Kronik Boyun Ağrısında Servikal Mobilite, Uyku Kalitesi ve Fonksiyonun Değerlendirilmesi

Yıl 2025, Cilt: 14 Sayı: 1, 123 - 131, 28.03.2025

Gamze Demircioğlu , Şüheda Özkan

Öz

Amaç: Kronik boyun ağrısı (KBA), biyopsikososyal yaklaşım gerektiren yaygın bir sorundur. Bu çalışmanın amacı ağrı, servikal mobilite, uyku kalitesi ve fonksiyonel durum arasındaki ilişkiyi sağlıklı kontrollerle karşılaştırarak incelemektir. Gereç ve Yöntemler: Altmış beş KBA'lı katılımcı ve altmış beş kontrol çalışmaya dahil edildi. Boyun ağrısı istirahatte ve aktivite sırasında Görsel Analog Skala (GAS) kullanılarak ölçüldü. Servikal mobilite, aktif servikal eklem hareket açıklığı (S-EHA) ölçmek için universal bir gonyometre kullanılarak tüm hareket düzlemlerinde değerlendirildi. Uyku kalitesi ve boyun ile ilgili fonksiyonel durumu değerlendirmek için Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ve Boyun Özürlülük İndeksi (BÖİ) kullanıldı. Bulgular: Servikal mobilitede gruplar arasında, fleksiyon, ekstansiyon ve lateral fleksiyon için S-EHA değerlerinde anlamlı farklar bulundu (p<0.05), ancak rotasyon değerlerinde anlamlı fark saptanmadı (p>0.05). Ayrıca, KBA’lı grupta kontrol grubuna kıyasla daha yüksek dizabilite düzeyleri ve daha kötü uyku kalitesi gözlendi (p<0.001). KBA’lı grupta, fleksiyon, ekstansiyon ve sol lateral fleksiyondaki azalmış S-EHA ile PUKİ skoru arasında zayıf negatif korelasyon bulundu (p<0.05). BÖİ, tüm düzlemlerdeki S-EHA ile anlamlı bir ilişki gösterdi (p<0.05). Bunun yanı sıra, NDI ile PSQI skoru arasında güçlü pozitif bir korelasyon saptandı (r=0.612; p<0.001). Sonuç: KBA olan bireyler, sağlıklı bireylere kıyasla servikal hareketlilik, uyku kalitesi ve fonksiyonel durum bakımından daha fazla kısıtlılık deneyimlerler. Ayrıca, artan boyun sakatlığı ile daha düşük uyku kalitesi arasında önemli bir ilişki olduğu tespit edilmiştir. Uyku bozukluklarının tedavi edilmesi, boyun sakatlığının hafifletilmesine ve genel sağlığın iyileştirilmesine katkı sağlayabilir.

Anahtar Kelimeler

Ağrı, Boyun, Eklem Hareket Açıklığı, Uyku Kalitesi, Fonksiyonel Durum

Evaluation of Cervical Mobility, Sleep Quality, and Function in Chronic Neck Pain

Öz

Objective: Chronic neck pain (CNP) is a common issue requiring a biopsychosocial approach. This study aimed to explore the relationship between pain, cervical mobility, sleep quality, and functional status, comparing these variables with healthy controls. Materials and Methods: Sixty-five participants with CNP and sixty-five controls were included. Neck pain at rest and during activity was measured using the Visual Analog Scale (VAS Cervical mobility was assessed in all planes of motion using a universal goniometer to measure the active cervical range of motion (C-ROM). The Pittsburgh Sleep Quality Index (PSQI) and Neck Disability Index (NDI) were used to evaluate sleep quality and neck-related functional status. Results: Cervical mobility showed significant differences in C-ROM for flexion, extension, and lateral flexion (p<0.05), while no significant differences were found in rotation between groups (p>0.05). Additionally, the CNP group exhibited higher disability levels and poorer sleep quality compared to the controls (p<0.001. In the CNP group reduced C-ROM in flexion, extension, and left lateral flexion showed a weak negative correlation with PSQI score (p<0.05). NDI was significantly associated with C-ROM in all planes (p<0.05). Moreover, NDI exhibited a strong positive correlation with the PSQI score (r=0.612; p<0.001). Conclusion: CNP individuals experience a negative status on cervical mobility, sleep quality, and functional status compared to healthy individuals. A significant relationship was also found between increased neck disability and poorer sleep quality. Treating sleep disturbances may help alleviate neck disability and improve overall health.

