The Effects of Manual Therapy on Balance and Cervical Proprioception
Condition: Neck Pain
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      Introduction: Neck pain causes disturbances in both proprioception and balance. The aim of
      the present study is to determine the effect of mobilization applied to the cervical region
      on static/dynamic balance and cervical proprioception in patients with nonspecific neck pain
      (NSNP).

      Materials and Methods: ... patients were randomly allovated into two groups. Both grups
      received conventional physiotherapy program (hot pack with transcutaneous electrical nerve
      stimulation); additionally, the experimental group received mobilization, and the control
      group received placebo mobilization twice a week for 3 weeks. Before and 3 weeks later,
      static/dynamic balance, cervical proprioception, cervical mobility and pain were evaluated
      respectively with Kinesthetic Skill Training System 3000 device, joint position error test,
      Cervical Joint Range of Motion Device, Visual Analogue Scale.
    

Detailed description: 
      Nonspecific neck pain (NSNP) is one of the most common causes of neck pain and it occurs as a
      result of postural or mechanical causes without a specific musculoskeletal pathology or
      injury history. Neck pain leads to a decrease in the activity of the deep cervical muscle
      which contains a large amount of muscle spindles, with an increase in the activity of the
      superficial cervical muscle. Depending on the pain, chemical changes occur in the cervical
      receptors and differentiation in sensitivity of the muscle spindle is observed. These changes
      in the structures of the cervical region predispose to deterioration in the sense of
      proprioception, which is an important component of balance. The disruption in proprioceptive
      abilities causes sensori-motor defects, muscle inhibition, muscle atrophy, and muscle
      fatigue. Changing cervical afferent information can affect proprioception as well as balance.
      Both the presence of neck pain and disruptions in the proprioceptive sense may reflect
      negatively on balance and postural control. In a study comparing patients with neck pain with
      asymptomatic individuals, increases in postural sway were found in patients with neck pain,
      and it was stated that the increased sway was associated with the dysfunction of the postural
      control system.

      In the light of these informations, treatment approaches that can positively contribute to
      proprioception and balance gain importance in patients with NSNP. Although manual therapy is
      used both to reduce pain, and to increase cervical mobility in patients with NSNP, the number
      of studies investigating the effects of manual therapy on balance and proprioception is quite
      insufficient.

      It was thought that mobilization applied to the cervical region can improve cervical
      proprioception and mobility, reduce pain and contribute positively to balance. The purpose of
      this study is to examine the effect of mobilization applications on the balance and cervical
      proprioception in patients with NSNP.
    

Intervention name(s): Cervical mobilization; Placebo mobilization
Intervention type(s): Other; Other
Intervention description(s): A kind of manual therapy tecnique applied to the cervical region; It was applied to the randomly selected cervical faset without any pushing or pulling in the same position and the same grip with cervical mobilization.
Other intervention name(s): Manual therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: randomized, controlled and double blind clinical trial
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Mobilization, Balance, Pain, Mobility, Joint position sense.