Kronik Boyun Ağrısı Olan Bireylerde Ağrı Şiddeti, Servikal Kas Kuvveti, Propriosepsiyon ve Denge Arasındaki İlişkilerin İncelenmesi

Abstract

Amaç: Çalışmanın amacı, kronik boyun ağrısı (KBA) olan bireylerde ağrı şiddeti, servikal kas kuvveti, propriosepsiyon ve denge arasındaki ilişkileri incelemekti. Gereç Yöntem: Çalışmaya 45 KBA’lı birey ve 46 boyun ağrısı olmayan sağlıklı birey dahil edildi. KBA’lı bireylerde istirahat ve aktivite sırasındaki boyun ağrısı şiddetleri görsel analog skala ile, her iki gruptaki bireylerin servikal fleksör ve ekstansör kas kuvveti izometrik dinamometre ile, servikal bölge propriosepsiyon duyusu servikal eklem pozisyon hata testi ile ve statik ve dinamik denge Biodex denge sistemi ile değerlendirildi. Sonuçlar: Sağlıklı bireylerle karşılaştırıldığında KBA’lı bireylerin servikal fleksör ve ekstansör kas kuvvetlerinin daha düşük, servikal bölge propriosepsiyonunun ve statik ve dinamik dengelerinin daha kötü olduğu bulundu (p<0,05). KBA’lı bireylerde, ağrı şiddeti ile, servikal kas kuvvetleri, servikal bölge propriosepsiyonu ve statik-dinamik denge ilişkiliydi (p<0,05). Ayrıca, KBA’lı bireylerde, servikal bölge propriosepsiyonu, servikal kas kuvvetleri ve statik-dinamik denge ile ilişkiliydi (p<0,05). Tartışma: KBA’da ağrı şiddetinin artmasıyla servikal kas kuvveti, propriosepsiyon ve denge zayıflayabilir, propriosepsiyonun zayıflaması dengeyi olumsuz etkileyebilir.

Keywords

• Kronik boyun ağrısı
• Kas kuvveti
• Propriosepsiyon
• Denge

Investigation of Relationships Between Pain Intensity, Cervical Muscle Strength, Proprioception and Balance in Individuals with Chronic Neck Pain

Abstract

Purpose: The aim of the study was to examine the relationships between pain intensity, cervical muscle strength, proprioception, and balance in individuals with chronic neck pain (CNP). Material and Methods: The study included 45 individuals with CNP and 46 healthy individuals without neck pain. Neck pain intensity at rest and during activity was assessed by a visual analog scale in the CNP group, cervical flexor and extensor muscle strength was assessed by an isometric dynamometer, cervical proprioception was assessed by cervical joint position error test, and static and dynamic balance was assessed by Biodex balance system in both groups. Results: Compared with healthy individuals, individuals with CNP had lower cervical flexor and extensor muscle strength, worse cervical proprioception, and worse static and dynamic balance (p<0.05). In individuals with CNP, pain intensity was associated with cervical muscle strength, cervical proprioception, and static-dynamic balance (p<0.05). In addition, cervical proprioception was associated with cervical muscle strength and static-dynamic balance in individuals with CNP (p<0.05). Discussion: Cervical muscle strength, proprioception, and balance may weaken with increasing pain intensity in CNP, and the weakening of proprioception may negatively affect balance.

