umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Acuity of goal-directed arm movements to visible targets in chronic neck pain
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Centre for Musculoskeletal Research, University of Gävle, Gävle; Alfta Research Foundation, Alfta, Sweden.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, University of Gävle, Gävle; Alfta Research Foundation, Alfta, Sweden.
Centre for Musculoskeletal Research, University of Gävle, Gävle; Alfta Research Foundation, Alfta, Sweden.ORCID iD: 0000-0001-7543-4397
Centre for Musculoskeletal Research, University of Gävle, Gävle.
2008 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, Vol. 40, no 5, 366-374 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate end-point acuity in goal-directed arm movements in subjects with chronic neck pain, while taking the trade-off between speed and accuracy into account, and to evaluate associations between reduced acuity and self-rated characteristics.

Design: Single-blinded, controlled, comparative group study.

Subjects: Forty-five subjects with chronic non-traumatic, non-specific neck pain (n = 24) and whiplash-associated disorders (n = 21). Healthy subjects served as controls (n = 22). The groups were age- and sex-matched.

Methods: Subjects performed fast and accurate pointing movements to a visual target. Group differences in end-point variability, controlled for peak velocity, were evaluated. Associations between end-point variability and self-rated symptoms, functioning, self-efficacy and kinesiophobia were analysed.

Results: End-point acuity, controlled for peak velocity, was reduced for both neck-pain groups. Similar spatial error patterns across all groups indicated no direction-specific reduction. For both neck-pain groups, associations were found between end-point acuity and neck movement deficits, physical functioning and, in whiplash, also balance and pain.

Conclusion: Acuity of goal-directed arm movements can be reduced in chronic neck pain. Associations between acuity and self-rated characteristics support the clinical validity of the results and indicate that impaired neck function contributes to reduced end-point acuity. The results can be of importance for characterization and rehabilitation of neck disorders.

Place, publisher, year, edition, pages
Foundation of Rehabilitation Information , 2008. Vol. 40, no 5, 366-374 p.
Keyword [en]
neck pain, whiplash injuries, somatosensory disorders, motor activity, psychomotor performance, proprioception, kinaesthesis, vision
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-3145DOI: 10.2340/16501977-0175PubMedID: 18461262OAI: oai:DiVA.org:umu-3145DiVA: diva2:141628
Conference
The International Association for the Study of Pain (IASP) symposium “Fundamentals of musculoskeletal pain”, on May 7–9, 2007 in Aalborg, Denmark and the PREMUS conference, on August 27–30, 2007 in Boston, USA
Note

This paper was presented as a poster at the International Association for the Study of Pain (IASP) symposium “Fundamentals of musculoskeletal pain”, on May 7–9, 2007 in Aalborg, Denmark and the PREMUS conference, on August 27–30, 2007 in Boston, USA.

Available from: 2008-05-02 Created: 2008-05-02 Last updated: 2015-08-25Bibliographically approved
In thesis
1. Position-matching and goal-directed reaching acuity of the upper limb in chronic neck pain: associations to self-rated characteristics
Open this publication in new window or tab >>Position-matching and goal-directed reaching acuity of the upper limb in chronic neck pain: associations to self-rated characteristics
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Neck-shoulder pain is common in the general population and causes individual suffering as well as large costs for the society. Despite substantial efforts, there is still a shortage of methods for objective diagnosis and effective rehabilitation of such disorders. Thus, there is a great need to develop and evaluate new methods for these purposes. From clinical observations and recent research it has become evident that sensorimotor control can be impaired in people with neck-shoulder pain and may play a role in the pathogenesis of these disorders. In this thesis, precision of goal-directed arm movements, a previously unstudied class of movements in neck-shoulder pain, was studied.

The main aim of the thesis was to investigate if people with chronic neck-shoulder pain have a reduced acuity of goal-directed movements of the upper extremity. A second aim was to study associations between reduced movement acuity and symptoms and self-rated characteristics.

Upper limb repositioning acuity was assessed in blindfolded subjects performing tests of active, ipsilateral position-matching of two target positions (long and short) in movements constrained to horizontal-adduction of the shoulder. Reduced repositioning acuity, suggesting impaired shoulder proprioception, was found for both subjects with whiplash associated disorders (WAD) and non-specific neck-shoulder pain (NS). The degree of reduced acuity was shown to correlate with self-ratings of various health concepts, functioning and pain. A conspicuous finding was that there was lack of correlation between short and long target errors, along with the fact that associations between repositioning acuity and symptoms and self-rated characteristics was primarily found for the short target position.

To further investigate the possible mechanisms underlying the disassociation between long and short target movement control, the association pattern between the outcome of several variants of ipsilateral position matching and velocity-discrimination tests, were studied. It was found that the perception of limb position in position-matching of short target locations appears to be predominantly based on movement velocity, whereas perception of limb position in movements to longer target locations may rely on a location-based perception mechanism.

To extend the research on reduced upper extremity proprioception in neck-shoulder pain to a more natural movement situation, acuity of goal-directed pointing including full vision and 3D multi-joint movements was investigated in WAD, NS and healthy controls subjects. The results revealed a reduced acuity for both neck-pain groups. Moreover, distinct associations between end-point acuity and neck movement problems, limitations of some physical functions and, in WAD; some aspects of pain, were revealed.

