title: Evidence of Impaired Proprioception in Chronic, Idiopathic Neck Pain: Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Despite common use of proprioceptive retraining interventions in people with chronic, idiopathic neck pain, evidence that proprioceptive dysfunction exists in this population is lacking. Determining whether proprioceptive dysfunction exists in people with chronic neck pain has clear implications for treatment prescription.
  
  
  OBJECTIVE
  The aim of this study was to synthesize and critically appraise all evidence evaluating proprioceptive dysfunction in people with chronic, idiopathic neck pain by completing a systematic review and meta-analysis.
  
  
  METHODS
  MEDLINE, CINAHL, PubMed, Allied and Complementary Medicine, EMBASE, Academic Search Premier, Scopus, Physiotherapy Evidence Database (PEDro), and Cochrane Collaboration databases were searched.
  
  
  METHODS
  All published studies that compared neck proprioception (joint position sense) between a chronic, idiopathic neck pain sample and asymptomatic controls were included.
  
  
  METHODS
  Two independent reviewers extracted relevant population and proprioception data and assessed methodological quality using a modified Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
  
  
  RESULTS
  Thirteen studies were included in the present review. Meta-analysis on 10 studies demonstrated that people with chronic neck pain perform significantly worse on head-to-neutral repositioning tests, with a moderate standardized mean difference of 0.44 (95% confidence interval=0.25, 0.63). Two studies evaluated head repositioning using trunk movement (no active head movement thus hypothesized to remove vestibular input) and showed conflicting results. Three studies evaluated complex or postural repositioning tests; postural repositioning was no different between groups, and complex movement tests were impaired only in participants with chronic neck pain if error was continuously evaluated throughout the movement.
  
  
  CONCLUSIONS
  A paucity of studies evaluating complex or postural repositioning tests does not permit any solid conclusions about them.
  
  
  CONCLUSIONS
  People with chronic, idiopathic neck pain are worse than asymptomatic controls at head-to-neutral repositioning tests.
authors.affiliation: T.R. Stanton, BScPT, MScRS, PhD, The Sansom Institute for Health Research, The University of South Australia, School of Health Sciences, GPO Box 2471, Adelaide, South Australia 5001; PainAdelaide Consortium, Adelaide, South Australia, Australia; and Neuroscience Research Australia, Randwick, New South Wales, Australia. Tasha.stanton@unisa.edu.au.
authors.forename: Tasha R
authors.initials: TR
authors.lastname: Stanton
authors.affiliation: H.B. Leake, BAppSc(Phty)(Hons), The Sansom Institute for Health Research, The University of South Australia, and PainAdelaide Consortium.
authors.forename: Hayley B
authors.initials: HB
authors.lastname: Leake
authors.affiliation: K.J. Chalmers, BAppSc(Phty)(Hons), The Sansom Institute for Health Research, The University of South Australia, and PainAdelaide Consortium.
authors.forename: K Jane
authors.initials: KJ
authors.lastname: Chalmers
authors.affiliation: G.L. Moseley, BAppSc(Phty)(Hons), PhD, FACP, The Sansom Institute for Health Research, The University of South Australia; PainAdelaide Consortium; and Neuroscience Research Australia.
authors.forename: G Lorimer
authors.initials: GL
authors.lastname: Moseley
mesh_terms: D059350:Chronic Pain / Q000150:complications / Q000503:physiopathology*; D006257:Head; D006801:Humans; D019547:Neck Pain / Q000150:complications / Q000503:physiopathology*; D011187:Posture; D011434:Proprioception; D020886:Somatosensory Disorders / Q000209:etiology* / Q000503:physiopathology