The impact of subclinical neck pain on goal-directed upper limb movement in the horizontal plane.

Subclinical neck pain (SCNP) refers to recurrent neck pain and/or stiffness for which individuals have not yet sought treatment. Prior studies have shown that individuals with SCNP have altered cerebellar processing that exhibits an altered body schema. The cerebellum also plays a vital role in upper limb reaching movements through refining internal models and integrating sensorimotor information. However, the impact of SCNP on these processes has yet to be examined in the context of a rapid goal-directed aiming response that relies on feedforward and feedback processes to guide the limb to the target. To address this, SCNP and control participants performed goal-directed upper limb movements with the dominant and non-dominant hands using light and heavy styli in the horizontal plane. The results show greater peak accelerations in SCNP participants using the heavy stylus. However, there were no other group differences seen, possibly due to the fact that reaching behavior predominantly relies on vision such that any proprioceptive deficits seen in those with SCNP can be compensated. This study illustrates the robust compensatory nature of the CNS when performing end-effector reaching tasks, suggesting studies altering visual feedback may be needed to see the full impact of SCNP on upper limb aiming.

Impact of subclinical neck pain on eye and hand movements in goal-directed upper limb aiming movements.

Individuals with untreated, mild-to-moderate recurrent neck pain or stiffness (subclinical neck pain (SCNP)) have been shown to have impairments in upper limb proprioception, and altered cerebellar processing. It is probable that aiming trajectories will be impacted since individuals with SCNP cannot rely on accurate proprioceptive feedback or feedforward processing (body schema) for movement planning and execution, due to altered afferent input from the neck. SCNP participants may thus rely more on visual feedback, to accommodate for impaired cerebellar processing. This quasi-experimental study sought to determine whether upper limb kinematics and oculomotor processes were impacted in those with SCNP. 25 SCNP and 25 control participants who were right-hand dominant performed bidirectional aiming movements using two different weighted styli (light or heavy) while wearing an eye-tracking device. Those with SCNP had a greater time to and time after peak velocity, which corresponded with a longer upper limb movement and reaction time, seen as greater constant error, less undershoot in the upwards direction and greater undershoot in the downwards direction compared to controls. SCNP participants also showed a trend towards a quicker ocular reaction and movement time compared to controls, while the movement distance was fairly similar between groups. This study indicates that SCNP alters aiming performances, with greater reliance on visual feedback, likely due to altered proprioceptive input leading to altered cerebellar processing.