KRONİK BOYUN AĞRILI BİREYLERDE KLASİK FİZYOTERAPİ PROGRAMINA EK OLARAK UYGULANAN SERVİKAL STABİLİZASYON VE OKULOMOTOR EGZERSİZLERİN AĞRI ŞİDDETİ, EKLEM POZİSYON HİSSİ VE FİZİKSEL PARAMETRELER ÜZERİNE ETKİLERİNİN KARŞILAŞTIRILMASI

Abstract

The aim of this study is to determine the effects of classical physiotherapy and two different treatment approaches added to classical physiotherapy on pain intensity, joint position sense (JPS), range of motion (ROM), activation and endurance of deep cervical flexors (DCF), postüre, balance, neck awareness, function and patient satisfaction in individuals with chronic neck pain (CNP). 72 volunteer individuals, aged between 30 and 55 years, who were diagnosed with CNP were included in the study. Individuals were divided into classical physiotherapy (CF, n=24), CF+Cervical Stabilization (CF+SS, n=24) and CF+Oculomotor Exercise (CF+OE, n=24) groups by stratified randomization method. Pain intensity was assessed by Numeric Pain Scale, JPS by Laser Pointer Assisted Angle Repetition test, cervical ROM by Inclinometer, DCF muscle activation and endurance by Biofeedback Pressure Unit, posture by Photography, static balance by Stork Balance test, dynamic balance by Y Balance test, neck awareness by Fremantle Neck Awareness Questionnaire, function by Neck Disability Index, satisfaction by Global Perceived Impact Questionnaire, before and after 8 weeks of treatment. All treatment approaches reduced pain intensity, joint position error values, and head anterior tilt in individuals with CNP; It was found to increase ROM, DCF muscle activation and endurance, static balance time and dynamic reach distance, and provided significant improvements in functionality and neck awareness (p<0.05). In the intergroup comparison, more effective results were achieved in the CF+SS and CF+OE groups compared to the CF-only group in terms of rotational ROM, DSF muscle activation and endurance, head anterior tilt, static balance, dynamic balance and functionality parameters. Satisfaction levels of the groups were similar (p>0.05). Cervical stabilization exercises are used to reduce forward head tilt, activate deep cervical flexor muscles and improve endurance and static and dynamic balance. It was concluded that adding oculomotor exercises to classical physiotherapy will increase the treatment success in increasing joint range of motion, static balance, activation and endurance of deep cervical flexor muscles and functional level, and that preferring oculomotor exercises will provide more clinical benefit, especially if the rotational limitations of the head are evident.