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Peterson G, Nilsson D, Jönsson M, Bennett K, Peolsson A. Neck muscle function improves after neck exercises in individuals with whiplash-associated disorders: a case-control ultrasound study with speckle-tracking analyses. Sci Rep 2024; 14:18793. [PMID: 39138247 PMCID: PMC11322392 DOI: 10.1038/s41598-024-69136-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/31/2024] [Indexed: 08/15/2024] Open
Abstract
A whiplash injury can alter neck muscle function, which remains years after the injury and may explain why symptoms such as persistent pain and disability occur. There is currently limited knowledge about dynamic neck muscle function in chronic whiplash-associated disorders (WAD), and about the extent to which altered muscle function can improve after rehabilitation. Ultrasound can detect mechanical neck muscle function by measuring real-time deformation and deformation rate in the muscles. This method was used for five dorsal neck muscles in participants with chronic WAD versus matched controls in resistant neck rotation. We obtained real-time, non-invasive ultrasound measurements using speckle tracking, multivariate analyses, and mixed-design ANOVA analyses. The results showed altered deformation in the three deepest neck muscle layers, with less deformation area in the WAD group compared to controls in rotation to the most painful side at baseline. Participants in the WAD group performed three months of neck-specific exercises, resulting in improved deformation in the deep neck muscles in WAD and with a similar deformation pattern to controls, and the significant group differences ceased. We reveal new and important insights into the capability of ultrasound to diagnose altered neck muscle function and evaluate an exercise intervention.
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Affiliation(s)
- Gunnel Peterson
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
- Unit of Physiotherapy, Department of Health Medicine and Caring Sciences, Linköping University, Campus US, Building 511, 15th Floor, 581 83, Linköping, Sweden.
| | - David Nilsson
- Computational Analytics Support Platform (CASP), Department of Chemistry, Umeå University, Umeå, Sweden
| | - Margaretha Jönsson
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Unit of Physiotherapy, Department of Health Medicine and Caring Sciences, Linköping University, Campus US, Building 511, 15th Floor, 581 83, Linköping, Sweden
| | - Kate Bennett
- Computational Analytics Support Platform (CASP), Department of Chemistry, Umeå University, Umeå, Sweden
| | - Anneli Peolsson
- Unit of Physiotherapy, Department of Health Medicine and Caring Sciences, Linköping University, Campus US, Building 511, 15th Floor, 581 83, Linköping, Sweden
- Unit of Clinical Medicine, Department of Health Medicine and Caring Sciences, Occupational and Environmental Medicine Centre, Linköping University, Linköping, Sweden
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2
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Snodgrass SJ, Weber KA, Wesselink EO, Stanwell P, Elliott JM. Reduced Cervical Muscle Fat Infiltrate Is Associated with Self-Reported Recovery from Chronic Idiopathic Neck Pain Over Six Months: A Magnetic Resonance Imaging Longitudinal Cohort Study. J Clin Med 2024; 13:4485. [PMID: 39124753 PMCID: PMC11312969 DOI: 10.3390/jcm13154485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/26/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Background: It is unclear why neck pain persists or resolves, making assessment and management decisions challenging. Muscle composition, particularly muscle fat infiltrate (MFI), is related to neck pain, but it is unknown whether MFI changes with recovery following targeted interventions. Methods: We compared muscle composition quantified from fat-water magnetic resonance images from the C3 to T1 vertebrae in individuals with and without chronic idiopathic neck pain at two times 6 months apart. Those with neck pain received six weeks of intervention (physiotherapy or chiropractic) after their baseline MRI; at 6 months, they were classified as recovered (≥3 on the 11-point Global Rating of Change scale) or not recovered. Results: At 6 months, both asymptomatic and recovered individuals had decreased MFI compared to baseline (asymptomatic estimated marginal mean difference -1.6% 95%; CI -1.9, -1.4; recovered -1.6; -1.8, -1.4; p < 0.001) whereas those classified as not recovered had increased MFI compared to baseline (0.4; 0.1, 0.7; p = 0.014), independent of age, sex and body mass index. Conclusions: It appears MFI decreases with recovery from neck pain but increases when neck pain persists. The relationship between cervical MFI and neck pain suggests MFI may inform diagnosis, theragnosis and prognosis in individuals with neck pain. Future development of a clinical test for MFI may assist in identifying patients who will benefit from targeted muscle intervention, improving outcomes.
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Affiliation(s)
- Suzanne J. Snodgrass
- Discipline of Physiotherapy, The University of Newcastle, Callaghan 2308, Australia
- Centre for Active Living and Learning, Hunter Medical Research Institute, New Lambton Heights 2305, Australia
| | - Kenneth A. Weber
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | | | - Peter Stanwell
- Discipline of Medical Radiation Science (Diagnostic Radiography), The University of Newcastle, Callaghan 2308, Australia;
| | - James M. Elliott
- The Kolling Institute, Northern Sydney (Arabanoo) Precinct, St Leonards 2065, Australia;
- Sydney School of Health Sciences, The University of Sydney, Camperdown 2050, Australia
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3
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Pokhrel S, Hwang J. Effect of screen configuration on the neck angle, muscle activity, and simulator sickness symptoms in virtual reality. Work 2024:WOR230230. [PMID: 38217564 DOI: 10.3233/wor-230230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND There is a lack of information about the optimal setup of multiple screen configurations in virtual reality (VR) office work. OBJECTIVE The objective of this study was to evaluate the effects of different screen configurations on neck flexion, rotation, neck muscle activity, and simulator sickness symptoms during Virtual Reality (VR) office work. METHODS Twelve participants (7 males; 21 to 27 years old) performed copy-paste and drag-drop tasks in three different screen configurations (single screen, primary-secondary screen, and double screen) in a randomized order. Optical motion capture system, electromyography (EMG) device, and simulator sickness questionnaire (SSQ) were used to measure the users' responses. RESULTS Neck rotation angles, muscle activities, and VR sickness were significantly affected by the screen configurations (p < 0.021). The primary-secondary screen showed the highest right rotation angle (median: -33.47°) and left sternocleidomastoid (SCM) muscle activities (median: 12.57% MVC). Both single (median: 22.42) and primary-secondary (median: 22.40) screen showed the highest value of SSQ. CONCLUSIONS The screen configurations in VR could be an important design factor affecting the users' physical demands of the neck and VR sickness symptoms. Asymmetric neck rotations caused by the primary-secondary screen conditions should be avoided.
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Affiliation(s)
- Sobhit Pokhrel
- Department of Industrial and Systems Engineering, Northern Illinois University, DeKalb, IL, USA
| | - Jaejin Hwang
- Department of Industrial and Systems Engineering, Northern Illinois University, DeKalb, IL, USA
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Bexander CSM, Hodges PW. Neck muscle activation in response to eye movement depends on sitting posture and is modified in whiplash associated disorders: Cross-sectional study. Musculoskelet Sci Pract 2023; 67:102837. [PMID: 37598498 DOI: 10.1016/j.msksp.2023.102837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Activity of specific neck muscles is modulated by eye movement. This activity modulation is exaggerated in people with whiplash associated disorders (WAD), but it is unknown whether it is impacted by sitting posture. OBJECTIVE This study investigated; (i) whether activity of cervical muscles differs with spinal posture; (ii) whether the effect of eye gaze direction (horizontal/vertical) on neck muscle activity differs between postures, and (iii) whether these effects differ between individuals with and without WAD. METHODS In three seated postures (normal relaxed, head forward, sit tall) electromyography (EMG) was recorded right obliquus capitis inferior (OI), multifidus (MF), splenius capitis (SP) and left sternocleidomastoid (SCM) with fine-wire and surface electrodes in ten healthy controls and nine with WAD. Electro-oculography recorded eye movements. RESULTS In controls, EMG was less for extensor muscles in Sit Tall than Head Forward, but higher in SCM. Only SC EMG modulated with eye movement. When WAD participants adopted similar sitting postures several responses were different; compared to Normal Relaxed posture OI EMG was less in Head Forward; MF EMG was less in Sit Tall; and SC was less in Head Forward and Sit Tall. Neck muscles in WAD were generally more sensitive to eye movement, except SC which did not modulate. CONCLUSIONS These finding support the hypothesis that neck muscle activity is influenced by spinal posture and eye movement. In WAD, this relationship is distorted and the response to eye movement is increased. SIGNIFICANCE These observations have potential implications for clinical management of individuals with WAD.
