Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain

Abstract

Background People with chronic neck pain have impaired proprioception (i.e., sense of neck position). It is unclear whether this impairment involves disruptions to the proprioceptive representation in the brain, peripheral factors, or both. Implicit motor imagery tasks, namely left/right judgements of body parts, assess the integrity of the proprioceptive represention. Previous studies evaluating left/right neck judgements in people with neck pain are conflicting. We conducted a large online study to comprehensively address whether people with neck pain have altered implicit motor imagery performance. Methods People with and without neck pain completed online left/right neck judgement tasks followed by a left/right hand judgement task (control). Participants judged whether the person in the image had their head rotated to their left or right side (neck task) or whether the image was of a left hand or a right hand (hand task). Participants were grouped on neck pain status (no pain; <3 months—acute; ≥3 months—chronic) and pain location (none, left-sided, right-sided, bilateral). Outcomes included accuracy (primary) and response time (RT; secondary). Our hypotheses—that (i) chronic neck pain is associated with disrupted performance for neck images and (ii) the disruption is dependent on the side of usual pain, were tested with separate ANOVAs. Results A total of 1,404 participants were recruited: 105 reported acute neck pain and 161 reported chronic neck pain. When grouped on neck pain status, people with chronic neck pain were less accurate than people without neck pain (p = 0.001) for left/right neck judgements, but those with acute neck pain did not differ from those without neck pain (p = 0.14) or with chronic neck pain (p = 0.28). Accuracy of left/right hand judgements did not differ between groups (p = 0.58). RTs did not differ between groups for any comparison. When grouped on neck pain location, people were faster and more accurate at identifying right-turning neck images than left-turning neck images, regardless of history or location of pain (p < 0.001 for both); people with no pain were more accurate and faster than people with bilateral neck pain (p = 0.001, p = 0.015) and were faster than those with left-sided neck pain (p = 0.021); people with right-sided neck pain were more accurate than people with bilateral neck pain (p = 0.018). Lastly, there was a significant interaction between neck image and side of neck pain: people with right-sided neck pain were more accurate at identifying right-sided neck turning images than people with left-sided neck pain (p = 0.008), but no different for left-sided neck turning images (p = 0.62). Conclusions There is evidence of impaired implicit motor imagery performance in people with chronic neck pain, which may suggest disruptions to proprioceptive representation of the neck. These disruptions seem specific to the neck (performance on hand images intact) but non-specific to the exact location of neck pain.

Distorted body schema after mastectomy with immediate breast reconstruction: a 4-month follow up study

“…The order of applications was organized according to the random number. The software was set in the “vanilla” mode with 40 images and 5 s of display time for each image ( Wallwork et al, 2020 ). The participant was asked to sit on a stool, and the iPad was placed on the table.…”

“…Hand and foot LRJTs were performed to evaluate upper and lower limb body representation; currently, various body part discrimination tests—such as shoulder, knee, and movement direction of the neck and back—are available ( Breckenridge et al, 2019 ). The assessment ability of LRJT depends on the affected body part; for example, the hand LRJT was not disrupted in participants with neck pain ( Wallwork et al, 2020 ).…”

“…Considering that the hand and shoulder LRJT ability represent the upper limb WBS ( Breckenridge et al, 2019 ; Breckenridge et al, 2020 ), there was little evidence reporting the assessment ability of upper limb LRJT and related factors in this population ( Boyd, Smoot & Nee, 2022 ). Furthermore, most of the study was conducted on chronic pain participants ( Barbosa et al, 2021 ; Bray & Moseley, 2011 ; Breckenridge et al, 2019 ; Breckenridge et al, 2020 ; Ismail et al, 2019 ; Magni, McNair & Rice, 2018 ; Pelletier et al, 2018a ; Pelletier, Higgins & Bourbonnais, 2018b ; Schmid & Coppieters, 2012 ; Wallwork et al, 2020 ; Wiebusch, Coombes & Silva, 2021a ); therefore, the effect of WBS disruption on the recovery of pain and disability was less understood.…”

Understanding the Left Right Judgement Test: A Literature Review

“…Most studies were conducted in patients with upper limb pain [37][38][39][40][41][42][43][44], including frozen shoulder, hand OA, carpal tunnel syndrome, wrist pain and lateral epicondylitis. The performance of the LRJT in patients with low limb pain [45][46][47][48], fibromyalgia [49] back and neck pain [50][51][52][53], and facial pain [54] was also investigated. Except for two populations with tendinopathies [44,46], the integrity of body schema was distorted in populations with limb and facial pain.…”

Neck Muscle Vibration Alters Upper Limb Proprioception as Demonstrated by Changes in Accuracy and Precision During an Elbow Repositioning Task

“…Previous research has demonstrated that chronic neck pain and subclinical recurrent neck pain (SCNP) alter afferent input from the neck and impact many cortical processes including proprioception [1,[10][11][12], sensorimotor integration (SMI) [13,14], and multisensory integration [15,16]. When comparing the effects of SCNP on head, shoulder, trunk and whole body positions during active and passive movement of the right shoulder, Paulus and Brumagne found significant differences in head movements between groups suggesting inconsistencies in reference frame selection [1].…”