Electrocortical activity, cervical position sense and pain in subjects with mechanical neck pain treated with the Mulligan concept

Abstract

Introduction: Mechanical neck pain can be defined as widespread pain in the cervical region, of multifactorial etiology, which can promote functional changes, such as modifications of proprioceptive and sensorimotor deficits triggered by pain. In the context of rehabilitation, aspects such as cervical position sense (CPS) and quantitative electroencephalography (qEEG) are capable of evaluating motor and somatosensory processes related to musculoskeletal pain. The Mulligan Concept has been highlighted by clinicians and researchers as tools for combating pain and improving functionality. Objective: To verify possible changes in pain perception, in the electrocortical activity of the central and parietal lobes; and in the cervical position sense in individuals with mechanical neck pain, submitted to the SNAGS technique. Methods: This investigation is characterized as a Pre and Post-intervention Experimental Study, with the sample composed of 16 individuals with mechanical neck pain allocated to a single group. The SNAGS technique of the Mulligan Concept was used as a form of treatment. The SPC was the pattern analyzed pre and post-procedure; as well as the EEGq was used as a tool to analyze the electrocortical pattern pre and immediate post-procedure, 5 and 10 minutes after the maneuver. The Visual Analog Scale of pain (EVA) was also used to measure the level of pain in the research individuals. Results: The sample consisted of 16 patients with mechanical neck pain (N = 16), Men = 4 and Women = 12, with a mean age = 30.3 years. The mean reduction in the percentage of pain was 57.1%. Regarding the SPC, the results indicated that there were no changes in the pre and post-intervention conditions, the Relative Error (RE) measured in degrees, at the Pre-intervention moment for the right side was 3.8º; and for the left side it was 3.5º. And at the Post-intervention moment for the right side it was 3.4º; and 3.3º for the left side. The electroencephalic activity showed a main effect between the conditions (pre, post, 5 and 10min) in the electrodes of Cz [F3.448 (p=0.02)]; P3 [F23.370 (p,0.01)]; Pz [F48.481 (p,0.01)]; P4 [F23.622 (p<0.01)]. Conclusion: Our findings respond positively when relating the use of the mulligan SNAGS technique with pain reduction. Regarding the proprioceptive control of the cervical, no significant changes were observed in the SPC analysis. The electrical activity showed inhibition of the somatosensory area with consequent activation of the motor area, when the absolute power of the alpha band was analyzed. This leads us to suggest that sensorimotor integration is fundamental for the success of motor control and somatosensory modulation, demonstrating to have strong effects on the execution of motor tasks.