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Hii EYX, Kuo YL, Cheng KC, Hung CH, Tsai YJ. Ultrasonographic measurement indicated patients with chronic neck pain had reduced diaphragm thickness and mobility along with declined respiratory functions. Musculoskelet Sci Pract 2024; 72:102951. [PMID: 38615408 DOI: 10.1016/j.msksp.2024.102951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Chronic neck pain (CNP) is a prevalent musculoskeletal condition including notable impairments in respiratory function. The diaphragm, serving dual roles in respiration and spinal stability, is intricately linked to the cervical spine through fascial, neurophysiological, and biomechanical connections. However, to date, none has investigated the diaphragm function in patients with CNP. OBJECTIVES To investigate the diaphragm function, respiratory muscle strength, and pulmonary function in patients with CNP. In addition, their associations were also examined. DESIGN A case-control study. METHODS A total of 54 participants were recruited including 25 patients with CNP (CNP group) and 29 healthy adults (CON group). Pulmonary function including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), and respiratory muscle strength represented by maximal inspiratory (MIP) and maximal expiratory pressure (MEP), as well as diaphragm function including ultrasonographic measures of mobility and thickness changes during maximal inspiration and expiration were assessed in all participants. Additionally, the intensity of pain and disability were evaluated using a Visual Analog Scale and Neck Disability Index only in patients with CNP. RESULTS Significant reductions of the FVC, FEV1, MIP, and MEP were found in the CNP group compared to the CON group (p < 0.05). The diaphragm mobility and thickness changes were also significantly decreased in the CNP group than the CON group with medium effect sizes (p < 0.05). Only diaphragm thickness change was positively correlated with FVC, FEV1, and MEP in patients with CNP. Furthermore, MEP showed the strongest contribution to diaphragm thickness change based on the regression analysis. CONCLUSIONS Impaired diaphragm function, respiratory muscle strength, and pulmonary function were observed in patients with CNP. Patients with smaller diaphragm thickness change had poorer pulmonary function and reduced maximal expiratory muscle strength. Diaphragm assessment and intervention may be considered in CNP management.
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Affiliation(s)
- Everlynn Yi-Xuan Hii
- Department of Physiotherapy, Faculty of Health and Life Science, INTI International University, Persiaran Perdana BBN, Putra Nilai, 71800, Nilai, Negeri Sembilan, Malaysia.
| | - Yi-Liang Kuo
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, Tainan, 701, Taiwan; Physical Therapy Center, National Cheng Kung University Hospital, No.138, Sheng Li Road, Tainan, 704, Taiwan.
| | - Kai-Chia Cheng
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, Tainan, 701, Taiwan.
| | - Ching-Hsia Hung
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, Tainan, 701, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, Tainan, 701, Taiwan.
| | - Yi-Ju Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, Tainan, 701, Taiwan; Physical Therapy Center, National Cheng Kung University Hospital, No.138, Sheng Li Road, Tainan, 704, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, Tainan, 701, Taiwan.
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Hernandez-Lucas P, Leirós-Rodríguez R, Lopez-Barreiro J, García-Soidán JL. Prevention of neck pain in adults with a Back School-Based intervention: a randomized controlled trial. Physiother Theory Pract 2024:1-11. [PMID: 38362871 DOI: 10.1080/09593985.2024.2316313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Neck pain is a health problem worldwide. To prevent it, experts recommend exercise and education. OBJECTIVE To evaluate the effects of a Back School-based intervention for the prevention of nonspecific neck pain in a healthy adult population. METHODS A randomized controlled trial with 58 participants with no history of neck pain within the past six months. The experimental group performed an 8-week Back School-based program. The control group maintained their usual lifestyle. Primary outcomes, which include the number of episodes, days and intensity of neck pain, and the number of medical visits, were recorded in a 1-year follow-up diary and analyzed using the Mann-Whitney test. Secondary outcomes, such as neck flexor, neck extensor, and scapular muscles endurance, were analyzed using the ANOVA test. RESULTS In the analysis of the primary outcomes, no significant differences were found in the number of episodes (p = 0.068,d = -0.49), number of days (p = 0.059,d = -0.54), or the average intensity of neck pain (p = 0.061,d = -0.53). There were significant changes in the number of medical visits (p = 0.033,d = -0.57). Moving to secondary outcomes, significant interactions were observed in neck flexor (p = 0.045, ηp2 = 0.036) and neck extensor endurance (p = 0.049, ηp2 = 0.035), but not in scapular muscle endurance (p = 0.536, ηp2 = 0.003). CONCLUSIONS The Back School-based program reduced the number of medical visits and increased the endurance of the cervical musculature. Trial registration in ClinicalTrials.gov: NCT05260645.
