From the Guidelines
Treating cervical sensorimotor control disorders requires a comprehensive and personalized rehabilitation approach, focusing on restoring proper movement patterns, reducing pain, and improving quality of life, as emphasized in recent guidelines 1. When managing cervical sensorimotor control disorders, it's crucial to prioritize a multimodal treatment plan that addresses the complex interplay of factors contributing to the condition.
- Begin with targeted exercises that improve proprioception and motor control, such as gentle cervical retraining exercises where you practice controlled head movements with feedback (using a laser pointer attached to the head or mirrors), as these can help retrain the neuromotor pathways that control neck movement 1.
- Incorporate specific neck stabilization exercises targeting the deep cervical flexors and extensors, performing 2-3 sets of 10-12 repetitions with 10-second holds, to restore the balance between deep and superficial neck muscles.
- Manual therapy techniques, including gentle mobilization and soft tissue work, can complement these exercises by reducing muscle guarding and improving range of motion.
- For pain management, non-steroidal anti-inflammatory medications like ibuprofen (400-600mg three times daily with food) may be used short-term, while heat or cold therapy can provide additional relief, as suggested by guidelines for managing cervical radiculopathy 1.
- Postural education is essential, emphasizing the importance of maintaining proper ergonomics during daily activities and taking frequent breaks from sustained positions to reduce the risk of exacerbating the condition.
- A personalized approach, considering the individual's preferences, goals, and cultural background, is vital for effective management, as highlighted in the Canadian Stroke Best Practice Recommendations 1. By adopting a comprehensive and personalized rehabilitation plan, individuals with cervical sensorimotor control disorders can experience significant improvements in their quality of life, reduction in pain, and enhanced functional abilities.
From the Research
Treatment Options for Cervical Sensorimotor Control Disorders
- Multiple clinical evaluations and treatments aiming at restoring the sensorimotor control system and neural plasticity have been proposed 2
- Conventional musculoskeletal intervention approaches may be sufficient only for patients with neck pain and minimal sensorimotor proprioceptive disturbances, while significant sensorimotor cervical proprioceptive disturbances might require more specific and novel treatment methods 3
- Adding rehabilitation of cervical related sensorimotor control to manual therapy and exercise for neck pain can be effective, with the addition of a combined program of joint position sense (JPS)/oculomotor exercises and balance exercises to local neck treatment resulting in improved outcomes 4
Specific Treatment Approaches
- Joint position sense (JPS) and oculomotor exercises can improve cervical proprioception and balance 4
- Balance exercises can also improve balance in neck neutral 4
- Sensorimotor training can be added to manual therapy and exercise to address deficits in cervical proprioception and balance 4
- Treatment approaches that address both psychological and physical components may be necessary for patients with high catastrophizing tendencies 5
Importance of Assessment and Diagnosis
- Determining the precise role of the cervical spine in dizziness requires a skilled interview and examination for cervical musculoskeletal and related sensorimotor impairments and relevant testing of other potential causes 6
- A combination and cluster of test outcomes, as well as comparing responses to specific tests when the cervical afferents are stimulated and not stimulated, can be important in diagnosis 6