Effect of Natural Apophyseal Glides (NAGs) on Cervical Joint Position Sense and Gravity Sway
Objective: Neck pain is reported to be associated with decreased cervical Joint Position Sense (JPS) and balance impairment. This study aimed to investigate the effects of Natural Apophyseal Glides (NAGs) and exercise therapy on JPS and center of gravity sway.Method: The subjects were 29 healthy adu...
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| Published in | Physical Therapy Japan Vol. 51; no. 4; pp. 112 - 118 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Physical Therapy
20.08.2024
一般社団法人日本理学療法学会連合 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0289-3770 2189-602X |
| DOI | 10.15063/rigaku.12444 |
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| Abstract | Objective: Neck pain is reported to be associated with decreased cervical Joint Position Sense (JPS) and balance impairment. This study aimed to investigate the effects of Natural Apophyseal Glides (NAGs) and exercise therapy on JPS and center of gravity sway.Method: The subjects were 29 healthy adult males and females randomly divided into three groups: the NAGs+Motor Control Exercise (MCE) group, the cervical vibration stimulation+MCE group, and the Sham NAGs+MCE group. The measures were the error value of the JPS by relocation test, Cervical Range of Motion, a rectangular area in the gravity sway test, and the neck lateral flexion angle during the neck rotation condition of the gravity sway test, which was measured before and after the intervention. Result: The results showed that the NAGs+MCE group had significantly lower JPS error values for both the right and left rotations. In comparison, the cervical vibration stimulation+MCE group had significantly lower values only for the right rotation. However, there were no significant differences among the groups in the items of the gravity sway test.Conclusion: This suggests that intervention with NAGs improves JPS but has no effect on gravity sway. |
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| AbstractList | Objective: Neck pain is reported to be associated with decreased cervical Joint Position Sense (JPS) and balance impairment. This study aimed to investigate the effects of Natural Apophyseal Glides (NAGs) and exercise therapy on JPS and center of gravity sway.Method: The subjects were 29 healthy adult males and females randomly divided into three groups: the NAGs+Motor Control Exercise (MCE) group, the cervical vibration stimulation+MCE group, and the Sham NAGs+MCE group. The measures were the error value of the JPS by relocation test, Cervical Range of Motion, a rectangular area in the gravity sway test, and the neck lateral flexion angle during the neck rotation condition of the gravity sway test, which was measured before and after the intervention. Result: The results showed that the NAGs+MCE group had significantly lower JPS error values for both the right and left rotations. In comparison, the cervical vibration stimulation+MCE group had significantly lower values only for the right rotation. However, there were no significant differences among the groups in the items of the gravity sway test.Conclusion: This suggests that intervention with NAGs improves JPS but has no effect on gravity sway. Objective: Neck pain is reported to be associated with decreased cervical Joint Position Sense (JPS) and balance impairment. This study aimed to investigate the effects of Natural Apophyseal Glides (NAGs) and exercise therapy on JPS and center of gravity sway.Method: The subjects were 29 healthy adult males and females randomly divided into three groups: the NAGs+Motor Control Exercise (MCE) group, the cervical vibration stimulation+MCE group, and the Sham NAGs+MCE group. The measures were the error value of the JPS by relocation test, Cervical Range of Motion, a rectangular area in the gravity sway test, and the neck lateral flexion angle during the neck rotation condition of the gravity sway test, which was measured before and after the intervention. Result: The results showed that the NAGs+MCE group had significantly lower JPS error values for both the right and left rotations. In comparison, the cervical vibration stimulation+MCE group had significantly lower values only for the right rotation. However, there were no significant differences among the groups in the items of the gravity sway test.Conclusion: This suggests that intervention with NAGs improves JPS but has no effect on gravity sway. 【目的】頚部痛では頚部関節位置覚（Joint Position Sense：以下，JPS）やバランス能力の低下が認められると報告され，徒手療法や運動療法の複合的治療が推奨される。本研究は運動療法と椎間関節自然滑走法（Natural Apophyseal Glides：以下，NAGs）の併用がJPSおよび重心動揺に与える影響を調査した。【方法】対象は健常成人男女29名とし，NAGs+モーターコントロールエクササイズ（Motor Control Exercise：以下，MCE）群，頚部振動刺激+MCE群，Sham NAGs+MCE群の3群へ無作為に分けた。介入前後でRelocation testによるJPSの誤差数値，頚部関節可動域，重心動揺検査の矩形面積，重心動揺検査頚部回旋条件中の頚部側屈角度を測定した。【結果】Relocation testでは介入前後による効果が認められ，NAGs+MCE群は左右回旋ともにJPSの誤差数値が有意に低下し，頚部振動刺激+MCE群は右回旋のみ有意に低下していた。【結論】NAGsによる介入はJPSを向上させる一助となる可能性が示唆された。 |
