Parâmetros de propriocepção cervical e marcha espaço-temporal em adultos com dor cervical crónica

Autores

DOI:

https://doi.org/10.47197/retos.v69.116308

Palavras-chave:

Adulto, dor crónica, dor no pescoço, marcha, propriocepção

Resumo

Objectivo: Avaliar a associação entre a propriocepção cervical e os parâmetros espaço-temporais da marcha em adultos com dor cervical crónica.

Métodos: Estudo transversal analítico com uma amostra de 37 adultos com dor cervical crónica. A propriocepção cervical foi medida através do Teste de Erro de Posição Articular. Os parâmetros espaço-temporais da marcha, incluindo a velocidade e assimetria da marcha, o comprimento da passada e a cadência, foram medidos através do Project Automation Framework (PAF) para a marcha do sistema de captura de movimentos Qualisys® Track Manager (QTM).

Resultados: Setenta e três por cento dos participantes eram mulheres, e a mediana de idades foi de 32 anos (intervalo interquartílico de 26 a 47). O erro global de posicionamento articular foi em média de 11,1 ± 2,9 graus, e 97,3% apresentaram comprometimento da propriocepção cervical. A velocidade da marcha apresentou uma média de 1,1 ± 0,1 m/s, a assimetria da marcha apresentou uma mediana de 3,4 (intervalo interquartílico: 2 a 6,9), o comprimento da passada foi de 1,3 ± 0,1 metros e a cadência foi de 98,9 ± 8,5 passos por minuto. Não foi encontrada associação entre a propriocepção cervical e a velocidade, assimetria, comprimento da passada ou cadência (p>0,05).

Discussão: Embora existam poucos estudos semelhantes, os seus resultados diferem, possivelmente devido a variações nos instrumentos utilizados, no desenho metodológico e nas características populacionais.

Conclusões: Este estudo sugere que a propriocepção cervical não está associada a parâmetros espaço-temporais da marcha, como a velocidade, assimetria, comprimento da passada e cadência, em adultos com dor cervical crónica.

Referências

Abualait, T., & Ahsan, M. (2022). Comparison of gender, age, and body mass index for spatiotemporal parameters of bilateral gait pattern. F1000Research, 10, 266. https://doi.org/10.12688/f1000research.51700.2

Akoglu, H. (2018). User’s guide to correlation coefficients. Turkish Journal of Emergency Medicine, 18(3), 91-93. https://doi.org/10.1016/j.tjem.2018.08.001

AlDahas, A., Devecchi, V., Deane, J. A., & Falla, D. (2023). Measurement properties of cervical joint posi-tion error in people with and without chronic neck pain. PloS One, 18(10), e0292798. https://doi.org/10.1371/journal.pone.0292798

AlDahas, A., Heneghan, N. R., Althobaiti, S., Deane, J. A., Rushton, A., & Falla, D. (2024). Measurement properties of cervical joint position error in people with and without neck pain: A systematic review and narrative synthesis. BMC Musculoskeletal Disorders, 25, 44. https://doi.org/10.1186/s12891-023-07111-4

Alshehri, S. H. S., Reddy, R. S., ALMohiza, M. A., Alshahrani, M. S., Alkhamis, B. A., Alnakhli, H. H., Koura, G. M., Gautam, A. P., Mukherjee, D., Alqhtani, R. S., Al Adal, S. Y., Alyami, A. M., & Alyazedi, F. M. (2025). Influence of cervical muscle strength and pain severity on functional balance and limits of stability in elderly individuals with chronic nonspecific neck pain: A cross-sectional study. BMC Geriatrics, 25(1), 18. https://doi.org/10.1186/s12877-024-05670-2

Andrade Ortega, J. A., Delgado Martínez, A. D., & Almécija Ruiz, R. (2010). Validation of the Spanish ver-sion of the Neck Disability Index. Spine, 35(4), E114-118. https://doi.org/10.1097/BRS.0b013e3181afea5d