The findings demonstrate that the precision of upper limb movements can be reduced in chronic neck-shoulder pain. Substantial associations with symptoms and self-rated functioning suggest a clinical relevance of acuity measures of goal-directed arm movements. The findings indicate that tests of sensorimotor control can provide objective measures that may be useful in biopsychosocial profiling and characterization of subgroups of patients with chronic neck-shoulder pain, and that training target control of goal-directed movements should be considered in rehabilitation programs of people with these disorders.

Place, publisher, year, edition, pages
Umeå: Kirurgisk och perioperativ vetenskap, 2008. 93 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1182
Keyword
Neck pain, whiplash injuries, shoulder, proprioception, kinesthesis, vision, psychophysiology, somatosensory disorders, psychomotor performance, self assessment
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-1635 (URN)978-91-7264-569-1 (ISBN)
Public defence
2008-05-22, Stora hörsalen, entréplan fd. Arbetslivsinstitutet, Johan Bures väg 5, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2008-05-02 Created: 2008-05-02 Last updated: 2010-01-18Bibliographically approved
2. Sensorimotor function in chronic neck pain: objective assessments and a novel method for neck coordination exercise
Open this publication in new window or tab >>Sensorimotor function in chronic neck pain: objective assessments and a novel method for neck coordination exercise
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic neck pain is a widespread problem that causes individual suffering as well as large costs for the society. The knowledge about the pathophysiology is poor and therefore specific diagnosis and causal treatment are rare. Important knowledge for characterization of the disorders has been gained from research on sensorimotor functions in people with neck pain. Moreover, rehabilitation regimes including sensorimotor exercises indicate promising results.

The main objectives of this thesis were to extend the knowledge on sensorimotor dysfunctions in chronic neck pain, and to develop a new exercise method for improving sensorimotor functions of the neck. The studies focused on aspects of postural control and movements of the arm and neck. These are vital functions for many activities of daily living. People with chronic (>3 months) neck pain were compared to healthy controls (CON). Neck pain related to trauma was referred to as whiplash associated disorders (WAD), while neck pain without association to trauma was referred to as non-specific (NS).

Arm-functioning was assessed in a pointing task. WAD and NS had reduced pointing precision compared to CON. The reduced precision was associated with self-rated difficulties performing neck movements, physical functioning, and in WAD, also pain and balance disturbances.

Postural control was assessed in quiet standing on a force platform without vision. The center of pressure signal was decomposed into it’s slow and fast components. WAD and NS were compared to CON. The results revealed an effect of age on the magnitude of the fast sway component, but no effect of group. The magnitude of the slow component was elevated in both WAD and NS. This increase was associated with self-rated balance disturbance, arm-functioning, difficulties to run and sensory alterations in WAD, while in NS, the increase in the slow sway component was associated with concurrent low back pain.

Neck movements were assessed in a cervical axial rotation test with maximal speed. In total 8 variables representing basic kinematics, including variables reflecting movement smoothness and conjunct motions were calculated. NS were compared to CON. Linear discriminant modelling indicated Peak Speed and conjunct motions as significant classification variables that together had a sensitivity of 76.3% and specificity of 77.6%. Retest reliability was good for Peak Speed but poor for the measure of conjunct motions. Peak Speed was slower in NS compared to CON, and even slower in a sub-group of NS with concurrent low back pain. Reduced Peak Speed was associated with self-rated difficulties performing neck movements, car driving, running, sleeping disturbances and pain.

The clinical applicability of a novel method for neck coordination exercise was assessed in a pilot study on persons with NS. The results supported the applicability and indicated positive effects of the exercise: reduced postural sway in quiet standing and increased smoothness in cervical rotations. Indications on improvement in self-rated disability and fear of movement were seen at six months follow up.

In conclusion, sensorimotor functions can be altered in chronic neck pain, particularly in neck disorders with concurrent low back pain and WAD. The discriminative ability and clinical validity displayed in pointing precision, postural sway and cervical axial rotation speed imply that such tests can be valuable tools in the assessment of chronic neck pain patients, and for selecting and evaluating treatment interventions. Indications of improvements seen in the pilot-study support a future RCT.

Place, publisher, year, edition, pages
Umeå: Institutionen för samhällsmedicin och rehabilitering, 2009. 88 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1273
Keyword
Neck pain, Whiplash, Sensorimotor, Motor Control, Motor Learning, Neck Coordination Exercise, Postural Control, Cervical kinematics, Reliability.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Rehabilitation Medicine
Identifiers
urn:nbn:se:umu:diva-22674 (URN)978-91-7264-809-8 (ISBN)
Distributor:
Sjukgymnastik, 901 87, Umeå
Public defence
2009-06-12, Aulan Vårdvetarhuset, Inst för samhällsmedicin och rehabilitering, Vårdvetarhuset, Umeå universitet, 901 87 Umeå, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2009-05-20 Created: 2009-05-14 Last updated: 2015-11-13Bibliographically approved

Open Access in DiVA

fulltext(626 kB)119 downloads
File information
File name FULLTEXT01.pdfFile size 626 kBChecksum SHA-512
d8a6eddf86cb8ca0d905fe05a54a709bab2b963c38b120988eca968b27d4c721ae11e2914d749a83fa4aeac1e3e8d50ee707030e46274fd09cbd3421b17fa365
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Sandlund, JonasRöijezon, UlrikBjörklund, Martin

Search in DiVA

By author/editor
Sandlund, JonasRöijezon, UlrikBjörklund, Martin
By organisation
Sports MedicinePhysiotherapy
In the same journal
Journal of Rehabilitation Medicine
Physiotherapy

Search outside of DiVA

GoogleGoogle Scholar
Total: 119 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 150 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf