Investigation of balance performance under different sensory and dual-task conditions in patients with chronic neck pain

Abstract

Background: Most studies suggest that people with chronic neck pain (CNP) have decreased balance abilities. However, balance performance during performing concurrent tasks is not clarified.

Objectives: To investigate balance performance under different sensory and dual-task conditions in people with and without CNP.

Method: Twenty-two women with CNP and twenty-two asymptomatic women were tested using the Biodex Stability System. Overall stability index (OSI), anterior/posterior stability index (APSI), medial/lateral stability index (MLSI) were obtained in two sessions: eyes-open and eyes-closed. Both sessions consisted of four conditions: quiet standing, rotating head, counting backward, standing on foam. Higher index scores mean poorer balance.

Design: Case-Control study.

Results: A mixed factorial ANOVA (2 × 8 design) showed that there was a main effect of CNP on OSI, APSI, and MLSI (p < 0.001), which indicates that CNP causes poor balance. Further, there was an interaction between CNP and test conditions for only OSI (p < 0.05). Simple effects tests showed that patients with CNP had higher OSI in all conditions except standing on foam with eyes-open, and quiet standing and counting backward with eyes-closed (p < 0.05). The largest effect size was obtained during rotating head with eyes-open (η²:0.301), followed by counting backward with eyes-open and quiet standing with eyes-open (η²:0.267 and 0.245). Performing a concurrent task, closing eyes, or standing on foam mostly increased OSI in both groups (p < 0.05).

Conclusions: Patients with CNP have poorer balance under different sensory and dual-task conditions. Addressing balance assessment while performing concurrent tasks, especially head rotations, may offer new insights into the management of CNP.

Keywords: Chronic neck pain; Dual task; Postural control; Somatosensory input.