Correlation between neck pain characteristics and gait parameters in patients with chronic mechanical neck pain (original) (raw)
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Frontiers in medicine, 2024
Background: Chronic neck pain (CNP) can lead to altered gait which is worse when combined with head movement. Gait parameters for indicating speed and symmetry have not been thoroughly investigated in older adults with CNP. This study aimed to compare gait performance in term of speed and symmetry in older adults with and without CNP during walking with head movement. Methods: Fifty young older adults, consisting of 36 healthy controls without neck pain (OLDs) and 14 older adults with CNP, participated in the study. Participants completed the Neck Disability Index and Activities-specific Balance Confidence Scale. The 10-Meter Walk Test (10MWT) was used to assess gait performance. Participants were instructed to walk at preferred speed under three different head movement patterns: no head movement (NM), horizontal head movement (HM), and vertical head movement (VM). The Inertial Measurement Unit was used to capture gait performance, and its software was used to analyze gait variables; gait speed, Locomotor Rehabilitation Index (LRI), gait asymmetry index, Phase Coordination Index (PCI). Results: The CNP group reported moderate neck pain with mild disability in activities of daily living, and less balance confidence than the OLD group (p < 0.05). The CNP group showed significantly slower gait speed and lower LRI during walking with both the HM and VM (p < 0.05), which corresponded to lower stride length and cadence. The gait asymmetry index in the CNP group was significantly higher than the OLD group during walking with VM (p < 0.05), whereas the PCI was significantly higher than the OLD group during walking with both HM and VM (p < 0.05). Conclusion: Chronic neck pain affects both speed and symmetry when walking with head movement. Gait parameters in this study could be implemented to identify changes in speed and symmetry of gait in older adults with CNP who have mild disability and high physical functioning.
Gait speed and gait asymmetry in individuals with chronic idiopathic neck pain
Musculoskeletal Science and Practice, 2019
Background: Recent studies have shown that individuals with chronic idiopathic neck pain (CINP) exhibit altered spatiotemporal gait parameters. Problems arising from the neck joints and related soft tissues, and most mechanical neck pain appear asymmetric. However, whether individuals with CINP have an asymmetric gait has not been clarified. Objectives: The aim was to investigate if there was a significant difference in gait speed (GS) and gait asymmetry (GA) between individuals with CINP and healthy controls. Design: Case-Control Study Method: Twenty individuals with CINP and 20 healthy controls were included. All participants performed the 10-meter walking test in three walking conditions: preferred walking (PW), preferred walking with head rotation and walking at maximum speed (MAXW). The timing gate system and pressure sensitive insoles were used to calculate GS and GA, respectively. GA was calculated using the difference between right and left swing durations. Results/Findings: Individuals with CINP had slower GS in all walking conditions compared to controls (p<0.05). In PW and MAXW conditions, gait was found to be asymmetric in individuals with CINP compared to controls (p<0.05). There was no difference in GA between the walking conditions in either group (p>0.05). Conclusions: Individuals with CINP had a slower and more asymmetrical gait. GA should be evaluated as a part of the routine gait analysis since it has potential to cause asymmetric loading on joints which could cause other musculoskeletal problems in the
The influence of neck pain on balance and gait parameters in community-dwelling elders
Manual Therapy, 2008
Neck pain has been shown to be associated with balance disturbances. Balance and gait speed are also known to decline with ageing. The aim of this study was to determine whether the presence of neck pain was associated with a decline in postural stability and gait speed over and above what is expected with normal ageing. Twenty female subjects with idiopathic neck pain and 20 healthy female controls aged between 65 and 82 years were studied. Subjects performed balance tests on a computerised force plate under conditions of eyes open, eyes closed on firm and soft surfaces in comfortable and narrow stance. Sway energy and root mean square (RMS) amplitude of sway were measured. Subjects also undertook a Timed Ten Metre Walk Test, with and without head turning.
Journal of Modern Rehabilitation (JMR), 2024
There is little evidence regarding the relationship between gait performance and psychological factors in people with chronic neck pain. This study evaluates gait performance in patients with neck pain and explores the relationship between gait performance and kinesiophobia, pain catastrophizing, pain intensity, and disability. Materials and Methods: A cross-sectional study was conducted on 34 patients with chronic neck pain and 29 age-and sex-matched controls were recruited for this study. The participants performed timed up-and-go (TUG), and 10-m walk tests (TMW) with and without head-turning tests. The associations between clinical gait tests, kinesiophobia (Tampa scale of kinesiophobia (TSK), pain catastrophizing scale, pain intensity (visual analog scale), and disability (neck disability index) were assessed. Results: People with neck pain had significant differences in the TUG, and TMW with and without head-turning tests compared to controls (P<0.01). Kinesiophobia and pain catastrophism were significantly correlated with TMW tests (r range=0.45 to 0.71, and 0.40 to 0.47, respectively). Pain intensity and disability were not correlated with gait tests. Conclusion: The gait performance, as represented by TUG and TMWs test scores, altered in patients with chronic neck pain in comparison controls. Fear of motion and pain catastrophizing thoughts correlated with clinical gait test scores.