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Affiliation(s)
- Catharina S M Bexander
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, Qld, 4072, Australia.
| | - Paul W Hodges
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, Qld, 4072, Australia.
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Majcen Rosker Z, Mocnik G, Kristjansson E, Vodicar M, Rosker J. Pupillometric parameters of alertness during unpredictable but not predictable smooth pursuit neck torsion test are altered in patients with neck pain disorders: a cross-sectional study. Exp Brain Res 2023:10.1007/s00221-023-06648-z. [PMID: 37454001 PMCID: PMC10386920 DOI: 10.1007/s00221-023-06648-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 05/26/2023] [Indexed: 07/18/2023]
Abstract
Despite commonly investigated predictable smooth-pursuit neck-torsion tasks (SPNT) in neck pain patients, unpredictable conditions have been seldom investigated but are indicative of preserved oculomotor functions during neck torsion. Although not previously studied, some speculations about compensatory cognitive mechanisms such as increased phasic alertness during unpredictable tasks were suggested. The aim of this study was to investigate eye movement accuracy and pupillometric responses during predictable and unpredictable SPNT test in neck pain patients and asymptomatic controls. Eye movements (gain and SPNT-difference) and pupillometry indicative of tonic (average and relative pupil diameter) and phasic (index of cognitive activity-ICA) alertness were measured in 28 idiopathic neck pain patients and 30 asymptomatic individuals using infrared video-oculography during predictable and unpredictable SPNT test. Gain in unpredictable SPNT test was lower as compared to predictable tasks and presented with similar levels in neutral and neck torsion positions, but not in the predictable SPNT test. ICA was lower during neutral position in all tasks in patients as compared to control group but increased during neck torsion positions in unpredictable tasks. Relative pupil diameters presented with no differences between the groups or neck positions, but the opposite was observed for average pupil diameter. Higher ICA indicates an increase in phasic alertness in neck pain patients despite no alterations in oculomotor control during SPNT test. This is the first study to indicate cognitive deficits in oculomotor task in neck pain patients. The latter could negatively affect other tasks where additional cognitive resources must be involved.
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Affiliation(s)
| | - Grega Mocnik
- Laboratory for Digital Signal Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000, Maribor, Slovenia
| | | | - Miha Vodicar
- Chair of Orthopaedics, Medical Faculty, University of Ljubljana, 1000, Ljubljana, Slovenia
- Department of Orthopaedic Surgery, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia
| | - Jernej Rosker
- Faculty of Health Sciences, University of Primorska, 6310, Izola, Slovenia
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Uchida D, Ono T, Honda R, Watanabe Y, Toda K, Baba S, Matsuo T, Baba H. Asymmetric epileptic spasms after corpus callosotomy in children with West syndrome may be a good indicator for unilateral epileptic focus and subsequent resective surgery. Epilepsia Open 2022; 7:474-487. [PMID: 35869791 PMCID: PMC9436295 DOI: 10.1002/epi4.12631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Daiki Uchida
- Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura Nagasaki Japan
- Department of Neurosurgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Tomonori Ono
- Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura Nagasaki Japan
- Epilepsy Center, National Hospital Organization Nagasaki Medical Center, Omura Nagasaki Japan
| | - Ryoko Honda
- Epilepsy Center, National Hospital Organization Nagasaki Medical Center, Omura Nagasaki Japan
- Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Omura Nagasaki Japan
| | - Yoshiaki Watanabe
- Epilepsy Center, National Hospital Organization Nagasaki Medical Center, Omura Nagasaki Japan
- Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Omura Nagasaki Japan
| | - Keisuke Toda
- Department of Neurosurgery, National Hospital Organization Nagasaki‐Kawatana Medical Center, Kawatana Nagasaki Japan
| | - Shiro Baba
- Department of Neurosurgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Takayuki Matsuo
- Department of Neurosurgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Hiroshi Baba
- Epilepsy Center, Nishi‐Isahaya Hospital, Isahaya Nagasaki Japan
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Deep and superficial cervical muscles respond differently to unstable motor skill tasks. Hum Mov Sci 2021; 80:102893. [PMID: 34763288 DOI: 10.1016/j.humov.2021.102893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 10/26/2021] [Accepted: 10/30/2021] [Indexed: 11/21/2022]
Abstract
Biomechanical modelling and physiological studies suggest that various spinal muscle layers differ in their contribution to spine movement and stiffness. This study aimed to investigate the activation of deep and superficial muscles in stable and unstable task conditions. Nine healthy participants performed a task of controlling a metal ball on a plate fixed to the head in seated position. In unstable tasks, visual feedback was provided by mirrors to move the ball to the centre of the plate by small head movements and maintain the position for 3 s. Task difficulty was adjusted in a stepwise progression of difficulty using five surfaces with materials of decreasing resistance. In the stable condition, the ball was fixed to the plate's centre. EMG was recorded with surface (sternocleidomastoid, anterior scalenes, upper trapezius) and fine-wire electrodes (rectus capitis posterior major, obliquus inferior, multifidus, semispinalis cervicis, splenius capitis). The outcome variable was root mean square (RMS) EMG during the part of the task when the ball was maintained in the centre position. Results revealed greater cervical muscle activity in the unstable than stable conditions (p < 0.001, ηp2 = 0.746). Control of deep and superficial cervical muscles differed (p = 0.003, ηp2 = 0.354). Deep cervical muscle activity was greater with unstable tasks, but did not differ with task difficulty. In contrast, superficial cervical muscle activity increased in a stepwise manner with increasing challenge. These results support the notion that the central nervous system uses different strategies for control of deep versus superficial muscle layers of the cervical spine in association with instability.
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Murillo C, Treleaven J, Cagnie B, Peral J, Falla D, Lluch E. Effects of dry needling of the obliquus capitis inferior on sensorimotor control and cervical mobility in people with neck pain: A double-blind, randomized sham-controlled trial. Braz J Phys Ther 2021; 25:826-836. [PMID: 34535409 PMCID: PMC8721073 DOI: 10.1016/j.bjpt.2021.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 06/14/2021] [Accepted: 07/30/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Impairments of sensorimotor control relating to head and eye movement control and postural stability are often present in people with neck pain. The upper cervical spine and particularly the obliquus capitis inferior (OCI) play an important proprioceptive role; and its impairment may alter cervical sensorimotor control. Dry needling (DN) is a valid technique to target the OCI. OBJECTIVES To investigate if a single DN session of the OCI muscle improves head and eye movement control-related outcomes, postural stability, and cervical mobility in people with neck pain. METHODS Forty people with neck pain were randomly assigned to receive a single session of DN or sham needling of the OCI. Cervical joint position error (JPE), cervical movement sense, standing balance and oculomotor control were examined at baseline, immediately post-intervention, and at one-week follow-up. Active cervical rotation range of motion and the flexion rotation test were used to examine the global and upper cervical rotation mobility, respectively. RESULTS Linear mixed-models revealed that the DN group showed a decrease of JPE immediately post-intervention compared to the sham group (mean difference [MD]= -0.93°; 95% confidence interval [CI]: -1.85, -0.02) which was maintained at one-week follow-up (MD= -1.64°; 95%CI: -2.85, -0.43). No effects on standing balance or cervical movement sense were observed in both groups. Upper cervical mobility showed an increase immediately after DN compared to the sham group (MD= 5.14°; 95%CI: 0.77, 9.75) which remained stable at one-week follow-up (MD= 6.98°; 95%CI: 1.31, 12.40). Both group showed an immediate increase in global cervical mobility (MD= -0.14°; 95%CI: -5.29, 4.89). CONCLUSION The results from the current study suggest that a single session of DN of the OCI reduces JPE deficits and increases upper cervical mobility in patients with neck pain. Future trials should examine if the addition of this technique to sensorimotor control training add further benefits in the management of neck pain.
