Effectiveness of an Eye-Cervical Re-education Program in Chronic Neck Pain
Condition: Neck Pain; Eye Strain
MeSH terms: Asthenopia; Neck Pain
Study type: Interventional

Summary: 
      The aim of the present study is to value the effectiveness of an Eye-Cervical Re-education
      Program (ECRP) to decrease pain and increase mobility in the cervical area compared to a
      Combined Physiotherapy Protocol (CPP) in patients with chronic neck pain symptoms.
    

Detailed description: 
      Background:

      In Physiotherapy there is a growing interest of authors to clarify the relationship between
      the visual system and the neck. Aspects such as deficiencies in eye movement during cervical
      rotation are common disorders in patients who have suffered whiplash trauma or have dizzy
      syndromes. On the other hand, deep muscle disorders of the neck are related to the decrease
      in cervical-ocular reflex. Furthermore, some disorders in eye movements in patients with
      idiopathic neck pain have been identified.

      Consequently, a pragmatic approach to multimodal intervention has been recommended to address
      changes in sensorimotor control at the cervical level. For this purpose, head-neck
      sensitization exercises (joint position sense training with head relocation), oculo-motor
      exercises (ie, eye stability, eye-neck coordination) or balance training have been proposed.
      These programs lead to a sensorimotor control, reducing pain and disability in the neck.
      However, it is not known if this approach to treatment is a significant improvement when
      compared to the implementation of other physiotherapy procedures, so it is unknown if the
      application of training oculocervical proprioception is more advisable than other modalities
      of physiotherapy treatment for the improvement of CNP symptoms.

      Material and method:

      This research is an analytical, longitudinal, prospective, experimental, evaluator blinded
      study. It is controlled with two parallel groups, randomized clinical trial.

      The sample consisted of patients recruited in a Physiotherapy consultation in Cadiz (Spain).
      These assessments were made before and after the start of program and to the end of
      intervention (8 months).

      Patients were randomized to control or experimental group. All patients are given a Combined
      Physiotherapy Protocol, no apply an Eye-Cervical Re-education Program in subjects in the
      first group and performing an Eye-Cervical Re-education Program in the second. This program
      was carried out by the physiotherapist. Subjects received a total of ten sessions on
      alternate days.
    

Intervention name(s): EYE-CERVICAL RE-EDUCATION PROGRAM; Combined Physiotherapy Protocol
Intervention type(s): Other; Other
Intervention description(s): Subjects received a total of ten sessions on alternate days.
This includes a total of 10 exercises that has proprioceptive reprogramming in the cervical area with the following phases:
To stimulate ocular mobility without including the cervical movement. The patient was placed in the supine position and the physiotherapist seated, at the height of the head.
To exercise cervical mobility with restricted eye movement. The patient is placed on a rotating stool. The ocular mobility is excluded with opaque glasses that allowed exclusively the foveal vision
Finally we stimulate eye and neck movement coordination. The patient continued to sit on the stool, this time without the glasses.; Thermotherapy (70 w continuous microwave for 10 minutes), therapeutic massage (surface rubbing for 5 minutes, 10 minutes of compression and kneading massage and 2 minutes of final surface friction), application of analgesic currents (TENS, by self-adhesive silicone electrodes 4x4 cm, symmetrical biphasic rectangular current, 200 µs width pulse, a frequency of 1 Hz for 10 minutes. The patient should notice a slight vibration, without it being painful).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: neck pain; eye; propioception; range of motion; pain