The influence of neck pain on balance and gait parameters in community-dwelling elders

Neck pain has been shown to be associated with balance disturbances. Balance and gait speed are also known to decline with ageing. The aim of this study was to determine whether the presence of neck pain was associated with a decline in postural stability and gait speed over and above what is expected with normal ageing. Twenty female subjects with idiopathic neck pain and 20 healthy female controls aged between 65 and 82 years were studied. Subjects performed balance tests on a computerised force plate under conditions of eyes open, eyes closed on firm and soft surfaces in comfortable and narrow stance. Sway energy and root mean square (RMS) amplitude of sway were measured. Subjects also undertook a Timed Ten Metre Walk Test, with and without head turning. There were trends for the elderly group with neck pain to have poorer balance than the healthy controls across most balance conditions, although differences were significant only in the following tests; comfortable stance--eyes closed on a firm surface (p=0.02), eyes open on a soft surface (p=0.01); narrow stance--eyes open on a firm surface (p=0.02). In the Timed Ten meter Walk Test, elderly subjects with neck pain had a slower self-selected gait speed (p=0.02) and cadence (p=0.04) in the head turn condition, as well as a longer gait cycle duration both with (p=0.00) and without head turns (p=0.04). The results of this study suggest that neck pain in the elderly may contribute to some disturbance in balance and gait parameters over and above that which occurs with normal ageing.