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Qu N, Jin J, Wang X, Deng Y, Zhang B, Qi Q. Quantitatively assessing the effect of cervical sagittal alignment on dynamic intervertebral kinematics by video-fluoroscopy technique. Musculoskelet Sci Pract 2024; 72:102959. [PMID: 38626497 DOI: 10.1016/j.msksp.2024.102959] [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: 07/10/2023] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Cervical sagittal alignment is crucial for distributing the head load to lower cervical segments and maintaining normal cervical spine function, but its biomechanical effect on the cervical spine was not fully elucidated. OBJECTIVE To investigate the effect of cervical sagittal alignment on dynamic intervertebral kinematics. DESIGN Cross-sectional study. METHODS Healthy participants without neck pain were recruited and divided into lordosis, straight and kyphosis groups according to the C2-C7 Cobb angle at the neutral position. The anti-directional and total joint motions were extracted across 10 epochs of dynamic cervical flexion and extension movements. RESULTS /findings: The overall anti-directional joint motion during flexion is larger in the kyphosis group when compared with the lordosis group (p = 0.021), while the range of flexion is smaller in the kyphosis group than that in the lordosis group (p = 0.017). The C2/C3 anti-directional joint motion during extension in the straight group is larger than that in the lordosis group (p = 0016). The range of extension in the kyphosis group (p < 0.001) and the straight group (p = 0.002) are larger than that in the lordosis group. The increased range of extension in the kyphosis and straight groups were mainly from the C3/C4, C4/C5, and C5/C6 joints(p < 0.05). CONCLUSION Changes in cervical sagittal alignment alter both the quality and quantity of the individual joint motions. More adjustments are required by the cervical joints to complete neck movements with the loss of lordosis. The lordotic curvature is a relatively effort-saving mode for the cervical spine from a biomechanical perspective.
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Affiliation(s)
- Ning Qu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - JiaHao Jin
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xu Wang
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - YanQun Deng
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Bin Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - QiHua Qi
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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O'Toole R, Watson D. Manual cervical therapy and vestibular migraine: A case series. HEALTH OPEN RESEARCH 2023; 5:12. [PMID: 38708034 PMCID: PMC11065132 DOI: 10.12688/healthopenres.13319.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 05/07/2024]
Abstract
Background Vestibular migraine (VM) is a relatively new diagnostic entity with incomplete knowledge regarding pathophysiological mechanisms and therapeutic guidelines. By reporting the effect of manual cervical therapy (MCT) on people with VM, we suggest a possible role for upper cervical afferents in VM treatment and/or pathogenesis. The objective was to describe the change in clinical presentation and self-reported symptoms of VM corresponding to MCT and followed up to six months. Methods A nonrandomised *ABA design was utilised to consecutively and prospectively evaluate selected patients with diagnosed VM. Symptom characteristics (frequency and intensity) were recorded along with standardised patient-reported outcomes (PROs) to document the response to MCT. Results Three patients were recruited who met the diagnostic criteria for VM. All three patients demonstrated improvement in both migraine attack and interictal symptom frequency. These improvements mirrored changes in PROs and were sustained over a six-month follow-up period. Conclusions The improvement that coincided with the intervention including MCT was rapid, observable and sustained. This suggests that the upper cervical spine could be a therapeutic target in VM and may have implications for future research into the pathogenesis of VM.
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Affiliation(s)
- Roger O'Toole
- Melbourne Headache Centre, Melbourne, Victoria, 3000, Australia
| | - Dean Watson
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Qu N, Tian H, De Martino E, Zhang B. Neck Pain: Do We Know Enough About the Sensorimotor Control System? Front Comput Neurosci 2022; 16:946514. [PMID: 35910451 PMCID: PMC9337601 DOI: 10.3389/fncom.2022.946514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Neck pain is a worldwide health problem. Clarifying the etiology and providing effective interventions are challenging for the multifactorial nature of neck pain. As an essential component of cervical spine function, the sensorimotor control system has been extensively studied in both healthy and pathological conditions. Proprioceptive signals generated from cervical structures are crucial to normal cervical functions, and abnormal proprioception caused by neck pain leads to alterations in neural plasticity, cervical muscle recruitment and cervical kinematics. The long-term sensorimotor disturbance and maladaptive neural plasticity are supposed to contribute to the recurrence and chronicity of neck pain. Therefore, multiple clinical evaluations and treatments aiming at restoring the sensorimotor control system and neural plasticity have been proposed. This paper provides a short review on neck pain from perspectives of proprioception, sensorimotor control system, neural plasticity and potential interventions. Future research may need to clarify the molecular mechanism underlying proprioception and pain. The existing assessment methods of cervical proprioceptive impairment and corresponding treatments may need to be systematically reevaluated and standardized. Additionally, new precise motor parameters reflecting sensorimotor deficit and more effective interventions targeting the sensorimotor control system or neural plasticity are encouraged to be proposed.
