On the relationship between pain intensity and postural sway in patients with non-specific neck pain

Ruhe, Alexander; Fejer, René; Walker, Bruce F.

doi:10.3233/bmr-130399

Cited by 33 publications

(27 citation statements)

References 41 publications

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“…Additionally, the fact that changes were only seen the in the AP rather than the ML direction also suggests somatosensory impairment rather than vestibular impairment. (Shumway-Cook and Horak, 1986, Horak and Macperson, 1996, Ruhe et al , 2013.…”

Section: Discussionmentioning

confidence: 99%

Use of neck torsion as a specific test of neck related postural instability

Williams

Tarmizi

Treleaven

2017

Musculoskeletal Science and Practice

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Background: Disturbed postural stability in neck pain (NP) is likely due to abnormal cervical afferent function. Several potential causes requires specific diagnostic tests. The neck torsion (head still body rotated) manoeuvre stimulates cervical but not vestibular receptors and identified abnormal cervical afferent input as the cause in patients with NP compared to healthy controls. Comparison between vestibular and NP subjects is now needed. Aims:To compare individuals with unilateral vestibular loss (UVL), persistent NP and asymptomatic controls. It was hypothesized that neck torsion will increase postural stability in NP compared to both the asymptomatic and UVL groups.Methods: Twenty UVL, 20 persistent NP and 20 asymptomatic control subjects underwent measurement of postural stability on a computerised force plate with eyes closed in comfortable stance under 5 conditions: neutral head, head rotated 45 degrees (left and right) and neck torsion (left and right) . Root mean square (rms) amplitude of sway was measured in the anterior posterior (AP) and medial lateral (ML) directions. Average torsion and torsion difference (average torsionneutral neck) were calculated.Results: NP subjects had significantly greater (p< 0.05) AP sway with average torsion and torsion difference compared to both control and UVL. There were no significant differences between control and UVL and no between group differences for neutral neck, rotation or rotation difference. Conclusion:The results of the study suggest that the torsion manouever may identify cervical afferent causes of disturbed postural stability. This is important for guiding assessment and management of balance disturbances in patients.

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Section: Discussionmentioning

confidence: 99%

Use of neck torsion as a specific test of neck related postural instability

Williams

Tarmizi

Treleaven

2017

Musculoskeletal Science and Practice

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“…We analyzed the classical postural parameters: the Surface area of CoP excursions and the Variance of Speed of CoP. The Surface area of the CoP represents 90% of the instantaneous positions of the CoP included within the confidence ellipse, eliminating the extreme points (Ruhe, Fejer, & Walker, ).…”

Section: Methodsmentioning

confidence: 99%

Plantar Exteroceptive Inefficiency causes an asynergic use of plantar and visual afferents for postural control: Best means of remediation

Foisy

Kapoula

2017

Brain and Behavior

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IntroductionSome subjects have difficulty to integrate both visual and plantar inputs, showing at the same time a “postural blindness” and a Plantar Exteroceptive Inefficiency (PEI). The former corresponds to a better stability eyes closed (EC) than eyes open (EO), while the latter is defined as a better stability on foam than on firm ground. Clinical studies reported that a manipulation of either plantar or visual input could affect the weight of both cues in postural control, suggesting interdependence in their use. The purpose of the experiment is to characterize the PEI phenomenon better and see if such synergy can be objectified.MethodsWe recruited 48 subjects (25 ± 3.3 years) and assessed their balance with a force platform, EO, EC, at 40 or 200 cm, on firm ground, Dépron® foam, Dynachoc® foam, or on a 3 mm‐thick Anterior Bar AB®. We assessed their sensorial preferences through their PQ and RQ.ResultsThe main results are that there normally exists a synergy in the use of plantar and visual afferents, but only at 40 cm and in the absence of PEI.ConclusionsPlantar Exteroceptive Inefficiency interferes with the role of vision in postural control, its effects are distance specific, are better revealed by Dépron® foam and the AB® improves posture but does not solve visual‐podal asynergy. These results also have clinical interests as they indicate the best way in terms of distance and choice of foam to diagnostic PEI. Finally, they suggest restricting the use of the AB®, commonly employed. These findings can be useful for clinicians concerned with foot, eye, and posture.

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“…The less efficient the system (affected by any kind of impairment or pathology), the less effective the control through efferent lines that can be affected by the "noise" as well [60]. Under these conditions, the loss of control redundancies may become the main reason for the loss of balance or of specific motor control functions [61]. With specific regard to balance, no evidence of effectiveness of Biolite treatment over vestibular or central deficits has been gained so far: only proprioceptive musculoskeletal deficits have been successfully treated and only these are targeted by the present application protocol.…”

Section: Conclusion: Areas Of Further Investigationmentioning

confidence: 98%

Biolite: A Patented Ultra-Low-Level Laser-Therapy Device for Treating Musculoskeletal Pain and Associated Impairments

Gallamini¹,

D’Angelo

Belloni³

2015

Journal of Acupuncture and Meridian Studies

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After an excursus on state-of-the-art knowledge for low-level laser therapy (LLLT), Biolite, a patented ultra-low-level laser therapy device used to treat musculoskeletal pain and associated impairments, is presented. The application protocols include short stimulation of sequences of acupuncture points. The observed effects seem, however, to be far from those that might be expected after acupuncture. The primary effect seems more likely to be an extracellular soft-tissue matrix reaction. The development of the technique, the studies performed, and the evidence collected over > 10 years suggest that specifically modulated laser light can interact with human tissues at light fluences well under those previously considered as being capable of having any effect. Musculoskeletal pain very often becomes an autonomous dysfunction that is independent of the original injury and that can be effectively treated using specific peripheral acupuncture-like stimulation. Because such acupuncture is capable of reducing motor control "interferences" from noxious stimuli, it can improve motor control performance, thereby reducing the risk of falls in the elderly individuals. The proposal of acupuncture-derived protocols to be applied by Western physiotherapists using an ultra-low-level laser therapy device is a further "bridge" between two different, and sometimes very different, clinical worlds to better serve our patients.

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On the relationship between pain intensity and postural sway in patients with non-specific neck pain

Cited by 33 publications

References 41 publications

Use of neck torsion as a specific test of neck related postural instability

Use of neck torsion as a specific test of neck related postural instability

Plantar Exteroceptive Inefficiency causes an asynergic use of plantar and visual afferents for postural control: Best means of remediation

Biolite: A Patented Ultra-Low-Level Laser-Therapy Device for Treating Musculoskeletal Pain and Associated Impairments

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