Impact of action observation therapy on pain, muscle strength, and tactile acuity in patients with chronic neck pain

• Autor(a) principal: Shrbaji, Tala Al
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10773/34862
• topic: Chronic idiopathic neck pain; Action observation; Muscle strength; Tactile acuity; Randomized clinical trial

Background: Chronic nonspecific neck pain (CNNP) is a prevalent complaint that displays functional reorganization and impairments of the nervous system, associated with psychosocial factors. Action observation is a novel neurorehabilitation approach that involves the mirror neuron system, in which sensory information of the observed action is transformed into motor representation. This approach could lead to corticospinal excitability and eventually hypoalgesia and improve function, however, the amount of evidence available is scarce. Objective: This study aims to assess the immediate effects of observing neck movements (action observation) on neck pain intensity, fear of movement, fear-avoidance beliefs, neck muscles' strength, and tactile acuity in individuals with CNNP when compared to the effects of observing a natural environment. Methods: This is a pilot randomized trial. Participants with CNNP were randomly allocated to the action observation (AO) group and to the control group. Both groups received only one session, in which the intervention was observing an 11-minute video. The AO group watched a video of a person performing specific therapeutic neck exercises while the control group watched a video of nature. Neck pain intensity, fear of movement, fear-avoidance beliefs, tactile acuity, and neck muscle strength were assessed both at baseline and immediately post-intervention. Results: A total of 30 participants entered the study (AO group: n=15; control group: n=15). There was a significant interaction between time (baseline vs. post-intervention) and group (control vs. experimental) for fear of movement (p=0.016), fear-avoidance beliefs-work subscale (p=0.047) and tactile acuity at the level C3-C4 (p=0.025). A statistically significant effect of time, but no significant interaction, was found for: pain intensity (p<0.001), with a mean decrease of 1.9 (40%) in the control group and 1.5 (29%) in the AO group; and tactile acuity (p≤0.011) at the following levels (with mean difference in cm) C3-C4 (0.71 and 0.13), C4-C5 (0.51 and 0.25), C5- C6 (0.46 and 0.29), C6-C7 (0.77 and 0.40), and C7-T1 (0.71 and 0.49), in the control and AO group, respectively. Conclusion: This study suggests that the impact of AO is inferior to observing nature for fear of movement and fear-avoidance beliefs related to work and similar for pain intensity and tactile acuity in patients with CNNP. Further studies with bigger sample sizes are needed.