| Author | Sato, Yuto Kuruma, Hironobu Firdausy, Aufa Miftah Abduh, Hardianty Andi Munawarah |
| Author_FL | 来間 弘展 佐藤 優斗 |
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| Author_xml | – sequence: 1 fullname: Abduh, Hardianty Andi Munawarah organization: Department of Physical Therapy Science, Graduate School of Human Health Sciences, Tokyo Metropolitan University – sequence: 1 fullname: Kuruma, Hironobu organization: Department of Physical Therapy Science, Graduate School of Human Health Sciences, Tokyo Metropolitan University – sequence: 1 fullname: Firdausy, Aufa Miftah organization: Department of Physical Therapy Science, Graduate School of Human Health Sciences, Tokyo Metropolitan University – sequence: 1 fullname: Sato, Yuto organization: Department of Physical Therapy Science, Graduate School of Human Health Sciences, Tokyo Metropolitan University |
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| DocumentTitle_FL | 椎間関節自然滑走法（Natural Apophyseal Glides: NAGs）が頚部関節位置覚および重心動揺に与える影響 |
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| References | 11） Moss P, Sluka K, et al.: The initial effects of knee joint mobilization on osteoarthritic hyperalgesia. Man Ther. 2007; 12: 109–118. 25） Honaker JA, Converse CM, et al.: Modified head-shake computerized dynamic posturography. Am J Audiol. 2009; 18: 108–113. 19） Sterling M, Jull G, et al.: Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther. 2001; 6: 72–81. 5） Clark B, Briggs A, et al.: Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine. Spine. 2002; 27: 694–701. 6） 森園徹志：頸部振動刺激の身体平衡に及ぼす影響．日本耳鼻咽喉科学会会報．1991; 94: 938–948. 9） Wah S, Puntumetakul R, et al.: Effects of proprioceptive and craniocervical flexor training on static blance in university student smartphone users with balance impairment: A randomized controlled trial. J Pain Res. 2021; 14: 1935–1947. 15） Hussain SI, Ahmad A, et al.: Effectiveness of natural apophyseal glides versus grade I and II maitland mobilization in non specific neck pain. Ann King Edw Med Univ. 2016; 22: 23–29. 12） Bialosky JE, Bishop MD, et al.: The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Man Ther. 2009; 14: 531–538. 22） Meinhart-Shibata P, Kramer M, et al.: Kinematic analyses of the 180° standing turn: Effects of age on strategies adopted by healthy young and older women. Gait Posture. 2005; 22: 119–125. 24） 五島圭子：重心動揺検査の検討—検査条件について—．Equilibrium Research. 1988; 47: 174–186. 17） Zafar H, Alghadir AH, et al.: Effect of different head-neck-jaw postures on cervicocephalic kinesthetic sense. J Musculoskelet Neuronal Interact. 2017; 17: 341–346. 4） Treleaven J, Jull G, et al.: Dizziness and unsteadiness following whiplash injury: Characteristic features and relationship with cervical joint position error. J Rehabil Med. 2003; 35: 36–43. 10） Corp N, Mansell G, et al.: Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. Eur J Pain. 2020; 25: 275–295. 16） Alahmari KA, Reddy RS, et al.: Association of age on cervical joint position error. J Adv Res. 2017; 8: 201–207. 13） Mulligan BR: Manual therapy: Nags, snags, mwms, etc. sixth edition. New Zealand, Bateson publishing, 2019, pp. 2–4. 8） Poole E, Treleaven J, et al.: The influence of neck pain on balance and gait parameters in community-dwelling elders. Man Ther. 2008; 13: 317–324. 18） Ianuzzi A, Pickar JG, et al.: Relationship between joint motion and facet joint capsule strain during cat and human lumber spinal motions. J Manipulative Physiol Ther. 2011; 34: 420–431. 1） Fejer R, Kyvik KO, et al.: The prevalence of neck pain in the world population: A systematic critical review of the literature. Eur Spine J. 2006; 15: 834–848. 20） Vicenzino B, Collins D, et al.: The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain. 1996; 68: 69–74. 3） Jull G, Falla D, et al.: Retraining cervical joint position sense: The effect of two exercise regimes. J Orthop Res. 2007; 25: 404–412. 2） 厚生労働省：2019年国民生活基礎調査の概況．https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa19/dl/14.pdf（最終閲覧日：2023/1/1 7） Abdelkader N, Mahmoud A, et al.: Decreased neck proprioception and postural stability after induced cervical flexer muscles fatigue. Musculoskeletal and neuronal interactions. 2020; 20: 421–428. 23） 樋口貴広，建内宏重：姿勢と歩行—協調からひも解く—．三輪書店，東京，2015, pp. 258–287. 21） Gong W: Effects of cervical joint manipulation on joint position sense of normal adults. J Phys Ther Sci. 2013; 25: 721–723. 14） Buyukturan O, Buyukturan B, et al.: The effect of mulligan mobilization technique in older adults with neck pain: A randomized controlled, double-blind study. Pain Res Manag. 2018; 2018: 1–7. |
