Proprioception and Rotation Range Sensitization Associated With Subclinical Neck Pain

Study Design. Cross-sectional study. Objective. To investigate neck proprioception, range of motion, muscle endurance, and self report of pain and disability in patients with subclinical neck pain. Summary of Background Data. Untreated (i.e., subclinical) neck pain represents a category intermediate between “no pain” and “treated (i.e., clinical) pain.” Therefore, the features that characterize it may be targeted for early management to prevent progression. Methods. Eighty-one healthy Korean university student volunteers, aged between 18 and 30 years (mean age, 23.2 years), were measured for proprioceptive sensitivity to differences in the extent of midrange neck retraction and rotation movements using a device that was not attached to the head; neck range of motion (twice) using the cervical range of motion device; and neck muscle endurance using a modified Biering-Sorensen test. Finally, patients were asked about any recurrent neck pain and completed Korean translations of four commonly used neck pain and disability questionnaires. Results. Patients were categorized into three frequency of neck pain groups: never/infrequent, monthly, or weekly. There were significant differences between these groups on the four self-report questionnaires. Neck muscle endurance was significantly lower for the groups reporting monthly and weekly pain compared with the never/infrequent group. At the second range of motion test, increased range was obtained for patients with infrequent or no neck pain, but left rotation range of motion was less on the second test (sensitization) for patients reporting monthly and weekly pain. Movement extent discrimination was best for the group with the greatest pain frequency. Conclusions. A history of subclinical neck pain is associated with lower neck muscle endurance capacity and with less rotation range of motion on second testing but when frequent (occurring weekly or more often) is associated with greater sensitivity in judging neck movement extent. Improving strength and rotation range should therefore be investigated as targets of treatment for subclinical neck pain.

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