Andrews, A. W., Vallabhajosula, S., Boise, S., & Bohannon, R. W. (2023). Normal gait speed varies by age and sex but not by geographical region: A systematic review. Journal of Physiotherapy, 69(1), 47-52. https://doi.org/10.1016/j.jphys.2022.11.005

Ayan, H., Kara, B., & Erbayraktar, R. (2023). Investigation of Gait Symmetry, Cervical Proprioception and Functionality in Individuals with Chronic Idiopathic Neck Pain. Annals of the Rheumatic Diseases, 82(Suppl 1), 1933-1933. https://doi.org/10.1136/annrheumdis-2023-eular.3020

Badakva, A. M., М, Б. А., Miller, N. V., В, М. Н., Zobova, L. N., & Н, З. Л. (2023). Integration of Vestibular, Visual and Proprioceptive Inputs in the Cerebral Cortex during Movement Control. Fiziologiâ Čeloveka, 49(2), Article 2. https://doi.org/10.31857/S0131164622600422

Burton, W., Ma, Y., Manor, B., Hausdorff, J. M., Kowalski, M. H., Bain, P. A., & Wayne, P. M. (2023). The impact of neck pain on gait health: A systematic review and meta-analysis. BMC Musculoskele-tal Disorders, 24(1), 618. https://doi.org/10.1186/s12891-023-06721-2

Bytyçi, I., & Henein, M. Y. (2021). Stride Length Predicts Adverse Clinical Events in Older Adults: A Sys-tematic Review and Meta-Analysis. Journal of Clinical Medicine, 10(12), 2670. https://doi.org/10.3390/jcm10122670

Cabral, S. (2018). Gait Symmetry Measures and Their Relevance to Gait Retraining. En Handbook of Human Motion (Vol. 1, pp. 429-447). Springer, Cham. https://doi.org/10.1007/978-3-319-14418-4_201

Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., Kerns, R., Von Korff, M., Porter, L., & Helmick, C. (2018). Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults—United States, 2016. Morbidity and Mortality Weekly Report, 67(36), 1001-1006. https://doi.org/10.15585/mmwr.mm6736a2

Danion, F., Varraine, E., Bonnard, M., & Pailhous, J. (2003). Stride variability in human gait: The effect of stride frequency and stride length. Gait & Posture, 18(1), 69-77. https://doi.org/10.1016/s0966-6362(03)00030-4

de Vries, J., Ischebeck, B. K., Voogt, L. P., van der Geest, J. N., Janssen, M., Frens, M. A., & Kleinrensink, G. J. (2015). Joint position sense error in people with neck pain: A systematic review. Manual Ther-apy, 20(6), 736-744. https://doi.org/10.1016/j.math.2015.04.015

Fairbank, J. C., Couper, J., Davies, J. B., & O’Brien, J. P. (1980). The Oswestry low back pain disability questionnaire. Physiotherapy, 66(8), 271-273.

GBD 2021 Neck Pain Collaborators. (2024). Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. The Lancet. Rheumatology, 6(3), e142-e155. https://doi.org/10.1016/S2665-9913(23)00321-1

Huerta, M. Á., Salazar, A., & Moral-Munoz, J. A. (2025). Trends in chronic neck and low back pain preva-lence in Spain (2006-2020): Differences by sex, age, and social class. Eur Spine J, 34(4), 1331-1340. https://doi.org/10.1007/s00586-025-08676-5

Jaén-Carrillo, D., García-Pinillos, F., Chicano-Gutiérrez, J. M., Pérez-Castilla, A., Soto-Hermoso, V., Moli-na-Molina, A., & Ruiz-Alias, S. A. (2023). Level of Agreement between the MotionMetrix System and an Optoelectronic Motion Capture System for Walking and Running Gait Measurements. Sensors (Basel, Switzerland), 23(10), 4576. https://doi.org/10.3390/s23104576

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A.-A., & Safiri, S. (2022). Neck pain: Global epidemiology, trends and risk factors. BMC Musculo-skeletal Disorders, 23, 26. https://doi.org/10.1186/s12891-021-04957-4