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Affiliation(s)
- Carlos Murillo
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Brussels, Belgium.
| | - Julia Treleaven
- Division of Physiotherapy, SHRS, University of Queensland, Brisbane, Australia
| | - Barbara Cagnie
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Javier Peral
- Department of Physical Therapy, University of Alcala, Madrid, Spain; Department of Physical Therapy, University of Valencia, Valencia, Spain
| | - Deborah Falla
- Center of Precision Rehabilitation for Spinal Pain, School of Sport, exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Enrique Lluch
- Pain in Motion International Research Group, Brussels, Belgium; Department of Physical Therapy, University of Valencia, Valencia, Spain
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The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain. Healthcare (Basel) 2020; 8:healthcare8040449. [PMID: 33139645 PMCID: PMC7712906 DOI: 10.3390/healthcare8040449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 11/16/2022] Open
Abstract
Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing gaze direction. We aimed to investigate how DNF and SCM activation varies according to gaze direction in the CCFT, and to prescribe the appropriate gaze direction for CNP. Twenty-eight CNP subjects had their maximum strength pressure level determined by CCFT for strength (20-~30 mmHg) and at each of the measured pressures, DNF and SCM thickness in each of four gaze directions (0°, 20°, 40°, and 60°) was measured by ultrasound imaging. The DNF to SCM ratio varied significantly according to gaze direction (p < 0.05), with gaze directions of 20° and 0° being significantly different from 40° (p < 0.05). Although there was no significant difference in DNF activation according to gaze direction, there was in SCM activation (p < 0.05), with SCM 60° significantly different from SCM 20° and SCM 40° (p < 0.05). In order to increase DNF activation efficiency during the CCFT, SCM activation should be controlled, and a gaze direction below 20° is the most efficient. This can inform DNF training of CNP patients in a clinical environment.
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Hage R, Dierick F, Roussel N, Pitance L, Detrembleur C. Age-related kinematic performance should be considered during fast head-neck rotation target task in individuals aged from 8 to 85 years old. PeerJ 2019; 7:e7095. [PMID: 31218133 PMCID: PMC6563793 DOI: 10.7717/peerj.7095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/08/2019] [Indexed: 02/04/2023] Open
Abstract
Kinematic behavior during fast cervical rotations is a useful parameter for assessing sensorimotor control performances in neck-pain patients. However, the influence of age in asymptomatic individuals from children to older people still needs to be explored. Our aim was to assess the impact of age on sensorimotor control performance of the head-neck with execution time and kinematic variables (time of task, mean speed/acceleration/deceleration, overshoots (OSs), minimum/maximum speed) during standardized fast rotation target task using the DidRen Laser test. A total of 80 volunteers were stratified in four different age-groups: Children (8–14 years): n = 16; Young Adults (18–35 years): n = 29; Old Adults (36–64 years): n = 18; Seniors (65–85 years): n = 17. Results showed that to perform the test, Children were slower (69.0 (60.6–87.3)s) compared to Young Adults (49.6 (45.6–55.6)s) with p < 0.001, and Old Adults (51.7 (48.4–55.8)s) with p < 0.001. It was also slower in Seniors (57 (52.3–67.6)s) compared to Young Adults with p < 0.013. Mean speed was slower in Children (9.4 ± 2.3 °s−1) and Seniors (10.6 ± 2.4 °s−1) compared to Young Adults (13.7 ± 1.9 °s−1) with p < 0.001 and Old Adults (13.3 ± 2.4 °s−1) with p < 0.001. Mean acceleration was slower for Children (8.4(7.6–10.2) °s−2) compared to Young Adults (11.1 (8.8–15.3) °s−2) with p < 0.016, and Old Adults (12.0(8.4–15.3) °s−2) with p < 0.015. Mean deceleration was slower for Children (−1.9(−2.6–1.4) °s−2) compared to Young Adults (−2.9(−3.7–2.5) °s−2) with p < 0.001 and Old Adults (−3.2(−3.7–2.3) °s−2) with p < 0.003. The DidRen Laser test allows us to discriminate age-specific performances for mean speed, acceleration and deceleration. Seniors and Children needed to be slower to become as precise as Young Adults and Old Adults. No difference was observed for OSs which assesses accuracy of movement. Age should therefore be considered as a key parameter when analyzing execution time and kinematic results during DidRen Laser test. These normative data can therefore guide clinicians in the assessment of subjects with neck pain.
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Affiliation(s)
- Renaud Hage
- Institut de Recherche Expérimentale et Clinique, Laboratoire NMSK, Université Catholique de Louvain, Brussels, Belgium
| | - Frédéric Dierick
- Forme et Fonctionnement Humain Lab, Department of Physical Therapy, CERISIC, CeREF, Haute Ecole Louvain en Hainaut, Charleroi, Hainaut, Belgium
| | - Nathalie Roussel
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Laurent Pitance
- Clinique Universitaire Saint-Luc, Stomatologie et Chirurgie Maxillo-Faciale, Université Catholique de Louvain, Brussels, Belgium
| | - Christine Detrembleur
- Institut de Recherche Expérimentale et Clinique, Laboratoire NMSK, Université Catholique de Louvain, Brussels, Belgium
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11
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Bexander CSM, Hodges PW. Cervical Rotator Muscle Activity With Eye Movement at Different Speeds is Distorted in Whiplash. PM R 2019; 11:944-953. [PMID: 30609281 DOI: 10.1002/pmrj.12059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 11/23/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND People with whiplash-associated disorders (WADs) report difficulty with quick head movements and cervicoocular dysfunction. Changes in coordination between eye movement and neck muscle activity may be involved. OBJECTIVE To examine whether activity of superficial and deep neck muscles increases with eye movement when the head is held in a fixed position, whether this differs between directions and speed of eye movement, and whether this is modified in WAD. DESIGN Convenience case series with unmatched controls. SETTING Research laboratory. PARTICIPANTS Nine individuals with chronic WAD grade II and 11 pain-free controls. METHODS Electromyography (EMG) was recorded from muscles that could act to rotate the neck to the right (right obliquus capitis inferior [OI], multifidus [MF], splenius capitis [SC], and left sternocleidomastoid [SCM]) with intramuscular or surface electrodes in 9 WAD participants and 11 pain-free controls. Eyes were rotated without head movement to track slow and medium-speed targets to the right or left, and as fast as possible (FP). MAIN OUTCOME MEASUREMENTS Amplitude of EMG. RESULTS In controls, SCM and SC EMG increased with right gaze (all P's < .03). EMG of the deep OI muscle increased in both directions (P < .001). WAD involved counterintuitive greater activity of SCM with left rotation across speeds of eye movement (SC with slow movement, P < .036), decreased OI EMG with gaze left (P < .019), and no change in MF EMG (P < .6) in either gaze direction. For FP tasks, EMG of all muscles was greater than slower speeds in controls (all P's < .0001), but not WAD (all P's > .33). CONCLUSIONS Coordination between neck muscle activity and eye movements with increasing speed is modified in WAD. Contrasting changes are present in deep and superficial neck muscles with implications for neck function that may explain some common WAD symptoms. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Catharina S M Bexander
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Paul W Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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12
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Elgueta-Cancino E, Marinovic W, Jull G, Hodges PW. Motor cortex representation of deep and superficial neck flexor muscles in individuals with and without neck pain. Hum Brain Mapp 2019; 40:2759-2770. [PMID: 30835902 DOI: 10.1002/hbm.24558] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 02/04/2019] [Accepted: 02/20/2019] [Indexed: 01/07/2023] Open
Abstract
Sensorimotor control of neck muscles differs between individuals with and without pain. Differences in the primary motor cortex (M1) maps of these muscles may be involved. This study compared M1 representations of deep (DNF) and superficial (SNF) neck flexor muscles between 10 individuals with neck pain (NP) and 10 painfree controls. M1 organisation was studied using transcranial magnetic stimulation (TMS) applied to a grid over the skull and surface electromyography of DNF (pharyngeal electrode) and SNF. Three-dimensional maps of M1 representation of each muscle were generated. Peaks in the SNF map that represented the sternocleidomastoid (SCM) and platysma muscles were identified. Unique centre of gravity (CoG)/map peaks were identified for the three muscles. In comparison to painfree controls, NP participants had more medial location of the CoG/peak of DNF, SCM, and platysma, greater mediolateral variation in DNF CoG (p = 0.02), fewer SNF and DNF map peaks (p = 0.01). These data show that neck flexor muscle M1 maps relate to trunk, neck, and face areas of the motor homunculus. Differences in M1 representation in NP have some similarities and some differences with observations for other musculoskeletal pain conditions. Despite the small sample size, our data did reveal differences and is comparable to other similar studies. The results of this study should be interpreted with consideration of methodological issues.
