Evidence of Impaired Proprioception in Chronic, Idiopathic Neck Pain: Systematic Review and Meta-Analysis.

Despite common use of proprioceptive retraining interventions in chronic, idiopathic neck pain, evidence that proprioceptive dysfunction exists in this population is lacking. Determining whether proprioceptive dysfunction exists in chronic neck pain has clear implications for treatment prescription. The authors aim was to synthesize and critically appraise all evidence evaluating proprioceptive dysfunction in those with chronic, idiopathic neck pain by completing a systematic review and meta-analysis. All published studies that compared neck proprioception (joint position sense) between a chronic, idiopathic neck pain sample and asymptomatic controls were included. Two independent reviewers extracted relevant population and proprioception data and assessed methodological quality using a modified STROBE statement. Thirteen studies were included in the present review. Meta-analysis on ten studies demonstrated that those with chronic neck pain perform significantly worse on ‘head-to-neutral’ repositioning tests, with a moderate standardized mean difference (SMD) of 0.44 (95% confidence interval: 0.25 to 0.63). Two studies evaluated head repositioning using trunk movement (no active head movement thus hypothesised to remove vestibular input) and found conflicting results. Three studies evaluated complex/postural repositioning tests: postural repositioning was no different between groups and complex movement tests were only impaired in chronic neck pain if error was continuously evaluated throughout the movement.

People with chronic, idiopathic neck pain demonstrate a moderate impairment in ‘head-to-neutral’ repositioning tests, when compared with asymptomatic controls.