Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Cervical Mobilization and Craniocervical Flexion Exercise on the Dynamic Balance and Gait Variability in Chronic Neck Pain Patients: Randomized Controlled Trial

목뼈 가동 운동과 머리목 굽힘 운동이 만성 목통증 환자의 동적균형과 보행변인에 미치는 영향: 무작위 임상시험

  • Choi, Tae-Seok (Department of Physical Therapy, Graduate School of Namseoul University) ;
  • Ryu, Byeong-Ho (Department of Physical Therapy, Namseoul University) ;
  • Lee, Sang-Bin (Department of Physical Therapy, Namseoul University)
  • 최태석 (남서울대학교 물리치료학과 일반대학원) ;
  • 유병호 (남서울대학교 물리치료학과) ;
  • 이상빈 (남서울대학교 물리치료학과)
  • Received : 2019.11.20
  • Accepted : 2019.12.20
  • Published : 2020.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

PURPOSE: The aim of this study is to find a more efficient intervention method through a study of the gait variables and dynamic balance of chronic neck pain patients. METHODS: Forty subjects aged between 40 and 60 years were allocated randomly to two groups; The first group performed PA (Posteroanterior Mobilization), and the second group conducted CCF (Craniocervical Flexion Exercise). The gait variability measured the speed, cadence, and dynamic balance in the forward, leftward, rightward, and rearward directions. An independent t-test, Wilcoxon signed-rank test, and paired t-test were used for statistical analysis. RESULTS: In the dynamic balance measurements, the variability of PA (p < .000) and CCF (p < .000) in the rightward direction, PA (p < .004) in leftward direction and forward direction increased significantly (p < .013). In an analysis of the gait variability, the cadence increased significantly in the PA group (p < .022) and not significantly in the CCF group (p < .056). On the other hand, there was no increase in the speed variable, in the PA group (p < .437). In the CCF group, the cadence increased significantly (p < .022). The differences in the PA and CCF group differences were not significant. CONCLUSION: The PA group showed a significant increase in the forward (p < .013), leftward (p < .004), and rightward directions (p < .000). Speed was significant in the CCF group, and cadence was significant in the PA group. The dynamic Balance was effective in the rightward direction in both groups, but there was no significant difference between the two groups.

Keywords

References

  1. Collaborators GBDRF. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1659-724. https://doi.org/10.1016/S0140-6736(16)31679-8
  2. Aruin AS, Latash ML. Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Exp Brain Res. 1995;103(2):323-32.
  3. Courtine G, Papaxanthis C, Laroche D, et al. Gaitdependent integration of neck muscle afferent input. Neuroreport. 2003;14(18):2365-8. https://doi.org/10.1097/00001756-200312190-00015
  4. Michaelson P, Michaelson M, Jaric S, et al. Vertical posture and head stability in patients with chronic neck pain. J Rehabil Med. 2003;35(5):229-35. https://doi.org/10.1080/16501970306093
  5. Sambajon VV, Cillo JE, Jr., Gassner RJ, et al. The effects of mechanical strain on synovial fibroblasts. J Oral Maxillofac Surg. 2003;61(6):707-12. https://doi.org/10.1053/joms.2003.50141
  6. Yun KH, Kim K. Effect of craniocervical flexion exercise using sling on thickness of sternocleidomastoid muscle and deep cervical flexor muscle. Journal of the Korean Society of Physical Medicine. 2013;8(2):253-61. https://doi.org/10.13066/kspm.2013.8.2.253
  7. Bronfort G, Haas M, Evans RL, et al. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004;4(3):335-56. https://doi.org/10.1016/j.spinee.2003.06.002
  8. Falla D, Jull G, Hodges PW. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res. 2004;157(1):43-8. https://doi.org/10.1007/s00221-003-1814-9
  9. Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine (Phila Pa 1976). 2004;29(19):2108-14. https://doi.org/10.1097/01.brs.0000141170.89317.0e
  10. Poole E, Treleaven J, Jull G. The influence of neck pain on balance and gait parameters in community-dwelling elders. Man Ther. 2008;13(4):317-24. https://doi.org/10.1016/j.math.2007.02.002
  11. Sjolander P, Michaelson P, Jaric S, et al. Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity. Man Ther. 2008;13(2):122-31. https://doi.org/10.1016/j.math.2006.10.002
  12. Jull GA, Falla D, Vicenzino B, et al. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14(6):696-701. https://doi.org/10.1016/j.math.2009.05.004
  13. Haldeman S, Carroll L, Cassidy JD. Findings from the bone and joint decade 2000 to 2010 task force on neck pain and its associated disorders. J Occup Environ Med. 2010;52(4):424-7. https://doi.org/10.1097/JOM.0b013e3181d44f3b
  14. Blosch C, Schafer R, de Marees M, et al. Comparative analysis of postural control and vertical jump performance between three different measurement devices. PloS one. 2019;14(9).
  15. Mormile M. Reliability and Validity of the GWalk for Use in Postural Control. 2017.
  16. Edmondston S, Bjornsdottir G, Palsson T, et al. Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain. Man Ther. 2011;16(4):332-8. https://doi.org/10.1016/j.math.2010.12.005
  17. Falla D, O'Leary S, Farina D, et al. The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain. Clin J Pain. 2012;28(7):628-34. https://doi.org/10.1097/AJP.0b013e31823e9378
  18. Seidel B, Krebs DE. Base of support is not wider in chronic ataxic and unsteady patients. Journal of rehabilitation medicine. 2002;34(6):288-92. https://doi.org/10.1080/165019702760390392
  19. Sjolander P, Johansson H, Djupsjobacka M. Spinal and supraspinal effects of activity in ligament afferents. Journal of Electromyography and Kinesiology. 2002;12(3):167-76. https://doi.org/10.1016/S1050-6411(02)00017-2
  20. Hoch MC, Andreatta RD, Mullineaux DR, et al. Two-week joint mobilization intervention improves self-reported function, range of motion, and dynamic balance in those with chronic ankle instability. Journal of orthopaedic research. 2012;30(11):1798-804. https://doi.org/10.1002/jor.22150
  21. Bhatt T, Wening J, Pai Y-C. Influence of gait speed on stability: recovery from anterior slips and compensatory stepping. Gait & posture. 2005;21(2):146-56. https://doi.org/10.1016/j.gaitpost.2004.01.008
  22. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. Lippincott Williams & Wilkins. 2007.
  23. Field S, Treleaven J, Jull G. Standing balance: a comparison between idiopathic and whiplash-induced neck pain. Manual therapy. 2008;13(3):183-91. https://doi.org/10.1016/j.math.2006.12.005
  24. Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual therapy. 2008;13(1):2-11. https://doi.org/10.1016/j.math.2007.06.003
  25. Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. journal of orthopaedic & sports physical therapy. 2009;39(5):364-77. https://doi.org/10.2519/jospt.2009.2834
  26. Findling O, Schuster C, Sellner J, et al. Trunk sway in patients with and without, mild traumatic brain injury after whiplash injury. Gait & posture. 2011;34(4):473-8. https://doi.org/10.1016/j.gaitpost.2011.06.021
  27. Jull GA. Deep cervical flexor muscle dysfunction in whiplash. Journal of musculoskeletal pain. 2000;8(1-2):143-54. https://doi.org/10.1300/j094v08n01_12