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Affiliation(s)
- Edith Elgueta-Cancino
- Centre of Clinical Excellence Research in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Welber Marinovic
- Centre of Clinical Excellence Research in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Gwendolen Jull
- Centre of Clinical Excellence Research in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul W Hodges
- Centre of Clinical Excellence Research in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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13
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Precision implantation with positional confirmation of fine-wire EMG electrodes in the deep posterior neck muscles. J Electromyogr Kinesiol 2018; 43:162-167. [DOI: 10.1016/j.jelekin.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 01/01/2023] Open
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Park J, Ko DH, Her J, Woo J. What is a more effective method of cranio-cervical flexion exercises? J Back Musculoskelet Rehabil 2018; 31:415-423. [PMID: 29332030 DOI: 10.3233/bmr-170860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cranio-cervical flexion exercise (CCFE) is a representative exercise that activates the deep muscles of neck pain patients. However, there is a lack of studies that propose specific exercise methods to examine the more effective activity level of the deep cervical flexor. OBJECTIVE The objective of this study is to propose a more effective exercise method through effect comparison based on an optimal degree of mouth-opening, a mouth-open versus mouth-closed position, eye gaze, and body position change during CCFE. METHODS As a result of examining the optimal degree of mouth-opening during CCFE using a pressure biofeedback unit with 50 subjects conforming to a selection standard, sternocleidomastoid muscle activity was examined. An optimal degree of mouth-opening during CCFE was examined as well. In addition, muscle thickness and muscle activity were measured based on eye gaze. Then, the effect of the exercise based on body position was examined. RESULTS The lowest sternocleidomastoid activity was presented at a mouth-opening of 20 mm. A significant difference was presented in sternocleidomastoid and longus colli muscle activity at a mouth-opening of (p< 0.05). The eye gaze of 45∘ below presented the lowest sternocleidomastoid activity. CONCLUSIONS The results suggest a new type of exercise method with the accompaniment of an optimal degree of mouth-opening of (20 mm), along with an eye gaze of 45∘ below, and an exercise method in the seated position without spatial restriction in order to increase the effect of CCFE, one of the conventional neck stabilization exercise methods.
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Affiliation(s)
- Junhyung Park
- Department of Rehabilitation Therapy, Hallym University, Chuncheon, Korea
| | - Do-Heung Ko
- Division of Speech Pathology and Audiology, Hallym University, Chuncheon, Korea
| | - Jingang Her
- Department of Physical Therapy, Hallym Polytechnic University, Chuncheon, Korea
| | - Jihea Woo
- Department of Physical Therapy, Hallym Polytechnic University, Chuncheon, Korea
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15
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Escaloni J, Butts R, Dunning J. The use of dry needling as a diagnostic tool and clinical treatment for cervicogenic dizziness: a narrative review & case series. J Bodyw Mov Ther 2018; 22:947-955. [DOI: 10.1016/j.jbmt.2018.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 01/21/2018] [Accepted: 02/08/2018] [Indexed: 12/20/2022]
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Corneil BD, Camp AJ. Animal Models of Vestibular Evoked Myogenic Potentials: The Past, Present, and Future. Front Neurol 2018; 9:489. [PMID: 29988517 PMCID: PMC6026641 DOI: 10.3389/fneur.2018.00489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/05/2018] [Indexed: 11/13/2022] Open
Abstract
Vestibular-evoked myogenic potentials (VEMPs) provide a simple and cost-effective means to assess the patency of vestibular reflexes. VEMP testing constitutes a core screening method in a clinical battery that probes vestibular function. The confidence one has in interpreting the results arising from VEMP testing is linked to a fundamental understanding of the underlying functional anatomy and physiology. In this review, we will summarize the key role that studies across a range of animal models have fulfilled in contributing to this understanding, covering key findings regarding the mechanisms of excitation in the sensory periphery, the processing of sensory information in central networks, and the distribution of reflexive output to the motor periphery. Although VEMPs are often touted for their simplicity, work in animals models have emphasized how vestibular reflexes operate within a broader behavioral and functional context, and as such vestibular reflexes are influenced by multisensory integration, governed by task demands, and follow principles of muscle recruitment. We will conclude with considerations of future questions, and the ways in which studies in current and emerging animal models can contribute to further use and refinement of this test for both basic and clinical research purposes.
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Affiliation(s)
- Brian D. Corneil
- Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
- Department of Psychology, University of Western Ontario, London, ON, Canada
- Robarts Research Institute, University of Western Ontario, London, ON, Canada
| | - Aaron J. Camp
- Discipline of Biomedical Science, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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17
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Chin S. Visual vertigo: Vertigo of oculomotor origin. Med Hypotheses 2018; 116:84-95. [PMID: 29857916 DOI: 10.1016/j.mehy.2018.04.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/25/2018] [Accepted: 04/30/2018] [Indexed: 01/28/2023]
Abstract
Since Róbert Bárány proposed his hypothesis on vestibulo-ocular reflex (VOR), dizziness associated with vertigo has been interpreted as being vestibular in origin. However, there have been many contradictory findings showing modulations of VOR, which have caused confusion as to VOR's role and accuracy. Further, there seems to be an influence of VOR when the anatomical inner ear structures are congenitally absent. Many people report vertiginous symptoms when they are exposed to visually challenging situations. These people with visually induced vertigo are usually found to have only mildly abnormal labyrinthine findings. Accurate visual information via binocular vision in animals, including humans, is important for the survival. Understanding how visual information is used in balance can help us to apply a different approach to the mechanism of vertigo. This article will review how accurate binocular viewing is possible for precise images through a complex oculomotor system and the proprioceptive senses of the external ocular muscles (EOMs). The proprioceptive senses from EOMs appear to affect motor efferents of the body. Oculomotor activities during viewing are important not just for learning but also for executing whole body motor responses. An error in the oculomotor afferents will cause a reaction to the error signal. This can be troubling for proper balancing during movement. Especially, common oculomotor causes (including fatigue of EOMs which is common in today's lifestyle) can contribute to many vertiginous conditions.
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Affiliation(s)
- Seong Chin
- Advocate Lutheran General Hospital, Department of Medicine, 1775 Dempster Street, Park Ridge, Illinois 60068, USA.
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18
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Katayama N, Koide K, Koide K, Mizuhashi F. The influence of horizontal cephalic rotation on the deviation of mandibular position. J Adv Prosthodont 2018; 10:401-407. [PMID: 30584468 PMCID: PMC6302081 DOI: 10.4047/jap.2018.10.6.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 10/05/2018] [Accepted: 11/18/2018] [Indexed: 11/08/2022] Open
Abstract
PURPOSE When performing an occlusal procedure, it is recommended that the patient should be sitting straight with the head in a natural position. An inappropriate mandibular position caused by an incorrect occlusal record registration or occlusal adjustment can result in damaged teeth and cause functional disorders in muscles and temporomandibular joints. The purpose of this study was to clarify the influence of horizontal cephalic rotation on mandibular position by investigating the three-dimensional positions of condylar and incisal points. MATERIALS AND METHODS A three-dimensional jaw movement measurement device with six degrees of freedom (the WinJaw System) was used to measure condylar and incisal points. The subjects were asked to sit straight with the head in a natural position. The subjects were then instructed to rotate their head horizontally 0°, 10°, 20°, 30°, 40°, 50°and 60° in the right or left direction. RESULTS The results indicated that horizontal cephalic rotation made the condyle on the rotating side shift forward, downward, and toward the inside, and the condyle on the counter rotating side shift backward, upward, and toward the outside. Significant differences in deviations were found for angles of rotation higher than 20°. The incisal point shifted in the forward and counterrotating directions, and significant differences were found for angles of rotation higher than 20°. CONCLUSION The mandibular position was altered by horizontal cephalic rotations of more than 20°. It is essential to consider the possibility of deviation of the mandibular position during occlusal procedures.
