• Ruhe A
• Fejer R
• Walker B

• Neck Pain
• Posture
• Review Literature as Topic
• Whiplash Injuries

Summary of Background data: Over the past 20 years, the center of pressure (COP) has been commonly used as an index of postural stability in standing. While several studies investigated COP excursions in neck pain and WAD patients and compared these to healthy individuals, no comprehensive analysis of the reported differences in postural sway pattern exists.

Search methods: Six online databases were systematically searched followed by a manual search of the retrieved papers.

Selection Criteria: Papers comparing COP measures derived from bipedal static task conditions on a force plate of non-specific neck pain and WAD sufferers to those of healthy controls.

Data collection and analysis: Two reviewers independently screened titles and abstracts for relevance. Screening for final inclusion, data extraction and quality assessment were carried out with a third reviewer to reconcile differences.

Results: Eight papers met the inclusion criteria. Heterogeneity in study designs prevented pooling of the data and no direct comparison of data across the studies was possible. Instead, a qualitative data analysis was conducted. There was broad consensus that patients with either type of neck pain have increased COP excursions compared to healthy individuals, a difference that was more pronounced in WAD sufferers. An increased sway in antero-posterior direction was observed in both groups.

Conclusions: Patients both types of neck pain exhibit greater postural instability than healthy controls, signified by greater COP excursions irrespective of the COP parameter chosen. Further, the decreased postural stability in neck pain sufferers appears to be associated with the presence of pain and to correlate with the extent of proprioceptive impairment, but appears unrelated pain duration.

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