| References_xml | – reference: 16） Alahmari KA, Reddy RS, et al.: Association of age on cervical joint position error. J Adv Res. 2017; 8: 201–207. – reference: 15） Hussain SI, Ahmad A, et al.: Effectiveness of natural apophyseal glides versus grade I and II maitland mobilization in non specific neck pain. Ann King Edw Med Univ. 2016; 22: 23–29. – reference: 9） Wah S, Puntumetakul R, et al.: Effects of proprioceptive and craniocervical flexor training on static blance in university student smartphone users with balance impairment: A randomized controlled trial. J Pain Res. 2021; 14: 1935–1947. – reference: 7） Abdelkader N, Mahmoud A, et al.: Decreased neck proprioception and postural stability after induced cervical flexer muscles fatigue. Musculoskeletal and neuronal interactions. 2020; 20: 421–428. – reference: 11） Moss P, Sluka K, et al.: The initial effects of knee joint mobilization on osteoarthritic hyperalgesia. Man Ther. 2007; 12: 109–118. – reference: 22） Meinhart-Shibata P, Kramer M, et al.: Kinematic analyses of the 180° standing turn: Effects of age on strategies adopted by healthy young and older women. Gait Posture. 2005; 22: 119–125. – reference: 25） Honaker JA, Converse CM, et al.: Modified head-shake computerized dynamic posturography. Am J Audiol. 2009; 18: 108–113. – reference: 6） 森園徹志：頸部振動刺激の身体平衡に及ぼす影響．日本耳鼻咽喉科学会会報．1991; 94: 938–948. – reference: 13） Mulligan BR: Manual therapy: Nags, snags, mwms, etc. sixth edition. New Zealand, Bateson publishing, 2019, pp. 2–4. – reference: 17） Zafar H, Alghadir AH, et al.: Effect of different head-neck-jaw postures on cervicocephalic kinesthetic sense. J Musculoskelet Neuronal Interact. 2017; 17: 341–346. – reference: 3） Jull G, Falla D, et al.: Retraining cervical joint position sense: The effect of two exercise regimes. J Orthop Res. 2007; 25: 404–412. – reference: 4） Treleaven J, Jull G, et al.: Dizziness and unsteadiness following whiplash injury: Characteristic features and relationship with cervical joint position error. J Rehabil Med. 2003; 35: 36–43. – reference: 1） Fejer R, Kyvik KO, et al.: The prevalence of neck pain in the world population: A systematic critical review of the literature. Eur Spine J. 2006; 15: 834–848. – reference: 8） Poole E, Treleaven J, et al.: The influence of neck pain on balance and gait parameters in community-dwelling elders. Man Ther. 2008; 13: 317–324. – reference: 5） Clark B, Briggs A, et al.: Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine. Spine. 2002; 27: 694–701. – reference: 18） Ianuzzi A, Pickar JG, et al.: Relationship between joint motion and facet joint capsule strain during cat and human lumber spinal motions. J Manipulative Physiol Ther. 2011; 34: 420–431. – reference: 10） Corp N, Mansell G, et al.: Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. Eur J Pain. 2020; 25: 275–295. – reference: 12） Bialosky JE, Bishop MD, et al.: The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Man Ther. 2009; 14: 531–538. – reference: 23） 樋口貴広，建内宏重：姿勢と歩行—協調からひも解く—．三輪書店，東京，2015, pp. 258–287. – reference: 2） 厚生労働省：2019年国民生活基礎調査の概況．https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa19/dl/14.pdf（最終閲覧日：2023/1/1） – reference: 24） 五島圭子：重心動揺検査の検討—検査条件について—．Equilibrium Research. 1988; 47: 174–186. – reference: 14） Buyukturan O, Buyukturan B, et al.: The effect of mulligan mobilization technique in older adults with neck pain: A randomized controlled, double-blind study. Pain Res Manag. 2018; 2018: 1–7. – reference: 20） Vicenzino B, Collins D, et al.: The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain. 1996; 68: 69–74. – reference: 21） Gong W: Effects of cervical joint manipulation on joint position sense of normal adults. J Phys Ther Sci. 2013; 25: 721–723. – reference: 19） Sterling M, Jull G, et al.: Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther. 2001; 6: 72–81. |
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| Snippet | Objective: Neck pain is reported to be associated with decreased cervical Joint Position Sense (JPS) and balance impairment. This study aimed to investigate... |
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| SubjectTerms | Center of gravity sway Cervical joint position sense Natural apophyseal glides (NAGs) Natural apophyseal glides（NAGs） Relocation test Vibration stimulation 振動刺激 重心動揺 頚部関節位置覚 |
| Title | Effect of Natural Apophyseal Glides (NAGs) on Cervical Joint Position Sense and Gravity Sway |
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