Comparison of Neck Awareness, Physical and Psychosocial Parameters in Inactive University Students with and without Neck Pain

Abstract

The aim of the study was to compare neck awareness, muscular endurance, mental state and self-efficacy parameters in young adults with and without neck pain and to examine the relationship of awareness with pain intensity, muscular endurance and anxiety and depression in the group with neck pain. A total of 104 students with neck pain (n=41) and without neck pain (n=63) with a mean age of 22.85 ± 3.53 years were included in the study. Visual Analog Scale (VAS), Cervical Deep Flexor Muscle Endurance Test, Hospital Anxiety and Depression Scale (HADS) and Fremantle Neck Awareness Questionnaire (FreBAQ) were used to collect the data. When the groups were compared in terms of physical and psychosocial data, it was determined that the group with neck pain was negatively affected compared to the group without neck pain in terms of all parameters (p<0.05). In the group with neck pain, there was a positive correlation between the FreBAQ and the HAD scale values(p<0.05); there was no correlation between deep flexor neck muscular endurance and neck pain(p>0.05). According to the results of the study, neck pain negatively affects physical and psychological factors in university students and neck awareness is especially associated with anxiety and depression.

Keywords

• Young Adult
• Neck Pain
• Neck Awareness
• Mental State
• Muscular Endurance

Boyun Ağrısı Olan ve Olmayan İnaktif Üniversite Öğrencilerinde Boyun Farkındalığı, Fiziksel ve Psikososyal Parametrelerinin Karşılaştırılması

Abstract

Çalışmanın amacı, boyun ağrısı olan ve olmayan genç yetişkin gruplarda boyun farkındalığı, kassal endurans, ruhsal durum ve öz-yeterlilik parametrelerin karşılaştırılması ve boyun ağrılı grupta farkındalığın ağrı şiddeti, kassal endurans ve anksiyete depresyon ile ilişkisinin incelenmesidir.Çalışmaya yaş ortalaması 22,85 ± 3,53 yıl olan, boyun ağrılı (n=41) ve boyun ağrısı olmayan (n=63) toplam 104 öğrenci dahil edilmiştir. Çalışmanın verilerinin toplanmasında Görsel Analog Skala (GAS), Servikal Derin Fleksör Kas Endurans Testi, Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) ve Fremantle Boyun Farkındalık Anketi (FreBFA) kullanılmıştır.Gruplar fiziksel ve psikososyal veriler açısından karşılaştırıldıklarında tüm parametreler açısından boyun ağrısı olan grubun boyun ağrısı olmayan gruba göre olumsuz yönde etkilendiği belirlenmiştir (p<0,05). Boyun ağrısı olan grupta, Fremantle Boyun Farkındalık Testi ile HAD ölçeği değerleri arasında pozitif bir korelasyon olduğu(p<0,05); derin fleksör boyun enduransı ile boyun ağrısı arasında ise bir korelasyon olmadığı bulunmuştur(p>0,05). Çalışmanın sonuçlarına göre boyun ağrısının üniversite öğrencilerinde fiziksel ve psikolojik faktörleri olumsuz yönde etkilediği ve boyun farkındalığının özellikle anksiyete ve depresyon ile ilişkili olduğu görülmüştür.

Keywords

• Genç Yetişkin
• Boyun Ağrısı
• Boyun Farkındalığı
• Ruhsal durum
• Kassal Endurans

References

1. Aydemir, Ö., Güvenir, T., Küey, L., Kültür, S., 1997. Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale. Türk Psikiyatri Dergisi 8(4), 280 -287.
2. Bandura A., 1994. Self-efficacy. Encyclopedia of Human Behavior, New York. Academic Press, pp. 71-81.
3. Blomgren, J., Strandell, E., Jull, G., Vikman, I., Röijezon, U., 2018. Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review. BMC musculoskeletal disorders, 19(1):415.
4. Blozik, E., Laptinskaya, D., Herrmann-Lingen, C., Schaefer, H., Kochen, M. M., Himmel, W., Scherer, M., 2009. Depression and anxiety as major determinants of neck pain: a cross-sectional study in general practice. BMC musculoskeletal disorders 10, 13. https://doi.org/10.1186/1471-2474-10-13
5. Carroll, L. J., Hogg-Johnson, S., van der Velde, G., Haldeman, S., Holm, L. W., Carragee, E. J., Hurwitz, E. L., Côté, P., Nordin, M., Peloso, P. M., Guzman, J., Cassidy, J. D., 2008. Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine, 33(4Suppl),S75–S82. https://doi.org/10.1097/BRS.0b013e31816445be
6. Cavlak, U., Yagci N., Aslan U.B., Ekici G., 2009. A new tool measuring health-related quality of life (HRQOL): The effects of musculoskeletal pain in a group of older Turkish people. Archives of Gerontology and Geriatrics 49, 298–303.
7. Chiarotto, A., Falla, D., Polli, A., Monticone, M., 2018. Validity and Responsiveness of the Pain Self-Efficacy Questionnaire in Patients With Neck Pain Disorders. The Journal of orthopaedic and sports physical therapy, 48(3), 204–216. https://doi.org/10.2519/jospt.2018.7605
8. Cramer, H., Mehling, W.E., Saha, F. J., Dobos, G., Lauche, R., 2018. Postural awareness and its relation to pain: validation of an innovative instrument measuring awareness of body posture in patients with chronic pain. BMC musculoskeletal disorders 19(1),109