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Affiliation(s)
- Naoto Katayama
- Functional Occlusal Treatment, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
| | - Kaoru Koide
- Functional Occlusal Treatment, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
- Removable Prosthodontics, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Katsuyoshi Koide
- Comprehensive Dental Care, The Nippon Dental University Niigata Hospital, Niigata, Japan
| | - Fumi Mizuhashi
- Removable Prosthodontics, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
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Horn D, Galli S, Berney A, Vingerhoets F, Aybek S. Testing Head Rotation and Flexion Is Useful in Functional Limb Weakness. Mov Disord Clin Pract 2017; 4:597-602. [PMID: 30363481 DOI: 10.1002/mdc3.12492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/09/2017] [Accepted: 03/15/2017] [Indexed: 11/11/2022] Open
Abstract
Background Functional (psychogenic) neurological disorders (FNDs) are common and should be diagnosed using positive diagnostic features of internal inconsistency. However, there is a lack of objective data regarding motor signs and a lack of signs relating to motor disorders that affect the upper body and neck. The objective of this study was to provide specificity and sensitivity data on 2 axial motor signs: the sternocleidomastoid (SCM) and platysma signs. Methods Thirty patients with motor FNDs according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, and 40 organic controls with unilateral weakness were prospectively included. The SCM functional sign and platysma organic signs were systematically tested and compared between groups. Results The SCM sign had high specificity of 90% (confidence interval [CI], 77%-96%) to detect FND when the platysma sign had 100% specificity (CI, 88%-100%) for detecting organic weakness. The co-occurrence of a positive SCM and a negative platysma sign in patients with unilateral weakness carried 95% specificity (CI, 83%-99%) and 63% sensitivity (CI, 44%-80%). Conclusion The SCM test and platysma signs can be used for the diagnosis of motor FND. The extent to which these add value to other validated signs (such as Hoover's sign) should be further evaluated.
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Affiliation(s)
- Dimitri Horn
- Neurology Service Hôpitaux Universitaires Genevois Geneva Switzerland
| | - Silvio Galli
- Neurology Service Hôpitaux Universitaires Genevois Geneva Switzerland
| | - Alexandre Berney
- Liaison Psychiatry Centre Hospitalier Universtaire Vaudois Lausanne Switzerland
| | | | - Selma Aybek
- Neurology Service Hôpitaux Universitaires Genevois Geneva Switzerland
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20
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Chin S. REMOVED: Visually Induced Vertigo: A Different Approach to the Understanding of Vertigo. Behav Med 2017:0. [PMID: 28537797 DOI: 10.1080/08964289.2017.1330943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Forbes PA, de Bruijn E, Nijmeijer SWR, Koelman JHTM, van der Helm FCT, Schouten AC, Tijssen MAJ, Happee R. Dynamic head-neck stabilization in cervical dystonia. Clin Biomech (Bristol, Avon) 2017; 42:120-127. [PMID: 28157620 DOI: 10.1016/j.clinbiomech.2017.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 01/11/2017] [Accepted: 01/15/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effective sensorimotor integration is essential to modulate (adapt) neck stabilization strategies in response to varying tasks and disturbances. This study evaluates the hypothesis that relative to healthy controls cervical dystonia patients have an impaired ability to modulate afferent feedback for neck stabilization with changes in the frequency content of mechanical perturbations. METHODS We applied anterior-posterior displacement perturbations (110s) on the torso of seated subjects, while recording head-neck kinematics and muscular activity. We compared low bandwidth (0.2-1.2Hz) and high bandwidth (0.2-8Hz) perturbations where our previous research showed a profound modulation of stabilization strategies in healthy subjects. Cervical dystonia patients and age matched controls performed two tasks: (1) maintain head forward posture and (2) allow dystonia to dictate head posture. FINDINGS Patients and controls demonstrated similar kinematic and muscular responses. Patient modulation was similar to that of healthy controls (P>0.05); neck stiffness and afferent feedback decreased with high bandwidth perturbations. During the head forward task patients had an increased neck stiffness relative to controls (P<0.05), due to increased afferent feedback. INTERPRETATION The unaffected modulation of head-neck stabilization (both kinematic and muscular) in patients with cervical dystonia does not support the hypothesis of impaired afferent feedback modulation for neck stabilization.
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Affiliation(s)
- Patrick A Forbes
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands; Department of Neuroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - Edo de Bruijn
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Sebastiaan W R Nijmeijer
- Department of Neurology and Clinical Neurophysiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes H T M Koelman
- Department of Neurology and Clinical Neurophysiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Frans C T van der Helm
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands; Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands
| | - Alfred C Schouten
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands; Laboratory of Biomechanical Engineering, Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, The Netherlands
| | - Marina A J Tijssen
- Department of Neurology and Clinical Neurophysiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Neurology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Riender Happee
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
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Park KN, Kwon OY, Kim SH, Jeon IC. An immediate effect of axial neck rotation training with real time visual feedback using a smartphone inclinometer on improvement in axial neck rotation function. Physiother Theory Pract 2017; 33:218-226. [PMID: 28095101 DOI: 10.1080/09593985.2016.1277288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this study was to compare the immediate effects of axial neck rotation training (Axi-NRT) with and without real-time visual feedback (VF) using a smartphone inclinometer on the range of motion (ROM) for axial neck rotation and the onset of compensatory neck lateral bending and extension during active neck rotation. METHODS Twenty participants with restricted ROM for neck rotation but no neck pain (21.1 ± 1.6 years and 8 males, 12 females) were recruited for Axi-NRT with VF, and twenty age- and gender-matched participants with restricted ROM for neck rotation were recruited for Axi-NRT without VF. Changes in ROM for neck rotation and the onset time of compensatory neck movement during active neck rotation were measured using an electromagnetic tracking system. RESULTS Axi-NRT with VF was more effective in increasing ROM for neck rotation and decreasing and delaying the onset of compensatory neck movements during active neck rotation compared with Axi-NRT without VF. CONCLUSIONS Repeated Axi-NRT using VF is useful to educate participants in maintaining the axis of the cervical spine and to increase ROM for axial neck rotation with less compensatory neck motion in participants with a restricted range of neck rotations.