Correlation of Neck Pain Severity with Balance in Subjects with Mechanical Neck Pain
2020
Background: Mechanical neck pain (MNP) is the most common cause of neck pain which causes sustained and abnormal loads on the neck and compromises the pain sensitive structures and therefore affects function of the cervical spine. MNP is characterised by reduced mobility, myofascial pain, faulty posture and altered cervical proprioception which can affect the balance of an individual. Hence, this study aimed to correlate pain severity with static and dynamic balance in young adults with MNP. Method:42 subjects of age 18 to 35 years with MNP were included in this study. The subjects were asked to rate neck pain severity using Numerical Pain Rating Scale (NPRS) whereas, static and dynamic balance was assessed using Modified Clinical test for Sensory Interaction in Balance (MCTSIB) and Modified Star Excursion Balance Test (MSEBT) respectively. Results: The findings demonstrated a significant positive correlation between neck pain severity and static balance when standing on unstable su...
Journal of Manipulative and Physiological Therapeutics, 2005
Background: Despite the high prevalence and cost of neck-pain problems, there is currently little data available on the physical characteristics associated with different levels of neck pain. Objective: To investigate associations between categories of response to neck pain/discomfort and (1) the endurance time of neck muscles, neck range of motion (ROM), and neck and head morphology, (2) sensitization or stretch effects arising from repeating end-of-range measurements, and (3) self-report data from neck pain and disability questionnaires. Design: A cross-sectional study design. Methods: Fifty-five Australian volunteers with and without neck pain, who were not taking time off work, were measured for neck muscle endurance, active neck ROM, craniocervical and thoracic posture, neck length, and head circumference and completed questionnaires about any neck pain/discomfort and disability. Results: Twenty-two subjects reported a level of neck pain/discomfort that had required treatment (treated neck pain), a group of 17 subjects reported experiencing low-level neck pain/discomfort on a recurrent basis for which they had not sought treatment (untreated neck pain), whereas 16 subjects had no experience of neck pain or discomfort (no pain). Neck muscle endurance time was significantly lower for both pain groups. The affective dimension of the Short-Form McGill Pain Questionnaire and neck disability questionnaires were scored significantly higher by subjects who had sought treatment than by those in either of the untreated groups. Both pain groups showed a range decrease for most directions of neck motion at second measurement. Conclusions: Neck muscle endurance times, repeated end-ROM testing, the Short-Form McGill Pain Questionnaire, and disability questionnaires may distinguish between groups with untreated, treated, and no neck pain.
Spine, 2016
Study Design. A cross-sectional observational study of threedimensional (3D) cervical kinematics in 41 chronic neck pain (CNPs) patients and 156 asymptomatic controls. Objective. The objective was to investigate 3D cervical kinematics by analyzing and comparing quantitative and qualitative parameters in healthy subjects and CNPs. Furthermore, subgroups were formed to explore the influence of pain-location on cervical kinematics. The possible correlation of kinematic parameters with the degree of functional disability was examined as well. Summary of Background Data. In patients with chronic neck pain, a clear pathological cause is frequently not identifiable. Therefore, the need to assess neck pain with a broader view than structure or anatomical-based divergences is desirable. Methods. Movements of the cervical spine were registered using an electromagnetic tracking system. Quantitative and qualitative kinematics were analyzed for active axial rotation, lateral bending, and flexion-extension motion components. Results. During lateral bending, the range of the main motion demonstrated significant higher values (P ¼ 0.001) in the controls (mean: 68.678 AE 15.178) than patients (mean: 59.288 AE 15.418). Significant differences were demonstrated between subgroups for several kinematic parameters (P < 0.05). Although differences were predominantly recorded between the ''symmetrical'' and ''asymmetrical'' pain group, some parameters also distinguished subgroups from controls. On average, the symmetrical group showed significant less harmonic movement patterns, expressed by qualitative parameters, in comparison with the ''asymmetrical'' group and controls. Furthermore, the ''asymmetrical'' group showed significant lower scores on quantitative parameters than the ''symmetrical'' group and controls. The degree of functional disability correlated moderately with changes in qualitative parameters. Conclusion. In this study, chronic neck pain patients with a symmetrical pain pattern showed significant poorer quality of movement, while those with asymmetrical pain showed a significant reduction in quantitative measures. Subgrouping of neck patients based on pain location may be of help for further research and clinics.
