The Effect of a Rehabilitation Exercise Program on Head Repositioning Accuracy and Reported Levels of Pain in Chronic Neck Pain Subjects

Abstract

Objectives. Currently, there is limited research on the effectiveness of rehabilitative exercises for neck pain patients generally, and chronic neck pain patients in particular. Interestingly, recent evidence suggests that dysfunction of cervicocephalic kinesthesia, as measured by head repositioning accuracy (HRA), is present in many chronic patients, and that active eye-head-neck, co-ordination exercises, may be useful in terms of patients' rehabilitation.The purpose of this study was twofold: i. to determine if there was a difference in HRA in chronic neck pain subjects versus controls; ii. to assess the effect of a rehabilitative exercise program on chronic neck pain subjects' HRA and reported levels of pain.Method. A prospective, intervention study on a convenience sample of chronic neck pain subjects (> 3 months duration) versus age and gender matched, asymptomatic control subjects was conducted. Exclusion criteria included any form of active treatment (> 1 per month) for musculoskeletal complaints, including medication, as well as any arthritic, orthopaedic, or neurological disorder.Both symptomatic and asymptomatic subjects were assigned, via stratified, random allocation, to either a rehabilitative exercise or non-ex-B. K. Humphreys, DC, PhD, and P. M. Irgens, BSc (Hons.), are affiliated with the

Effects of Neck-Specific Exercises Compared to Waiting List for Individuals With Chronic Whiplash-Associated Disorders: A Prospective, Randomized Controlled Study

“…The results are also consistent with the only available study comparing exercise (4-week) and WL in chronic neck pain [18]. The results from the present study demonstrate more between group changes than those reported in individuals with WAD by Vikne et al [14] and Michaleff et al [15].…”

“…As WAD patients may show changes in condition over time without intervention, comparison of some exercise interventions to no treatment might be useful in guiding rehabilitation protocols. Except for a small study by Humphreys & Ingens [18], no study has investigated individuals with chronic WAD who either performed exercise or remained at waiting list without any intervention. Humphreys & Ingens [18] investigated the effect of proprioceptive training with eye-head-neck exercises in a sample of 28 patients with chronic (>3 months) neck pain, where 61% had previously had a whiplash injury.…”

“…Except for a small study by Humphreys & Ingens [18], no study has investigated individuals with chronic WAD who either performed exercise or remained at waiting list without any intervention. Humphreys & Ingens [18] investigated the effect of proprioceptive training with eye-head-neck exercises in a sample of 28 patients with chronic (>3 months) neck pain, where 61% had previously had a whiplash injury. The results of the NSE protocol used in the RCT by Ludvigsson et al [16,17] seem promising, but need to be confirmed compared with a no-intervention control group.…”

Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs

“…There is some evidence that programs that emphasize gaze stability, eye head co-ordination and cervical position sense and balance tasks without local cervical spine treatment have resulted in either decreased medication intake, improved neck pain and disability, HRA and or balance in those with neck pain (Revel et al , 1994, Fitz-Ritson, 1995, Humphreys and Irgens, 2002, Jull et al, 2007, Treleaven, 2010. Improvements in balance and symptoms of dizziness have also been observed following a vestibular or oculomotor rehabilitation program or tailored sensorimotor program in patients with persistent WAD (Hansson et al , 2006, Storaci et al , 2006, Treleaven, 2010.…”

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

“…52,102,116 Vestibular rehabilitation programs have been shown to be useful in those with concussion 1,45 and resulted in improved balance and dizziness in individuals with WAD. 27 Interestingly, in those with WAD, this training did not improve neck pain or movement.…”