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Särkilahti N, Hirvonen M, Lavapuro J, Takatalo J, Löyttyniemi E, Tenovuo O. Sensorimotor tests in patients with neck pain and its associated disorders: a systematic review and meta-analysis. Sci Rep 2024; 14:12764. [PMID: 38834665 DOI: 10.1038/s41598-024-63545-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
This systematic review aimed to synthesize the current evidence regarding neck sensorimotor testing in individuals with neck pain, assess the differences between neck pain groups and healthy controls, and recognize factors that might affect test results. We performed the data search using PubMed, Embase, PsycINFO, CINAHL, and Scopus databases. We used a two-step screening process to identify studies. Furthermore, we screened the reference lists for additional studies. Hedges g was used to present the difference between neck pain groups and asymptomatic individuals. We assessed the quality of the studies using the QUADAS tool. The final review included 34 studies, of which 25 were related to the joint position error test, four to the smooth pursuit neck torsion test and six to the balance test. Our meta-analysis showed poorer joint-position sense, oculomotor function, and wider postural sway in individuals with neck pain than healthy controls. The size of the difference between the groups seemed to be influenced by the intensity of the pain and the presence of dizziness. Therefore, it might be helpful in future studies to differentiate patients with neck pain into subgroups based on their symptom and demographic profiles to assess other factors that significantly affect cervical sensorimotor control.
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Affiliation(s)
- Niklas Särkilahti
- Department of Clinical Neurosciences, Faculty of Medicine, University of Turku, Turku, Finland.
- Neurocenter, Turku University Hospital, Turku, Finland.
| | - Milka Hirvonen
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Joona Lavapuro
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Jani Takatalo
- Medical Research Center Oulu, University of Oulu, Oulu, Finland
- Loisto Terveys, Oulu, Finland
| | - Eliisa Löyttyniemi
- The Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland
| | - Olli Tenovuo
- Department of Clinical Neurosciences, Faculty of Medicine, University of Turku, Turku, Finland
- Turku Brain Injury Centre, Turku University Hospital, Turku, Finland
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Vitali D, Olugbade T, Eccleston C, Keogh E, Bianchi-Berthouze N, de C Williams AC. Sensing behavior change in chronic pain: a scoping review of sensor technology for use in daily life. Pain 2024; 165:1348-1360. [PMID: 38258888 DOI: 10.1097/j.pain.0000000000003134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/26/2023] [Indexed: 01/24/2024]
Abstract
ABSTRACT Technology offers possibilities for quantification of behaviors and physiological changes of relevance to chronic pain, using wearable sensors and devices suitable for data collection in daily life contexts. We conducted a scoping review of wearable and passive sensor technologies that sample data of psychological interest in chronic pain, including in social situations. Sixty articles met our criteria from the 2783 citations retrieved from searching. Three-quarters of recruited people were with chronic pain, mostly musculoskeletal, and the remainder with acute or episodic pain; those with chronic pain had a mean age of 43 (few studies sampled adolescents or children) and 60% were women. Thirty-seven studies were performed in laboratory or clinical settings and the remainder in daily life settings. Most used only 1 type of technology, with 76 sensor types overall. The commonest was accelerometry (mainly used in daily life contexts), followed by motion capture (mainly in laboratory settings), with a smaller number collecting autonomic activity, vocal signals, or brain activity. Subjective self-report provided "ground truth" for pain, mood, and other variables, but often at a different timescale from the automatically collected data, and many studies reported weak relationships between technological data and relevant psychological constructs, for instance, between fear of movement and muscle activity. There was relatively little discussion of practical issues: frequency of sampling, missing data for human or technological reasons, and the users' experience, particularly when users did not receive data in any form. We conclude the review with some suggestions for content and process of future studies in this field.
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Affiliation(s)
- Diego Vitali
- Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
| | - Temitayo Olugbade
- School of Engineering and Informatics, University of Sussex, Brighton, United Kingdom
- Interaction Centre, University College London, London, United Kingdom
| | - Christoper Eccleston
- Centre for Pain Research, The University of Bath, Bath, United Kingdom
- Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Psychology, The University of Helsinki, Helsinki, Finland
| | - Edmund Keogh
- Centre for Pain Research, The University of Bath, Bath, United Kingdom
| | | | - Amanda C de C Williams
- Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
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Anarte-Lazo E, Falla D, Rodriguez-Blanco C, Bernal-Utrera C. Higher Neck Pain Intensity and Pain Catastrophizing Soon After A Whiplash Injury Partially Explain the Presence of Persistent Headache: A Prospective Study. Clin J Pain 2024; 40:349-355. [PMID: 38465710 DOI: 10.1097/ajp.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/25/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To understand whether pain-related factors soon after a whiplash injury can explain the presence of chronic headache. MATERIALS AND METHODS A prospective study with a follow-up of 6 months was performed, including 42 patients with acute whiplash-associated disorders. Neck pain intensity, the Neck Disability Index, the Tampa Scale of Kinesiophobia, the Pain Catastrophizing Scale, and the Anxiety State-Trait Scale were assessed at baseline. Differences in clinical characteristics between those with and without headache at 6 months were determined. The relative risk of presenting with headache was evaluated. A logistic regression model was performed to assess which factors at baseline could explain the presence of headache at 6 months. RESULTS At 6 months, one-third of the sample presented with chronic headache. Significant differences were found for several outcome measures when people with and without headache were compared ( P <0.001). The highest relative risk of presenting with headache was found for moderate/severe levels of pain catastrophizing during the acute phase (RR=15.00, 95% CI=3.93, 57.22). The level of neck pain intensity and pain catastrophizing at baseline partially explained the presence of headache at 6 months ( R2 =0.627). DISCUSSION The risk of presenting with persistent headache attributed to a whiplash injury is increased when people present with higher neck pain intensity and pain catastrophizing soon after a whiplash injury. Evaluating neck pain intensity and pain catastrophizing at baseline may assist in identifying those more likely to develop chronic headache, potentially providing an opportunity for early targeted interventions.
