Movement variability in people with neck pain disorders

Alsultan, Feras ORCID: 0000-0002-3470-8272 (2021). Movement variability in people with neck pain disorders. University of Birmingham. Ph.D.

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Abstract

Neck pain, a common source of morbidity and disability, not only affects people physically, but can have significant social and psychological impact. People with chronic neck pain (CNP) may present with number of symptoms and signs associated with their condition, including decreased range of motion (RoM), increased fatigue, neuromuscular dysfunction and altered joint position sense. An abundance of research has examined how the quantity of neck movement is modified when people have neck pain, however, the quality or variability of movement has received much less attention, even though it may be a better indicator of ongoing neuromuscular dysfunction in people with CNP. This thesis presents unique research to investigate whether the variability of movement is modified in people with neck pain disorders, and seeks to understand the mechanisms underlying these changes. Three experimental studies were undertaken to examine movement variability during active cervical movements and gait in people with neck pain. These studies revealed consistent findings of reduced movement variability and developed further insights regarding mechanisms underlying movement variability changes in people with neck pain disorders. Specifically, the first study aimed to investigate movement variability during active neck movements, and assessed correlations between movement variability parameters and clinical features. It found reduced movement variability in people with CNP compared to asymptomatic participants during flexionextension and rotation movements, and also documented a negative correlation between fear of movement and movement variability for all neck rotation conditions. For the second study, the aim was to examine the variability of neck and trunk rotation during single- and dual-task gait in people with CNP relative to asymptomatic participants, and also to evaluate the correlation between the variability of neck and trunk rotation and clinical features. The results showed that people with CNP displayed reduced variability of trunk rotation during dual-task gait compared to asymptomatic ii people. The third study aimed to investigate the effects of acute neck-muscle soreness, induced via eccentric exercise, in asymptomatic participants on neck movement variability during active neck movements. The findings demonstrated reduced neck movement variability immediately after, 24 hours after and 48 hours after eccentric exercise, consistent with the findings observed in people with CNP. The fourth study was a systematic review, which was subsequently conducted to explore the existing evidence regarding whether differences in the quality of movement, including movement variability, exist in people with CNP compared to asymptomatic people, based on the available literature. In addition, this review was used to determine the characteristics of the measurements used to investigate movement changes and quality. This review revealed that further investigation is required to evaluate movement variability, for example by examining variability during more challenging tasks such as walking with head rotation and in activities of daily living. Findings indicated that using the average of standard deviation as a parameter to measure movement variability has potential to detect changes in kinematics. Overall, examining movement variability and understanding the mechanisms underlying its changes in people with neck pain has shown potential to provide important insights into the impact of neck pain disorders on those affected.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):