Balance Performance in Dual Task in Patients With Cervical Disc Herniation Related Chronic Neck Pain:a Comparative Study
Condition: Cervical Pain; Postural Balance
MeSH terms: Intervertebral Disc Displacement; Neck Pain; Hernia
Study type: Observational

Summary: 
      Intense pain and moderate disability are seen most patients with symptomatic cervical disc
      herniation (CDH). Since neck motion and motor control are associated with changes in neck
      pain and disability, it is highly likely that patients with neck pain related disability
      would display dual-task interference (DTI) during postural control with a cognitive task.

      It is very important for patients with cervical disk herniation to perform more than one task
      at the same time for many activities of daily living. Therefore, the aim of this study was to
      compare balance performance in dual task between patients with CDH related chronic neck pain
      and asymptomatic controls.
    

Detailed description: 
      This study was designed cross-sectional controlled study. Thirty-two patients with CDH
      related chronic neck pain and twenty-three age and sex-matched asymptomatic controls
      participated in this study.

      The Neck Disability Index (NDI) was used to assess neck pain related disability. The Biodex
      Balance System (BBS; Biodex Medical Systems, Shirley, New York, USA) was used to assess
      postural control. This system allows individuals to measure their stability limits. It also
      examines the control of the center of gravity on the support surface and balance abilities
      when trying to move it. The evaluated parameters of this system are presented below; modified
      clinical test of sensory integration of balance (mCTSIB), athletic single leg test (ASLT),
      limits of stability (LOS), and fall risk assessment were performed with and without a
      cognitive task. Dual-task interference (DTI) was assessed.

      In order to avoid the order bias of postural control measurements during "Single-task" and
      "Dual-task" for each case, the order of the measurements was determined by randomization on
      the first day by using sealed envelope method. After single/double task randomization was
      made, the order of tests was also randomized by using sealed envelopes containing two
      different orders (1-mCTSIB, 2-ASLT, 3-Fall test, 4-LOS and 1- LOS, 2- Fall test, 3- ASLT,
      4-mCTSIB).

      Before starting the evaluations, the participants were informed about the tests. Considering
      methodological bias, the same investigator performed all assessments and all participants
      received standardized and identical instructions.

      Single and dual task measurements were made as follows:

      Single task measurements involved the measurement of balance parameters by using Biodex
      Balance System without any additional cognitive task. For assessment of dual task
      performance, the participants were asked to perform an additional cognitive task (counting
      backwards from 200 by three or seven) during measurements .

      DTI values were calculated for all balance parameters using the formulas below :

      DTI %= (Dual Task-Single Task)/Single Task*100
    

Intervention name(s): neck pain and dual task
Intervention type(s): Other
Intervention description(s): The Neck Disability Index (NDI) was used to assess neck pain related disability. The Biodex Balance System was used to assess postural control.Clinical test of sensory integration of balance (mCTSIB), athletic single leg test (ASLT), limits of stability (LOS), and fall risk assessment were performed with and without a cognitive task.In order to avoid the order bias of postural control measurements during "Single-task" and "Dual-task" for each case, the order of the measurements was determined by randomization on the first day by using sealed envelope method. After single/double task randomization was made, the order of tests was also randomized by using sealed envelopes containing two different orders (1-mCTSIB, 2-ASLT, 3-Fall test, 4-LOS and 1- LOS, 2- Fall test, 3- ASLT, 4-mCTSIB).
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Between the ages of 18-64 men and women.
      
Keywords: Cervical Pain; postural balance; Biodex Balance System; Cervical disc herniation