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Rehabilitation program for traumatic chronic cervical pain associated with unsteadiness: a single case study

Lafond D, Champagne A, Cadieux R, Descarreaux M - Chiropr Osteopat (2008)

Bottom Line: Altered sensorimotor control of the cervical spine and sensorimotor integration problems affecting postural control have been observed in CNP patients.Pre-intervention data revealed that the postural control system was challenged when postural control sensory inputs were altered, particularly during the head-extended-backward condition.These results warrant further studies to investigate the relationships between pain amelioration, sensorimotor control of the cervical spine, muscle fitness and postural steadiness.

Affiliation: Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada. danik.lafond@uqtr.ca

ABSTRACT

Background: Neck problems are often recurring or chronic. After pain, unsteadiness and balance problems are among the most frequent symptoms reported by chronic neck pain (CNP) patients. Altered sensorimotor control of the cervical spine and sensorimotor integration problems affecting postural control have been observed in CNP patients. Very few data are available regarding the post-intervention effects of rehabilitation programs on postural control in CNP.

Case presentation: This is a case study of a traumatic CNP patient (a 45-year old female) with postural unsteadiness who participated in an 8-week rehabilitation program combining therapeutic exercises with spinal manipulative therapy. Pre-intervention data revealed that the postural control system was challenged when postural control sensory inputs were altered, particularly during the head-extended-backward condition. Post-intervention centre of pressure measurements indicated a drastic reduction in postural sway during trials with changes in neck orientation.

Conclusion: This case report indicates that an 8-week rehabilitation program combining therapeutic exercises with spinal manipulative therapy may have had an effect on improvement of postural control in a trauma CNP patient with unsteadiness. These results warrant further studies to investigate the relationships between pain amelioration, sensorimotor control of the cervical spine, muscle fitness and postural steadiness.

Oculomotor and head/eye proprioceptive exercises. A) Head-to-target or head movement following the target with the eyes in a neutral position. B) Eyes-to-target or eye movement following the target with different head positions. C) Head-to-target or head movement following the target with the eyes in a neutral position and the subject lying supine on a Swiss ball, with the head in a weight-dependent neutral position.
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Figure 2: Oculomotor and head/eye proprioceptive exercises. A) Head-to-target or head movement following the target with the eyes in a neutral position. B) Eyes-to-target or eye movement following the target with different head positions. C) Head-to-target or head movement following the target with the eyes in a neutral position and the subject lying supine on a Swiss ball, with the head in a weight-dependent neutral position.

Mentions: ▪ Oculomotor and head/eye exercises: in the upright, sitting and supine positions. Eye tracking involved moving target exercises (Figure 2A) and eye/head coordination exercises (Figure 2B). Progression included increasing neck rotation amplitude, instability on a Swiss ball and augmenting neck muscle activity with the head in a weight-dependent position (Figure 2C).

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Rehabilitation program for traumatic chronic cervical pain associated with unsteadiness: a single case study

Lafond D, Champagne A, Cadieux R, Descarreaux M - Chiropr Osteopat (2008)

Oculomotor and head/eye proprioceptive exercises. A) Head-to-target or head movement following the target with the eyes in a neutral position. B) Eyes-to-target or eye movement following the target with different head positions. C) Head-to-target or head movement following the target with the eyes in a neutral position and the subject lying supine on a Swiss ball, with the head in a weight-dependent neutral position.
© Copyright Policy - open-access
Figure 2: Oculomotor and head/eye proprioceptive exercises. A) Head-to-target or head movement following the target with the eyes in a neutral position. B) Eyes-to-target or eye movement following the target with different head positions. C) Head-to-target or head movement following the target with the eyes in a neutral position and the subject lying supine on a Swiss ball, with the head in a weight-dependent neutral position.
Mentions: ▪ Oculomotor and head/eye exercises: in the upright, sitting and supine positions. Eye tracking involved moving target exercises (Figure 2A) and eye/head coordination exercises (Figure 2B). Progression included increasing neck rotation amplitude, instability on a Swiss ball and augmenting neck muscle activity with the head in a weight-dependent position (Figure 2C).

Bottom Line: Altered sensorimotor control of the cervical spine and sensorimotor integration problems affecting postural control have been observed in CNP patients.Pre-intervention data revealed that the postural control system was challenged when postural control sensory inputs were altered, particularly during the head-extended-backward condition.These results warrant further studies to investigate the relationships between pain amelioration, sensorimotor control of the cervical spine, muscle fitness and postural steadiness.

Affiliation: Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada. danik.lafond@uqtr.ca

ABSTRACT

Background: Neck problems are often recurring or chronic. After pain, unsteadiness and balance problems are among the most frequent symptoms reported by chronic neck pain (CNP) patients. Altered sensorimotor control of the cervical spine and sensorimotor integration problems affecting postural control have been observed in CNP patients. Very few data are available regarding the post-intervention effects of rehabilitation programs on postural control in CNP.

Case presentation: This is a case study of a traumatic CNP patient (a 45-year old female) with postural unsteadiness who participated in an 8-week rehabilitation program combining therapeutic exercises with spinal manipulative therapy. Pre-intervention data revealed that the postural control system was challenged when postural control sensory inputs were altered, particularly during the head-extended-backward condition. Post-intervention centre of pressure measurements indicated a drastic reduction in postural sway during trials with changes in neck orientation.

Conclusion: This case report indicates that an 8-week rehabilitation program combining therapeutic exercises with spinal manipulative therapy may have had an effect on improvement of postural control in a trauma CNP patient with unsteadiness. These results warrant further studies to investigate the relationships between pain amelioration, sensorimotor control of the cervical spine, muscle fitness and postural steadiness.

View Similar Images In: Results  - Collection
View Article: PubMed Central - HTML -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=2600629&rFormat=json&query=null&req=5