The Proprioception Connection

Does neck pain influence our spatial perception? One study investigates the link between proprioception and pain.
Matthew F. Funk, D.C., Associate Professor in the University of Bridgeport College of Chiropractic, in collaboration with Dr. Richard Saporito, also a member of the Chiropractic faculty, conducted a pilot investigation into differences in neck proprioception between asymptomatic subjects and those with cervical pain.

connection_400Proprioception is a sense or knowledge of position, posture and equilibrium of the body. “We have sensory receptors in our neck, in our eyes and in our ears that allow us to sense where we are. All three sensors have to work together in order for us to have balance and coordinated motion. So we took out the visual part, and we were trying to see if we can measure an individual’s ability to get back to the starting neutral point using position sense alone, and how that might vary by gender, age, presence or absence of neck pain,” says Funk.

Subjects in the study were seated on a chair with a screen in front of them. They were blindfolded and wore a bicycle helmet equipped with a laser pointer. Subjects were first asked to look straight ahead, which was considered the neutral point, as well as move their heads in each of the six cardinal directions (flexion, extension, left lateral bending, left lateral rotation, right lateral bending and right lateral rotation) and return to the neutral point. Movements of each subject were measured and recorded.

The project investigated the effects of any treatment and the levels of neck pain in the subjects after treatment, measured again with the same device. The efficiency of the treatment was taken into consideration by the differences in the neck’s ability without visual clues to return to the neutral point.

“When we are on a boat, the wave movements make our inner ear receptors move, but our eyes don’t match that, and we start to feel a little queasy. That’s an example of how much our eyes, inner ears and muscles and joints of our neck receptors interact with each other. It all happens automatically. Even when sitting on a chair, there is information transmitted from your brain to your neck on how to keep your head still, focus on different things and so on. So, we are trying to measure how the ear and neck proprioception is supposed to function without the visual information.”

The main research was conducted on chiropractic students, but the initial findings indicate that there are differences in gender, age, between subjects with neck pain and those without. Funk would like to extend the research onto a broader population, since that could give more information about the types of treatment, and then formulate the details and conclusions of the project.

This project is significant because while there is a growing body of evidence regarding the effectiveness of manual therapy procedures (massage, manipulation and mobilization) for different types of neck pain, the treatment of neck pain and its effects on proprioception is not as well studied. The outcomes of this study were presented at UB’s 2011 Faculty Research Day and at the 2012 Association of Chiropractic Colleges Research Agenda Conference, held in Las Vegas, Nevada.

Funk has always had an interest in evidence-based practice. In fact, he started his involvement in scholarly publications even prior to his appointment to UB. Funk is not only involved in considerable research and service activities, but also serves double duty as a clinician in the outpatient clinic, supervising fourth-year chiropractic interns and as a lead professor in clinical sciences courses.