ABSTRACT
OBJECTIVE: The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP). METHODS: Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded. RESULTS: The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05). CONCLUSION: Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.
Subject(s)
Chronic Pain , Neck Pain , Postural Balance , Humans , Neck Pain/therapy , Male , Female , Chronic Pain/therapy , Single-Blind Method , Adult , Postural Balance/physiology , Middle Aged , Virtual Reality , Virtual Reality Exposure Therapy/methods , Exercise Therapy/methods , Posture/physiology , Treatment OutcomeABSTRACT
AIM: To compare the effects of virtual reality (VR) and motor control (MC) exercises. METHODS: Forty-one participants with chronic neck pain (CNP) were randomized into the VR or MC group. Both groups performed 18 sessions over 6 weeks. The primary outcomes were pain intensity (visual analogue scale), pain pressure thresholds (PPTs), joint position sense error (JPSE), and muscle performance. The secondary outcomes were the Profile Fitness Mapping Questionnaire (ProFitMap-Neck), Hospital Anxiety-Depression Scale (HADS), and quality of life (SF-36). Data were analysed using T-Tests, and Fisher's Exact Test. Mean (standard deviation), median (interquartile range), effect size and %95 confidence interval (CI) were reported. RESULTS: The results of Independent T-Tests showed that VR was advantageous in terms of PPTs of the C1/C2 and C5/C6 articular pillar bilaterally and large effect size (Cohen's d > 0.8, p < 0.05). Moreover, VR was more effective in decreasing JPSE (Cohen's d > 0.08; mean difference changes between -2.91 and -1.24, %95 CI -4.47 to 0.80) and functional limitation (ProFitMap-Neck) (Cohen's d = 0.7, mean difference 8.27, %95 CI 0.20 to 16.35). The results of T-Tests demonstrated that neither intervention was superior in terms of pain intensity, muscle performance, symptoms (ProFitMap-Neck), HADS, or SF-36 (Cohen's d < 0.5). CONCLUSIONS: VR can be applied for improving proprioception and for decreasing cervical articular pain in CNP patients. In addition, VR may be more effective for decreasing functional limitations in patients. Clinicians can choose MC exercises with or without VR for improving pain, muscle performance, symptoms, anxiety/depression, and quality of life.
Subject(s)
Chronic Pain , Virtual Reality , Humans , Neck Pain/therapy , Quality of Life , Chronic Pain/therapy , Exercise Therapy/methodsABSTRACT
AIM: The aim of this study was to try to find parametric ratios for the diagnosis and pathophysiology of carpal tunnel syndrome using MR. MATERIAL AND METHODS: Dominant side wrist MRI examinations of 27 female carpal tunnel patients and 21 normal females were compared. The carpal tunnel contents area / carpal tunnel cross section area ratio was defined, analysed and discussed with the literature. RESULTS: Carpal tunnel contents / wrist area ratios of the carpal tunnel patients were measured and compared with the control group. This comparison revealed that the proportion of the contents of the carpal tunnel is increased in the carpal tunnel syndrome patients. Palmar bowing was found to be increased and median nerve cross section area was found to be increased at the proximal entrance of the carpal tunnel. CONCLUSION: As Phalen has postulated, the volume of the contents of the carpal tunnel were found to be increased in the carpal tunnel syndrome patients. Carpal tunnel cross section areas remained the same with the control group. This increase can be demonstrated by MRI imaging which can provide an evidence for the pathophysiology of carpal tunnel syndrome.
