Effect of Proprioceptive Training Using Head Mounted Laser in Chronic Mechanical Neck Pain
Condition: Mechanical Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      The purpose of this study is to compare the effect of conventional physical therapy with and
      without cervical proprioceptive training using head-mounted laser system on cervical joint
      position sense error, pain, cervical range of motion and neck disability index.
      Proprioception disturbs in any function and structural impairments that is mechanical neck
      pain. Different studies has been done to find out the best therapy for pain management. Aim
      of the researcher is to give cost-effective, not so time-consuming, most effective physical
      therapy treatment. A literature gap exists on the effects of proprioceptive training combined
      with conventional physical therapy, no studies have directly compared the effect of
      proprioceptive training using head-mounted laser with and without conventional physical
      therapy. In our clinical setting, proprioceptive training for mechanical neck pain is not
      used as much as it should be. It would be a new thing to add and it can be cost-effective and
      better treatment for symptoms resolution
    

Detailed description: 
      Mechanical neck pain (MNP) is a common condition, affecting 30% to 50% of the general
      population, and is most prevalent in middle age. It is responsible for reducing the quality
      of life and one of the leading causes of disability worldwide with annual prevalence of
      48.5%. Mechanical neck pain is characterized by several structural and functional features.
      The causes of MNP include structural and functional impairment of cervical muscles,
      degenerative changes of cervical spine, arthritis, inflammation, and trauma, abnormal
      posture, and movements. Current studies have found that one of the main problems in patients
      with MNP is the impairment of cervical proprioception. decreased range of motion (ROM) and
      functional ability, greater muscle fatigability and a reduction in the strength and endurance
      capacity of the muscles.

      Despite neck disorders being so common in the population, little evidence supporting
      effective interventions has been identified. Conservative treatments used to help manage MNP
      are numerous and include usual medical care various forms of exercise, massage, and
      acupuncture. Medications, manual therapies, and exercise are the most widely used treatment
      modalities for MNP. 33% of individuals with neck pain sought care from physical therapy.
      Physical therapy improves pain, function and patient satisfaction in adults suffering from
      MNP, improves neck disability index. Physical therapy treatment includes cervical and
      thoracic spine mobilization/manipulation techniques active and passive exercise, ultrasound,
      transcutaneous electrical nerve stimulation, patient education. Spinal manipulative therapy
      (SMT), trigger point dry needling and trigger point manual therapy.

      Proprioception is the sense of perceiving self-movement, action of parts of the body and
      location. It is a term commonly used to describe the ascending information by the afferent
      receptors towards the central nervous system contributing to the neuromuscular control of
      movement and encompasses the sensation of joint movement (kinaesthesia) and joint position
      (joint position sense). Cervical spine has a very delicate proprioceptive system, which
      signals the position of the head relative to the trunk, coordinates the vestibular and visual
      systems and it plays a crucial role in controlling posture and balance and is of great
      importance for spatial orientation. The deficits of Proprioception of cervical spine have
      been associated with age, pain muscle fatigue, forward head posture, cervical spondylosis,
      reduced balance control and abnormal posture, decreased neck muscle strength and altered
      motor control in the cervical spine.

      In last two decades the interest in the assessment and treatment of proprioception of the
      cervical spine has increased exponentially. Cervical joint position sense (JPS) is a major
      component of proprioception and mainly reflects the ascending input (afferent) of cervical
      muscle, disc, capsule, and ligament receptors. Proprioception is evaluated using the Joint
      Position Sense Error (JPSE), which reflects a person's ability to accurately return his head
      to a predefined target after a cervical movement.

      Evidence to date suggests that the management of sensorimotor control disturbances due to
      chronic neck pain may need to address the primary causes and secondary effects of alterations
      in proprioceptive activity. A variety of treatments are available for cervical spine
      proprioception. It includes proprioception training, retraining of deep cervical flexor and
      extensor muscles, and etiological management of pain, strength training, cervical
      manipulation and acupuncture and many other conventional therapy protocols. Cervical
      proprioception training not only improves patient-perceived pain and disability but also has
      an effect on other aspects of neuromuscular function, specifically the coordination between
      the deep and superficial cervical flexors and balance.
    

Intervention name(s): Proprioceptive training using head mounted laser; Conventional Physical therpay
Intervention type(s): Other; Other
Intervention description(s): Exercises include head relocation practice, i.e., relocating the head back to the natural head posture and to pre-determined positions in range with eyes open using feedback from a laser attached to their head. And then tracing the figure of eight with the help of laser.; Conventional physical therapy for mechanical neck pain which includes cervical range of motion (flexion, extension, lateral rotation, and rotation), neck isometric exercises, stretching's (scalene, trapezius, SCM) and TENS with heating pad.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: the participants are divided into two groups, control group will recieve conventional physical therapy and experimental group will recieve proprioceptive training with conventional physcial therapy.
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: proprioception; joint position sense error; head mounted laser; cervical range of motion