Balance Control in Chronic Neck Pain Subjects: a Clinical Assessment.

Background: Balance has been found to be decreased in chronic neck pain (CNP) patients of both idiopathic and traumatic onset. Balance has been recommended to be tested in CNP patients. However, there exists no clinical balance test valid for this population. Purpose: The purpose with this study was to increase knowledge about balance tests that could pick out CNP subjects with balance disturbances. Aim: To explore if the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) along with adjunct positions can pick out the CNP subjects with balance disturbances. Methods: A pilot, cross-sectional study was conducted in 10 subjects with CNP (≥3- month duration) and with Neck Disability Index (NDI) ≥10 out of 50, who were recruited from an outpatient clinic in Southwestern Norway. Balance was assessed using the mCTSIB (four test conditions) along with six adjunct test conditions. Each test condition was held for 30 seconds. Results: The mCTSIB demonstrated a ceiling effect. The adjunct positions with the eyes closed in tandem and especially one-leg standing appear to provide an indication of balance disturbances in CNP subjects. No associations were found between results on balance tests and NDI, pain intensity, or dizziness status. When using a 10-second cut- off score obtained from normative data, there was, in this study, a 20% failure rate for subjects to reach the cut-off score in tandem standing with the eyes closed and 80% in one- leg standing with the eyes-closed. Conclusion: As a result of a low sample size, limited conclusions can be drawn. The eyes- closed conditions for tandem standing or especially one-leg standing appear to provide an indication of balance disturbances in CNP subjects. No correlations have been found between performance on standing tests and NDI, pain intensity, or dizziness status