We developed a mental task with gaze direction recognition (GDR) by which subjects observed neck rotation of another individual from behind and attempted to recognize the direction of gaze. A randomized controlled trial was performed in test ( ) and control ( ) groups of subjects with chronic neck pain undergoing physical therapy either with or without the GDR task carried out over 12 sessions during a three-week period. Primary outcome measures were defined as the active range of motion and pain on rotation of the neck. Secondary outcome measures were reaction time (RT) and response accuracy in the GDR task group. ANOVA indicated a main effect for task session and group, and interaction of session. Post hoc testing showed that the GDR task group exhibited a significant simple main effect upon session, and significant sequential improvement of neck motion and relief of neck pain. Rapid effectiveness was significant in both groups. The GDR task group had a significant session-to-session reduction of RTs in correct responses. In conclusion, the GDR task we developed provides a promising rehabilitation measure for chronic neck pain. 1. Introduction Chronic neck pain lasts longer than six months and is caused by cervical spondylosis deformans, cervical intervertebral disc displacement, or cervical sprain. Conventional therapies include thermotherapy, electric stimulation, and cervical traction [1] and involve soft tissues/joints in the neck in order to alter viscoelastic properties of relevant muscles [2], increase blood flow [3], and separate facet joints [4]. These modalities have been evaluated [5–7], but their efficacies remain unclear [8]. There is increasing evidence that chronic pain problems are characterised by alterations in brain structure and function [9]. The pathological mechanism underlying the prolongation of peripheral pain is thought to involve conflict between sensory-motor cortical processing networks [10, 11]. A cortical model of long-term pain implicated the neural consequences of incongruence between sensory and visuomotor feedback, or prolonged visuosensory-motor conflict [11]. Therapeutic measures such as mirror therapy, motor imagery programming, and virtual visual feedback aim to overcome sensory-motor incongruence and alleviate chronic limb pain. Phantom limb pain was hypothesized to be due to conflict between motor intension and visual-sensory experience in the central nervous system [12]. McCabe et al. examined mirror visual feedback for the treatment of complex regional pain syndrome type 1 and reported reduced limb pain when
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