Neck pain is one of the most common musculoskeletal complaints and its prevalence is between
10-22%. Approximately half of all individuals will experience a clinically important neck
pain episode over the course of their lifetime. Neck pain is categorized by duration as
acute, subacute and chronic neck pain (acute, <6 weeks; subacute, ≤3 months; chronic, >3
months). Chronic neck pain is more common in women and its incidence increases with age.
Cervical disc herniation, cervical spondylosis, cervical stenosis, myofascial pain syndrome,
cervical instability, whiplash injury, Klippel feil syndrome, thoracic outlet syndrome,
cervical sprain, cervical strain, tumors, rheumatic diseases, torticollis, inflammatory neck
pain are the main causes.
Anterior tilt of the head is a common posture in neck pain. In this posture, the upper
cervical vertebrae are extension, the lower cervical vertebrae are flexion and the cervical
lordosis is decreased. With neck pain, inhibition occurs in the deep neck flexor (longus coli
and capitis) and extensor (multifidus, rotator, semispinalis) muscles, increased fat
infiltration, deterioration in type 1 and 2 fiber ratios, and muscle atrophy. The risk of
micro and macro trauma increases and muscle support decreases. Thus, there is an increase in
the activation response and fatigue of the neck superficial muscle group (trapeze, scalene,
sternocleidomastoid muscles), and a decrease in neck joint movement and proprioception sense.
As a result, it was determined that there are deficiencies in the sense of proprioception in
patients with neck pain.
Studies have shown that many receptors related to the sense of position are on deep cervical
flexor muscles such as Musculus Longus Capitis and Musculus Longus Colli. In cases where
there are changes such as atrophy and fat infiltration in these muscles, there is a decrease
in proprioceptive sensation.Conservative treatment is the first choice in the treatment of
neck pain. The important components of this treatment are stretching, strengthening, posture,
stabilization, proprioception, relaxation, joint movement exercises and aerobic exercises.
The purpose of stabilization exercises, which have been used in the treatment of chronic neck
pain recently; to support the vertebral column by activating the stabilizing muscles and to
improve posture by increasing kinesthetic awareness.
This study will examine the relationship between the sense of cervical proprioception and
cervical stabilization exercises in patients with chronic neck pain.
In this study, between 15 June 2022 and 30 January 2023; 72 volunteers, aged between 18-55
years, with neck pain for more than 3 months, with good cognitive function, who applied to
the our Physical Medicine and Rehabilitation Clinic will be included. The patients will be
randomized to two groups as cervical stabilization exercise group and conventional cervical
exercise treatment group. The patients in group 1 will receive cervical stabilization
exercises 1 session a day, 3 days a week for 6 weeks, and the patients in group 2 will
perform cervical stabilization exercises for 6 weeks, 3 days a week, 1 session a day.
conventional cervical exercises will be given. Patients of both groups will do their
exercises in the first 3 weeks accompanied by a physiotherapist, and in the last 3 weeks as a
home exercise program.
Before the start of the treatment, at the end of the 3rd week and at the end of the 6th week;
pain intensity, level of neck disability, quality of life, cervical range of motion and
cervical joint position sense will be evaluated and both groups will be compared in these
parameters.
Demographic information (address, telephone, age, occupation, height, weight, marital status,
etc.) of the patients to be included in the study will be recorded and general
musculoskeletal examinations will be performed. The patients will be compared to evaluate for
Visual Analogue Scale (VAS), Neck Disability Index (NDI) and Short Form-36 (SF-36), cervical
range of motion and cervical joint position sense after intervention. Cervical range of
motion and cervical joint position sense will be evaluated with the Cervical Range of Motion
Deluxe Device (CROM).