Recurrent neck pain patients exhibit altered joint motion pattern during cervical flexion and extension movements. (January 2020)

• Record Type: Journal Article
• Authors: Qu, Ning; Graven-Nielsen, Thomas; Lindstrøm, Rene; Blogg Andersen. DC, Victoria; Hirata, Rogerio Pessoto
• Is Part Of: Clinical biomechanics. Volume 71(2020)
• Page Start: 125
• Page End: 132
• Publication Date: 2020-01
• Subjects: Recurrent neck pain -- Flexion -- Extension -- Cervical joint motion -- Video-fluoroscopy -- Pressure pain threshold; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2019.10.026
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: Impaired sensorimotor ability has been demonstrated in recurrent neck pain patients. It is however not clear if cervical joint motion and pressure pain sensitivity in recurrent neck pain patients are different from asymptomatic controls. Methods: Cervical flexion and extension motions were examined by video-fluoroscopy and pressure pain thresholds were assessed bilaterally over C2/C3, C5/C6 facet joints and right tibialis anterior in eighteen recurrent neck pain patients and eighteen healthy subjects. Individual joint motion was analyzed by dividing fluoroscopic videos into 10 epochs. The motion opposite to the primary direction (anti-directional motion) and motion along with the primary direction (pro-directional motion) of each joint were extracted across epochs. Total joint motion was the sum of anti-directional and pro-directional motions. Joint motion variability was represented by the variance of joint motions across epochs. Findings: Compared to controls, recurrent neck pain patients showed: 1) decreased anti-directional motion at C2/C3 and C3/C4 ( P < 0.05) and increased anti-directional motion at C5/C6 and C6/C7 ( P < 0.05) during extension motion. 2) Increased overall anti-direction motion during flexion motion ( P < 0.05). 3) Lower joint motion variability at C3/C4 during extension motion ( P < 0.05). Interpretation: Recurrent neck pain patients showed a redistribution of anti-directional motion between the middle cervical spine and the lower cervical spine during cervical extension and increased overall anti-directional motion during cervical flexion compared with healthy controls. The anti-directional motion was more sensitive to neck pain compared to other cervical joint motion parameters in the present study. Highlights: Altered cervical joint motion patterns were found in patients with neck pain. Neck pain redistributed anti-directional joint motion during extension. Neck pain increased overall anti-directional joint motion during flexion. Anti-directional motion was most sensitive to neck pain in this study. Recurrent neck pain showed no localized and widespread hyperalgesia in this study.