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Affiliation(s)
- Kyue-Nam Park
- a Department of Physical Therapy , College of Medical Science, Jeonju University , Jeonju , South Korea
| | - Oh-Yun Kwon
- b Department of Physical Therapy , College of Health Science, Yonsei University , Wonju , South Korea
| | - Si-Hyun Kim
- c Department of Physical Therapy , College of Health Science, Yonsei University , Wonju , South Korea
| | - In-Cheol Jeon
- b Department of Physical Therapy , College of Health Science, Yonsei University , Wonju , South Korea
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Øverås CK, Myhrvold BL, Røsok G, Magnesen E. Musculoskeletal diagnostic ultrasound imaging for thickness measurement of four principal muscles of the cervical spine -a reliability and agreement study. Chiropr Man Therap 2017; 25:2. [PMID: 28070269 PMCID: PMC5215195 DOI: 10.1186/s12998-016-0132-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 12/06/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The reliability of musculoskeletal diagnostic ultrasound imaging (MSK-DUSI) for the evaluation of neck musculature has been sparsely documented in the research literature. Until now, research has featured a limited number of subjects and only few studies have tested for both inter- and intra-reliability using appropriate methodology. METHODS Four examiners conducted an inter- and intra-rater reliability and agreement study. Fifty females with and without neck pain (NP) between the ages of 20-70 were recruited from October 2014 to April 2015. The muscles that were evaluated were the longus colli (Lcol), the rectus capitis posterior major (Rcpm), the deep cervical extensors (Dce) and the semispinalis capitis (Sscap). Each of the examiners captured ultrasound images of their allocated muscle and measured the thickness of that muscle twice, on separate occasions, for the first part of the intra-rater reliability study. For the second part, a second image of the same muscle was taken on the same subject and measured by the same examiner. The four examiners then met to measure on each other's images, to test inter-rater reliability. Their results were compared pair-wise using Interclass Correlation Coefficients (ICC) and Bland-Altman plots. Linear regression analysis was performed to evaluate for possible bias. RESULTS Inter-rater reliability was found to be good for Lcol and Sscap muscles and moderate towards poor for the deeper Rcpm and Dce muscles. Intra-rater reliability was good for all the muscles, with the exception of the Dce, which was found to be moderate in the second part of the study. The B&A plots showed good agreement, few outliers, and no bias. However, the agreement intervals indicated a measurement error within the variance of the method that may not have been acceptable for these small muscles if the aim is to evaluate change in thickness. CONCLUSIONS This study found that MSK-DUSI had variable reliability in assessing the thickness of the Lcol, Rcpm, Dce, and Sscap muscles. No bias was demonstrated, but agreement intervals were wide.
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Affiliation(s)
- Cecilie Krage Øverås
- MSc Chiropractic, MSc Ultrasound (Musculoskeletal), NEMUS Trondheim, Fjordgata 80, 7010 Trondheim, Norway
| | - Birgitte Lawaetz Myhrvold
- MSc Health Sciences, Clinical Biomechanics, MSc Ultrasound (Musculoskeletal), NEMUS Ullevål, Sognsveien 75B, 0855 Oslo, Norway
| | - Gro Røsok
- DC, MSc Ultrasound (Musculoskeletal), Kiropraktorhuset Elverum, Storgata 7b, 2408 Elverum, Norway
| | - Eli Magnesen
- DC, MSc Ultrasound (Musculoskeletal), Kiropraktorklinikken Holmestrand, Havnegaten 23, 3080 Holmestrand, Norway
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Matheron E, Zandi A, Wang D, Kapoula Z. A 1-Diopter Vertical Prism Induces a Decrease of Head Rotation: A Pilot Investigation. Front Neurol 2016; 7:62. [PMID: 27199886 PMCID: PMC4848294 DOI: 10.3389/fneur.2016.00062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 04/11/2016] [Indexed: 11/13/2022] Open
Abstract
Clinical studies in non-specific chronic arthralgia and back pain seem to indicate an association between vertical heterophoria (VH - latent vertical retinal misalignment) and asymmetrical head rotation. Such clinical observations suggest a link between VH and head rotation, but this was never tested. The purpose of this study was to simulate a VH in healthy subjects and examine its influence on the amplitude of active head rotation during 3D motion capture in upright stance. Subjects were asked to rotate their head three times from the straight ahead position and then to the right, back to straight ahead, to the left, and back to the straight ahead again. Three randomized conditions were run: normal viewing, with a 1-diopter prism base down on the dominant eye, or the non-dominant eye. The most important finding is that the experimental VH whichever the eye with the prism induces a significant decrease in the mean angle of head rotation compared to the normal viewing condition. This decrease was significant for rotation to the left. We suggest that the prism-induced VH modifies the reference posture and thereby affects head rotation; further studies are needed to confirm this effect and to extend to other types of dynamic activities.
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Affiliation(s)
- Eric Matheron
- IRIS Team, Physiopathologie de la Vision et Motricité Binoculaire, CNRS FR3636, UFR Biomédicale, Université Paris Descartes, Paris, France
| | - Ava Zandi
- IRIS Team, Physiopathologie de la Vision et Motricité Binoculaire, CNRS FR3636, UFR Biomédicale, Université Paris Descartes, Paris, France
| | - Danping Wang
- CNRS FR3636, UFR Biomédicale, Université Paris Descartes, Paris, France
| | - Zoï Kapoula
- IRIS Team, Physiopathologie de la Vision et Motricité Binoculaire, CNRS FR3636, UFR Biomédicale, Université Paris Descartes, Paris, France
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Kim MS. Neck kinematics and sternocleidomastoid muscle activation during neck rotation in subjects with forward head posture. J Phys Ther Sci 2015; 27:3425-8. [PMID: 26696712 PMCID: PMC4681919 DOI: 10.1589/jpts.27.3425] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/13/2015] [Indexed: 02/05/2023] Open
Abstract
[Purpose] The present study investigated differences in the kinematics of the neck and
activation of the sternocleidomastoid (SCM) muscle during neck rotation between subjects
with and without forward head posture (FHP). [Subjects and Methods] Twenty-eight subjects
participated in the study (14 with FHP, 14 without FHP). Subjects performed neck rotation
in two directions, left and right. The kinematics of rotation-lateral flexion movement
patterns were recorded using motion analysis. Activity in the bilateral SCM muscles was
measured using surface electromyography. Differences in neck kinematics and activation of
SCM between the groups were analyzed by independent t-tests. [Results] Maintaining FHP
increased the rotation-lateral flexion ratio significantly in both directions. The FHP
group had significantly faster onset time for lateral flexion movement in both directions
during neck rotation. Regarding the electromyography of the SCM muscles during neck
rotation in both directions, the activity values of subjects with FHP were greater than
those of subjects without FHP for the contralateral SCM muscles. [Conclusion] FHP can
induce changes in movement in the frontal plane and SCM muscle activation during neck
rotation. Thus, clinicians should consider movement in the frontal plane as well as in the
sagittal plane when assessing and treating patients with forward head posture.
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Affiliation(s)
- Man-Sig Kim
- Department of Systems Management Engineering, College of Engineering, Inje University, Republic of Korea
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26
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Goonetilleke SC, Katz L, Wood DK, Gu C, Huk AC, Corneil BD. Cross-species comparison of anticipatory and stimulus-driven neck muscle activity well before saccadic gaze shifts in humans and nonhuman primates. J Neurophysiol 2015; 114:902-13. [PMID: 26063777 DOI: 10.1152/jn.00230.2015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/09/2015] [Indexed: 11/22/2022] Open
Abstract
Recent studies have described a phenomenon wherein the onset of a peripheral visual stimulus elicits short-latency (<100 ms) stimulus-locked recruitment (SLR) of neck muscles in nonhuman primates (NHPs), well before any saccadic gaze shift. The SLR is thought to arise from visual responses within the intermediate layers of the superior colliculus (SCi), hence neck muscle recordings may reflect presaccadic activity within the SCi, even in humans. We obtained bilateral intramuscular recordings from splenius capitis (SPL, an ipsilateral head-turning muscle) from 28 human subjects performing leftward or rightward visually guided eye-head gaze shifts. Evidence of an SLR was obtained in 16/55 (29%) of samples; we also observed examples where the SLR was present only unilaterally. We compared these human results with those recorded from a sample of eight NHPs from which recordings of both SPL and deeper suboccipital muscles were available. Using the same criteria, evidence of an SLR was obtained in 8/14 (57%) of SPL recordings, but in 26/29 (90%) of recordings from suboccipital muscles. Thus, both species-specific and muscle-specific factors contribute to the low SLR prevalence in human SPL. Regardless of the presence of the SLR, neck muscle activity in both human SPL and in NHPs became predictive of the reaction time of the ensuing saccade gaze shift ∼70 ms after target appearance; such pregaze recruitment likely reflects developing SCi activity, even if the tectoreticulospinal pathway does not reliably relay visually related activity to SPL in humans.
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Affiliation(s)
- Samanthi C Goonetilleke
- Department of Physiology & Pharmacology, University of Western Ontario, London, Ontario, Canada
| | - Leor Katz
- Center for Perceptual Systems and Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
| | - Daniel K Wood
- Department of Neurobiology, Northwestern University, Evanston, Illinois
| | - Chao Gu
- Department of Psychology, University of Western Ontario, London, Ontario, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada; and
| | - Alexander C Huk
- Center for Perceptual Systems and Institute for Neuroscience, The University of Texas at Austin, Austin, Texas
| | - Brian D Corneil
- Department of Physiology & Pharmacology, University of Western Ontario, London, Ontario, Canada; Department of Psychology, University of Western Ontario, London, Ontario, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada; and Robarts Research Institute, London, Ontario, Canada
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Zetterberg C, Richter HO, Forsman M. Temporal Co-Variation between Eye Lens Accommodation and Trapezius Muscle Activity during a Dynamic Near-Far Visual Task. PLoS One 2015; 10:e0126578. [PMID: 25961299 PMCID: PMC4427187 DOI: 10.1371/journal.pone.0126578] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 04/06/2015] [Indexed: 11/18/2022] Open
Abstract
Near work is associated with increased activity in the neck and shoulder muscles, but the underlying mechanism is still unknown. This study was designed to determine whether a dynamic change in focus, alternating between a nearby and a more distant visual target, produces a direct parallel change in trapezius muscle activity. Fourteen healthy controls and 12 patients with a history of visual and neck/shoulder symptoms performed a Near-Far visual task under three different viewing conditions; one neutral condition with no trial lenses, one condition with negative trial lenses to create increased accommodation, and one condition with positive trial lenses to create decreased accommodation. Eye lens accommodation and trapezius muscle activity were continuously recorded. The trapezius muscle activity was significantly higher during Near than during Far focusing periods for both groups within the neutral viewing condition, and there was a significant co-variation in time between accommodation and trapezius muscle activity within the neutral and positive viewing conditions for the control group. In conclusion, these results reveal a connection between Near focusing and increased muscle activity during dynamic changes in focus between a nearby and a far target. A direct link, from the accommodation/vergence system to the trapezius muscles cannot be ruled out, but the connection may also be explained by an increased need for eye-neck (head) stabilization when focusing on a nearby target as compared to a more distant target.
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Affiliation(s)
- Camilla Zetterberg
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
- Department of Medical Sciences, Section of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Hans O. Richter
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Mikael Forsman
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Localized Pressure Pain Sensitivity is Associated With Lower Activation of the Semispinalis Cervicis Muscle in Patients With Chronic Neck Pain. Clin J Pain 2013; 29:898-906. [DOI: 10.1097/ajp.0b013e318278d4c4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Schomacher J, Falla D. Function and structure of the deep cervical extensor muscles in patients with neck pain. ACTA ACUST UNITED AC 2013; 18:360-6. [DOI: 10.1016/j.math.2013.05.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 05/13/2013] [Accepted: 05/20/2013] [Indexed: 01/03/2023]
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Nimbarte AD, Alabdulmohsen RT, Guffey SE, Etherton JR. The Impact of Use of Dual Monitor Screens on 3D Head–Neck Posture and Activity of Neck Muscles. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21577323.2012.667051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schomacher J, Petzke F, Falla D. Localised resistance selectively activates the semispinalis cervicis muscle in patients with neck pain. ACTA ACUST UNITED AC 2012; 17:544-8. [DOI: 10.1016/j.math.2012.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 05/16/2012] [Accepted: 05/23/2012] [Indexed: 02/07/2023]
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Chronic trauma-induced neck pain impairs the neural control of the deep semispinalis cervicis muscle. Clin Neurophysiol 2012; 123:1403-8. [DOI: 10.1016/j.clinph.2011.11.033] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 11/23/2011] [Accepted: 11/25/2011] [Indexed: 11/22/2022]
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Ultrasound-guided insertion of intramuscular electrodes into suboccipital muscles in the non-human primate. J Electromyogr Kinesiol 2012; 22:553-9. [PMID: 22445030 DOI: 10.1016/j.jelekin.2012.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 01/11/2012] [Accepted: 02/21/2012] [Indexed: 11/21/2022] Open
Abstract
The head-neck system is highly complex from a biomechanical and musculoskeletal perspective. Currently, the options for recording the recruitment of deep neck muscles in experimental animals are limited to chronic approaches requiring permanent implantation of electromyographic electrodes. Here, we describe a method for targeting deep muscles of the dorsal neck in non-human primates with intramuscular electrodes that are inserted acutely. Electrode insertion is guided by ultrasonography, which is necessary to ensure placement of the electrode in the target muscle. To confirm electrode placement, we delivered threshold electrical stimulation through the intramuscular electrode and visualized the muscle twitch. In one animal, we also compared recordings obtained from acutely- and chronically-implanted electrodes. This method increases the options for accessing deep neck muscles, and hence could be used in experiments for which the invasive surgery inherent to a chronic implant is not appropriate. This method could also be extended to the injection of pharmacological agents or anatomical tracers into specific neck muscles.
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Schomacher J, Dideriksen JL, Farina D, Falla D. Recruitment of motor units in two fascicles of the semispinalis cervicis muscle. J Neurophysiol 2012; 107:3078-85. [PMID: 22402657 DOI: 10.1152/jn.00953.2011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study investigated the behavior of motor units in the semispinalis cervicis muscle. Intramuscular EMG recordings were obtained unilaterally at levels C2 and C5 in 15 healthy volunteers (8 men, 7 women) who performed isometric neck extensions at 5%, 10%, and 20% of the maximal force [maximum voluntary contraction (MVC)] for 2 min each and linearly increasing force contractions from 0 to 30% MVC over 3 s. Individual motor unit action potentials were identified. The discharge rate and interspike interval variability of the motor units in the two locations did not differ. However, the recruitment threshold of motor units detected at C2 (n = 16, mean ± SD: 10.3 ± 6.0% MVC) was greater than that of motor units detected at C5 (n = 92, 6.9 ± 4.3% MVC) (P < 0.01). A significant level of short-term synchronization was identified in 246 of 307 motor unit pairs when computed within one spinal level but only in 28 of 110 pairs of motor units between the two levels. The common input strength, which quantifies motor unit synchronization, was greater for pairs within one level (0.47 ± 0.32) compared with pairs between levels (0.09 ± 0.07) (P < 0.05). In a second experiment on eight healthy subjects, interference EMG was recorded from the same locations during a linearly increasing force contraction from 0 to 40% MVC and showed significantly greater EMG amplitude at C5 than at C2. In conclusion, synaptic input is distributed partly independently and nonuniformly to different fascicles of the semispinalis cervicis muscle.
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Affiliation(s)
- Jochen Schomacher
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Bexander CSM, Hodges PW. Cervico-ocular coordination during neck rotation is distorted in people with whiplash-associated disorders. Exp Brain Res 2011; 217:67-77. [PMID: 22179527 DOI: 10.1007/s00221-011-2973-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 11/30/2011] [Indexed: 12/20/2022]
Abstract
People with whiplash-associated disorders (WAD) not only suffer from neck/head pain, but commonly report deficits in eye movement control. Recent work has highlighted a strong relationship between eye and neck muscle activation in pain-free subjects. It is possible that WAD may disrupt the intricate coordination between eye and neck movement. Electromyographic activity (EMG) of muscles that rotate the cervical spine to the right (left sternocleidomastoid, right obliquus capitis inferior (OI), right splenius capitis (SC) and right multifidus (MF)) was recorded in nine people with chronic WAD. Cervical rotation was performed with five gaze conditions involving different gaze directions relative to cervical rotation. The relationship between eye position/movement and neck muscle activity was contrasted with previous observations from pain-free controls. Three main differences were observed in WAD. First, the superficial muscle SC was active with both directions of cervical rotation in contrast to activity only with right rotation in pain-free controls. Second, activity of OI and MF varied between directions of cervical rotation, unlike the non-direction-specific activity in controls. Third, the effect of horizontal gaze direction on neck muscle EMG was augmented compared to controls. These observations provide evidence of redistribution of activity between neck muscles during cervical rotation and increased interaction between eye and neck muscle activity in people with WAD. These changes in cervico-ocular coordination may underlie clinical symptoms reported by people with WAD that involve visual deficits and changes in function during cervical rotation such as postural control.