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Affiliation(s)
- Ernesto Anarte-Lazo
- Doctoral Program in Health Sciences
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Cleofas Rodriguez-Blanco
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Carlos Bernal-Utrera
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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AlDahas A, Devecchi V, Deane JA, Falla D. Responsiveness of the cervical joint position error test to detect changes in neck proprioception following four weeks of home-based proprioceptive training. PLoS One 2024; 19:e0303066. [PMID: 38728251 PMCID: PMC11086922 DOI: 10.1371/journal.pone.0303066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION People with chronic neck pain (CNP) commonly exhibit a range of physical impairments including cervical proprioceptive deficits. Assessing proprioception using a head mounted laser to assess joint position error (JPE) is a reliable and valid measure. However, the responsiveness of this measure has not been assessed. OBJECTIVE To assess the responsiveness of the measure of cervical JPE after a 4-week home-based neck proprioceptive training intervention in people with CNP. DESIGN An observational study to assess the responsiveness of the measure of cervical JPE. METHODS The JPE test was assessed in people with CNP before and after 4 weeks of neck proprioception training. JPE was assessed as participants performed neck joint position sense tests for flexion, extension, right rotation, and left rotation in sitting and standing which were performed in a random order. Both the absolute and constant JPE were assessed. The intervention consisted of neck repositioning exercises as well as movement sense exercises. Cohen's d effect size was used to assess the internal responsiveness of the JPE test. The Pearson's correlation was used to assess the change of scores of the laser pointer and measures from inertial measurement units (IMUs) (external responsiveness). RESULTS After 4 weeks of proprioception training, JPE assessed in sitting reduced from 2.69◦-3.57◦ to 1.88◦-1.98◦ for flexion, extension, and right rotation with large effect sizes (Cohen's d range: 1.25-2.00). For left rotation, JPE reduced from 3.23◦ to 1.9◦, and the effect size was close to being large (Cohen's d: 0.79). When assessed in standing, JPE reduced from 3.49◦-4.52◦ to 1.5◦-2.33◦ with large effect sizes (Cohen's d range: 0.89-1.25) for flexion, extension, right rotation, and left rotation. Large effect sizes were not observed for the constant JPE when assessed in either sitting or standing. The assessment of the external responsiveness revealed weak correlations between the change of scores obtained from the laser pointer and the IMUs for all movements, apart from the constant JPE in sitting for left rotation, which showed a strong correlation (r = 0.7). CONCLUSION The results of this study showed that the measure of the JPE has sufficient internal responsiveness, however, the external responsiveness was inadequate. Further research is advised.
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Affiliation(s)
- Ahmad AlDahas
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Physical Therapy, Al-Sabah Medical Hospital, Ministry of Public Health, Shuwaikh Industrial, Kuwait
| | - Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Janet A. Deane
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Anarte-Lazo E, Liew BXW, Devecchi V, Bernal-Utrera C, Rodriguez-Blanco C, Falla D. Network analyses reveal the interaction between physical features, fear of movement and neck pain and disability in people with acute and chronic whiplash-associated disorders. Eur J Pain 2024; 28:322-334. [PMID: 37725095 DOI: 10.1002/ejp.2184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/20/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND AND OBJECTIVE A network analysis can be used to quantitatively assess and graphically describe multiple interactions. This study applied network analyses to determine the interaction between physical and pain-related factors and fear of movement in people with whiplash-associated disorders (WAD) during periods of acute and chronic pain. METHODS Physical measurements, including pressure pain-thresholds (PPT) over neural structures, cervical range of motion, neck flexor and extensor endurance and the cranio-cervical flexion test (CCFT), in addition to subjective reports including the Tampa Scale of Kinesiophobia (TSK-11), Neck Disability Index (NDI) and neck pain and headache intensity, were assessed at baseline in 47 participants with acute WAD. TSK-11, NDI and pain intensity were assessed for the same participants 6 months later (n = 45). Two network analyses were conducted to estimate the associations between features at baseline and at 6 months and their centrality indices. RESULTS Both network analyses revealed that the greatest weight indices were found for NDI and CCFT at baseline and for neck pain and headache intensity and NDI and TSK-11 at both time points. Associations were also found betweeen cervical muscle endurance and neck pain intensity in the acute phase. Cervical muscle endurance assesssed during the acute phase was also associated with NDI after 6 months - whereas PPT measured at baseline was associsated with headache intensity after 6 months. CONCLUSION The strongest associations were found for headache and neck pain intensity and neck disability and fear of movement, both during acute pain and when mesured 6 months later. The extent of neck endurance and measures of PPT at baseline may be associated with neck disability and headache, respectively, 6 months after a whiplash injury. SIGNIFICANCE Through two network analyses, we evaluated the interaction between pain-related factors, fear of movement, neck disability and physical factors in people who had experienced a whiplash injury. We demonstrated that physical factors may be involved in the maintenance and development of chronic pain after a whiplash injury. Nevertheless, the strongest associations were found for headache and neck pain intensity and neck disability and fear of movement, both during acute and chronic phases.
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Affiliation(s)
- Ernesto Anarte-Lazo
- Doctoral Program in Health Sciences, University of Seville, Seville, Spain
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, UK
| | - Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Carlos Bernal-Utrera
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Cleofas Rodriguez-Blanco
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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