9. Demyttenaere, K., Bruffaerts, R., Lee, S., Posada-Villa, J., Kovess, V., Angermeyer, M.C., 2007. Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain 129(3), 332-42.
10. Dere, T., 2021. Servikal disk hernili bireylerde kassal enduransın ağrı, boyun farkındalığı ve kinezyofobi ile ilişkisinin incelenmesi. Yüksek lisans tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
11. Dimitriadis, Z., Kapreli, E., Strimpakos, N., Oldham, J., 2015. Do psychological states associate with pain and disability in chronic neck pain patients?. Journal Back Musculoskelet Rehabilitaion 28(4),797-802.
12. Edmondston, S.J., Björnsdóttir, G., Pálsson, T., Solgard, H., Ussing, K., Allison, G., 2011. Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain. Manuel Therapy, 16(4), 332–338. 10.1016/j.math.2010.12.005.
13. Falla, D.L., Jull, G.A., Hodges, P.W., 2004. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine 29(19):2108-14.
14. Fejer, R., Kyvik, K. O., Hartvigsen, J., 2006. The prevalence of neck pain in the world population: a systematic critical review of the literature. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 15(6), 834–848. https://doi.org/10.1007/s00586-004-0864-4
15. Fricton, J., Anderson, K., Clavel, A., Fricton, R., Hathaway, K., Kang, W., Jaeger, B., Maixner, W., Pesut, D., Russell, J., Weisberg, M. B., Whitebird, R., 2015. Preventing Chronic Pain: A Human Systems Approach-Results From a Massive Open Online Course. Global advances in health and medicine, 4(5), 23–32. https://doi.org/10.7453/gahmj.2015.048
16. Gallego-Sendarrubias, G.M., Rodríguez-Sanz, D., Calvo-Lobo, C., Martín, J.L., 2020. Efficacy of dry needling as an adjunct to manual therapy for patients with chronic mechanical neck pain: a randomised clinical trial. Acupuncture in Medicine 38(4),244-254. doi:10.1136/acupmed-2018-011682
17. Harris,K.D., Heer, M.D., Roy,T.C., Santos, D.M., Whitman,J.M., Wainne, S.R., 2005. Reliability of a Measurement of Neck Flexor Muscle Enduranc. Physical Therapy 85 (12), 1349-1355.
18. Hidalgo, B., Hall, T., Bossert, J., Dugeny, A., Cagnie, B., Pitance, L., 2017. The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review. Journal of back and musculoskeletal rehabilitation 6,30(6),1149-1169. doi: 10.3233/BMR-169615. PMID: 28826164; PMCID: PMC5814665.
19. Hogg-Johnson, S., Van Der Velde, G., Carroll, L.J., Holm, L.W., Cassidy, J.D., Guzman, J., 2008. The burden and determinants of neck pain in the general population Spine 17(1), 39-51.
20. Kahlaee, A. H., Rezasoltani, A., Ghamkhar, L., 2017. Is the clinical cervical extensor endurance test capable of differentiating the local and global muscles?. The spine journal : official journal of the North American Spine Society 17(7), 913–921. https://doi.org/10.1016/j.spinee.2017.01.014
21. Kanchanomai, S., Janwantanakul P., Pensri, P., Jiamjarasrangsi, W., 2011. Risk factors for the onset and persistence of neck pain in undergraduate students: 1-year prospective cohort study. BMC Public Health 11, 566-574.
22. Kim, H.J., Kim, J.S. 2015. The relationship between smartphone use and subjective musculoskeletal symptoms and university students. Journe Physical Therapy Science27, 575–579.
23. Kurtaran, M., Baktır, S., Şeker Abanoz, E., Yeldan, İ., 2019. Evaluation of Pain, Alexithymia, Depressive Symptom Prevalence and Quality of Life in University Students Sakarya Tıp Dergisi 9(3),433-41.
24. Lau, H. M., Wing Chiu, T. T., Lam, T. H., 2011. The effectiveness of thoracic manipulation on patients with chronic mechanical neck pain - a randomized controlled trial. Manual therapy 16(2), 141–147. https://doi.org/10.1016/j.math.2010.08.003
25. 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
26. Linton, S.J., 2000. A review of psychological risk factors in back and neck pain. Spine 25(9), 1148-56.
27. Liu, F., Fang, T., Zhou, F., Zhao, M., Chen, M., You, J., 2018. Association of Depression/Anxiety Symptoms with Neck Pain: A Systematic Review and Meta-Analysis of Literature in China. Pain research & management. 3259431.
