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Pembimbing :dr. Untung Goenarto ,Sp.S
Oleh :Ryan Aprilian Putri G4A013011
BAGIAN SMF ILMU PENYAKIT SARAFRSUD. PROF. DR. MARGONO SOEKARJOFAKULTAS KEDOKTERAN DAN ILMU-ILMU KESEHATANUNIVERSITAS JENDERAL SOEDIRMAN2014
TEXT BOOK REVIEW
Chronic Neck Pain and Vertigo: Is a True Balance Disorder Present?
BACKGROUND
The mechanisms that control posture are extremely complex and involve a wide variety of structures: peripheral afferents (i.e. proprioceptive, exteroceptive, labyrinthine and visual afferents), the central nervous system (the CNS notably the brain stem, cerebellum, basal ganglia and the hemispheres) and the effector musclesAlterations in one of these components can generate balance disorders. Degradation of cervical proprioception is often related to chronic neck pain, which is a frequent reason for consultation in rheumatology and physical medicine.Several studies have shown that deterioration of the cervical spines proprioceptive capacities results in perturbed postural stability control in chronic neck pain patients . The use of specific rehabilitation programmes to re-establish cervical proprioception improves balance in these patients (Yahia et al, 2009) .With the objective of explaining the occurrence of vertigoand postural instability in chronic neck pain, we evaluatedbalance on a force platform in chronic neck pain patients (withor without vertigo) and control subjects. We hypothesized thatthe presence of balance disorders in chronic neck pain patientscaused their episodes of vertigo and postural instability.
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OVERVIEWNECK PAIN (Roques, 2011).
VERTIGO (Makofsky, 2010) .
BALANCE SYSTEM
Balance results from a multimodal mechanism involving :
proprioceptive receptorssendinformation to the CNS.
VISUALVESTIBULARThis information is integrated by CNS structures whose efferent pathways then modulate muscle tone and trigger the postural adaptations required for the maintenance of posture or coherent movement. The latter factors must be under control at all times, in order to correct for and adjust to a new situation. If the various components of the sensory information are discordant, the subject experiences a sensation of imbalance.
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The mechanisms that control posture are extremely complex and involve a wide variety of structures.Neck pain is a common condition that creates discomfort in any of the structures in the neckVertigo is defined an illusion of movement, the most common is a feeling or sensation of a rotation body to the environment or otherwise, feeling the environment around us felt spinningMany Studies told that the presence of balance disorders in chronic neck pain patients caused their episodes of vertigo and postural instability.
CONCLUSION10American Chronic Pain Ascociation. 2010. Neuropathic Pain. Available on: http://www.theacpa.org/conditionDetail.aspx?id=29.Bablis, Peter. Pollard, Henry. Bonello, Rod Bonello. 2008. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial. Chiropractic & Osteopathy. California USA: , 16:4 doi:10.1186/1746-1340-16-4Cooper Grant. 2006. Essential Physical Medicine and Rehabilitation. Humana Press Inc; New Jersey. hal 249.Guez M, Hildingsson C, Nilsson M, Toolanen.2002.. The Prevalence of Neck pain: a Population-Based Study Northern Sweden, Departement of Orthopaedics University Hospital, Umea, Sweden.Guyton A C, Hall J E. 2008. textbook of medical physiology, 11 th edition. Singapore: Elsevier Pte Ltd and EGC Medical PublisherJoesoef AA. 2002. Tinjauan umum mengenai vertigo. Dalam: Joesoef AA, Kusumastuti K.(eds.). Neurootologi klinis:Vertigo. Kelompok Studi Vertigo Perdossi. hal.xiii-xxviii. Lumbantobing SM. 2008. Neurologi Klinik. Pemeriksaan Fisik dan Mental. FKUI. Hal 50 73.Makofsky HW, 2010. Spinal Manual Therapy, An Introduction to Soft Tissue Mobilization, Spinal Manipulation, Therapeutic and Home Exercises Second Edition; Slack Incorporated; Thorofare, USA; hal 9-10.
ReferencesMcKenzie R, Kubey C,. 2000. 7 Steps to a Pain-Free Life, How to Rapidly relieve back and Neck Pain using the McKenzie Method; Dutton; New York; 2000; hal 139-145.McKenzie R, May S. 2006. The Cervical and Thoracic Spine Mechanical Diagnosis and Therapy Volume One; Spinal Publications; Raumati Beach; ; hal 75Rix GD, Bagust J. Cervicocephalic kinesthesic sensibility in patients with chronic, non traumatic cervical spine pain. Arch Phys Med Rehabilitation 2001;82:9119.Roques CF, Lafont, Sahrmann S. 2011 Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines; Elsevier Mosby; USA; hal 1.Rowbotham, M. C., Petersen, K.L., Davies, P.S., Friedman, E.K., & Fields, H.L.,2000. Recent Development in The Treatment of Neuropathic Pain. In: Devor, M., Rowbotham, M.C., & Wiesenfeld-Hallin, Z. (ed). Proceeding of the 9th World on Pain. Seattle: IASP PressSherwood L. 2010. Human Physiology: The Peripheral Nervous System. 7th ed. Canada: Brooks/ColeTortora GJ, Derrickson BH. 2009. Principles of Anatomy and Physiology: Sensory, Motor and Integrative System. 12th ed. Asia: WilleyWaldman, Steven D. 2001. Pain Management 2nd edition. Amerika: ElsevierWreksoatmodjo. 2004. BR. Vertigo : Aspek Neurologi. Tinjauan Kepustakaan. Cermin Dunia Kedokteran No.144.. Hal 41 46.Woolf, C. J., 2004: Pain: Moving from Symptom Control toward Mechanism-Specific Pharmacologic Management, Ann Intern Med; 140:441-451Yahia, A. Ghroub, S. Jribi , J. Malla , S. Baklouti , A. Ghorbel , M.H. Elleuch . 2009: Chronic neck pain and vertigo: Is a True Balance Disorder Present?. Annals of Physical and Rehabilitation Medicine 52: 556567
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