Sensorimotor Exercises Practice and Yoga in Chronic Neck Pain

Neck pain is an important public health problem with a high lifetime prevalence and frequently occurring in all industrialized countries. Clinical practice guidelines for chronic neck pain recommend conservative management. Conservative treatment includes many approaches such as endurance, stretching and strengthening exercises, manual therapy, proprioceptive exercises, pilates and yoga. In patients with chronic neck pain, atrophy of deep neck muscles, deterioration in fiber type ratio, muscle tenderness and decreased range of motion are observed. These problems cause poor cervical postural control system and thus impaired sense of proprioception, loss of balance, decreased eye movement and cervical muscle activity. Sensorimotor control of upright posture and head-eye movement relies on information from the vestibular, visual, and proprioceptive systems that assemble throughout the central nervous system.The cervical spine has an important role in providing proprioceptive input. This role is associated with an abundance of cervical mechanoreceptors. Recent studies have shown that proprioceptive training is associated with cervical joint position sense, joint range of motion, pain and disability. Also yoga combines physical exercises with breathing techniques and meditation and yoga is one of the most commonly used complementary treatments for neck pain.The aim of study is to determine the effectiveness of exercises for sensorimotor structure and yoga exercises with physical and meditative effects in individuals with chronic neck pain.

Inclusion criteria for the study were: having a diagnosis of 'chronic neck pain', being over the age of 18, persistence of pain for more than 3 months, no neurogenic deficit, and agreeing to participate in the study. Exclusion criteria from the study are as follows: Having speech and comprehension problems, undergoing surgery on the neck region, having a history of trauma and cancer, and a diagnosis of vestibular disorder. After the analysis of the GPower 3.1 program to decide on the sample size, it was seen that a total of 50 participants should be included in the study for a statistical power of 82% (alpha:0.05). Participants diagnosed with chronic neck pain will be randomly divided into two groups as sensorimotor exercise group and yoga group by the evaluator. Sensorimotor exercise group; oculomotor exercise to provide information from the visual system, laser target exercise to provide information from the proprioception system, and postural stability exercise to provide information from the vestibular system. Yoga group will be given yoga exercises. Within the content of oculomotor exercise, gaze stability exercise and head-body coordination exercise will be given to the participants. Laser target exercise will be given with the laser target fixed on the participant's head and 90 cm away from the target. Postural stability exercise will be given in form of tandem exercise and standing on one leg. Yoga exercises will be applied by changing and combining 14 poses every week. The study will take 8 weeks. Participants in both groups will also be treated for 2 days a week. Participants will be evaluated twice, before and after treatment. Participants will be evaluated with Demographic Information Form, SF-36 Quality of Life Scale, Neck Disability Questionnaire, Tampa Kinesiophobia Scale, Numerical Pain Scale, Joint Range of Motion Measurement (G-Pro), Joint Position Error Test. Data analysis of the study will be done using SPSS 22.0 package program. The difference between Independent Groups will be compared with the Student's-t independent Test.

Eligibility Criteria:
Inclusion Criteria:

* Being diagnosed with chronic neck pain at Grade 1 and 2 level,
* Being over 18 years old,
* Pain lasting more than 3 months,
* Absence of neurogenic deficit

Exclusion Criteria:

* Having been diagnosed with chronic neck pain at Grade 3 and 4 level,
* Having problems with speaking and understanding,
* Having undergone surgery on the neck region,
* Having a history of trauma,
* Having a history of cancer,
* Diagnosis of vestibular disorder.