- Title
- Cervical spine kinematics associated with chronic idiopathic neck pain
- Creator
- Moghaddas, Diana
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2023
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Chronic neck pain is a significant health issue, with high patient and healthcare burden. Idiopathic neck pain has no identified pathophysiological cause, with current treatment focused on addressing physical impairments. As patients commonly report difficulties during daily functional activities involving movement of the head and neck within three-dimensional (3D) planes, a deeper understanding of spinal kinematics during functional activities in people with neck pain may assist to improve pain management. In clinical settings, a patient’s ability to perform a functional task is observed by a health professional, however, it is not typically quantified objectively. Using 3D motion analysis to quantify alterations in movement during functional tasks, clinicians may gain a more in-depth understanding of a patient’s symptoms and can tailor treatment plans for better pain management. As people with neck pain often seek treatment due to limitations during functional movement activities, interventions that focus on retraining tasks (i.e., task-specific training) may assist in improving functional outcomes in people with neck pain. Therefore, the overarching aim of this thesis is to investigate 3D movement kinematics in individuals with idiopathic chronic neck pain. Specifically, the aims are to review and summarise existing literature reporting 3D kinematics in individuals with neck pain (Chapter 3), to investigate 3D spinal kinematics during functional tasks in individuals with and without chronic neck pain in a cross-sectional study (Chapter 4), and to investigate the effects of task-specific training on spinal kinematics, neck pain and disability using a randomised controlled trial (Chapter 5). Chapter 3 is a systematic review of the possible differences between individuals with and without neck pain in cervical and thoracic kinematics during functional movement, measured by 3D motion analysis. Of 4416 title/abstracts screened, 5 cross-sectional studies were included. Functional tasks across studies included typing, using a virtual reality device while participants tracked a target with their eyes, reaching and postural tasks. Results suggested people with neck pain displayed greater neck flexion postures, reduced head velocity and reduced smoothness of movement compared to asymptomatic controls. Chapter 4 is a cross-sectional study that examines kinematic differences in the cervical and thoracic spine between individuals with chronic idiopathic neck pain and healthy age- and sex-matched control participants during functional tasks. Participants with chronic neck pain (n=33) and asymptomatic controls (n=30) performed four functional tasks: overhead reach forward, right and left, and putting on a seatbelt, while evaluated using 3D motion capture. Results indicated for overhead reach to the left and right and seatbelt tasks, people with neck pain maintain a more flexed head-neck segment and have greater head-neck lateral flexion. Chapter 5 is a pilot RCT that assessed whether adding task-specific training to usual evidence-based physiotherapy (manual therapy and exercise) changes cervical kinematics, pain, and disability in individuals with chronic idiopathic neck pain. Twenty-one individuals with neck pain were randomised to receive usual physiotherapy (manual therapy + tailored exercise) or usual physiotherapy + task-specific training (i.e., practice of patient-specific functional task). For four functional tasks (overhead reach forward, right, and left, and putting on a seatbelt), kinematic variables were assessed: joint angles, range of motion (ROM°), velocity (m s-1) and timing (% of movement phase) for joint angles, pain and disability. Compared to usual physiotherapy alone, the addition of task-specific training provided no greater improvement on kinematics, pain, and disability. Both treatment groups demonstrated improvements in pain and disability, and changes in kinematics such as reduced headneck angle flexion and fewer velocity peaks. The findings of this thesis may assist clinicians to improve their understanding of kinematics associated with neck pain. This may lead to more effective observations of functional movement, ultimately to improve treatment outcomes for people with neck pain.
- Subject
- neck pain; kinematics; cervical; biomechanics; spinal; functional
- Identifier
- http://hdl.handle.net/1959.13/1506776
- Identifier
- uon:55929
- Rights
- Copyright 2023 Diana Moghaddas
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 12 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 217 KB | Adobe Acrobat PDF | View Details Download |