Impact of action observation therapy on pain in patients with nonspecific chronic neck pain

• Autor(a) principal: Buo-Assaf, Mario
• 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/10773/35993
• topic: Chronic nonspecific neck pain; Action observation; Pressure pain threshold; Randomized clinical trial

Background: Chronic neck pain (CNP) is one of the most common musculoskeletal disorders. It is associated with psychosocial factors such as stress, anxiety and depression, but also impairments of the nervous system such as the endogenous pain modulation. Action observation (AO) is a recent neurorehabilitation approach that involves the mirror neuron system, in which there seem to be an overlap between the observation and the execution of a movement. Currently, this approach has been more investigated in the literature but seems to have conflicting results as to its effect on CNP. Objective: This study aims to assess the immediate effects of action observation of specific neck exercises on neck pain intensity and pressure pain threshold in individuals with CNP when compared to observing a video with a natural scenery. Methods: This is a pilot randomized controlled trial. Participants with CNP were randomly allocated to the action observation (AO) group and to the control group. Both groups received a single 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 and pressure pain threshold were assessed both at baseline and immediately post-intervention. Results: A total of 30 participants entered the study (AO group=15; control group=15). There was a statistically significant effect of time (baseline vs. post-intervention), but no significant interaction for group (control vs. experimental) for: pain intensity (p<0.001), with a mean decrease of 1.89 (35%) in the control group and 1.43 (30%) in the AO group; fear of movement (p=0.023) with a mean decrease of 1.8 (8.7%) in the control group and 1.4 (9.1%) in the AO group and fear-avoidance beliefs-work subscale (p=0.014) with a mean decrease of 0.47 (3.2%) in the control group and 2.27 (12.1%) in the AO group. No significant interaction between time and group (p≥0.069) nor a significant main effect of time (p≥0.547) was found for pressure pain thresholds. Conclusion: This study suggests that both AO technique and the observation of natural scenes reduced pain intensity, fear of movement and fear-avoidance beliefs related to work but had no effect over the pressure pain threshold in patients with CNP. Further studies with larger sample sizes are needed.