016-3509-5.
    1. Kristjansson E., Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. Journal of Orthopaedic & Sports Physical Therapy. 2009;39(5):364–377. doi: 10.2519/jospt.2009.2834.
    1. Ghamkhar L., Kahlaee A. H., Nourbakhsh M. R., Ahmadi A., Arab A. M. Relationship between proprioception and endurance functionality of the cervical flexor muscles in chronic neck pain and asymptomatic participants. Journal of Manipulative and Physiological Therapeutics. 2018;41(2):129–136. doi: 10.1016/j.jmpt.2017.08.006.
    1. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual Therapy. 2008;13(1):2–11. doi: 10.1016/j.math.2007.06.003.
    1. Panjabi M. M. A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. European Spine Journal. 2006;15(5):668–676. doi: 10.1007/s00586-005-0925-3.
    1. McCaskey M. A., Schuster-Amft C., Wirth B., Suica Z., De Bruin E. D. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review. BMC Musculoskeletal Disorders. 2014;15(1):p. 382. doi: 10.1186/1471-2474-15-382.
    1. Revel M., Minguet M., Gergoy P., Vaillant J., Manuel J. L. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Archives of Physical Medicine and Rehabilitation. 1994;75(8):895–899. doi: 10.1016/0003-9993(94)90115-5.
    1. Humphreys B. K., Irgens P. M. The effect of a rehabilitation exercise program on head repositioning accuracy and reported levels of pain in chronic neck pain subjects. Journal of Whiplash & Related Disorders. 2002;1(1):99–112. doi: 10.3109/j180v01n01_09.
    1. Jull G., Falla D., Treleaven J., Hodges P., Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. Journal of Orthopaedic Research. 2007;25(3):404–412. doi: 10.1002/jor.20220.
    1. Izquierdo T., Pecos-Martin D., Girbés E., et al. Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: a randomized controlled clinical trial. Journal of Rehabilitation Medicine. 2016;48(1):48–55. doi: 10.2340/16501977-2034.
    1. Ylinen J., Nykänen M., Kautiainen H., Häkkinen A. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Manual Therapy. 2007;12(2):192–197. doi: 10.1016/j.math.2006.06.010.
    1. Takala E. P. Pressure pain threshold on upper trapezius and levator scapulae muscles. Repeatability and relation to subjective symptoms in a working population. Scandinavian Journal of Rehabilitation Medicine. 1990;22(2):63–68.
    1. Jørgensen R., Ris I., Falla D., Juul-Kristensen B. Reliability, construct and discriminative validity of clinical testing in subjects with and without chronic neck pain. BMC Musculoskeletal Disorders. 2014;15(1):p. 408. doi: 10.1186/1471-2474-15-408.
    1. Bijur P. E., Silver W., Gallagher E. J. Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine. 2001;8(12):1153–1157. doi: 10.1111/j.1553-2712.2001.tb01132.x.
    1. Lázaro C., Bosch F., Torrubia R., Baños J. E. The development of a Spanish questionnaire for assessing pain: preliminary data concerning reliability and validity. European Journal of Psychological Assessment. 1994;10:145–151.
    1. Pérez-cabezas V., Ruiz-Molinero C. Effectiveness of a proprioceptive training program in chronic neck pain : pilot study. Cuestiones de Fisioterapia. 2018;47(2):87–97.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York, NY, USA: Lawrence Erlbaum Associates Publishers; 1988.
    1. Grissom R. J. Probability of the superior outcome of one treatment over another. Journal of Applied Psychology. 1994;79(2):314–316. doi: 10.1037/0021-9010.79.2.314.
    1. Lluch E., Arguisuelas M. D., Coloma P. S., Palma F., Rey A., Falla D. Effects of deep cervical flexor training on pressure pain thresholds over myofascial trigger points in patients with chronic neck pain. Journal of Manipulative and Physiological Therapeutics. 2013;36(9):604–611. doi: 10.1016/j.jmpt.2013.08.004.
    1. Bobos P., Billis E., Papanikolaou D. T., Koutsojannis C., MacDermid J. C. Does deep cervical flexor muscle training affect pain pressure thresholds of myofascial trigger points in patients with chronic neck pain? A prospective randomized controlled trial. Rehabilitation Research and Practice. 2016;2016:8. doi: 10.1155/2016/6480826.6480826
    1. Jull G. A., Falla D., Vicenzino B., Hodges P. W. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Manual Therapy. 2009;14(6):696–701. doi: 10.1016/j.math.2009.05.004.
    1. Falla D., OʼLeary S., Farina D., Jull G. Association between intensity of pain and impairment in onset and activation of the deep cervical flexors in patients with persistent neck pain. The Clinical Journal of Pain. 2011;27(4):309–314. doi: 10.1097/ajp.0b013e31820212cf.
    1. O’Leary S., Falla D., Elliott J. M., Jull G. Muscle dysfunction in cervical spine pain: implications for assessment and management. Journal of Orthopaedic & Sports Physical Therapy. 2009;39(5):324–333. doi: 10.2519/jospt.2009.2872.
    1. Falla D. L., Jull G. A., Hodges P. W. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 2004;29(19):2108–2114. doi: 10.1097/01.brs.0000141170.89317.0e.
    1. Falla D., Farina D. Muscle fiber conduction velocity of the upper trapezius muscle during dynamic contraction of the upper limb in patients with chronic neck pain. Pain. 2005;116(1):138–145. doi: 10.1016/j.pain.2005.03.038.
    1. Richter H. O., Zetterlund C., Lundqvist L.-O. Eye-neck interactions triggered by visually deficient computer work. Work. 2011;39(1):67–78. doi: 10.3233/wor-2011-1152.
    1. Corneil B. D., Olivier E., Munoz D. P. Visual responses on neck muscles reveal selective gating that prevents express saccades. Neuron. 2004;42(5):831–841. doi: 10.1016/s0896-6273(04)00267-3.
    1. Richter H. O., Zetterberg C., Forsman M. Trapezius muscle activity increases during near work activity regardless of accommodation/vergence demand level. European Journal of Applied Physiology. 2015;115(7):1501–1512. doi: 10.1007/s00421-015-3125-9.
    1. Hansson E., Persson L., Malmström E. Influence of vestibular rehabilitation on neck pain and cervical range of motion among patients with whiplash-associated disorder: a randomized controlled trial. Journal of Rehabilitation Medicine. 2013;45(9):906–910. doi: 10.2340/16501977-1197.
    1. Harper B., Jagger K., Aron A., Steinbeck L., Stecco A. A commentary review of the cost effectiveness of manual therapies for neck and low back pain. Journal of Bodywork and Movement Therapies. 2017;21(3):684–691. doi: 10.1016/j.jbmt.2016.09.014.
    1. Chiu T. T., Hui-Chan C. W., Cheing G. A randomized clinical trial of TENS and exercise for patients with chronic neck pain. Clinical Rehabilitation. 2005;19(8):850–860. doi: 10.1191/0269215505cr920oa.
    1. Treleaven J., Jull G., LowChoy N. Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. Journal of Rehabilitation Medicine. 2005;37(4):219–223. doi: 10.1080/16501970510027989.
    1. Jull G. A., O’Leary S. P., Falla D. L. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. Journal of Manipulative and Physiological Therapeutics. 2008;31(7):525–533. doi: 10.1016/j.jmpt.2008.08.003.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir