Is there any coexistence of sacroiliac joints dysfunction with dysfunctions of the occipito-atlanto-axial complex? Part I: The sensorimotor function
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Department of Medical Rehabilitation, Medical University of Łódź, The Dr Z. Radliński Provincial Centre of Orthopaedics and Locomotor System Rehabilitation in Łódź, Poland
Submission date: 2011-05-24
Acceptance date: 2011-11-22
Publication date: 2020-04-10
Corresponding author
Tomasz Adamczewski   

Department of Medical Rehabilitation, Medical University of Łódź, The Dr Z. Radliński Provincial Centre of Orthopaedics and Locomotor System Rehabilitation in Łódź, Drewnowska 75, 91-002 Łódź, Poland. Tel.:+48 42 253 71 77, +48 42 253 71 42, +48 505 941 857; fax: +48 42 654 01 19.
Pol. Ann. Med. 2012;19(1):32-37
Suboccipital muscles and ligaments of the cervicocephalic joints (CCJ) embody a large number of proprioceptors. There exists a possible correlation between the sacroiliac joints (SIJ) dysfunction with the suboccipital muscles atrophy leading to headaches and body imbalance. This can be caused by the sensorimotor dysfunction of cervical segments due to their functional connections with the SIJ.

The aim of this study was to investigate the coexistence of SIJ dysfunction and the sensorimotor dysfunction of the CCJ.

Material and methods:
A double-blind test of CCJ and SIJ by Kaltenborn and Evjenth was conducted involving 80 patients experiencing low back pain, 40 of whom were diagnosed with SIJ dysfunction. Functional tests of the cervical spine were performed with Sensoneck. StatGraphics Centurion XV was employed to obtain the statistical analysis of the data.

Results and discussion:
There was a tendency towards reduced strength of the C2 muscles and a statistically significant instability of the C1 segment in the study group. Exteroceptive sensation was not disturbed. Sensorimotor function of the CCJ differed in the number of errors made by patients with SIJ dysfunction, especially concerning complex head movements. The intragroup analysis indicated that more errors were made by those having the left SIJ dysfunction.

1. In patients with SIJ dysfunction the tendency towards asymmetrical muscle strength was observed for the C2 segment. 2. Exteroceptive sensation in the upper cervical dermatomes was not distorted by the influence of SIJ dysfunctions. 3. The sensorimotor function of the upper cervical motor segments was significantly worse for the population of patients with SIJ dysfunction, especially on the left side. 4. Sensoneck is a useful tool for an objective assessment of a manual therapy employed in the dysfunction concerning the occipito-atlanto-axial region.

None declared.
Andary MT, Hallgren RC, Greenman PE, Rechtien JJ. Neurogenic atrophy of suboccipital muscles after a cervical injury: a case study. Am J Phys Med Rehabil. 1998;77(6):545–549.
Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine. 2004;4(3):335–356.
Greenman PE. Innominate shear dysfunction in the sacroiliac syndrome. J Manual Med. 1986;4:176–178.
Greenman PE. Principles of Manual Medicine. Baltimore: Lippincott Williams & Wilkins; 2003:510–537.
Hallgren RC, Greenman PE, Rechtien JJ. Atrophy of suboccipital muscles in patients with chronic pain: a pilot study. J Am Osteopath Assoc. 1994;94(12):1032–1038.
De Hertogh W, Vaes P, Beckwée D, van Suijlekom H, Duquet W, van Roy P. Lack of impairment of kinaesthetic sensibility in cervicogenic headache patients. Cephalalgia. 2008;28(4):323–328.
Humphreys BK. Cervical outcome measures: testing for postural stability and balance. J Manipulative Physiol Ther. 2008;31(7):540–546.
Kaltenborn F. Kręgosłup: badanie manualne i mobilizacja [Spine: manual examination and mobilization]. Toruń: Rolewski. 1989:306–318.
Kirkesola G. Sling Exercise Therapy – S-E-T. A concept for active treatment and training ailments in the musculoskeletal apparatus. Fysioterapeuten. 2000;12:9–16.
Learman KE, Myers JB, Lephart SM, Sell TC, Kerns GJ, Cook CE. Effects of spinal manipulation on trunk proprioception in subjects with chronic low back pain during symptom remission. J Manipulative Physiol Ther. 2009;32(2):118–126.
Lephart SM, Fu FH. Proprioception and Neuromuscular control in joint stability. Champaign: Human Kinetics; 2000.
Lephart SM, Henry TJ. The physiological basis for open and closed kinetic chain. Rehabilitation for the upper extremity. J Sport Rehabil. 1996;5(1):171–187.
McPartland JM, Brodeur RR, Hallgren RC. Chronic neck pain, standing balance and suboccipital muscles atrophy: a pilot study. J Manipulative Physiol Ther. 1997;20(1):24–29.
Panjabi MM. A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J. 2006;15(5):668–676.
Proske U. Kinesthesia: the role of muscle receptors. Muscle Nerve. 2006;34(5):545–558.
Revel M, Andre-Deshays C, Minguet M. Cervicocephalic kinesthetic sensibility in patients with cervical pain. Arch Phys Med Rehabil. 1991;72(5):288–291.
Revel M, Minguet M, Gergoy P, Vaillant J, Manuel J. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil. 1994;75(8):895–899.
Riemann RB, Guszkiewicz IN, Lephart SM, Fu FH. Proprioception and neuromuscular control in joint stability. Champaign: Human Kinetics, 2000:37–51.
Sjölander P, Michaelson P, Jaric S, Djupsjöbacka M. Sensorimotor disturbances in chronic neck pain – range of motion, peak velocity, smoothness of movement, and repositioning acuity. Man Ther. 2008;13(2):122–131.
Swait G, Rushton AB, Miall RC, Newell D. Evaluation of cervical proprioceptive function: optimizing protocols and comparison between tests in normal subjects. Spine. 2007;32(24):692–701.
Taylor JL, McCloskey DI. Proprioception in the neck. Exp Brain Res. 1988;70(2):351–360.
Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Man Ther. 2008;13(1):2–11.
Vleeming A, Pool-Goudzwaard AL, Hammudoghlu D, Stoeckart R, Snijders CJ, Mens JM. The function of the long dorsal sacroiliac ligament: its implication for understanding low back pain. Spine. 1996;21(5):556–562.
Vleeming A, Pool-Goudzwaard AL, Stoeckart R, van Winger- den JP, Snijders CJ. The posterior layer of the thoracolumbar fascia: its function in load transfer from spine to legs. Spine. 1995;20(7):753–758.
Zaborowska-Sapeta K, Kowalski IM, Protasiewicz-Fałdowska H, Wolska O. Evaluation of the effectiveness of Chêneau brace treatment for idiopatic scoliosis – own observations. Pol Ann Med. 2010;17(1):44–53.
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