Award Date

5-2015

Degree Type

Thesis

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Committee Member

Kai Yu Ho

Second Committee Member

Emilio Puentedura

Third Committee Member

Merrill Landers

Fourth Committee Member

Kathryn Hausbeck Korgan

Number of Pages

53

Abstract

Purpose: The purpose of this study was to determine 1) if there were any differences in gait parameters between participants with mechanical neck pain and those without and 2) if cervical spine manipulation has an immediate effect on these gait parameters.

Methods: Twenty participants with mechanical neck pain and twenty participants without neck pain were randomly assigned into either the sham or manipulation group. The two intervention groups participated in walking across a GAITRite Walkway that recorded gait parameters such as stride length, cadence and step width before and after cervical spine manipulation. The participants walked at their own cadence with 1) head forward, 2) head turning up and down and 3) head turning side-to-side. T-tests were used to assess 8 different gait parameters between groups before and after intervention and to assess cervical range of motion differences between groups and before and after intervention in the sagittal, transverse and coronal plane. Repeated measures two-way ANOVA was used to assess pre and post intervention differences between groups in the NDI, NPRS and GROC. Post-hoc pair-wise corrections were to be used in the event of significant interactions between treatments and groups. Statistical significant was set at p <0.05.

Results: Compared to pain-free subjects, the T-tests demonstrated that patients with mechanical neck pain had smaller values of gait velocity, stride length, and step length before any treatment was provided (p<0.05). Prior to treatment, T-tests revealed no differences in cervical ROMs between persons with and without neck pain for the sagittal plane motion (P = 0.182); frontal plane motion (P = 0.347); and transverse plane (P = 0.181). The 2-way ANOVAs revealed a significant “group” main effect in gait velocity during normal walking (P=0.004), indicating participants with neck pain increased their velocity whereas participants without neck pain demonstrated decreased velocity regardless of intervention given. A separate independent t-test indicated that there was a significant interaction in GROC score changes between treatment and group (P =0.043).

Conclusion: Our study indicated that patients with neck pain walked more slowly with shorter stride length and step length. . These gait characteristics observed might be strategies to compensate for gait instability, which involves proprioceptive deficits from the cervical spine. Additionally participants with neck pain increased their gait velocity post intervention whereas participants without neck pain demonstrated decreased velocity post intervention (manipulation/sham). While our results suggest TJM did improve gait velocity in those with neck pain post manipulation, we did not see significant changes in other gait parameters. This study suggests that clinicians should consider the assessment and management of gait performance, balance and risk of falling in patients with acute mechanical neck pain.

Keywords

Gait in humans; Neck pain; Physical therapy

Disciplines

Applied Statistics | Physical Therapy | Rehabilitation and Therapy | Statistics and Probability

Language

English


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