Kim, D., Lewis, C. L., & Gill, S. V. (2021). Effects of obesity and foot arch height on gait mechanics: A cross-sectional study. PLOS ONE, 16(11), e0260398. https://doi.org/10.1371/journal.pone.0260398

Kirmizi, M., Simsek, I. E., Elvan, A., Akcali, O., & Angin, S. (2019). Gait speed and gait asymmetry in indi-viduals with chronic idiopathic neck pain. Musculoskeletal Science & Practice, 41, 23-27. https://doi.org/10.1016/j.msksp.2019.03.001

Kırmızı, M., Şimşek, İ. E., Elvan, A., Akçalı, Ö., & Angın, S. (2020). Investigating spatiotemporal gait pa-rameters and gait stability in individuals with chronic idiopathic neck pain. Journal of Exercise Therapy and Rehabilitation, 6(3), Article 3.

Kumar, R., Bogia, P., Singh, V., & Reddy, T. O. (2025). The running gait analysis technology: A compre-hensive systematic literature review. Journal of Orthopaedics, 62, 75-83. https://doi.org/10.1016/j.jor.2024.10.013

Laskowski, E. R., Newcomer-Aney, K., & Smith, J. (2000). Proprioception. Physical Medicine and Reha-bilitation Clinics of North America, 11(2), 323-340, vi.

Lockhart, T. E., Soangra, R., Chung, C., Frames, C., Fino, P., & Zhang, J. (2014). Development of automat-ed gait assessment algorithm using three inertial sensors and its reliability. Biomedical Sciences Instrumentation, 50, 297-306.

Madsalae, T., Thongprong, T., Chaikeeree, N., & Boonsinsukh, R. (2024). Changes in gait performances during walking with head movements in older adults with chronic neck pain. Frontiers in Medi-cine, 11, 1324375. https://doi.org/10.3389/fmed.2024.1324375

Marzieh M. Ardestani, Christopher Ferrigno, Mehran Moazen, & Markus A. Wimmer. (2016). From normal to fast walking: Impact of cadence and stride length on lower extremity joint moments. Gait & Posture, 46, 118-125. https://doi.org/10.1016/j.gaitpost.2016.02.005

McCambridge, J., Witton, J., & Elbourne, D. R. (2014). Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. Journal of Clinical Epidemiology, 67(3), 267-277. https://doi.org/10.1016/j.jclinepi.2013.08.015

McGrath, R. L., Ziegler, M. L., Pires-Fernandes, M., Knarr, B. A., Higginson, J. S., & Sergi, F. (2019). The effect of stride length on lower extremity joint kinetics at various gait speeds. PLOS ONE, 14(2), e0200862. https://doi.org/10.1371/journal.pone.0200862

Ministerio de Salud, Instituto Nacional de Salud. (2004). La medición de la talla y el peso. Guía para el personal de la salud del primer nivel de atención. Ministerio de Salud, Instituto Nacional de Sa-lud. https://www.gob.pe/institucion/ins/noticias/1132261-ministerio-de-salud-aprueba-guia-de-actividad-fisica-segun-curso-de-vida

Ministerio de Salud, Instituto Nacional de Salud. (2012). Guía técnica para la valoración nutricional antropométrica de la persona adulta. Ministerio de Salud, Instituto Nacional de Salud. https://www.gob.pe/institucion/minsa/informes-publicaciones/314114-guia-tecnica-para-la-valoracion-nutricional-antropometrica-de-la-persona-adulta

Mirelman, A., Shema, S., Maidan, I., & Hausdorff, J. M. (2018). Chapter 7—Gait. En B. L. Day & S. R. Lord (Eds.), Handbook of Clinical Neurology (Vol. 159, pp. 119-134). Elsevier. https://doi.org/10.1016/B978-0-444-63916-5.00007-0

Murray, M. P., Kory, R. C., Clarkson, B. H., & Sepic, S. B. (1966). Comparison of free and fast speed walk-ing patterns of normal men. American Journal of Physical Medicine, 45(1), 8-23.

