Unveiling the Nexus of Cervical Proprioception, Postural Stability, and Impeding Factors in Cervical Spondylosis: Insights from Reposition Errors, Limits of Stability, and Mediation Analysis

Abstract

Cervical proprioception and postural stability play crucial roles in maintaining optimal head and neck positioning, yet their relationship and implications in cervical spondylosis (CS) remain underexplored. This study aims to investigate cervical proprioceptive reposition errors, limits of stability, and their association in individuals with CS while considering the mediating effects of pain and kinesiophobia. The primary objectives are to compare cervical proprioceptive reposition errors and limits of stability variables between individuals with CS and age-matched healthy controls, explore their associations within the CS group, and determine the mediating roles of pain and kinesiophobia. A cross-sectional study recruited 60 individuals with CS and 60 healthy controls. Cervical joint reposition errors (JREs) were assessed using a cervical range-of-motion device, while limits of stability were evaluated using a computerized dynamic posturography system. Pain, kinesiophobia, and demographic data were collected. Parametric tests, correlation analyses, and multiple regression were employed for data analysis. Individuals with CS exhibited significantly higher cervical JREs in flexion, extension, and rotation compared with healthy controls (p < 0.001). Within the CS group, correlations revealed associations between JREs and limits-of-stability variables (p < 0.05). Mediation analysis demonstrated significant direct and indirect effects of pain and kinesiophobia on the relationship between JREs and limits-of-stability variables in the CS group (p < 0.005). CS is associated with impaired cervical proprioception, increased reposition errors, and compromised postural stability. This study highlights the interplay between proprioception, stability, pain, and psychological factors, emphasizing the need for comprehensive interventions in individuals with CS to enhance functional outcomes and quality of life.