Effect of kinesthetic and visual motor imagery with biofeedback on cervical position sense and balance in patients with mechanical neck pain: Randomized controlled trial

Abstract

Purpose

To examine impact of kinesthetic and visual motor imagery (MI) training on balance, cervical proprioception, and function in mechanical neck pain patients.

Methods

Fifty-three patients were assessed for eligibility. Nine patients were excluded for different reasons, and the remaining forty-four were randomly allocated into two groups (study and control). The patients were assessed pre- and post-treatment for cervical proprioception, neck mobility, balance, and pain using cervical joint position sense error (JPSE) test via overhead laser pointer, neck disability index (NDI), multidirectional reach test (MDRT), and visual analogue scale for pain (VAS-P), respectively. The study group (N = 22) received kinesthetic and visual MI training and a conventional physical therapy program, while the control group (N = 22) received a conventional program. Both groups received three sessions per week for four weeks. Both the statistical analyzer and the patients were blinded, and the study was registered in clinicaltrials.gov ID: XXXXXX.

Results

Forty-four patients were included in the study and were randomly assigned to equal groups. Following intervention, the two groups’ comparison demonstrated improvement with a significant decrease in the neck JPSE, NDI, and VAS-P and an increase in MDRT scores in the study group more than in the control one, while within-group comparison, there was a significant decrease in the neck JPSE, NDI, and VAS-P, and an increase in MDRT scores post-intervention compared with that of baseline in both groups (p < 0.05).

Conclusion

MI training with biofeedback is an effective therapeutic intervention for enhancing balance, neck position sense, and decreasing mechanical neck pain.