Nakazato, T., Quezada, P., Gutiérrez, C., & Romaní, F. (2024). Chronic Neck Pain Prevalence Before and After COVID-19 Restrictions and Its Relationship With Digital Device Screen Viewing: A Popula-tion Study. Annals of Rehabilitation Medicine, 48(2), 124-134. https://doi.org/10.5535/arm.230030

Papageorgiou, S. N. (2022). On correlation coefficients and their interpretation. Journal of Orthodon-tics, 49(3), 359-361. https://doi.org/10.1177/14653125221076142

Patterson, K. K., Nadkarni, N. K., Black, S. E., & McIlroy, W. E. (2012). Gait symmetry and velocity differ in their relationship to age. Gait & Posture, 35(4), 590-594. https://doi.org/10.1016/j.gaitpost.2011.11.030

Peel, N. M., Alapatt, L. J., Jones, L. V., & Hubbard, R. E. (2019). The Association Between Gait Speed and Cognitive Status in Community-Dwelling Older People: A Systematic Review and Meta-analysis. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 74(6), 943-948. https://doi.org/10.1093/gerona/gly140

Peng, B., Yang, L., Li, Y., Liu, T., & Liu, Y. (2021). Cervical Proprioception Impairment in Neck Pain-Pathophysiology, Clinical Evaluation, and Management: A Narrative Review. Pain and Therapy, 10(1), 143-164. https://doi.org/10.1007/s40122-020-00230-z

Prochazka, A. (2021). Proprioception: Clinical relevance and neurophysiology. Current Opinion in Physiology, 23, 100440. https://doi.org/10.1016/j.cophys.2021.05.003

Proske, U., & Gandevia, S. C. (2012). The Proprioceptive Senses: Their Roles in Signaling Body Shape, Body Position and Movement, and Muscle Force. Physiological Reviews, 92(4), 1651-1697. https://doi.org/10.1152/physrev.00048.2011

Qu, N., Tian, H., De Martino, E., & Zhang, B. (2022). Neck Pain: Do We Know Enough About the Sen-sorimotor Control System? Frontiers in Computational Neuroscience, 16, 946514. https://doi.org/10.3389/fncom.2022.946514

Qualisys AB. (2022a). Qualisys Gait module. https://www.qualisys.com/analysis/gait/#features

Qualisys AB. (2022b). Qualisys Track Manager User Manual. https://docs.qualisys.com/qtm/

Rahman, S., Kidwai, A., Rakhamimova, E., Elias, M., Caldwell, W., & Bergese, S. D. (2023). Clinical Diag-nosis and Treatment of Chronic Pain. Diagnostics, 13(24), 3689. https://doi.org/10.3390/diagnostics13243689

Raizah, A., Reddy, R. S., Alshahrani, M. S., Gautam, A. P., Alkhamis, B. A., Kakaraparthi, V. N., Ahmad, I., Kandakurti, P. K., & ALMohiza, M. A. (2023). A Cross-Sectional Study on Mediating Effect of Chronic Pain on the Relationship between Cervical Proprioception and Functional Balance in Elderly Individuals with Chronic Neck Pain: Mediation Analysis Study. Journal of Clinical Medi-cine, 12(9), 3140. https://doi.org/10.3390/jcm12093140

Riskowski, J. L., Mikesky, A. E., Bahamonde, R. E., Alvey, T. V., & Burr, D. B. (2005). Proprioception, gait kinematics, and rate of loading during walking: Are they related? Journal of Musculoskeletal & Neuronal Interactions, 5(4), 379-387.

Roren, A., Mayoux-Benhamou, M.-A., Fayad, F., Poiraudeau, S., Lantz, D., & Revel, M. (2009). Comparison of visual and ultrasound based techniques to measure head repositioning in healthy and neck-pain subjects. Manual Therapy, 14(3), 270-277. https://doi.org/10.1016/j.math.2008.03.002

Rosmaninho, I., Ribeirinho-Soares, P., & Nunes, J. P. L. (2021). Walking Speed and Mortality: An Updated Systematic Review. Southern Medical Journal, 114(11), 697-702. https://doi.org/10.14423/SMJ.0000000000001318

