Effects of Local Treatment With and Without Sensorimotor and Balance Exercises in Neck Pain

NCT ID: NCT03149302

Last Updated: 2022-10-06

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 168 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-11-01
• Study Completion Date: 2021-12-24

Brief Summary

The sensorimotor disturbance and postural instability have been demonstrated to be associated with neck pain. Specific therapeutic exercise and manual therapy for the cervical spine are effective interventions for improving dizziness symptoms, neck impairments, functional ability and quality of life. However, the effects of these interventions on the actual impairment of joint position sense and balance remain uncertain. Adaptive changes in the sensorimotor and postural control systems may need to be specifically addressed.

Detailed Description

The sensorimotor (joint position sense and oculomotor control) and postural stability (balance) disturbances have been demonstrated to be associated with neck pain. Specific therapeutic exercise directed to neuromuscular impairments and manual therapy for the cervical spine are effective interventions for improving dizziness symptoms, neck impairments, functional ability and quality of life. However, the effects of these interventions on the actual impairment of joint position sense and balance remain uncertain. Adaptive changes in the sensorimotor and postural control systems may need to be specifically addressed. Currently, it is not known whether the clinician has to train every impairment or can choose between sensorimotor training and balance training in the rehabilitation of neck pain. Different training approaches may have specific influences on the different outcomes and their outcomes will be important to inform the optimal and efficient management of persons with chronic neck pain.

Conditions

Neck Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Local neck treatment (LNT)

Cervical mobilization and specific therapeutic exercises

Group Type: EXPERIMENTAL

Local neck treatment (LNT)

Intervention Type: OTHER

The local neck treatment consists of cervical mobilization and specific therapeutic exercises (30 minutes). The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

LNT plus sensorimotor exercises

Local neck treatment plus a tailored sensorimotor exercise program.

Group Type: EXPERIMENTAL

LNT plus sensorimotor exercises

Intervention Type: OTHER

The local neck treatment (30 minutes) plus the sensorimotor exercise program (15 minutes). The sensorimotor exercises include cervical joint position sense and oculomotor training. The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

LNT plus balance exercises

Local neck treatment plus balance training program.

Group Type: EXPERIMENTAL

LNT plus balance exercises

Intervention Type: OTHER

The local neck treatment (30 minutes) plus the balance exercise program (15 minutes).The balance program includes with static balance and progress to dynamic balance and gait. The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

LNT plus sensorimotor/balance exercises

A combination of local neck treatment, sensorimotor control exercise, and balance exercise.

Group Type: EXPERIMENTAL

LNT plus sensorimotor/balance exercises

Intervention Type: OTHER

The local neck treatment (30 minutes) plus the sensorimotor exercise program (15 minutes) and the balance exercises (15 minutes). The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

Interventions

Local neck treatment (LNT)

The local neck treatment consists of cervical mobilization and specific therapeutic exercises (30 minutes). The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

Intervention Type: OTHER

LNT plus sensorimotor exercises

The local neck treatment (30 minutes) plus the sensorimotor exercise program (15 minutes). The sensorimotor exercises include cervical joint position sense and oculomotor training. The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

Intervention Type: OTHER

LNT plus balance exercises

The local neck treatment (30 minutes) plus the balance exercise program (15 minutes).The balance program includes with static balance and progress to dynamic balance and gait. The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

Intervention Type: OTHER

LNT plus sensorimotor/balance exercises

The local neck treatment (30 minutes) plus the sensorimotor exercise program (15 minutes) and the balance exercises (15 minutes). The participants will attend 12 individual treatment sessions (2 visits per week for 6 weeks).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• insidious neck pain for at least 3 months
• an average neck pain intensity over the past week ≥ 30 mm on a 100 mm visual analog scale (VAS)
• a score of neck pain and disability ≥ 10/ 100 on the Neck Disability Index-Thai version
• an absolute error of cervical joint position error > 4.5°
• an inability to stand in tandem stance with eyes closed for 30 seconds
• cervical segmental joint dysfunction (pain provoked >2/10 with abnormal tissue resistance)

Exclusion Criteria

• a previous history of neck and head injury or surgery
• known or suspected vestibular pathology
• vertigo or dizziness caused by underlying pathology in the ear, brain, or sensory nerve pathways (e.g. benign paroxysmal positional vertigo and BPPV)
• vascular disorders (e.g. a migraine and hypertension)
• any musculoskeletal or neurological conditions that could affect a balance
• inflammatory joint disease
• systemic conditions
• cognitive impairment
• taking four or more medications
• received physiotherapy treatment for their neck disorder in the past 12 months

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

The University of Queensland

OTHER

Sponsor Role: collaborator

University of Applied Sciences and Arts of Southern Switzerland

OTHER

Sponsor Role: collaborator

Chiang Mai University

OTHER

Sponsor Role: lead

Responsible Party

Sureeporn Uthaikhup

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Sureeporn Uthaikhup, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Department of physical therapy, Chiang Mai university

Locations

Department of Physical Therapy, Faculty of Associated Medical Sciences

Chiang Mai, , Thailand

Countries

Thailand

References

Reid SA, Callister R, Katekar MG, Rivett DA. Effects of cervical spine manual therapy on range of motion, head repositioning, and balance in participants with cervicogenic dizziness: a randomized controlled trial. Arch Phys Med Rehabil. 2014 Sep;95(9):1603-12. doi: 10.1016/j.apmr.2014.04.009. Epub 2014 May 2.

Reference Type: BACKGROUND

PMID: 24792139 (View on PubMed)

Treleaven J, Peterson G, Ludvigsson ML, Kammerlind AS, Peolsson A. Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs. Man Ther. 2016 Apr;22:122-30. doi: 10.1016/j.math.2015.10.017. Epub 2015 Nov 26.

Reference Type: BACKGROUND

PMID: 26678652 (View on PubMed)

Sremakaew M, Jull G, Treleaven J, Barbero M, Falla D, Uthaikhup S. Effects of local treatment with and without sensorimotor and balance exercise in individuals with neck pain: protocol for a randomized controlled trial. BMC Musculoskelet Disord. 2018 Feb 13;19(1):48. doi: 10.1186/s12891-018-1964-3.

Reference Type: DERIVED

PMID: 29433500 (View on PubMed)

Other Identifiers

Chiangmai university

Identifier Type: -

Identifier Source: org_study_id