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Affiliation(s)
- Ning Qu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - HaoChun Tian
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Enrico De Martino
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Aerospace Medicine and Rehabilitation Laboratory, Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bin Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Bin Zhang,
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Wang X, Qu N, Wang Y, Dong J, Jiao J, Wu M. Effects of experimental pain on the cervical spine reposition errors. BMC Musculoskelet Disord 2022; 23:259. [PMID: 35300653 PMCID: PMC8932173 DOI: 10.1186/s12891-022-05170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/28/2022] [Indexed: 12/04/2022] Open
Abstract
Background Healthy subjects showed normal variance of cervical spine reposition errors of approximately 2 degrees. Effects of experimental pain on cervical spine reposition errors were unknown; thus, the purpose of this study was to investigate the effects of experimental pain on cervical spine reposition errors. Methods A repeated measured study design was applied. Thirty healthy subjects (12 males) were recruited. Reposition errors were extracted from upright cervical positions before and after cervical flexion movement in healthy subjects before and during experimental neck pain. Cervical spine reposition errors were calculated based on anatomical landmarks of each cervical joint. Reposition errors were extracted in degrees as constant errors and absolute errors for further statistical analysis. Repeated measures analysis of variance (RM-ANOVA) was applied to analyse experimental pain effects on either constant errors or absolute errors of different cervical joints. Results The cervical spine showed non-significant difference in reposition errors regarding the constant errors (P>0.05) while larger reposition errors regarding the absolute errors during experimental pain compared to before experimental pain (P<0.001). In addition, the pain level joint (C4/C5) and its adjacent joints (C3/C4 and C5/C6) indicated larger reposition errors regarding absolute errors (P=0.035, P=0.329 and P=0.103, respectively). Conclusions This study firstly investigated the cervical spine reposition errors in experimental neck pain and further found the joints adjacent to the pain level showed larger errors compared to the distant joints regarding absolute errors. It may imply that the larger reposition errors in specific cervical joint indicate probable injury or pain existed adjacent to the joints. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05170-7.
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Affiliation(s)
- Xu Wang
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China
| | - Ning Qu
- The Department of Orthopaedics, The first Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Yang Wang
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China
| | - Jian Dong
- The Department of Rehabilitation, China- Japan Union Hospital of Jilin University, Changchun, 130021, China
| | - Jianhang Jiao
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China
| | - Minfei Wu
- The Department of Spine, The second Hospital of Jilin University, Jilin University, Changchun, 130041, China.
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Zhou Y, Zhou W, Aisaiti A, Wang B, Zhang J, Svensson P, Wang K. Dentists have a high occupational risk of neck disorders with impact on somatosensory function and neck mobility. J Occup Health 2021; 63:e12269. [PMID: 34390307 PMCID: PMC8363657 DOI: 10.1002/1348-9585.12269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/06/2021] [Accepted: 07/26/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Musculoskeletal disorders (MSDs) in the neck and shoulder region may be associated with significant impairment of quality of life and well-being. The study was to determine the prevalence of painful MSDs in Chinese dentists and evaluate somatosensory function and neck mobility compared with non-dental professional controls. METHODS One hundred dentists (age: 36.5 ± 9.8 years) and 102 controls (age: 36.2 ± 10.0 years) were recruited between September 2019 and December 2020. The Medical Outcome Study 36-item short-form health survey questionnaire and information of MSDs history were recorded. The cervical range of motion (CROM) with and without pain, and the pressure pain thresholds (PPTs) of the facial and neck muscles were tested. Chi-square test, Mann-Whitney U test and multiple linear regression analysis were used to analyze the data. The factors in the multiple linear regression analysis were occupation, working age, and gender. RESULTS The prevalence rate of neck pain was significantly higher in dentists (73.0%) compared with the controls (52.0%) (P = .002). The regression models of cervical range of posterior extension, lateral flexion and rotation were statistically significant (P ≤ .001). The regression models of PPTs of the tested facial and neck muscles were statistically significant (P < .001). CONCLUSION Dentists are at higher risk of neck pain. The bigger cervical range of left rotation of dentists could be related to the working posture. The lower PPTs in dentists may reflect a hypersensitivity in the facial and neck muscles. Preventive measures are needed to reduce occupational hazards in dentists.