Anahtar Kelimeler

Pain, Neck, Range of Motion, Sleep Quality, Functional Status.

Kaynakça

• Agargün, M.K., Kara H., Anlar O. (1996). Pittsburgh uyku kalitesi indeksinin gecerligi ve guvenirligi. Turk Psikiyatri Dergisi, 7, 107-115.
• Aimi, M. A., Raupp, E. G., Schmit, E. F. D., Vieira, A., & Candotti, C. T. (2019). Correlation between cervical morphology, pain, functionality, and ROM in individuals with cervicalgia. Coluna/Columna, 18(2), 136–140. https://doi.org/10.1590/S1808
• Andreucci, A., Madrid-Valero, J. J., Ferreira, P. H., & Ordoñana, J. R. (2020). Sleep quality and chronic neck pain: a cotwin study. Journal of clinical sleep medicine : Jcsm : Official Publication Of The American Academy Of Sleep Medicine, 16(5), 679–687. https://doi.org/10.5664/jcsm.8316
• Aslan, E., Karaduman, A., Yakut, Y., Aras, B., Simsek, I. E., & Yaglı, N. (2008). The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study. Spine,33(11),E362-E365. https://doi.org/10.1097/BRS.0b013e31817144e1
• Ateş, R., Özbek, H., Yıldız, Z., & Başkurt, Z. (2023). Non-spesifik Boyun Ağrısı Olan Genç Bireylerde Uyku Pozisyonunun Boyun Yeti Yitimi, Üst Ekstremite Fonksiyonu ve Uyku Kalitesi Üzerine Etkileri. Journal f Turkish Sleep Medicine, 10(3). https://doi.org/10.4274/tjsm.galenos.2023.40427
• Begum, M. R., & Hossain, M. A. (2019). Validity and reliability of visual analogue scale (VAS) for pain measurement. Journal of Medical Case Reports And Reviews, 2(11).
• Beltran-Alacreu, H., López-de-Uralde-Villanueva, I., Calvo-Lobo, C., Fernández-Carnero, J., & La Touche, R. (2018). Clinical features of patients with chronic non-specific neck pain per disability level: A novel observational study. Revista Da Associacao Medica Brasileira (1992), 64(8), 700–709. https://doi.org/10.1590/18069282.64.08.700
• Chang, J. R., Fu, S. N., Li, X., Li, S. X., Wang, X., Zhou, Z., Pinto, S. M., Samartzis, D., Karppinen, J., & Wong, A. Y. (2022). The differential effects of sleep deprivation on pain perception in individuals with or without chronic pain: A systematic review and meta-analysis. Sleep Medicine Reviews, 66, 101695. https://doi.org/10.1016/j.smrv.2022.101695
• da Silva, R. M., Bezerra, M. A., Santos-de-Araújo, A. D., de Paula Gomes, C. A. F., da Silva Souza, C., de Souza Matias, P. H. V. A., & Dibai-Filho, A. V. (2018). Inactive individuals with chronic neck pain have changes in range of motion and functional performance of the shoulder. Physiotherapy Research International: The Journal For Researchers And Clinicians In Physical Therapy, 23(4), e1739. https://doi.org/10.1002/pri.1739
• Dos Santos, R. A., Derhon, V., Brandalize, M., Brandalize, D., & Rossi, L. P. (2016). Evaluation of knee range of motion: Correlation between measurements using a universal goniometer and a smartphone goniometric application. Journal Of Bodywork And Movement Therapies, 21(3), 699–703. https://doi.org/10.1016/j.jbmt.2016.11.008
• Elbinoune, I., Amine, B., Shyen, S., Gueddari, S., Abouqal, R., & Hajjaj-Hassouni, N. (2016). Chronic neck pain and anxiety-depression: Prevalence and associated risk factors. Pan African Medical Journal, 24, 89. https://doi.org/10.11604/pamj.2016.24.89.8831
• Faul, F., Erdfelder, E., Lang, A.G., Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2),175-91. doi: 10.3758/bf03193146.