Keywords

• Chronic neck pain
• Muscle strength
• Proprioception
• Balance

References

1. Andias, R., & Silva, A. G. (2019). A systematic review with meta‐analysis on functional changes associated with neck pain in adolescents. Musculoskelet Care, 17(1), 23-36. https://doi.org/10.1002/msc.1377
2. Aslıyüce, Y. Ö., Demirel, A., & Ülger, Ö. (2022). Investigation of joint position sense and balance in individuals with chronic idiopathic neck pain: a cross-sectional study. J Manipulative Physiol Ther, 45(3), 188-195. https://doi.org/10.1016/j.jmpt.2022.06.006
3. Baldwin, S. L., VanArnam, T. W., & Ploutz-Snyder, L. L. (2004). Reliability of dynamic bilateral postural stability on the Biodex Stability System in older adults. Med Sci Sports Exerc, 36(5), S30. https://doi.org/10.1249/00005768-200405001-00143
4. Cagnie, B., Cools, A., De Loose, V., Cambier, D., & Danneels, L. (2007). Differences in isometric neck muscle strength between healthy controls and women with chronic neck pain: the use of a reliable measurement. Arch Phys Med Rehabil, 88(11), 1441-1445. https://doi.org/10.1016/j.apmr.2007.06.776
5. Chiu, T. T. W., & Lo, S. K. (2002). Evaluation of cervical range of motion and isometric neck muscle strength: reliability and validity. Clin Rehabil, 16(8), 851-858. https://doi.org/10.1191/0269215502cr550oa
6. Cohen, S. P. (2015). Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc, 90(2), 284-99. https://doi.org/10.1016/j.mayocp.2014.09.008
7. de Oliveira Carnevalli, A. P., Bevilaqua-Grossi, D., Oliveira, A. I. S., Carvalho, G. F., Fernández-De-Las-Peñas, C., & Florencio, L. L. (2018). Intrarater and inter-rater reliability of maximal voluntary neck muscle strength assessment using a handheld dynamometer in women with headache and healthy women. J Manipulative Physiol Ther, 41(7), 621-627. https://doi.org/10.1016/j.jmpt.2018.01.006
8. Dieleman, J. L., Cao, J., Chapin, A., Chen, C., Li, Z., Liu, A., et al. (2020). US health care spending by payer and health condition, 1996-2016. Jama, 323(9), 863-884. https://doi.org/10.1001/jama.2020.0734