28. Monticone, M., Giordano, A., Franchignoni, F., 2021. Scale Shortening and Decrease in Measurement Precision: Analysis of the Pain Self-Efficacy Questionnaire and Its Short Forms in an Italian-Speaking Population With Neck Pain Disorders. Physical Therapy 101(6), pzab039. https://doi.org/10.1093/ptj/pzab039
29. Moreira, C., Bass, A.R., Brandão, M.P., Silva, A.G., 2017. Do patients with chronic neck pain have distorted body image and tactile dysfunction? European Journal of Physiotherapy 19(4):215-21.
30. Nagrale, A. V., Glynn, P., Joshi, A., Ramteke, G., 2010. The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial. The Journal of manual & manipulative therapy 18(1), 37–43. https://doi.org/10.1179/106698110X12595770849605.
31. Nicholas, M.K., 2007. The pain self-efficacy questionnaire: taking pain into account. European journal of pain 11(2), 153–163. https://doi.org/10.1016/j.ejpain.2005.12.008
32. Onan, D., Gokmen, D., Ulger, O. 2019. The Fremantle Neck Awareness Questionnaire in Chronic Neck Pain Patients: Turkish Version, Validity and Reliability Study. Spine 45(3), E163–E169. doi: 10.1097/BRS.0000000000003207
33. Özel, M., 2022. Kronik boyun ağrısında boyun farkındalığı ile eklem pozisyon hissi, baş postürü ve kas enduransı arasındaki ilişki. Yüksek lisans tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
34. Parazza, S., Vanti, C., O'Reilly, C., Villafañe, J. H., Tricás Moreno, J. M.,Estébanez De Miguel, E., 2014. The relationship between cervical flexor endurance, cervical extensor endurance, VAS, and disability in subjects with neck pain. Chiropractic & manual therapies 22(1), 10. https://doi.org/10.1186/2045-709X-22-10.
35. Piper, A., 2009. Comparison of endurance capacity of deep cervical flexors between healthy and subjects with cervical pain. Manuelle Therapie 13, 202-211.
36. Savcı, S., Öztürk, M., Arıkan, H., İnal İnce, D., Tokgözoğlu, L., 2006. Physical activity levels of university students. Archives of the Turkish Society of Cardiology 34(3), 166-172.
37. Schomacher, J., Falla, D., 2013. Function and structure of the deep cervical extensor muscles in patients with neck pain. Manual Therapy 18(5),360–366. https://doi.org/10.1016/j.math.2013.05.009
38. Shahidi, B., Curran-Everett, D., Maluf, K.S., 2015. Psychosocial, Physical, and Neurophysiological Risk Factors for Chronic Neck Pain: A Prospective Inception Cohort Study. The Journal of Pain 16(12),1288-1299.
39. Sherer, M., Adams, C.H., 1983. Construct validation of the Self-Efficacy Scale. Psychol Rep, 53:899-902.
40. Sihawong, R., Janwantanakul, P., Sitthipornvorakul, E., Pensri, P., 2011. Exercise therapy for office workers with nonspecific neck pain: a systematic review. Journal Manipulative Physiol Therapy 34, 62-71
41. Şimşek, Ş. , Yağcı, N. , Oymak Soysal, A. N. , Kaş Özdemir, A., Bergin, M., 2022. The relatıon between paın, functıonal status, and neck awareness ın ındıvıduals wıth chronıc neck paın. Türk Fizyoterapi ve Rehabilitasyon Dergisi 33 (2) , 106-113. DOI: 10.21653/tjpr.979737
42. Von Bothmer, M.I., Fridlund, B., 2005. Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students. Nursing Health Science 7, 107-18.
43. Wand, B.M., Catley, J., Rabey, M., O’Sullivan, B.P., O’Connel, E. N.,Smitth, J., 2016. Disrupted Self-Perception in People With Chronic Low Back Pain. Further Evaluation of the Fremantle Back Awareness Questionnaire. The Journel of Pain 17 (9), 1011- 1012.
44. Wewers, M.E., Lowe, N.K., 1990. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing & Health 13, 227-236.
45. Wiech, K., 2016. Deconstructing the sensation of pain: the influence of cognitive processes on pain perception. Science 354 (6312), 584–587.
46. Woodman, J., Ballard, K., Hewitt, C., MacPherson, H., 2018. Self-efficacy and self-care-related outcomes following Alexander Technique lessons for people with chronic neck pain in the ATLAS randomised, controlled trial. European Journal of İntegrative Medicine 17, 64–71. https://doi.org/10.1016/j.eujim.2017.11.006
47. Yıldırım, F., İlhan, İ.Ö., 2010. The Validity and Reliability of the General Self-Effi cacy Scale-Turkish Form Türk Psikiyatri Dergisi 21(4), 301-308.
48. Zigmond, A. S., Snaith, R. P., 1983. The hospital anxiety and depression scale. Acta psychiatrica Scandinavica 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb0971