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

Abstract 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 outco...

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Main Authors: Wren Burton, Yan Ma, Brad Manor, Jeffrey M. Hausdorff, Matthew H. Kowalski, Paul A. Bain, Peter M. Wayne
Format: Article
Language:English
Published: BMC 2023-07-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-023-06721-2
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author Wren Burton
Yan Ma
Brad Manor
Jeffrey M. Hausdorff
Matthew H. Kowalski
Paul A. Bain
Peter M. Wayne
author_facet Wren Burton
Yan Ma
Brad Manor
Jeffrey M. Hausdorff
Matthew H. Kowalski
Paul A. Bain
Peter M. Wayne
author_sort Wren Burton
collection DOAJ
description Abstract 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.
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spelling doaj.art-c9cc62c54a17459491e0842551cf4a5b2023-07-30T11:03:18ZengBMCBMC Musculoskeletal Disorders1471-24742023-07-0124112510.1186/s12891-023-06721-2The impact of neck pain on gait health: a systematic review and meta-analysisWren Burton0Yan Ma1Brad Manor2Jeffrey M. Hausdorff3Matthew H. Kowalski4Paul A. Bain5Peter M. Wayne6Osher Center for Integrative Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolOsher Center for Integrative Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolHinda and Arthur Marcus Institute for Aging ResearchCenter for the Study of Movement Cognition and MobilityOsher Center for Integrative Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolCountway Library, Harvard Medical SchoolOsher Center for Integrative Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolAbstract 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.https://doi.org/10.1186/s12891-023-06721-2Neck painGaitWalkingCervicalgiaCervicodyniaStride
spellingShingle Wren Burton
Yan Ma
Brad Manor
Jeffrey M. Hausdorff
Matthew H. Kowalski
Paul A. Bain
Peter M. Wayne
The impact of neck pain on gait health: a systematic review and meta-analysis
BMC Musculoskeletal Disorders
Neck pain
Gait
Walking
Cervicalgia
Cervicodynia
Stride
title The impact of neck pain on gait health: a systematic review and meta-analysis
title_full The impact of neck pain on gait health: a systematic review and meta-analysis
title_fullStr The impact of neck pain on gait health: a systematic review and meta-analysis
title_full_unstemmed The impact of neck pain on gait health: a systematic review and meta-analysis
title_short The impact of neck pain on gait health: a systematic review and meta-analysis
title_sort impact of neck pain on gait health a systematic review and meta analysis
topic Neck pain
Gait
Walking
Cervicalgia
Cervicodynia
Stride
url https://doi.org/10.1186/s12891-023-06721-2
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