Rössler, R., Wagner, J., Knaier, R., Rommers, N., Kressig, R. W., Schmidt-Trucksäss, A., & Hinrichs, T. (2024). Spatiotemporal gait characteristics across the adult lifespan: Reference values from a healthy population - Analysis of the COmPLETE cohort study. Gait & Posture, 109, 101-108. https://doi.org/10.1016/j.gaitpost.2024.01.005

Rowe, E., Beauchamp, M. K., & Astephen Wilson, J. (2021). Age and sex differences in normative gait patterns. Gait & Posture, 88, 109-115. https://doi.org/10.1016/j.gaitpost.2021.05.014

Ruiz-Malagón, E. J., García-Pinillos, F., Molina-Molina, A., Soto-Hermoso, V. M., & Ruiz-Alias, S. A. (2023). RunScribe Sacral Gait LabTM Validation for Measuring Pelvic Kinematics during Human Loco-motion at Different Speeds. Sensors (Basel, Switzerland), 23(5), 2604. https://doi.org/10.3390/s23052604

Saltychev, M., Pylkäs, K., Karklins, A., & Juhola, J. (2024). Psychometric properties of neck disability index—A systematic review and meta-analysis. Disability and Rehabilitation, 1-17. https://doi.org/10.1080/09638288.2024.2304644

Särkilahti, N., Hirvonen, M., Lavapuro, J., Takatalo, J., Löyttyniemi, E., & Tenovuo, O. (2024). Sensorimo-tor tests in patients with neck pain and its associated disorders: A systematic review and meta-analysis. Scientific Reports, 14(1), 12764. https://doi.org/10.1038/s41598-024-63545-3

Senden, R., Meijer, K., Heyligers, I. C., Savelberg, H. H. C. M., & Grimm, B. (2012). Importance of correct-ing for individual differences in the clinical diagnosis of gait disorders. Physiotherapy, 98(4), 320-324. https://doi.org/10.1016/j.physio.2011.06.002

Slaght, J., Sénéchal, M., Hrubeniuk, T. J., Mayo, A., & Bouchard, D. R. (2017). Walking Cadence to Exercise at Moderate Intensity for Adults: A Systematic Review. Journal of Sports Medicine (Hindawi Publishing Corporation), 2017, 4641203. https://doi.org/10.1155/2017/4641203

Stanton, T. R., Leake, H. B., Chalmers, K. J., & Moseley, G. L. (2016). Evidence of Impaired Proprioception in Chronic, Idiopathic Neck Pain: Systematic Review and Meta-Analysis. Physical Therapy, 96(6), 876-887. https://doi.org/10.2522/ptj.20150241

Steingrímsdóttir, Ó. A., Landmark, T., Macfarlane, G. J., & Nielsen, C. S. (2017). Defining chronic pain in epidemiological studies: A systematic review and meta-analysis. Pain, 158(11), 2092-2107. https://doi.org/10.1097/j.pain.0000000000001009

Subbarayalu, A. V., & Ameer, M. A. (2017). Relationships among head posture, pain intensity, disability and deep cervical flexor muscle performance in subjects with postural neck pain. Journal of Taibah University Medical Sciences, 12(6), 541-547. https://doi.org/10.1016/j.jtumed.2017.07.001

Tramonti, C., Griguoli, F., Di Martino, S., Lamola, G., Falossi, F., Palattella, G., Raffaetà, G., Chisari, C., & Parchi, P. (2024). The Effect of Proprioceptive Insoles on Gait Kinematics in Healthy Partici-pants. JPO: Journal of Prosthetics and Orthotics, 36(4), 273. https://doi.org/10.1097/JPO.0000000000000500

Treede, R.-D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., Cohen, M., Evers, S., Finnerup, N. B., First, M. B., Giamberardino, M. A., Kaasa, S., Korwisi, B., Kosek, E., Lavand’homme, P., Nicholas, M., Perrot, S., Scholz, J., Schug, S., … Wang, S.-J. (2019). Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain, 160(1), 19-27. https://doi.org/10.1097/j.pain.0000000000001384

