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European Journal of Physical and Rehabilitation Medicine 2019 February;55(1):63-70

DOI: 10.23736/S1973-9087.18.05118-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Train the brain! Immediate sensorimotor effects of mentally-performed flexor exercises in patients with neck pain. A pilot study

Konstantin BEINERT 1 , Marc SOFSKY 1, Jörg TROJAN 2

1 Department of Physiotherapy, University of Applied Health Sciences Rhein-Neckar, Mannheim, Germany; 2 Department of Psychology, University of Koblenz-Landau, Landau, Germany



BACKGROUND: Sensorimotor tests, like cranio-cervical flexion and cervical joint position sense tests, share a strong cognitive component during their execution. However, cognitive training for those tests has not been investigated so far.
AIM: The aim of this study was to compare mental and physical exercises for improving the sensorimotor function of the cervical spine.
DESIGN: A within-subject design with 16 participants.
SETTING: Outpatient physiotherapy center.
POPULATION: Patients with chronic neck pain.
METHODS: Participants were instructed to perform specific active or mental exercises for the deep and superficial neck flexor muscles. The primary outcomes were cranio-cervical flexion test performance, postural sway, cervical joint position sense and pressure pain threshold. A mixed model analysis was used.
RESULTS: The interventions improved cranio-cervical flexion performance (P<0.001), with no difference between actively or mentally-performed exercises. Postural sway increased after actively (P<0.01) and mentally (P<0.05) performed deep cervical neck flexor exercises, but not after superficial neck flexor exercises. Mentally-performed superficial neck flexor exercises improved cervical joint position sense when compared to mentally-performed deep cervical flexor exercises (P<0.05), and actively performed superficial neck flexor exercises were effective in improving cervical joint position sense acuity compared to mentally-performed deep cervical flexor exercises (P<0.05) for relocation tasks in the transverse plane. The pressure pain threshold at the cervical spine increased after active deep cervical flexor exercises (P<0.05) and after mental superficial neck flexor exercise (P<0.05).
CONCLUSIONS: Mentally-performed deep cervical flexor exercises improved cranio-cervical flexion test performance and pressure pain threshold at the cervical spine, while postural sway increased. Mentally-performed superficial neck flexor exercises improved cervical joint position sense acuity more than mentally-performed deep cervical flexor exercises.
CLINICAL REHABILITATION IMPACT: Mentally-performed exercises are recommended in the early stages of rehabilitation to counteract extensive muscle impairment, and these can be incorporated into daily routine.


KEY WORDS: Neck pain - Neck muscles - Posture - Pain threshold

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