title: Subclinical neck pain and the effects of cervical manipulation on elbow joint position sense.
abstract: OBJECTIVE
  The objectives of this study were to investigate whether elbow joint position sense (JPS) accuracy differs between participants with a history of subclinical neck pain (SCNP) and those with no neck complaints and to determine whether adjusting dysfunctional cervical segments in the SCNP group improves their JPS accuracy.
  
  
  METHODS
  Twenty-five SCNP participants and 18 control participants took part in this pre-post experimental study. Elbow JPS was measured using an electrogoniometer (MLTS700, ADInstruments, New Zealand). Participants reproduced a previously presented angle of the elbow joint with their neck in 4 positions: neutral, flexion, rotation, and combined flexion/rotation. The experimental intervention was high-velocity, low-amplitude cervical adjustments, and the control intervention was a 5-minute rest period. Group JPS data were compared, and it was assessed pre and post interventions using 3 parameters: absolute, constant, and variable errors.
  
  
  RESULTS
  At baseline, the control group was significantly better at reproducing the elbow target angle. The SCNP group's absolute error significantly improved after the cervical adjustments when the participants' heads were in the neutral and left-rotation positions. They displayed a significant overall decrease in variable error after the cervical adjustments. The control group participants' JPS accuracy was worse after the control intervention, with a significant overall effect in absolute and variable errors. No other significant effects were detected.
  
  
  CONCLUSIONS
  These results suggest that asymptomatic people with a history of SCNP have reduced elbow JPS accuracy compared to those with no history of any neck complaints. Furthermore, the results suggest that adjusting dysfunctional cervical segments in people with SCNP can improve their upper limb JPS accuracy.
authors.affiliation: New Zealand College of Chiropractic, Auckland, New Zealand. heidi.haavik@nzchiro.co.nz
authors.forename: Heidi
authors.initials: H
authors.lastname: Haavik
authors.forename: Bernadette
authors.initials: B
authors.lastname: Murphy
mesh_terms: D000328:Adult; D004551:Elbow Joint / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal; D019547:Neck Pain / Q000503:physiopathology* / Q000628:therapy*; D011434:Proprioception; D055815:Young Adult