Physiotherapy Theory and Practice, 2019
Introduction: Gait impairment has been associated with neck pain. It is relevant to understand the possible influence of narrow-based walk and an attention-demanding secondary task on gait performance in neck pain. Purpose: To investigate the effects of tandem walk and cognitive and motor dual-tasks on gait speed in persons with chronic idiopathic neck pain (CINP) compared with controls. Methods: A cross-sectional study. Thirty participants with CINP and 30 asymptomatic controls participated in the study. Gait speed was assessed using a timed 10-m walk test at a comfortable pace under four conditions: (1) comfortable walk (as reference); (2) tandem walk (single task); (3) cognitive dual-task walking; and (4) motor dual-task walking. Dual-task interference was calculated. Results: There was no difference in comfortable gait speed between groups (p= 0.40). The CINP group had slower gait speed during the tandem walk than controls (p= 0.02). The dualtask interference on gait speed was not different between groups (p = 0.67 for cognitive, p = 0.93 for motor). Conclusion: Participants with CINP had impaired gait stability during tandem walk. An attentiondemanding secondary task did not influence gait speed in individuals with CINP compared to controls. The study suggests that tandem walk could be considered as an assessment tool and part of rehabilitation for neck pain.
Chronic neck pain is a widespread problem that causes individual suffering as well as large costs for the society. The knowledge about the pathophysiology is poor and therefore specific diagnosis and causal treatment are rare. Important knowledge for characterization of the disorders has been gained from research on sensorimotor functions in people with neck pain. Moreover, rehabilitation regimes including sensorimotor exercises indicate promising results. The main objectives of this thesis were to extend the knowledge on sensorimotor dysfunctions in chronic neck pain, and to develop a new exercise method for improving sensorimotor functions of the neck. The studies focused on aspects of postural control and movements of the arm and neck. These are vital functions for many activities of daily living. People with chronic (>3 months) neck pain were compared to healthy controls (CON). Neck pain related to trauma was referred to as whiplash associated disorders (WAD), while neck pain without association to trauma was referred to as non-specific (NS). Arm-functioning was assessed in a pointing task. WAD and NS had reduced pointing precision compared to CON. The reduced precision was associated with self-rated difficulties performing neck movements, physical functioning, and in WAD, also pain and balance disturbances. Postural control was assessed in quite standing on a force platform without vision. The center of pressure signal was decomposed into it's slow and fast components. WAD and NS were compared to CON. The results revealed an effect of age on the magnitude of the fast sway component, but no effect of group. The magnitude of the slow component was elevated in both WAD and NS. This increase was associated with self-rated balance disturbance, arm-functioning, difficulties to run and sensory alterations in WAD, while in NS, the increase in the slow sway component was associated with concurrent low back pain. Neck movements were assessed in a cervical axial rotation test with maximal speed. In total 8 variables representing basic kinematics, including variables reflecting movement smoothness and conjunct motions were calculated. NS were compared to CON. Linear discriminant modelling indicated Peak Speed and conjunct motions as significant classification variables that together had a sensitivity of 76.3% and specificity of 77.6%. Retest reliability was good for Peak Speed but poor for the measure of conjunct motions. Peak Speed was slower in NS compared to CON, and even slower in a subgroup of NS with concurrent low back pain. Reduced Peak Speed was associated with self-rated difficulties performing neck movements, car driving, running, sleeping disturbances and pain. The clinical applicability of a novel method for neck coordination exercise was assessed in a pilot study on persons with NS. The results supported the applicability and indicated positive effects of the exercise: reduced postural sway in quite standing and increased smoothness in cervical rotations. Indications on improvement in self-rated disability and fear of movement were seen at six months follow up. In conclusion, sensorimotor functions can be altered in chronic neck pain, particularly in neck disorders with concurrent low back pain and WAD. The discriminative ability and clinical validity displayed in pointing precision, postural sway and cervical axial rotation speed imply that such tests can be valuable tools in the assessment of chronic neck pain patients, and for selecting and evaluating treatment interventions. Indications of improvements seen in the pilot-study support a future RCT.