Neck proprioception and mobility improved after upper neck and spine treatment: a randomized controlled trial

Spinal dysfunction at the occipito-atlantal (C0-C1) joint complex in conjunction with other spinal regions induces maladaptive plasticity from processing altered neck sensory input, yielding poor head and neck proprioception. Past work found that the One-to-Zero (OTZ) system, which manipulated the C0-C1 joint prior to other regions of joint dysfunction, improves cervical kinesthesia likely by impacting the proprioceptors that are densely located around the C0-C1joint. The aim of the current study was to determine the impact of OTZ on cervical kinesthesia, as compared to no treatment. A pragmatic, parallel group RCT conducted at a private practice randomized 72 participants (ages 18 to 65), into treatment (T) (n = 36) or control (C) (n = 36) groups. T received OTZ treatment until initial symptoms improved by 80%. Neck ranges of motion (ROM), and cervical kinesthesia (head to neutral (HtoN) and head to target (HtoT) at 50 and 65% of maximum head rotation were measured with eyes closed at baseline and after T (two to six weeks) or C period (2 weeks). Three trials per side were performed for all head repositioning tests, with trial error used to calculate repositioning errors. Significant time by group interactions were found for the primary outcome measure of HtoT-50%: Absolute, constant and variable error improved to a greater extent for T. HtoN: Constant error on the right side improved for C, while variable error improved more for T on both right and left sides. Secondary outcomes- significant time by group interactions were found for: Range of motion (neck extension, lateral flexion, and rotation); Visual analog pain ratings and Neck disability which all improved more for T. Selective improvements in neck kinesthesia in association with improved mobility suggest that the OTZ system normalizes proprioceptive afferent feedback resulting in short-term improvements in neck proprioception.