Recent research on sensorimotor function has contributed essentially to the understanding of possible pathophysiological mechanisms, associations between pain and altered motor control and to the development of assessment and rehabilitation methods of musculoskeletal pain disorders. The sensory and motor functions of the cervical spine are fundamental for the stability and movement control of the head, for the arm and hand function, as well as for the postural control. Thus, sensorimotor deficiencies in neck pain disorders may have important impact not only regarding symptoms but also on physical functioning in daily living and work life. Pathophysiological models explaining the associations between pain and altered sensorimotor function include, e.g., disturbed proprioceptive information due to altered sensitivity of muscle spindle afferents, and altered muscle activation patterns due to pain adaptations. According to these models, sensorimotor deficiencies may be of immense importance for the recurrence, persistence and spread of musculoskeletal pain disorders. Assessments of sensorimotor function in neck pain disorders have revealed deficiencies including, e.g., reduced range of motion and movement speed of cervical movements; reduced acuity in movements of the neck, shoulder and elbow; and reduced muscle strength, as well as altered activation synergies of the deep and superficial cervical muscles. Disturbances have also been identified for occulomotor function and postural control, especially in neck pain related to trauma and cervicogenic dizziness. For references see, e.g. (1). In line with the above, specific exercise regimes designed to improve sensorimotor function, such as neck coordination and proprioception exercises, have shown promising results in reducing pain and improving motor functions, e.g., (2). A common characteristic of these exercises is that they involve slow movements and closed skills tasks (i.e., the task is highly predictable). According to the literature on motor learning, exercises involving more open skills tasks can be useful for training sensorimotor function. Therefore, new methods have been developed which involve less predictable exercises and thereby increase the demand for on-line adjustments of the neuromuscular control system (3, 4). Taken together, these theoretical and empirical premises support the value of assessment and exercise of sensorimotor function in the rehabilitation of neck pain disorders. Further research is, however, warranted, e.g., regarding the neuromuscular mechanisms involved in various types of exercises; the predictive ability of the efficiency of interventions for a specific individual; and RCT-studies including long-term follow-up. References1. Röijezon U. Sensorimotor function in chronic neck pain: Objective assessmentsand a novel method for neck coordination exercise [PhD-thesis]:Umeå University, ISSN 0346-6612; ISBN: 978-91-7264-809-8; 2009.2. Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervicaljoint position sense: The effect of two exercise regimes. J Orthop Res2007 Mar; 25: 404–412.3. Kristjansson E, Oddsdottir GL. “The Fly”: A new clinical assessment andtreatment method for deficits of movement control in the cervical spinereliability and validity. Spine 2010; 35: E1298–E305.4. Röijezon U, Björklund M, Bergenheim M, Djupsjöbacka M. A novelmethod for neck coordination exercise--a pilot study on persons withchronic non-specific neck pain. J Neuroeng Rehabil 2008; 5: 36.
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