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Train the brain! Immediate sensorimotor effects of mentally-performed flexor exercises in patients with neck pain. A
Konstantin Beinert1, Marc Sofsky2, Jörg Trojan3
1Department of Physiotherapy, University of Applied Health Sciences Rhein-Neckar, Mannheim, Germany - konstantin.beinert@hgwr.de.
Background:
Sensorimotor tests, like cranio-cervical flexion and cervical joint position sense tests, share a strong cognitive component during their execution. However, cognitive training for those tests has not been investigated so far.
Aim:
The aim of this study was to compare mental and physical exercises for improving the sensorimotor function of the cervical spine.
Design:
A within-subject design with 16 participants.
Setting:
Outpatient physiotherapy center.
Population:
Patients with chronic neck pain.
Methods:
Participants were instructed to perform specific active or mental exercises for the deep and superficial neck flexor muscles. The primary outcomes were cranio-cervical flexion test performance, postural sway, cervical joint position sense and pressure pain threshold. A mixed model analysis was used.
Results:
The interventions improved cranio-cervical flexion performance (P<0.001), with no difference between actively or mentally-performed exercises. Postural sway increased after actively (P<0.01) and mentally (P<0.05) performed deep cervical neck flexor exercises, but not after superficial neck flexor exercises. Mentally-performed superficial neck flexor exercises improved cervical joint position sense when compared to mentally-performed deep cervical flexor exercises (P<0.05), and actively performed superficial neck flexor exercises were effective in improving cervical joint position sense acuity compared to mentally-performed deep cervical flexor exercises (P<0.05) for relocation tasks in the transverse plane. The pressure pain threshold at the cervical spine increased after active deep cervical flexor exercises (P<0.05) and after mental superficial neck flexor exercise (P<0.05).
Conclusions:
Mentally-performed deep cervical flexor exercises improved cranio-cervical flexion test performance and pressure pain threshold at the cervical spine, while postural sway increased. Mentally-performed superficial neck flexor exercises improved cervical joint position sense acuity more than mentally-performed deep cervical flexor exercises.
Clinical Rehabilitation Impact:
Mentally-performed exercises are recommended in the early stages of rehabilitation to counteract extensive muscle impairment, and these can be incorporated into daily routine.
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