The Neck Proprioception Characteristics Of Chronic Non-specific Neck Pain People

Objective: Chronic neck pain affects people’s daily life and work seriously,and causes heavy social and economic burden;While whether there is the lack of proprioceptive ability in the neck pain population is still controversial.This study compares the differences in accuracy,range of movement,average speed during cervical proprioceptive reposition test and strength of the neck between healthy and chronic non-specific neck pain people.Answering whether chronic non-specific neck pain people have worse proprioceptive ability and changes in motor strategies,whether there is a correlation between neck strength and proprioception.This study aims to provide targeted and useful rehabilitation advice for chronic non-specific neck pain people.Methods: 58 subjects were recruited,including 21 healthy subjects and 37 chronic non-specific neck pain subjects.The kinematics data in proprioception test was collected by Qualisys capture system and the musculoskeletal model was established by Visual 3D.The accuracy,average speed and amplitude of movement during the head reposition test were calculated.After that,the endurance of deep neck flexors and isometric strength were measured,to explore their correlations with proprioception.Results: Compared with the healthy control group,the chronic non-specific neck pain group,(1)had significantly higher score of the current VAS(p=0.000),last week’s VAS(p=0.000),NDI(p=0.000)and TSK(p=0.000)scores than the control group,which meant worse pain and function conditions;there was no significant difference in age,height,weight and BMI between two groups;(2)the head forward posture of the neck pain group was significantly worse than the healthy group(p=0.002),and there was no significant difference in the cervico-thoracic angle and shoulder protraction between two groups;(3)the endurance of deep neck flexors(p=0.031),the isometric strength of flexors(p=0.037)and left lateral flexors(p=0.008)in the neck pain group were significantly lower than the control group,and there was no significant difference in the isometric strength of extensors and right lateral flexors;(4)the average speed during reposition in each direction of the neck pain group was significantly lower than the control group(p < 0.05);(5)there was no significant difference of the movement amplitude during reposition test in two groups;(6)As the results of neck reposition tests,the AE(p=0.025),CE(p=0.003),VE(p=0.003)and RMSE(p=0.015)in the flexion direction of neck pain group were significantly higher than the control group;the VE(p=0.001)in the extension direction was significantly higher than the control group,but there was no significant difference in CE,AE and RMSE;the AE(p=0.002)and RMSE(p=0.002)in the left lateral flexion direction were significantly higher than the control group,but there was no significant difference in CE and VE;the CE(p=0.017),AE(p=0.000)and RMSE(p=0.000)in the right lateral flexion direction were significantly higher than the control group,but there was no significant difference in VE;There was no significant difference in AE,CE,VE and RMSE between the two groups in the left rotation direction;the AE(p=0.047)in the right rotation direction was significantly higher than the control group,but there was no significant difference in CE,VE and RMSE;(7)there was a significant positive correlation between the scores of VAS,NDI and TSK(p<0.05),and there was also correlations among the strength in directions(p<0.05);(8)Isometric strength in flexion,extension and lateral flexion directions were not significantly related to proprioceptive characteristics in the corresponding direction;except for VE in the left rotation direction(p<0.05),there was no significant correlation between the endurance of deep neck flexors and proprioceptive characteristics in all directions.Conclusion: Compared with the healthy control group,the chronic non-specific neck pain group(1)have the deficiency of neck proprioception,which is mainly presented in flexion,left and right lateral flexion directions;(2)have the changes of kinematic characteristics and movement strategies as slower average speed in the reposition test;(3)have the head front posture and the deficiency of neck strength.(4)There is no correlation between isometric strength,deep neck flexors’ endurance and the ability of neck proprioception.Suggestions:(1)proprioception training of the neck should be included in the treatment of chronic non-specific neck pain,especially for flexion,left and right lateral flexion directions.(2)The movement speed of the neck during active movement or reposition test should be included in the assessment of chronic neck pain people.