Effect of neck torsion on standing balance in elderly people with non-specific neck pain

Abstract

The neck torsion manoeuvre, stimulating the cervical receptors may be useful to determine if underlying neck pain might be causing impaired balance in elderly people. The aims of this study were to determine whether the neck torsion position substantially influences balance responses in elders with and without neck pain and to determine the relationship of postural sway and neck pain features. Participants consisted of 68 elderly people (34 with neck pain and 34 no neck pain). Balance was tested using a force plate in comfortable stance with neck neutral and torsion positions on firm and soft surfaces. Postural outcomes were anterior-posterior (AP) and medial-lateral (ML) displacements, sway area and velocity. Pain features were intensity, duration, and disability. The results demonstrated that the neck pain group exhibited increased postural sway in the torsion condition on firm and soft surfaces (most outcomes) compared to controls (p < 0.05). The neck pain group also had increased AP displacement and velocity (soft surface) and sway area (both surfaces) in the neutral condition. Increased postural sway was mostly demonstrated in the torsion condition compared to the neutral condition for both groups (p < 0.05). There were no relationships between postural sway and neck pain features. The study suggests that the neck torsion position, stimulating the cervical receptors resulted in increased postural sway (displacements, sway area and velocity) in elderly people, to a greater extent in those with neck pain. The torsion position is valuable for assessment of impaired balance related to abnormal cervical input in older adults.