Effectiveness of Kinaesthetic Exercise program on Position Sense, Pain, and Disability in Chronic Neck Pain Patients with Cervical Spondylosis – A Randomized Comparative Trial

Abstract

Background Chronic neck pain (CNP) is a significant health problem with only a few evidence-based treatment options. There is growing evidence for the effectiveness of kinaesthetic rehabilitation in musculoskeletal disorders. This study aims to assess kinaesthetic exercise programs' efficacy on cervical position sense, pain, and disability in subjects with cervical spondylosis (CS).

Methods CNP subjects (>3 months) with a diagnosis of CS were randomly assigned to either a study group (n=125) who received kinesthetic exercises or to a comparative group (n=125) who received isometric neck exercises and deep cervical flexor (DCF) strengthening exercises. Both group subjects participated in the individualized training program for 24 sessions in 6 weeks. The outcome measures were cervical joint position errors (JPE’s) in flexion, extension, rotation left and right, pain intensity, and neck disability.

Results All outcomes were improved significantly from baseline to post 24 sessions of intervention. When compared between groups, there was a significant reduction in JPE’s in flexion (mean difference [MD]= 071, CI=0.22–1.20, p=0.001), extension (MD=1.26, CI=0.70–1.81, p< 0.001) and right rotation (MD=1.08, CI=0.58–1.58, p<0.001), pain intensity (MD=1.58, CI=1.09–2.08, p<0.001), and neck disability (MD=10.27, CI=7.42–13.12, p<0.001) after 24 sessions of intervention favoring the study group.

Conclusion Study group subjects who received kinesthetic rehabilitation showed more significant improvements in terms of improved proprioception, decreased pain intensity and disability following 24 sessions of interventions compared with the comparative group.

Zusammenfassung

Hintergrund Chronischer Nackenschmerz (Chronic Neck Pain, NCP) ist ein bedeutendes Gesundheitsproblem mit nur wenig evidenzbasierten Behandlungsmöglichkeiten. Jedoch gibt es zunehmend mehr Belege für die Wirksamkeit kinästhetischer Rehabilitationsmaßnahmen bei Erkrankungen des Bewegungssystems. Ziel dieser Studie ist es, die Effekte kinästhetischer Übungsprogramme auf die Propriozeption, die Schmerzintensität und die Bewegungseinschränkung der Halswirbelsäule bei Patienten mit zervikaler Spondylose (cervical spondylosis, CS) zu untersuchen.

Methoden CNP-Patienten ( > 3 Monate) mit der Diagnose CS wurden randomisiert entweder der Interventionsgruppe (n = 125), die kinästhetische Übungen durchführte, oder der Vergleichsgruppe (n = 125) zugeordnet, die isometrische Spannungs- und Kräftigungsübungen für die tiefen Nackenflexoren durchführte. Die Patienten beider Gruppen nahmen 6 Wochen lang an dem individualisierten Trainingsprogramm über insgesamt 24 Einheiten teil. Es wurden Positionsfehler der Halswirbel in Beugung, Streckung, Rotation links und rechts sowie Schmerzintensität und Bewegungseinschränkung des Halswirbelsäule (HWS) gemessen.

Ergebnisse Alle Messergebnisse konnten im zeitlichen Verlauf signifikant verbessert werden. Im Gruppenvergleich gab es eine signifikante Reduktion der Positionsfehler der HWS in Flexion (mittlere Differenz [MD] = 071, CI = 0,22–1,20, p = 0,001), Extension (MD = 1,26, CI = 0,70–1,81, p < 0,001) und Rechtsrotation (MD = 1,08, KI = 0,58–1,58, p < 0,001) sowie der Schmerzintensität (MD = 1,58, KI = 1,09–2,08, p < 0,001) und Bewegungseinschränkung der HWS (MD = 10,27, KI = 7,42–13,12, p < 0,001) nach 24 Trainingseinheiten zugunsten der Interventionsgruppe.

Schlussfolgerung Die Patienten der Interventionsgruppe, die kinästhetische Rehabilitationsmaßnahmen erhielten, zeigten nach 24 Trainingseinheiten gegenüber der Vergleichsgruppe signifikantere Verbesserungen im Sinne einer verbesserten Propriozeption, verminderten Schmerzintensität sowie Bewegungseinschränkung.

Key words

Cervical spondylosis - neck pain - proprioception - kinesthesia - head reposition sense

Schlüsselwörter

Zervikale Spondylose - neck pain - proprioception - kinesthesia - head reposition sense

Publication History

Received: 29 May 2020

Accepted: 14 October 2020

Article published online:
23 November 2020

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