ABSTRACT
INTRODUCTION: Neck pain is a very common musculoskeletal disorder associated with high socioeconomic costs derived from work absenteeism and medical expenses. Previous studies have suggested that patients with neck pain of different origins present sensorimotor control impairments compared with the asymptomatic population. However, there is a small number of published studies focusing on these with conflicting results. In addition, the existing methodological limitations highlight the need for more and better quality studies. Moreover, longitudinal studies are necessary to investigate whether changes in pain or disability in individuals with chronic neck pain over time associate with changes in cervical sensorimotor control. METHODS AND ANALYSIS: This is a descriptive, observational, longitudinal, prospective study consecutively enrolling 52 patients with non-specific neck pain and 52 age-matched asymptomatic participants.Intensity of pain, neck disability, duration of symptoms, topography of pain and comorbidities will be registered at baseline. Sensorimotor control variables including active range of motion, movement speed, acceleration, smoothness of motion, head repositioning accuracy and motion coupling patterns will be recorded as primary outcomes by means of inertial sensors during the following tests consecutively performed in two sessions separated by 12 months: (1) kinematics of planar movements, (2) kinematics of the craniocervical flexion movement, (3) kinematics during functional tasks and (4) kinematics of task-oriented neck movements in response to visual targets.Secondary outcomes will include: (1) Regular physical activity levels, (2) Kinesiophobia, (3) Symptoms related to central sensitisation and (4) The usability of the inertial measurement unit sensor technology. ETHICS AND DISSEMINATION: This study was approved by the Research Ethics Committee of CEU San Pablo University (495/21/39). Patients will be recruited after providing written informed consent and they will be able to withdraw their consent at any time. Only the study investigators will have access to the study data. The results will be disseminated through scientific publications, conferences and media. TRIAL REGISTRATION NUMBER: NCT05032911.
Subject(s)
Chronic Pain , Neck Pain , Humans , Longitudinal Studies , Neck Pain/diagnosis , Observational Studies as Topic , Prospective Studies , Range of Motion, Articular/physiologyABSTRACT
The aim of this case series is to clarify if a physiotherapy program can reduce the frequency, intensity and duration of the headache episodes in patients with cluster headache. A 7-case series with cluster headache patients was conducted. Every subject received physiotherapy treatment based on manual therapy and exercise, maintaining pharmacological treatment prescribed by the neurologist. Frequency, intensity and duration of the episodes, pressure pain thresholds (PPT) and psychological variables were measured 5 times: pre-intervention, post-intervention, 1 month follow-up, 2 months follow-up and 3 months follow-up. Two of the seven subjects decreased their frequency of headaches over 50 % and another in 16,67 %. There were no significant changes in duration or intensity. Results also showed an improvement in impact of headache in 6 of 7 cases. Those cases that decreased more their headache frequency also decreased their pain catastrophizing. A program of physiotherapy based in manual therapy and exercise, might be an effective and safe complement to decrease the frequency of the episodes of CH in short-term (4 months follow-up) including interdisciplinary working with neurologists and other health care professionals.
ABSTRACT
Introducción: las lateralizaciones funcionales motoras, el procesamiento de un estímulo sensitivo y las asimetrías cerebrales funcionales no se comprenden del todo y se desconoce si existen asociaciones entre las asimetrías cerebrales funcionales por estimulación visual con las lateralizaciones en humanos.Objetivo: determinar la relación entre las lateralizaciones motoras y las asimetrías cerebrales por estimulación sensitiva mediante la combinación de instrumentos de medición subjetivos y objetivos.Métodos: se trabajó con 35 adultos jóvenes sanos, se les realizó una serie de pruebas de lateralidad motora y sensitiva, un estudio electrofisiológico potencial evocado visual, simultáneamente con un electroencefalograma. Se determinaron las áreas cerebrales visuales homólogas por cada hemisferio y la asimetría entre ellas. Se calculó el índice global de asimetría entre las regiones cerebrales dorsal, ventral, temporal y frontal y se buscaron asociaciones entre estas regiones, las lateralidades funcionales y sensoriales.Resultados: hubo un predominio a la derecha de las lateralizaciones motoras con respecto a las pruebas sensitivas. A partir del potencial evocado visual en el grupo se observaron áreas de las regiones dorsales y ventrales en ambos hemisferios cerebrales. La región visual temporal se destacó a la derecha y la frontal a la izquierda. Se encontraron asociaciones entre las regiones frontal, ventral y dorsal con algunas de las lateralidades funcionales estudiadas.Conclusiones: se concluye que en ciertas áreas cerebrales existió lateralidad predominante de acuerdo con el estudio volumétrico de ambos hemisferios, no siendo así en regiones cerebrales específicas.Palabras clave: lateralidad y asimetrías cerebrales funcionales, potencial evocado visual, electroencefalograma, áreas visuales cerebrales (AU)
Introduction: motor functional lateralizations, processing a sensory stimulus and functional brain asymmetries are not fully understood and it is unknown whether there are associations between functional brain asymmetries by visual stimulation with lateralizations in humans.Objective: to determine the relationship between motor lateralizations and brain asymmetry by sensory stimulation through the combination of subjective and objective measurement instruments.Methods: the work was carried out with 35 healthy young adults, who underwent a series of tests of motor and sensory laterality, an electrophysiological study visually evoked potential, simultaneously with an electroencephalogram. Visual homologous brain areas to each hemisphere and asymmetry between them were determined. Global asymmetry index was calculated between the dorsal, ventral, temporal and frontal brain regions and it was sought associations between these regions, functional and sensory lateralities.Results: there was a predominance of right motor lateralizations regarding the sensory tests. It was observed areas of the dorsal and ventral regions in both hemispheres from the visually evoked potential in the group. The temporal visual region was highlighted to the right and the frontal to the left. It was found associations between the frontal, ventral and dorsal regions with some of the functional lateralities studied.Conclusions: it is concluded that in certain brain areas existed predominant laterality according to the volumetric study of both hemispheres, which is not the case in specific brain regions (AU)
