THE PREVALENCE OF SENSORIMOTOR DISTURBANCES AMONG PATIENTS WITH CHRONIC NECK PAIN: A SYSTEMATIC REVIEW.

Abstract

Background: Chronic neck pain in different nature, especially related with whiplash-associated disorders (WAD) is commonly accompanied with more complicated sensorimotor disturbances. Such disturbances include proprioception, balance impairments and abnormalities of oculomotor control, vestibular function, and visual processing. These disorders are clinically important to patients' activities of daily life routines due to their complex mechanisms. But they are often underestimated and misdiagnosed. Objective: Primarily to systematically review the prevalence, characteristics, mechanisms, and relevance for clinical approaches of sensorimotor disturbances in adults with chronic neck pain. Secondly to identify the influence of sensorimotor disturbances to the neck patient's quality of life , treatment approaches and comorbidities. Methods: 35 peer-reviewed studies published in English were included in this systematic review. The studies were selected through comprehensive database searching and screened for eligibility criteria. Studies involved adult participants with chronic non-traumatiс or traumatic neck pain and reported prevalence data for at least one sensorimotor disturbances. Further narrative synthesis was conducted. Risk of bias was assessed using appropriate tools chosen to each study design. Results: Sensorimotor impairments were common in all groups with chronic neck pain: oculomotor dysfunction (91%), vestibular disturbances (88%), postural control deficits (87%), proprioceptive changes (85%), and visual symptoms (79%). These impairments were often combined with each other, especially in the WAD population with symptom severity. This suggested a trauma-related disruption of cervical afferent pathways in. In addition, these 4 disorders were frequently observed in women and were more frequent in the elderly. Pathophysiologic explanations for the mechanisms include altered sensorimotor integration, reflex dysfunction (COR, VOR), and impaired proprioceptive feedback. Several studies have reported decreased quality of life, increased disability, and associated psychological morbidities such as anxiety and depression. Rehabilitation interventions have been shown to be effective. Conclusion: Chronic neck pain, especially the one in people with WAS, is associated with numerous disruptions of different sensory systems. This data highlights the importance of sensory evaluation in standardized clinical evaluation procedures alongside the treatment. The further research should pay more attention to standardized outcome measures, long-term trials, and exploration of sensorimotor-psychosocial interactions.