• Farooq, M. N., Mohseni-Bandpei, M. A., Gilani, S. A., Ashfaq, M., & Mahmood, Q. (2018). The effects of neck mobilization in patients with chronic neck pain: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 22(1), 24–31. https://doi.org/10.1016/j.jbmt.2017.03.007
• Ferreira, C. S. B., Dibai-Filho, A. V., Politti, F., Souza, C. D. S., Biasotto-Gonzalez, D., & Fidelis-de-Paula-Gomes, C. A. (2021). Correlation between tactile acuity, pain intensity, and functional capacity in individuals with chronic neck pain. Revista da Associacao Medica Brasileira (1992), 67(6), 857–861. https://doi.org/10.1590/1806-9282.20210170
• Husak, A. J., & Bair, M. J. (2020). Chronic pain and sleep disturbances: a pragmatic review of their relationships, comorbidities, and treatments. Pain Medicine, 21(6), 1142-1152. https://doi.org/10.1093/pm/pnz343
• Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskeletal Disorders, 23(1), 26. https://doi.org/10.1186/s12891-021-04957-4.
• Kohyama J. (2021). Which is more important for health: sleep quantity or sleep quality?. Children (Basel, Switzerland), 8(7), 542. https://doi.org/10.3390/children8070542
• Kovacs, F. M., Seco, J., Royuela, A., Melis, S., Sánchez, C., Díaz-Arribas, M. J., Meli, M., Núñez, M., Martínez-Rodríguez, M. E., Fernández, C., Gestoso, M., Mufraggi, N., Moyá, J., Rodríguez-Pérez, V., Torres-Unda, J., Burgos-Alonso, N., Gago-Fernández, I., & Abraira, V. (2015). Patients with neck pain are less likely to improve if they experience poor sleep quality: a prospective study in routine practice. The Clinical Journal of Pain, 31(8), 713–721. https://doi.org/10.1097/AJP.0000000000000147
• Kyrosis, I., Paraskevopoulos, E., Koumantakis, G. A., & Christakou, A. (2024). The Relationship between Heart Rate Variability, Pain Intensity, Pain Catastrophizing, Disability, Quality of Life and Range of Cervical Motion in Patients with Chronic Non-Specific Neck Pain: A Cross-Sectional Study. Healthcare (Basel, Switzerland), 12(11), 1055. https://doi.org/10.3390/healthcare12111055).
• Lee, H., Hübscher, M., Moseley, G. L., Kamper, S. J., Traeger, A. C., Mansell, G., & McAuley, J. H. (2015). How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain. Pain, 156(6), 988–997. https://doi.org/10.1097/j.pain.0000000000000146
• Lee, M. K., & Oh, J. (2022). The relationship between sleep quality, neck pain, shoulder pain and disability, physical activity, and health perception among middle-aged women: a cross-sectional study. BMC Women's Health, 22(1), 186. https://doi.org/10.1186/s12905-022-01773-3
• Lin, L. H., Lin, T. Y., Chang, K. V., Wu, W. T., & Özçakar, L. (2024). Pain neuroscience education for reducing pain and kinesiophobia in patients with chronic neck pain: A systematic review and meta-analysis of randomized controlled trials. European Journal of Pain (London, England), 28(2), 231–243. https://doi.org/10.1002/ejp.2182
• Mazza, C., Ricci, E., Biondi, S., Colasanti, M., Ferracuti, S., Napoli, C., & Roma, P. (2020). A nationwide survey of psychological distress among Italian people during the COVID-19 pandemic: Immediate psychological responses and associated factors. International Journal of Environmental Research and Public Health, 17(9), 3165. https://doi.org/10.3390/ijerph17093165
• Meisingset, I., Stensdotter, A. K., Woodhouse, A., & Vasseljen, O. (2016). Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment. Manual Therapy, 22, 94–100. https://doi.org/10.1016/j.math.2015.10.013
