The impact of neck pain on gait health: a systematic review and meta-analysis.

Autor: Burton W; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA. wmburton@bwh.harvard.edu.; DC. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. wmburton@bwh.harvard.edu., Ma Y; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA.; DC. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Manor B; Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA., Hausdorff JM; Center for the Study of Movement Cognition and Mobility, Tel Aviv, Israel.; Sagol School of Neuroscience and Department of Physical Therapy, Sacker School of Medicine Tel Aviv University, Tel Aviv, Israel.; Department of Orthopedic Surgery, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA., Kowalski MH; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA., Bain PA; Countway Library, Harvard Medical School, Boston, MA, USA., Wayne PM; Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA.; DC. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2023 Jul 29; Vol. 24 (1), pp. 618. Date of Electronic Publication: 2023 Jul 29.
DOI: 10.1186/s12891-023-06721-2
Abstrakt: Background: Evidence exists demonstrating the negative impacts of chronic musculoskeletal pain on key measures of gait. Despite neck pain being the second most common musculoskeletal pain condition, there is a paucity of evidence exploring the impacts of neck pain specifically on these outcomes. The aims of this work were to systematically review the current evidence of the associations between chronic neck pain and measures of gait health and to conduct meta-analysis for quantitative assessment of the effect sizes under different walking conditions.
Methods: Systematic review was conducted following PRISMA guidelines. Databases searched included MEDLINE, Embase, Web of Science, CINAHL, and PEDro. Eligible study designs included observational studies consisting of an exposure group with chronic neck pain and control group without chronic neck pain and primary outcomes relating to gait health. For outcomes amenable to meta-analysis, a random-effects model was used to derive summary estimates of Hedge's g depicted graphically with forest plots. Other gait outcomes were narratively summarized. Risk of bias was also assessed.
Results: The original search yielded 1918 articles; 12 met final eligibility criteria including 10 cross-sectional studies. Outcomes were grouped first by the five domains of gait: pace, rhythm, asymmetry, variability, and postural control; and second by the tested walking conditions. Meta-analyses for gait speed revealed large effect-sizes indicating that individuals with chronic neck pain had slower measures of gait and lower measures of cadence. Gait outcomes that were narratively summarized supported these findings.
Conclusion: The quantitative and qualitative findings of this systematic review and meta-analysis suggest a negative impact of CNNP on measures of gait health, particularly gait speed, under various walking conditions. However, broad interpretation of these results should be cautious. Testing gait under dual task conditions may be particularly sensitive to the impact of CNNP, and future work is needed to better understand how pain disrupts this important functionality of the locomotor system. Additionally, consideration should be made to assess measures of variability and investigate these relationships in the older adult population.
(© 2023. The Author(s).)
Databáze: MEDLINE
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