Treleaven, J. (2008). Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual Therapy, 13(1), 2-11. https://doi.org/10.1016/j.math.2007.06.003

Tudor-Locke, C., Han, H., Aguiar, E. J., Barreira, T. V., Jr, J. M. S., Kang, M., & Rowe, D. A. (2018). How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: a nar-rative review. Br J Sports Med, 52, 776-788. https://doi.org/10.1136/bjsports-2017-097628

Tuthill, J. C., & Azim, E. (2018). Proprioception. Current Biology, 28(5), R194-R203. https://doi.org/10.1016/j.cub.2018.01.064

Vernon, H., & Mior, S. (1991). The Neck Disability Index: A study of reliability and validity. Journal of Manipulative and Physiological Therapeutics, 14(7), 409-415.

Veronese, N., Stubbs, B., Volpato, S., Zuliani, G., Maggi, S., Cesari, M., Lipnicki, D. M., Smith, L., Schofield, P., Firth, J., Vancampfort, D., Koyanagi, A., Pilotto, A., & Cereda, E. (2018). Association Between Gait Speed With Mortality, Cardiovascular Disease and Cancer: A Systematic Review and Meta-analysis of Prospective Cohort Studies. Journal of the American Medical Directors Association, 19(11), 981-988.e7. https://doi.org/10.1016/j.jamda.2018.06.007

Viteckova, S., Kutilek, P., Svoboda, Z., Krupicka, R., Kauler, J., & Szabo, Z. (2018). Gait symmetry measures: A review of current and prospective methods. Biomedical Signal Processing and Control, 42, 89-100. https://doi.org/10.1016/j.bspc.2018.01.013

Wannaprom, N., Treleaven, J., Jull, G., & Uthaikhup, S. (2018). Neck muscle vibration produces diverse responses in balance and gait speed between individuals with and without neck pain. Musculo-skeletal Science & Practice, 35, 25-29. https://doi.org/10.1016/j.msksp.2018.02.001

Weir, C. B., & Jan, A. (2025). BMI Classification Percentile And Cut Off Points. En StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK541070/

Wibault, J., Vaillant, J., Vuillerme, N., Dedering, Å., & Peolsson, A. (2013). Using the cervical range of mo-tion (CROM) device to assess head repositioning accuracy in individuals with cervical radicu-lopathy in comparison to neck- healthy individuals. Manual Therapy, 18(5), 403-409. https://doi.org/10.1016/j.math.2013.02.004

Wohlrab, M., Klenk, J., Delgado-Ortiz, L., Chambers, M., Rochester, L., Zuchowski, M., Schwab, M., Beck-er, C., & Jaeger, S. U. (2022). The value of walking: A systematic review on mobility and healthcare costs. European Review of Aging and Physical Activity, 19(1), 31. https://doi.org/10.1186/s11556-022-00310-3

Yoshimoto, K., & Shinya, M. (2022). Use of the Azure Kinect to measure foot clearance during obstacle crossing: A validation study. PloS One, 17(3), e0265215. https://doi.org/10.1371/journal.pone.0265215

Zhang, F., Wang, H., Bai, Y., Huang, L., Zhong, Y., & Li, Y. (2025). Gait Speed and All-Cause Mortality in Whole-Spectrum Chronic Kidney Disease: A Systematic Review and Meta-Analysis Included 6217 Participants. Journal of Cachexia, Sarcopenia and Muscle, 16(1), e13739. https://doi.org/10.1002/jcsm.13739

Publicado

18-07-2025

Edição

Secção

Artigos de caráter científico: trabalhos de pesquisas básicas e/ou aplicadas.

Como Citar

Sánchez-Huamash, C. M., Bravo-Cucci , S. D., Carrión-Bazán, J. L., Aranda-Sánchez, M. R., Narazas-Molina, K., Mora-Marín, A., & Trujillo-Chavez, C. (2025). Parâmetros de propriocepção cervical e marcha espaço-temporal em adultos com dor cervical crónica. Retos, 69, 1386-1400. https://doi.org/10.47197/retos.v69.116308