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Clinical Trial
. 2008 Dec 23;5:36.
doi: 10.1186/1743-0003-5-36.

A Novel Method for Neck Coordination Exercise--A Pilot Study on Persons With Chronic Non-Specific Neck Pain

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Free PMC article
Clinical Trial

A Novel Method for Neck Coordination Exercise--A Pilot Study on Persons With Chronic Non-Specific Neck Pain

Ulrik Röijezon et al. J Neuroeng Rehabil. .
Free PMC article

Abstract

Background: Chronic neck pain is a common problem and is often associated with changes in sensorimotor functions, such as reduced proprioceptive acuity of the neck, altered coordination of the cervical muscles, and increased postural sway. In line with these findings there are studies supporting the efficacy of exercises targeting different aspects of sensorimotor function, for example training aimed at improving proprioception and muscle coordination. To further develop this type of exercises we have designed a novel device and method for neck coordination training. The aim of the study was to investigate the clinical applicability of the method and to obtain indications of preliminary effects on sensorimotor functions, symptoms and self-rated characteristics in non-specific chronic neck pain

Methods: The study was designed as an uncontrolled clinical trial including fourteen subjects with chronic non-specific neck pain. A new device was designed to allow for an open skills task with adjustable difficulty. With visual feedback, subjects had to control the movement of a metal ball on a flat surface with a rim strapped on the subjects' head. Eight training sessions were performed over a four week period. Skill acquisition was measured throughout the intervention period. After intervention subjects were interviewed about their experience of the exercise and pain and sensorimotor functions, including the fast and slow components of postural sway and jerkiness-, range-, position sense-, movement time- and velocity of cervical rotation, were measured. At six-month follow up, self-rated pain, health and functioning was collected.

Results: The subjects improved their skill to perform the exercise and were overall positive to the method. No residual negative side-effects due to the exercise were reported. After intervention the fast component of postural sway (p = 0.019) and jerkiness of cervical rotation (p = 0.032) were reduced. The follow up showed decreased disability (one out of three indices) and fear of movement, and increased general health (three out of eight dimensions).

Conclusion: The results support the clinical applicability of the method. The improvements in sensorimotor functions may suggest transfer from the exercise to other, non-task specific motor functions and justifies a future randomized controlled trial.

Figures

Figure 1
Figure 1
Schematic of the neck coordination exercise apparatus. The exercise task was to control the movement of a metal ball on a flat surface mounted on the subjects head.
Figure 2
Figure 2
Exploded drawing of the neck coordination exercise device, including the removable rim and an exchangeable surface. Four different surfaces were used in order to vary the rolling resistance of the ball.
Figure 3
Figure 3
The removable rim viewed from the side and from above. Before commencing a trial, the subject should place the ball in a starting position (at front, back, left or right) by tilting the plate. All measurements are in millimetres.
Figure 4
Figure 4
Performance of the exercise task for the fastest surface during the exercise period. The figure illustrates the distribution of median trial times over all subjects separately for each block of trials. Due to variation in progression between subjects the number of blocks of trials performed in this condition ranged from 11 to 20. Therefore, for block 1–11 n = 14 and for block 12–20 n = 13, 11, 11, 10, 9, 8, 6, 3 and 1 respectively. For each box plot, the whiskers represent maximum and minimum values, the top and bottom of the box represent the 75th and 25th quartiles and the horizontal line in the box represent the median.

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