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The primary aim of the study was to examine the difference between mental fatigue, in-body, out-of-body and mindfulness parameters in people with chronic neck pain compared to a healthy control group, and to analyze the relationships between mental fatigue and neck disability level and awareness levels, and between awareness levels and neck disability level and quality of life.
The secondary aim was to examine the relationships between pain intensity, frequency, duration, pain self-efficacy, physical condition, anxiety and depression, mental fatigue and awareness levels in people with chronic neck pain.
Neck pain is a prevalent musculoskeletal issue that can cause significant disability. Individuals with neck pain may experience changes in muscle structure and behavior, as well as sensory-perceptual-motor issues such as decreased proprioception and related neuromuscular changes. Additionally, neck pain can lead to psychological problems such as anxiety and depression.Although some awareness parameters have been evaluated in studies on neck pain in the literature and it has been shown that chronic pain is associated with impaired body awareness and that this impairment contributes to and/or maintains chronic pain, no study has been found to examine all awareness parameters in detail. Another cause that compromises the accuracy of information contributing to body awareness is mental fatigue. Mental fatigue can negatively affect a person's level of perception. In one study, it was stated that mental fatigue was a determinant of neck disability, but studies on this subject were found to be very insufficient. Therefore, the aim of this study was to examine the sub-parameters of awareness and mental fatigue in people with chronic neck pain, to compare them with healthy people and to examine the relationship between the parameters evaluated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Individuals experiencing neck pain | Study Group Inclusion Criteria:
Study Group Exclusion Criteria:
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| Healthy individuals without neck pain | Control Group Inclusion Criteria:
Control Group Exclusion Criteria:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mental Fatigue: | Other | The Mental Fatigue Scale (MFS) will be used to assess mental fatigue. |
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| Measure | Description | Time Frame |
|---|---|---|
| Mental Fatigue | The Mental Fatigue Scale (MFS) will be used to assess mental fatigue. It includes questions about general fatigue, lack of initiative, mental fatigue, concentration difficulties, memory problems, slowness of thinking, sensitivity to stress, increased tendency to be emotional, irritability, sensitivity to light and noise, decreased or increased sleep. It has a 7-point Likert-type scale and is scored from 0 to 3. A rating of 0 indicates normal functioning, 1 indicates mild problem, 2 indicates significant problem and 3 indicates maximum problem. According to the total score, 0-10= no mental fatigue problem, 10.5-14.5= mild mental fatigue, 15-20= quite serious mental fatigue, ≥ 20.5= serious mental fatigue. | 2024 may- 2024 July |
| General Body Awareness | General body awareness of individuals will be assessed with the Body Awareness Questionnaire (BAQ). | 2024 may- 2024 July |
| Neck Disability | Neck disability index will be used to assess this parameter. The questionnaire contains 10 questions related to different activities. Each question is scored between 0 and 5. The level of disability is determined according to the total score obtained from the questionnaire. 0-4 = no disability, 5-14 = mild disability, 15-24 = moderate disability, 25- 34 = severe disability, 35 and above = total disability. | 2024 may- 2024 July |
| General health questionnaire | The SF-12, which is more practical and shorter than the SF-36 but contains the same sub-dimensions as the SF-36, will be used to assess quality of life. SF-12 consists of 8 sub-dimensions and 12 items including physical functioning (2 items), physical role, body pain, general health, energy, social functioning, emotional role and mental health. The questionnaire scoring is calculated under the headings of physical and mental health, which are the two main components of general health. | 2024 may - 2024 July |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Assessment | Pain intensity will be assessed by Visual Analog Scale (VAS).0: I have no pain 10: I have unbearable pain In addition, pain duration and pain frequency will be questioned. | 2024 may- 2024 July |
| Pain self efficacy |
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Study Group Inclusion Criteria:
Study Group Exclusion Criteria:
Control Group Inclusion Criteria:
Control Group Exclusion Criteria:
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individuals with neck pain and healthy individuals without neck pain
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hacettepe University | Ankara | Sıhhiye | 06100 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29304254 | Background | Amiri Arimi S, Ghamkhar L, Kahlaee AH. The Relevance of Proprioception to Chronic Neck Pain: A Correlational Analysis of Flexor Muscle Size and Endurance, Clinical Neck Pain Characteristics, and Proprioception. Pain Med. 2018 Oct 1;19(10):2077-2088. doi: 10.1093/pm/pnx331. | |
| 36897182 | Background | Dere T, Alemdaroglu-Gurbuz I. Muscular endurance and its association with neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain. Somatosens Mot Res. 2024 Sep;41(3):134-141. doi: 10.1080/08990220.2023.2186390. Epub 2023 Mar 10. |
| Label | URL |
|---|---|
| The Relevance of Proprioception to Chronic Neck Pain: A Correlational Analysis of Flexor Muscle Size and Endurance, Clinical Neck Pain Characteristics, and Proprioception | View source |
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| ID | Term |