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Affiliation(s)
- Catharina S M Bexander
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
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Goonetilleke SC, Gribble PL, Mirsattari SM, Doherty TJ, Corneil BD. Neck muscle responses evoked by transcranial magnetic stimulation of the human frontal eye fields. Eur J Neurosci 2011; 33:2155-67. [DOI: 10.1111/j.1460-9568.2011.07711.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shugg JAJ, Jackson CD, Dickey JP. Cervical spine rotation and range of motion: pilot measurements during driving. TRAFFIC INJURY PREVENTION 2011; 12:82-87. [PMID: 21259177 DOI: 10.1080/15389588.2010.529973] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Previous studies have evaluated the cervical range of axial rotation during simulated driving conditions. The goals of this pilot study were to describe cervical spine rotation during in-car driving and determine the percentage of time outside neutral neck rotation and peak cervical axial rotation angles that the subjects adopted during various driving conditions. METHODS Subjects drove around a specified route through the city of Guelph, Ontario, which included residential, thruway, and highway driving; additional minor driving tasks, such as lane changes, were also included. The cervical range of motion was measured continuously throughout the drive using an electromagnetic sensor; we also used videotape to document the specific driving tasks. RESULTS The subjects spent 87.0 percent (SD=8.8) of time with their cervical spine in the neutral axial rotation position (±15 degrees). The percentage of time that the subjects spent outside of the neutral range of cervical axial rotation depended upon the driving section (including residential, thruway, and highway), and driving task being performed (starts, stops, and lane changes). The subjects spent a significantly greater proportion of time with their necks rotated beyond neutral during residential driving compared to thruway and highway driving (19.1% SD=8.3 vs. 10.7% SD=9.5 and 9.3% SD=8.7, respectively; p<.001). During driving, the peak angles of cervical axial rotation were an average of 35.7 degrees (SD=14.2) left and 42.5 degrees (SD=18.0) right. CONCLUSIONS We observed a large degree of variability in cervical axial rotation during driving. We observed that most of the driving tasks related to stopping had increased proportion of time out of neutral rotation. Also, right-hand lane changes increased time out of neutral rotation more than left-hand lane changes. Drivers routinely adopt nonneutral head positions (on average 13% of the time); this is likely not enough to lead to injury.
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Affiliation(s)
- Jarrod A J Shugg
- Joint Biomechanics Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
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Abstract
SYNOPSIS There is irrefutable evidence of an association between mechanical neck pain (MNP) and dysfunction of the muscles of the cervical spine. A myriad of impairments have been demonstrated that include changes in the physical structure (cross-sectional area, fatty infiltration, fiber type), as well as changes in behavior (timing and activation level), of the cervical muscles. Such changes suggest an impaired capacity of the cervical muscles to generate, sustain, and maintain precision of the required levels of torque needed for optimal function. In the context of physical support, these changes potentially have deleterious consequences for the cervical region, which relies heavily on its muscles for mechanical stability. While interventions focused on the retraining of cervical muscle function have shown favorable responses in alleviating MNP, the development of best practice strategies for the assessment and management of cervical muscle dysfunction is still a work in progress. One obstacle in researching the efficacy of cervical muscle training is that, as yet, we do not possess the capacity to optimally measure and classify those patients most likely to respond to different methods of training that would enrich clinical practice. While gains in this area are emerging, the ability of a clinician to best identify the need and implement the most appropriate method of training cervical muscle function is still largely dependent on a comprehensive examination of the patient that considers all aspects of the patient's disorder and functional requirements. LEVEL OF EVIDENCE Level 5.
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Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther 2009; 39:364-77. [PMID: 19411769 DOI: 10.2519/jospt.2009.2834] [Citation(s) in RCA: 202] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
SYNOPSIS The term sensorimotor describes all the afferent, efferent, and central integration and processing components involved in maintaining stability in the postural control system through intrinsic motor-control properties. The scope of this paper is to highlight the sensorimotor deficits that can arise from altered cervical afferent input. From a clinical orthopaedic perspective, the peripheral mechanoreceptors are the most important in functional joint stability; but in the cervical region they are also important for postural stability, as well as head and eye movement control. Consequently, conventional musculoskeletal intervention approaches may be sufficient only for patients with neck pain and minimal sensorimotor proprioceptive disturbances. Clinical experience and research indicates that significant sensorimotor cervical proprioceptive disturbances might be an important factor in the maintenance, recurrence, or progression of various symptoms in some patients with neck pain. In these cases, more specific and novel treatment methods are needed which progressively address neck position and movement sense, as well as cervicogenic oculomotor disturbances, postural stability, and cervicogenic dizziness. In this commentary we review the most relevant theoretical and practical knowledge on this matter and implications for clinical assessment and management, and we propose future directions for research. LEVEL OF EVIDENCE Level 5.
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Blouin JS, Siegmund GP, Carpenter MG, Inglis JT. Neural control of superficial and deep neck muscles in humans. J Neurophysiol 2007; 98:920-8. [PMID: 17537909 DOI: 10.1152/jn.00183.2007] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Human neck muscles have a complex multi-layered architecture. The role and neural control of these neck muscles were examined in nine seated subjects performing three series of isometric neck muscle contractions: 50-N contractions in eight fixed horizontal directions, 25-N contractions, and 50-N contractions, both with a continuously changing horizontal force direction. Activity in the left sternocleidomastoid, trapezius, levator scapulae, splenius capitis, semispinalis capitis, semispinalis cervicis, and multifidus muscles was measured with wire electrodes inserted at the C(4)/C(5) level under ultrasound guidance. We hypothesized that deep and superficial neck muscles would function as postural and focal muscles, respectively, and would thus be controlled by different neural signals. To test these hypotheses, electromyographic (EMG) tuning curves and correlations in the temporal and frequency domains were computed. Three main results emerged from these analyses: EMG tuning curves from all muscles exhibited well-defined preferred directions of activation for the 50-N isometric forces, larger contractions (25 vs. 50 N) yielded more focused EMG tuning curves, and agonist neck muscles from all layers received a common neural drive in the range of 10-15 Hz. The current results demonstrate that all neck muscles can exhibit phasic activity during isometric neck muscle contractions. Similar oscillations in the EMG of neck muscles from different layers further suggest that neck motoneurons were activated by common neurons. The reticular formation appears a likely generator of the common drive to the neck motoneurons due to its widespread projections to different groups of neck motoneurons.
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Kobayashi M, Yabushita T, Zeredo JL, Toda K, Soma K. Splenius muscle activities induced by temporomandibular joint stimulation in rats. Brain Res Bull 2007; 72:44-8. [PMID: 17303506 DOI: 10.1016/j.brainresbull.2006.10.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Revised: 10/26/2006] [Accepted: 10/31/2006] [Indexed: 11/25/2022]
Abstract
Recent studies show that temporomandibular joint disorders cause hyperalgesia and deficits in the postural control of cervical region. However, the effects of specific modalities of receptors in the temporomandibular joint area on these phenomena are still unclear. In this study, we investigated the neck muscle activities while natural mechanical stimulation was applied to the temporomandibular joint. Single motor unit activities were recorded bilaterally from the splenius muscles in 22 Wistar rats. Mechanical stimulation applied to the left temporomandibular joint elicited tonic discharges in the left or right splenius muscle. The mean threshold values for mechanical stimulation were 48.1 (+/-16.2 S.E.M.) and 54.1 mN (+/-16.3 S.E.M.) for left and right sides, respectively. It is suggested that the temporomandibular joint mechanoreceptors not only affect the motor unit activities of neck muscles, but also are concerned in the regulation of postural control of the head.
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Affiliation(s)
- Masaki Kobayashi
- Orthodontic Science, Department of Orofacial Development and Function, Division of Oral Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo 113-8549, Japan.
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