ABSTRACT. The authors' aim was to evaluate the effect of balance training on cervical joint position sense in people with subclinical neck pain. Thirty-four participants were randomly assigned to balance training or to stay active. Sensorimotor function was determined before and after 5 weeks of training by assessing the ability to reproduce the neutral head position and a predefined rotated head position. After balance training, the intervention group showed improved joint repositioning accuracy and decreased pain whereas no effects were observed in the control group. A weak correlation was identified between reduced neck pain intensity and improved joint repositioning. The present data demonstrate that balance training can effectively improve cervical sensorimotor function and decrease neck pain intensity.

BACKGROUND CONTEXT: People with neck pain display a diminished joint position sense and disturbed postural control, which is thought to be a result of impaired somatosensory afferent activity and/or integration. Afferent processing can be artificially manipulated by vibration and was shown to reduce motor performance in healthy subjects. However, the effect of vibration on sensorimotor function in neck pain patients is scarcely investigated. PURPOSE: To assess the effect of neck muscle vibration on joint position sense and postural control in neck pain subjects and healthy controls. STUDY DESIGN: Case control study.PATIENT SAMPLE: Thirteen neck pain patients and 10 healthy controls participated in the present study. OUTCOME MEASUREMENTS: Cervical joint position sense and dynamic and static postural stability. METHODS: Short-term, targeted neck muscle vibration with 100 Hz was applied after baseline measurement. RESULTS: Vibration had opposite effects in patients and healthy subjects. Patients showed improved joint position sense (p!.01) and reduced dynamic postural sway (p!.05) after vibration, whereas vibration resulted in reduced joint position sense acuity (p!.05) and a nonsignificant increase in postural sway in healthy controls. CONCLUSIONS: This is the first study showing an improved motor performance after neck muscle vibration in patients with neck pain. Thus, vibration may be used to counteract sensorimotor impairment of the cervical spine. Potential underlying mechanisms are discussed.

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Neck muscle vibration induced short-lasting general as well as longer-lasting specific effects on analgesia and sensorimotor function. Based on our observations, future studies should investigate potential benefits of neck muscle vibration as adjunct to physical therapy in order to improve cervical sensorimotor function. Implications for Rehabilitation A single session of neck muscle vibration improves cervical joint position sense in neck patients for up to 24 h. Neck muscle vibration improves arm-matching acuity in neck pain patients. Neck muscle vibration increases pressure pain thresholds at the stimulated place but decrease pressure pain thresholds more distally. Neck muscle vibration shows distinct effects in neck pain patients and healthy control.