9. Fejer, R., Kyvik, K. O., & Hartvigsen, J. (2006). The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J, 15, 834-848. https://doi.org/10.1007/s00586-004-0864-4
10. Gandevia, S., McCloskey, D., & Burke, D. (1992). Kinaesthetic signals and muscle contraction. Trends Neurosci, 15(2), 62-65. https://doi.org/10.1016/0166-2236(92)90028-7
11. Gatev, P., Thomas, S., Kepple, T., & Hallett, M. (1999). Feedforward ankle strategy of balance during quiet stance in adults. J Physiol, 514(3), 915-928. https://doi.org/10.1111/j.1469-7793.1999.915ad.x
12. Jahre, H., Grotle, M., Smedbråten, K., Dunn, K. M., & Øiestad, B. E. (2020). Risk factors for non-specific neck pain in young adults. A systematic review. BMC Musculoskelet Disord, 21(1), 1-12. https://doi.org/10.1186/s12891-020-03379-y
13. Kirmizi, M., Yalcinkaya, G., Sengul, Y. S., Kalemci, O., & Angin, S. (2021). Investigation of balance performance under different sensory and dual-task conditions in patients with chronic neck pain. Musculoskelet Sci Pract, 56, 102449. https://doi.org/10.1016/j.msksp.2021.102449
14. Langley, G., & Sheppeard, H. (1985). The visual analogue scale: its use in pain measurement. Rheumatol Int, 5(4), 145-148. https://doi.org/10.1007/BF00541514
15. Lund, J. P., Donga, R., Widmer, C. G., & Stohler, C. S. (1991). The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. Can J Physiol Pharmacol, 69(5), 683-694. https://doi.org/10.1139/y91-102
16. Michaelson, P., Michaelson, M., Jaric, S., Latash, M. L., Sjölander, P., & Djupsjöbacka, M. (2003). Vertical posture and head stability in patients with chronic neck pain. J Rehabil Med, 35(5), 229-235. https://doi.org/10.1080/16501970306093
17. Michiels, S., De Hertogh, W., Truijen, S., November, D., Wuyts, F., & Van de Heyning, P. (2013). The assessment of cervical sensory motor control: a systematic review focusing on measuring methods and their clinimetric characteristics. Gait & Posture, 38(1), 1-7. https://doi.org/10.1016/j.gaitpost.2012.10.007
18. Onan, D., Gokmen, D., & Ulger, O. (2020). The Fremantle Neck Awareness Questionnaire in chronic neck pain patients: Turkish version, validity and reliability study. Spine, 45(3), 163-169. https://doi.org/10.1097/BRS.0000000000003207
19. Özüdoğru, A., Canlı, M., Kuzu, Ş., Aslan, M., Ceylan, İ., & Alkan, H. (2023). Muscle strength, balance and upper extremity function are not predictors of cervical proprioception in healthy young subjects. Somatosens Mot Res, 1-5. https://doi.org/10.1080/08990220.2023.2183832
20. Pedersen, J., Ljubisavljevic, M., Bergenheim, M., & Johansson, H. (1998). Alterations in information transmission in ensembles of primary muscle spindle afferents after muscle fatigue in heteronymous muscle. J Neurosci, 84(3), 953-959. https://doi.org/10.1016/S0306-4522(97)00403-X
21. Peng, B., Yang, L., Li, Y., Liu, T., & Liu, Y. (2021). Cervical proprioception impairment in neck pain-pathophysiology, clinical evaluation, and management: a narrative review. Pain Ther, 10, 143-164. https://doi.org/10.1007/s40122-020-00230-z
22. Reddy, R. S., Meziat-Filho, N., Ferreira, A. S., Tedla, J. S., Kandakurti, P. K., & Kakaraparthi, V. N. (2021). Comparison of neck extensor muscle endurance and cervical proprioception between asymptomatic individuals and patients with chronic neck pain. J Bodyw Mov Ther, 26, 180-186. https://doi.org/10.1016/j.jbmt.2020.12.040
23. Reddy, R. S., Tedla, J. S., Dixit, S., & Abohashrh, M. (2019). Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis. BMC Musculoskelet Disord, 20(1), 1-7. https://doi.org/10.1186/s12891-019-2846-z
24. Revel, M., Andre-Deshays, C., & Minguet, M. (1991). Cervicocephalic kinesthetic sensibility in patients with cervical pain. Arch Phys Med Rehabil, 72(5), 288-291. https://doi.org/10.5555/uri:pii:000399939190243C
25. Ruhe, A., Fejer, R., & Walker, B. (2011). Altered postural sway in patients suffering from non-specific neck pain and whiplash associated disorder - a systematic review of the literature. Chiropr Man Therap, 19(1), 1-11. https://doi.org/10.1186/2045-709X-19-13
26. Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: appropriate use and interpretation. Anesth Analg, 126(5), 1763-1768. https://doi.org/10.1213/ANE.0000000000002864
27. Silva, A. G., & Cruz, A. L. (2013). Standing balance in patients with whiplash-associated neck pain and idiopathic neck pain when compared with asymptomatic participants: a systematic review. Physiother Theory Pract, 29(1), 1-18. https://doi.org/10.3109/09593985.2012.677111
28. Silverman, J. L., Rodriquez, A. A., & Agre, J. C. (1991). Quantitative cervical flexor strength in healthy subjects and in subjects with mechanical neck pain. Arch Phys Med Rehabil, 72(9), 679-681. https://doi.org/10.5555/uri:pii:0003999391902144
29. Stanton, T. R., Leake, H. B., Chalmers, K. J., & Moseley, G. L. (2016). Evidence of impaired proprioception in chronic, idiopathic neck pain: systematic review and meta-analysis. Phys Ther, 96(6), 876-887. https://doi.org/10.2522/ptj.20150241
30. Treleaven, J. (2008). Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Man Ther, 13(1), 2-11. https://doi.org/10.1016/j.math.2007.06.003
31. Treleaven, J. (2017). Dizziness, unsteadiness, visual disturbances, and sensorimotor control in traumatic neck pain. J Orthop Sports Phys Ther, 47(7), 492-502. https://doi/10.2519/jospt.2017.7052
32. Ulutatar, F., Ulutatar C. U., & Duruoz, M. T. (2019). Cervical proprioceptive impairment in patients with rheumatoid arthritis. Rheumatol Int, 39(12), 2043-2051. https://doi.org/10.1007/s00296-019-04419-0
33. Vuillerme, N., & Pinsault, N. (2009). Experimental neck muscle pain impairs standing balance in humans. Exp Brain Res, 192, 723-729. https://doi.org/10.1007/s00221-008-1639-7
34. Yasuda, T., Nakagawa, T., Inoue, H., Iwamoto, M., & Inokuchi, A. (1999). The role of the labyrinth, proprioception and plantar mechanosensors in the maintenance of an upright posture. Eur Arch Otorhinolaryngol, 256, 27-32. https://doi.org/10.1007/PL00014149
35. Ylinen, J., Takala, E.-P., Kautiainen, H., Nykänen, M., Häkkinen, A., Pohjolainen, T., et al. (2004). Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. Eur J Pain, 8(5), 473-478. https://doi.org/10.1016/j.ejpain.2003.11.005