Mehmet DURAY, Filiz ALTUĞ, Uğur CAVLAK, Şule ŞIMŞEK

Kronik boyun ağrılı hastalarda proprioseptif eğitimin denge üzerine etkisi

Amaç: Bu randomize kontrollü araştırmanın amacı kronik boyun ağrısına (KBA) sahip hastalarda proprioseptif eğitimin denge üzerine etkisini incelemektir. Gereç ve Yöntem: Çalışmaya katılan 40 hasta randomize olarak çalışma ve kontrol gruplarına ayrıldı. Her iki gruba da Konvansiyonel Fizik Tedavi uygulanırken, çalışma grubu proprioseptif eğitim için ek olarak bakış yönü tanıma egzersizi (BYTE) ile tedavi edildi. Hastalara, tedavinin başlangıcında, tedavi bitiminde ve son seanstan 3 hafta sonra ağrı şiddeti [Görsel Analog Skalası (GAS)], boyun özür seviyesi [Boyun Özür İndeksi (BÖİ)] ve denge [Dört Adım Kare Testi (DAKT), gözler açık ve kapalı tek ayak denge testi (TADT)] değerlendirmeleri yapıldı. Bulgular: Tedavi öncesi değerlendirmeler bakımından gruplar arasında fark bulunmadı. Tedavi öncesi ile karşılaştırıldığında her iki grubun GAS skorlarında istatistiksel olarak anlamlı azalma vardı (p

Effect of proprioceptive training on balance in patients with chronic neck pain

Objectives: The aim of this randomized controlled study was to investigate the effect of proprioceptive training on balance inpatients with chronic neck pain (CNP).Methods: Forty patients participating in the study were randomly divided into study and control groups. Both of the groups underwentconventional physical therapy; additionally, the study group was rehabilitated with gaze direction recognition exercise(GDRE) for proprioceptive training. Exercises were performed during 3 weeks with five sessions per week. Pain intensity [visualanalog scale (VAS)], neck disability [Neck Disability Index (NDI)], and balance [four step square test (FSST), single leg balance test(SLBT) with eyes opened and closed] assessments were conducted in the patients before and after the treatment and 3 weeksafter the last session.Results: No differences were observed between the groups in terms of pre-treatment measurements. There was a statisticallysignificant decrease in VAS scores in both groups compared with pre-treatment conditions (p0.05).Conclusion: Proprioceptive training should be included in physiotherapy programs to improve balance; it decreases the disabilitylevel in patients with CNP.

PDF

___

Falla D, Lindstrøm R, Rechter L, Boudreau S, Petzke F. Effectiveness of an 8-week exercise programme on pain and specificity of neck muscle activity in patients with chronic neck pain: a randomized controlled study. Eur J Pain 2013;17(10):1517–28.
Gross AR, Paquin JP, Dupont G, Blanchette S, Lalonde P, Cristie T, et al. Exercises for mechanical neck disorders: A Cochrane review update. Man Ther 2016;24:25–45.
Gross A, Langevin P, Burnie SJ, Bédard-Brochu MS, Empey B, Dugas E, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev 2015;(9):CD004249.
Kroeling P, Gross A, Graham N, Burnie SJ, Szeto G, Goldsmith CH, et al. Electrotherapy for neck pain. Cochrane Database Syst Rev 2013;(8):CD004251.
Mousavi-Khatir R, Talebian S, Maroufi N, Olyaei GR. Effect of static neck flexion in cervical flexion-relaxation phenomenon in healthy males and females. J Bodyw Mov Ther 2016;20(2):235–42.
Lafond D, Champagne A, Cadieux R, Descarreaux M. Rehabilitation program for traumatic chronic cervical pain associated with unsteadiness: a single case study. Chiropr Osteopat 2008;16:15.
Treleaven J, Chen X, Sarig Bahat H. Factors associated with cervical kinematic impairments in patients with neck pain. Man Ther 2016;22:109-15.
Yousif N, Cole J, Rothwell J, Diedrichsen J. Proprioception in motor learning: lessons from a deafferented subject. Exp Brain Res 2015;233(8):2449–59.
Aslan E, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagli N. The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976) 2008;33(11):E362–5.
Isık EI, Altug F, Cavlak E. Reliability and validity of four step square in older adults. Turkish Journal of Geriatrics 2015;18(2):151–5.
Nobusako S, Matsuo A, Morioka S. Effectiveness of the gaze direction recognition task for chronic neck pain and cervical range of motion: a randomized controlled pilot study. Rehabil Res Pract 2012;2012:570387.
Pettorossi VE, Schieppati M. Neck proprioception shapes body orientation and perception of motion. Front Hum Neurosci 2014;8:895.
Horn ME, Brennan GP, George SZ, Harman JS, Bishop MD. A value proposition for early physical therapist management of neck pain: a retrospective cohort analysis. BMC Health Serv Res 2016;16:253.
Meisingset I, Woodhouse A, Stensdotter AK, Stavdahl Ø, Lorås H, Gismervik S, et al. Evidence for a general stiffening motor control pattern in neck pain: a cross sectional study. BMC Musculoskelet Disord 2015;16:56.
Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control-Part 2: case studies. Man Ther 2008;13(3):266–75.
O’Leary S, Jull G, Kim M, Uthaikhup S, Vicenzino B. Training mode-dependent changes in motor performance in neck pain. Arch Phys Med Rehabil 2012;93(7):1225–33.
Röijezon U, Björklund M, Bergenheim M, Djupsjöbacka M. A novel method for neck coordination exercise--a pilot study on persons with chronic non-specific neck pain. J Neuroeng Rehabil 2008;5:36.
Poliak S, Norovich AL, Yamagata M, Sanes JR, Jessell TM. Muscle-type Identity of Proprioceptors Specified by Spatially Restricted Signals from Limb Mesenchyme. Cell 2016;164(3):512–25.
Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res 2007;25(3):404–12.
McCaskey MA, Schuster-Amft C, Wirth B, Suica Z, de Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review. BMC Musculoskelet Disord 2014;15:382.
Atya AM, Ahmed GM. Effectiveness of Physical Therapy Intervention on Neck Proprioception and Balance Parameters in Patients With Chronic Mechanical Neck Pain. Bulletin of Faculty of Physical Therapy 2009;4(2):41–7.