The impact of fall history on instability, disability, and anxiety in patients with chronic neck pain

TL;DR

People with chronic neck pain who have a history of falling show worse balance, more disability, and higher anxiety than those without a fall history.

Contribution

This study identifies fall history as a potential low-cost indicator of postural instability and increased anxiety in chronic neck pain patients.

Findings

Patients with chronic neck pain and fall history had significantly worse postural stability under eyes-closed conditions.

Fall history was associated with higher disability, anxiety, and perceived instability scores compared to those without falls.

Balance deficits in chronic neck pain patients were more pronounced on unstable surfaces with limited visual input.

Abstract

This study aimed to investigate the impact of fall history on postural stability, disability, and anxiety in individuals with chronic neck pain (CNP). It was hypothesized that patients with a history of falls would exhibit greater postural instability, perceived disability, and anxiety levels compared with those without a fall history and healthy controls.

A total of 62 participants were included: 16 CNP patients with a history of falling (Group Ia), 21 CNP patients without falls (Group Ib), and 25 healthy controls. Assessments included the Neck Disability Index (NDI), Beck Anxiety Inventory (BAI), and Visual Analog Scale (VAS) for instability, and static postural stability was measured using a force platform under four sensory conditions.

Group Ia demonstrated significantly higher NDI, BAI, and VAS scores than Group Ib and controls (p < 0.05). Postural stability was significantly worse in Group Ia under eyes-closed conditions on both firm and foam surfaces (p < 0.05). Group Ib showed balance deficits only on the foam surface with eyes closed. No significant differences were found under eyes-open conditions (p > 0.05).

Fall history in patients with chronic neck pain is associated with greater balance impairments and increased anxiety, suggesting that a simple self-reported fall history may serve as a low-cost indicator of disrupted postural control. These findings may provide a practical guide for early screening of fall risk in clinical settings and highlight the importance of implementing preventive strategies for individuals with chronic neck pain.

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