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Affiliation(s)
- Yanli Zhou
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Department of TMD and Orofacial Pain, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Weina Zhou
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Department of TMD and Orofacial Pain, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Jiangsu Key Laboratory of Oral Diseases, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Adila Aisaiti
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Department of TMD and Orofacial Pain, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Bingjie Wang
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Department of TMD and Orofacial Pain, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jinglu Zhang
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Department of TMD and Orofacial Pain, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Jiangsu Key Laboratory of Oral Diseases, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Peter Svensson
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmo, Sweden
| | - Kelun Wang
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Andersen V, Wang X, de Zee M, Østergaard LR, Plocharski M, Lindstroem R. The global end-ranges of neck flexion and extension do not represent the maximum rotational ranges of the cervical intervertebral joints in healthy adults - an observational study. Chiropr Man Therap 2021; 29:18. [PMID: 34034773 PMCID: PMC8145792 DOI: 10.1186/s12998-021-00376-3] [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: 10/14/2020] [Accepted: 05/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background In clinical diagnosis, the maximum motion of a cervical joint is thought to be found at the joint’s end-range and it is this perception that forms the basis for the interpretation of flexion/extension imaging studies. There have however, been representative cases of joints producing their maximum motion before end-range, but this phenomenon is yet to be quantified. Purpose To provide a quantitative assessment of the difference between maximum joint motion and joint end-range in healthy subjects. Secondarily to classify joints into type based on their motion and to assess the proportions of these joint types. Study design This is an observational study. Subject sample Thirty-three healthy subjects participated in the study. Outcome measures Maximum motion, end-range motion and surplus motion (the difference between maximum motion and end-range) in degrees were extracted from each cervical joint. Methods Thirty-three subjects performed one flexion and one extension motion excursion under video fluoroscopy. The motion excursions were divided into 10% epochs, from which maximum motion, end-range and surplus motion were extracted. Surplus motion was then assessed in quartiles and joints were classified into type according to end-range. Results For flexion 48.9% and for extension 47.2% of joints produced maximum motion before joint end-range (type S). For flexion 45.9% and for extension 46.8% of joints produced maximum motion at joint end-range (type C). For flexion 5.2% of joints and for extension 6.1% of joints concluded their motion anti-directionally (type A). Significant differences were found for C2/C3 (P = 0.000), C3/C4 (P = 0.001) and C4/C5 (P = 0.005) in flexion and C1/C2 (P = 0.004), C3/C4 (P = 0.013) and C6/C7 (P = 0.013) in extension when comparing the joint end- range of type C and type S. The average pro-directional (motion in the direction of neck motion) surplus motion was 2.41° ± 2.12° with a range of (0.07° -14.23°) for flexion and 2.02° ± 1.70° with a range of (0.04°-6.97°) for extension. Conclusion This is the first study to categorise joints by type of motion. It cannot be assumed that end-range is a demonstration of a joint’s maximum motion, as type S constituted approximately half of the joints analysed in this study.
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Affiliation(s)
- Victoria Andersen
- Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark.
| | - Xu Wang
- The Second Hospital of Jilin University, Jilin University, Qianjin St. 2699, Changchun, 130021, China.
| | - Mark de Zee
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
| | - Lasse Riis Østergaard
- Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
| | - Maciej Plocharski
- Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
| | - René Lindstroem
- Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
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Novel assessment of the variation in cervical inter-vertebral motor control in a healthy pain-free population. Sci Rep 2021; 11:10769. [PMID: 34031512 PMCID: PMC8144187 DOI: 10.1038/s41598-021-90306-3] [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: 01/25/2021] [Accepted: 04/19/2021] [Indexed: 11/09/2022] Open
Abstract
Spinal control at intervertebral levels is dependent on interactions between the active, passive and neural control elements. However, this has never been quantifiable, and has therefore been outside the reach of clinical assessments and research. This study used fluoroscopy during repeated unconstrained flexion and return neck movements to calculate intersegmental motor control (MC), defined as the difference and variation in repeated continuous angular motion from its average path. The study aimed to determine control values for MC at individual levels and its variability. Twenty male volunteers aged 19–29 received fluoroscopic screening of their cervical spines during 4 repetitions of neutral to full flexion and return motion. Moving vertebral images from C0–C1 to C6–C7 were tracked using cross-correlation codes written in Matlab. MC for each level was defined as the mean of the absolute differences between each repetition’s angular path and their mean and its variability as represented by the SD. 1-way ANOVA and Tukey multiple comparisons were used to identify significant contrasts between levels. The mean MC differences and SDs were highest at C1-2, suggesting that this level has the least control and the most variability. Results at this level alone were highly significant (F-ratio 10.88 and 9.79 P < 0.0001). Significant contrasts were only found between C1-C2 and all other levels. The mean MC difference for summed C1-6 levels was 3.4° (0.7–6.1). This study is the first to quantify intervertebral MC in the cervical spine in asymptomatic people. Studies of neck pain patients are now merited.