|---|---|
| D019547 | Neck Pain |
| D005222 | Mental Fatigue |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D011788 | Quality of Life |
| D000073222 | Patient Health Questionnaire |
| ID | Term |
|---|---|
| D006304 | Health Status |
| D003710 | Demography |
| D015991 | Epidemiologic Measurements |
| D011634 | Public Health |
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| Body Awareness: | Other | Individuals' general body awareness will be assessed with the Body Awareness Questionnaire (BAQ). Neck awareness of individuals will be assessed with the Fremantle Neck Awareness Questionnaire (FreBFA). Short Form of the Five Facet Mindfulness Questionnaire (FFMQ - Short Form) will be used to assess people's mindfulness. - In-body awareness: For the sense of interoception, the Multidimensional Assessment of Interoceptive Awareness Scale, which assesses interoceptive body awareness, will be used. To evaluate proprioception, a Cervical Range of Motion (CROM) device is used. The bucket test will be used to assess subjective visual verticality, which is one of the sub-dimensions of verticality perception. Two scales will be used to assess people's awareness of weight transfer symmetry. - Out of Body Awareness: "Right-Left Confusion Hand Test" will be used to evaluate the mental rotation skill within the scope of the sense of extroception. |
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| Neck Disability Level | Other | Neck disability index will be used to assess this parameter. |
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| Quality Of Life | Other | SF-12 will be used to assess quality of life. |
|
| Pain Assessment: | Other | Pain intensity will be assessed by Visual Analog Scale (VAS). In addition, pain duration and pain frequency will be questioned. The Pain Self-Efficacy Questionnaire will be used to assess the confidence of people with chronic pain to perform certain tasks and behaviors despite their pain. |
|
| Physical Condition: | Other | Normal range of motion of the cervical region will be evaluated with the "Cervical Range of Motion" device. New York Posture Rating Scale will be used to evaluate posture. Symmetry of weight transfer to both lower extremities of the individuals in standing upright position will be evaluated. |
|
| Anxiety and Depression: | Other | Beck Depression and Beck Anxiety scales will be used to assess depression and anxiety. |
|
| weight transfer awareness |
Two scales were used to assess weight transfer awareness. Results will be recorded in kg. |
| 2024 may- 2024 July |
| neck awareness | Individuals' neck awareness will be assessed with the Fremantle Neck Awareness Questionnaire (FreBFA). | 2024 may- 2024 July |
| mindfulness | Short Form of the Five Facet Mindfulness Questionnaire (FFMQ - Short Form) will be used to assess people's mindfulness | 2024 may- 2024 July |
| interoception | For the sense of interoception, the Multidimensional Assessment of Interoceptive Awareness Scale, which assesses interoceptive body awareness, will be used. | 2024 may- 2024 July |
| proprioception | The Cervical Range of Motion (CROM) device is used to assess proprioception. The device assesses proprioception in 6 different directions of the neck. | 2024 may- 2024 July |
| verticality | The bucket test will be used to assess subjective visual verticality, which is one of the sub-dimensions of verticality perception. | 2024 may- 2024 July |
| extroception | The sense of extroception will be evaluated with the right-left hand confusion test. | 2024 may- 2024 July |
The Pain Self-Efficacy Questionnaire will be used to assess the confidence of people with chronic pain to perform certain tasks and behaviors despite their pain. Each item is rated on a 7-point Likert-type scale (0=not at all confident, 6=fully confident). The total score ranges from 0 to 60, with higher scores indicating greater self-efficacy for functioning despite pain.
| 2024 may- 2024 July |
| Anxiety and Depression | Beck Depression and Beck Anxiety scales will be used to assess depression and anxiety. Both questionnaires have 21 questions and are scored between 0-3. According to the total scores, 0-9 points in the Beck Depression Scale indicates normal level, 10-16 points indicates mild depression, 17-29 points indicates moderate depression and 30-63 points indicates severe depression. On the Beck Anxiety Scale, 0-17 points are classified as low anxiety, 18-24 points as moderate anxiety, and 25 and above points as high anxiety. | 2024 may- 2024 July |
| Range of motion | Normal range of motion of the cervical region will be evaluated with the "Cervical Range of Motion" device. Active ranges of motion in flexion-extension, lateral flexion and rotation directions will be recorded with the subjec | 2024 may- 2024 July |
| Posture Assesment | New York Posture Rating Scale will be used to evaluate posture. Posture changes that may occur in 13 different parts of the body including head, neck, shoulders, shoulders, back, waist, hip and ankle are observed. According to the results of the observation, five (5) points are given if the person has proper posture, three (3) points if the posture is moderately impaired, and one (1) point if there is a serious impairment. A high score means that the posture is good. | 2024 may- 2024 July |
| Weight transfer | Symmetry of weight transfer to both lower extremities of the individuals in a standing upright position will be evaluated. It will be recorded in kg. | 2024 may- 2024 July |
| Muscular endurance and its association with neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain | View source |
| D005221 | Fatigue |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D004778 |
| Environment and Public Health |
| D011795 | Surveys and Questionnaires |
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D011581 | Psychological Tests |
| D004191 | Behavioral Disciplines and Activities |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |