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Background: Cervical proprioception, referring to the awareness of the head's position in space, plays a crucial role in maintaining postural control and preventing musculoskeletal injuries. While previous research has established the importance of cervical proprioception in motor function, its specific impact on body awareness and pain-related aspects remains less explored, particularly in healthy young individuals.
Aim: This prospective cross-sectional study aims to investigate the impact of cervical proprioceptive error on body awareness, pressure pain threshold, pressure pain tolerance, conditioned pain modulation, and temporal summation in healthy young individuals.
Methods: In asymptomatic participants, cervical proprioception will be assessed using the 'head position error test' in both right and left rotation directions with the CROM device. Participants will be then divided into two groups based on the presence of proprioceptive deviation (>5°). Body awareness will beassessed using the 'Body Awareness Questionnaire,' while pressure pain threshold, pain tolerance, and temporal summation will be measured bilaterally with an algometer device (2 cm lateral to the C2 and C7 spinal processes, midpoint of the upper part of the trapezius, and over the temporomandibular joint) in both groups. Subsequently, the two groups will be compared using independent samples t-tests.
Cervical proprioception, which refers to the awareness of the head's position in space, is a fundamental component of postural control and the prevention of musculoskeletal injuries. This sense is mediated by sensory receptors located in the muscles, joints, and skin of the cervical spine, providing critical feedback for maintaining balance and coordinating movements. Previous studies have extensively documented the role of cervical proprioception in motor function, highlighting its importance in activities that require precise head and neck movements.
Despite these findings, there is a gap in the literature regarding the specific impact of cervical proprioception on body awareness and pain-related parameters in healthy individuals. Body awareness, or the conscious perception of body position and movement, is essential for efficient motor control and overall well-being. Additionally, understanding how proprioceptive errors in the cervical region might influence pain perception could provide insights into mechanisms underlying chronic pain conditions.
The primary aim of this prospective cross-sectional study is to investigate the impact of cervical proprioceptive error on body awareness, pressure pain threshold, pressure pain tolerance, conditioned pain modulation, and temporal summation in asymptomatic young individuals.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Proprioceptive deficit positive group | This group consists of young participants who exhibit a proprioceptive error in their cervical proprioception test. Proprioceptive error refers to an inaccurate perception of the head's position in space. In this study, participants with a deviation greater than 5 degrees during the test will be classified into this group. |
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| Proprioceptive deficit negative goup | This group includes young participants who do not show any proprioceptive error in the cervical proprioception test. These participants accurately perceive the position of their head and thus do not have a proprioceptive deficit (less than 5 degrees) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Assessment of cervical proprioception | Other | Cervical proprioception will be assessed using the 'head position error test' in both right and left rotation directions with the CROM device. Participants will be then divided into two groups based on the presence of proprioceptive errors (>5°). |
| Measure | Description | Time Frame |
|---|---|---|
| Quantitative sensory testing | Quantitative sensory testing including pain threshold, tolerance, conditioned pain modulation, and temporal summation will be assessed by pressure algometer. The "pain threshold" is the point at which a person first feels pain, the "pain tolerance" is the last point that a person can tolerate, and the "temporal summation" is the first painful threshold evaluated after 10 repeats of the pain threshold. Conditioned pain modulation is the modulation of pain perception under varying conditions. In the current study, a cold stimulus will be used. | Immediately after the intervention |
| Assessment of body awareness | Body awareness will be assessed through a questionnaire, consisting of 18 items, divided into 4 subgroups aimed at determining the sensitivity level of normal or abnormal body composition (1. Changes during the body process, 2. Sleep-wake cycle, 3. Estimation of disease onset, 4. Prediction of bodily reactions). Participants are asked to rate each item on a scale of 1 to 7. The overall score is calculated, and a higher score indicates better body awareness. The validity and reliability of the questionnaire are reported to be high. | Immediately after the intervention |
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Inclusion Criteria:
* Being between 18-25 years old
Exclusion Criteria:
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The study involves healthy young participants aged between 18 and 25 years. The participants will be divided into two groups based on the presence of cervical proprioceptive deviation (greater than 5°) as measured by the 'head position error test' using a CROM device.
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| Name | Affiliation | Role |
|---|---|---|
| Nagihan Acet | Atılım University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atılım University | Ankara | Ankara | 06560 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 2009044 | Background | Revel M, Andre-Deshays C, Minguet M. Cervicocephalic kinesthetic sensibility in patients with cervical pain. Arch Phys Med Rehabil. 1991 Apr;72(5):288-91. | |
| 11799407 | Background | Kulkarni V, Chandy MJ, Babu KS. Quantitative study of muscle spindles in suboccipital muscles of human foetuses. Neurol India. 2001 Dec;49(4):355-9. |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| 33464539 | Background | Peng B, Yang L, Li Y, Liu T, Liu Y. Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain Ther. 2021 Jun;10(1):143-164. doi: 10.1007/s40122-020-00230-z. Epub 2021 Jan 12. |
| 19440300 | Background | Mehling WE, Gopisetty V, Daubenmier J, Price CJ, Hecht FM, Stewart A. Body awareness: construct and self-report measures. PLoS One. 2009;4(5):e5614. doi: 10.1371/journal.pone.0005614. Epub 2009 May 19. |
| 25931733 | Background | Yang J, Lee B, Kim C. Changes in proprioception and pain in patients with neck pain after upper thoracic manipulation. J Phys Ther Sci. 2015 Mar;27(3):795-8. doi: 10.1589/jpts.27.795. Epub 2015 Mar 31. |
| 23640315 | Background | Law EY, Chiu TT. Measurement of cervical range of motion (CROM) by electronic CROM goniometer: a test of reliability and validity. J Back Musculoskelet Rehabil. 2013;26(2):141-8. doi: 10.3233/BMR-2012-00358. |
| 21885906 | Background | Walton DM, Macdermid JC, Nielson W, Teasell RW, Chiasson M, Brown L. Reliability, standard error, and minimum detectable change of clinical pressure pain threshold testing in people with and without acute neck pain. J Orthop Sports Phys Ther. 2011 Sep;41(9):644-50. doi: 10.2519/jospt.2011.3666. Epub 2011 Sep 1. |
| Background | Karaca, S. (2017). Vücut Farkındalığı Anketinin Türkçe uyarlaması: Geçerlik ve güvenirlik çalışması (Yayınlanmamış yüksek lisans tezi). Muğla Sıtkı Koçman Üniversitesi Sağlık Bilimleri Enstitüsü, Muğla. |
| 31162824 | Background | Heisler AC, Song J, Dunlop DD, Wohlfahrt A, Bingham CO III, Bolster MB, Clauw DJ, Marder W, Phillips K, Neogi T, Lee YC. Association of Pain Centralization and Patient-Reported Pain in Active Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2020 Aug;72(8):1122-1129. doi: 10.1002/acr.23994. Epub 2020 Jul 21. |
| 40257972 | Derived | Acet N, Begen S. The proprioceptive puzzle: An observational study investigating the effects of cervical proprioceptive errors on quantitative sensory testing and body awareness in young individuals. PLoS One. 2025 Apr 21;20(4):e0321645. doi: 10.1371/journal.pone.0321645. eCollection 2025. |