Eye-Cervical Re-education Versus Motor Imagery Therapy on Proprioception in Chronic Mechanical Neck Pain

Eye-Cervical Re-education Versus Motor Imagery Therapy on Pain, Function, and Proprioception in Chronic Mechanical Neck Pain: A Randomized Controlled Trial

this study will be conducted to investigate the effect of eye-cervical re-education versus motor imagery therapy on pain intensity level, pain pressure threshold, neck disability, cervical proprioception, and scapular protraction in patients with chronic mechanical neck pain.

Chronic neck pain is a common problem in modern and industrialized countries and among employed individuals. Pain is classified as chronic neck pain persists for more than 3 month, it may be felt all the time or worsen with certain activities. The cervical spine has an important role in providing the proprioceptive input and this is reflected in the abundance of cervical mechanoreceptors and their central and reflex connections to the vestibular, visual, and central nervous systems. Eye-cervical re-education program (ECRP) refer to a therapeutic procedure for correcting posture cephalic level in patients with cervical pain by improving eye-neck proprioception that reduced symptoms experienced by patients and improvement of the quality of cervical afferent input into the central nervous system. Motor imagery is the mental realization of motion without any motion occurs. It has two categories: kinesthetics and visual imagery. Kinaesthetic imagery is the situation of feeling a motion. Visual imagery has two types: internal visual and external visual. In the internal visual imagery, the motion is visualized within the body by seeing feet and arms. The external visual imagery is that one sees himself/herself from outside. one hundred and twenty patients will be allocated randomly into three groups; group A will receive eye cervical re-education and conventional therapy, group B will receive motor imagery therapy and conventional therapy and group C will receive conventional therapy only three times a week for four weeks.

Inclusion Criteria:

1. Age will range from 18 to 70 years
2. Patients of both sexes.
3. Neck pain diagnosed by physician greater than 3 months in duration.
4. Active or latent myofascial trigger points (MTrPs) in at least one of the following muscles: upper trapezius, levator scapulae, or splenius capitis. Both active and latent MTrPs were considered because latent MTrPs have been associated with the development of sensory motor dysfunction and may contribute to different chronic musculoskeletal pain disorders

Exclusion Criteria:

1. Dizziness syndrome.
2. Post-traumatic as whiplash
3. Neurological, infectious, or tumor cervical pain.
4. Pregnant women.
5. Patients having speech and understanding problems.
6. Past history of neck surgery
7. Dizziness syndrome.
8. Post-traumatic as whiplash.
9. Neurological, infectious, or tumor cervical pain.
10. Pregnant women.
11. Patients having speech and understanding problems.
12. Past history of neck surgery .