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Alsultan F, Cescon C, Heneghan NR, Rushton A, Barbero M, Falla D. Eccentric exercise and delayed onset muscle soreness reduce the variability of active cervical movements. J Biomech 2020; 111:109962. [PMID: 32882522 DOI: 10.1016/j.jbiomech.2020.109962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 11/18/2022]
Abstract
People with acute neck pain commonly present with restricted neck movement. However, it is unknown whether the presence of acute pain affects the quality of neck movement, specifically neck movement variability. We examined the effects of acute neck muscle soreness induced via eccentric exercise in healthy volunteers, on the variability of neck movement by examining changes in parameters of the helical axis during active neck movements. An experimental, single-arm repeated measures study recruited 32 healthy participants, male and female, aged between 18 and 55 years. Repetitive active neck movements (flexion-extension, bilateral lateral flexion and bilateral rotation) were performed at different speeds, either at full range of motion (RoM) or restricted to 45° RoM at baseline, pre-exercise (T0), immediately following eccentric neck exercise (T1), 24 h (T2) and 48 h post-exercise (T3). The mean distance (MD) and mean angle (MA) parameters of the helical axis were extracted to quantify movement variability. MD, measured during movements performed at full RoM, reduced significantly at T2 compared to T0 (P = 0.001) regardless of direction or speed of movement. MA was significantly lower at T2 and T3 compared to T1 (P = 0.029 and P = 0.033, respectively). When RoM was restricted to 45°, significantly lower MD values were observed at T3 compared to T1 (P = 0.034), and significantly lower MA values were measured at T3 compared to T0, T1 and T2 (all P < 0.0001). This study uniquely demonstrates that neck movement variability is reduced immediately after, 24 h and 48 h after eccentric exercise, indicating that acute neck muscle soreness modifies the quality of neck movement.
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Affiliation(s)
- Feras Alsultan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK; Physical Therapy Department, College of Medical Rehabilitation, Qassim University, Buraidah, Saudi Arabia
| | - Corrado Cescon
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
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Qu N, Graven-Nielsen T, Lindstrøm R, Blogg Andersen Dc V, Hirata RP. Recurrent neck pain patients exhibit altered joint motion pattern during cervical flexion and extension movements. Clin Biomech (Bristol, Avon) 2020; 71:125-132. [PMID: 31726402 DOI: 10.1016/j.clinbiomech.2019.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/23/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impaired sensorimotor ability has been demonstrated in recurrent neck pain patients. It is however not clear if cervical joint motion and pressure pain sensitivity in recurrent neck pain patients are different from asymptomatic controls. METHODS Cervical flexion and extension motions were examined by video-fluoroscopy and pressure pain thresholds were assessed bilaterally over C2/C3, C5/C6 facet joints and right tibialis anterior in eighteen recurrent neck pain patients and eighteen healthy subjects. Individual joint motion was analyzed by dividing fluoroscopic videos into 10 epochs. The motion opposite to the primary direction (anti-directional motion) and motion along with the primary direction (pro-directional motion) of each joint were extracted across epochs. Total joint motion was the sum of anti-directional and pro-directional motions. Joint motion variability was represented by the variance of joint motions across epochs. FINDINGS Compared to controls, recurrent neck pain patients showed: 1) decreased anti-directional motion at C2/C3 and C3/C4 (P < 0.05) and increased anti-directional motion at C5/C6 and C6/C7 (P < 0.05) during extension motion. 2) Increased overall anti-direction motion during flexion motion (P < 0.05). 3) Lower joint motion variability at C3/C4 during extension motion (P < 0.05). INTERPRETATION Recurrent neck pain patients showed a redistribution of anti-directional motion between the middle cervical spine and the lower cervical spine during cervical extension and increased overall anti-directional motion during cervical flexion compared with healthy controls. The anti-directional motion was more sensitive to neck pain compared to other cervical joint motion parameters in the present study.
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Affiliation(s)
- Ning Qu
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Rene Lindstrøm
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | | | - Rogerio Pessoto Hirata
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark.
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