• Mohammad W.S., Hamza H.H., ElSais W.M. (2015) Assessment of neck pain and cervical mobility among female computer workers at Hail University. International Journal of Occupational Safety and Ergonomics 21(1), 105-10. https://doi.org/10.1080/10803548.2015.101795.
• Multanen, J., Häkkinen, A., Kautiainen, H., & Ylinen, J. (2021). Associations of neck muscle strength and cervical spine mobility with future neck pain and disability: a prospective 16-year study. BMC Musculoskeletal Disorders, 22(1), 911. https://doi.org/10.1186/s12891-021-04807-3
• Muñoz-Muñoz, S., Muñoz-García, M. T., Alburquerque-Sendín, F., Arroyo-Morales, M., & Fernández-de-las-Peñas, C. (2012). Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. Journal of Manipulative and Physiological Therapeutics, 35(8), 608–613. https://doi.org/10.1016/j.jmpt.2012.09.003
• Öksüz, H., & Atılgan, E. (2019). Kronik Boyun ağrısında elektromyografi biofeedback ile relaksasyon eğitiminin ağri, disabilite ve depresyon üzerindeki etkisi. Sağlık Akademisi Kastamonu, 4(2), 98-113.https://doi.org/10.25279/sak.486777
• Özgören, Ç., Ciddi, P. K., & Sahin, M. (2022). Kronik boyun ağrısında eklem pozisyon hissinin ağrı, eklem hareket açıklığı, kas kuvveti, hareket korkusu, fonksiyonellik ve yaşam kalitesi parametreleri ile ilişkisi. Journal of Exercise Therapy and Rehabilitation, 9(1), 48-58. https://doi.org/10.15437/jetr.748619.
• Rudolfsson, T., Björklund, M., & Djupsjöbacka, M. (2012). Range of motion in the upper and lower cervical spine in people with chronic neck pain. Manual Therapy, 17(1), 53–59. https://doi.org/10.1016/j.math.2011.08.007.
• Sarig Bahat, H., Weiss, P. L., Sprecher, E., Krasovsky, A., & Laufer, Y. (2014). Do neck kinematics correlate with pain intensity, neck disability or with fear of motion?. Manual Therapy, 19(3), 252–258. https://doi.org/10.1016/j.math.2013.10.006
• Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation Coefficients: Appropriate Use and Interpretation. Anesthesia and Analgesia, 126(5), 1763–1768. https://doi.org/10.1213/ANE.0000000000002864
• Tao, Y., Galbusera, F., Niemeyer, F., Samartzis, D., Vogele, D., & Wilke, H. J. (2021). Radiographic cervical spine degenerative findings: a study on a large population from age 18 to 97 years. European Spine Journal, 30(2), 431–443. https://doi.org/10.1007/s00586-020-06615-0
• Umeda, M., & Kim, Y. (2019). Gender differences in the prevalence of chronic pain and leisure time physical activity among US adults: A NHANES study. International Journal Of Environmental Research and Public Health, 16(6), 988. https://doi.org/10.3390/ijerph16060988
• Walton, D. M., Carroll, L. J., Kasch, H., Sterling, M., Verhagen, A. P., Macdermid, J. C., Gross, A., Santaguida, P. L., Carlesso, L., & ICON (2013). An Overview of Systematic Reviews on Prognostic Factors in Neck Pain: Results from the International Collaboration on Neck Pain (ICON) Project. The Open Orthopaedics Journal, 7, 494–505. https://doi.org/10.2174/1874325001307010494. Zetterqvist, V., Holmström, L., Maathz, P., & Wicksell, R. K. (2017). Pain avoidance predicts disability and depressive symptoms three years later in individuals with whiplash complaints. Acta Anaesthesiologica Scandinavica, 61(4), 445–455. https://doi.org/10.1111/aas.12874