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Affiliation(s)
- Pablo Hernandez-Lucas
- Department of Functional Biology and Health Sciences. Faculty of Physiotherapy, University of Vigo, Pontevedra, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group. Nursing and Physical Therapy Department, University of León, Ponferrada, Spain
| | - Juan Lopez-Barreiro
- Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain
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Figas G, Kostka J, Pikala M, Kujawa JE, Adamczewski T. Analysis of Clinical Pattern of Musculoskeletal Disorders in the Cervical and Cervico-Thoracic Regions of the Spine. J Clin Med 2024; 13:840. [PMID: 38337534 PMCID: PMC10856133 DOI: 10.3390/jcm13030840] [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: 12/05/2023] [Revised: 12/31/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Cervical spine disorders (CSDs) are a common cause of neck pain. Proper diagnosis is of great importance in planning the management of a patient with neck pain. Hence, the aim of this study is to provide an overview of the clinical pattern of early-stage functional disorders affecting the cervical and cervico-thoracic regions of the spine, considering the age and sex of the subjects. Methods: Two hundred adult volunteers were included in the study. Manual examination of segments C0/C1-Th3/Th4 was performed according to the methodology of the Katenborn-Evjenth manual therapy concept and the spine curvatures were assessed (cervical lordosis and thoracic kyphosis). Results: The most common restricted movement was lateral flexion to the left, and the least disturbed movement were observed in the sagittal plane (flexion and extension). The most affected segment was C7/Th1 (71.5% participants had problems in this segment), and the least affected segment was Th3/Th4 (69.5% participants had no mobility disorders in this segment). The number of disturbed segments did not differ between men and women (p > 0.05), but increased with age (r = 0.14, p = 0.04). Conclusions: Cervical mobility in adult population is frequently restricted. The number of affected segments increased with age and was not sex-dependent.
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Affiliation(s)
- Gabriela Figas
- Clinic of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (G.F.); (J.E.K.); (T.A.)
| | - Joanna Kostka
- Department of Gerontology, Medical University of Lodz, 93-113 Lodz, Poland
| | - Małgorzata Pikala
- Department of Epidemiology and Biostatistics, Medical University of Lodz, 90-752 Lodz, Poland;
| | - Jolanta Ewa Kujawa
- Clinic of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (G.F.); (J.E.K.); (T.A.)
| | - Tomasz Adamczewski
- Clinic of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (G.F.); (J.E.K.); (T.A.)
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Aragón-Basanta E, Venegas W, Ayala G, Page A, Serra-Añó P. Relationship between neck kinematics and neck dissability index. An approach based on functional regression. Sci Rep 2024; 14:215. [PMID: 38167615 PMCID: PMC10761888 DOI: 10.1038/s41598-023-50562-x] [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: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Numerous studies use numerical variables of neck movement to predict the level of severity of a pathology. However, the correlation between these numerical variables and disability levels is low, less than 0.4 in the best cases, even less in subjects with nonspecific neck pain. This work aims to use Functional Data Analysis (FDA), in particular scalar-on-function regression, to predict the Neck Disability Index (NDI) of subjects with nonspecific neck pain using the complete movement as predictors. Several functional regression models have been implemented, doubling the multiple correlation coefficient obtained when only scalar predictors are used. The best predictive model considers the angular velocity curves as a predictor, obtaining a multiple correlation coefficient of 0.64. In addition, functional models facilitate the interpretation of the relationship between the kinematic curves and the NDI since they allow identifying which parts of the curves most influence the differences in the predicted variable. In this case, the movement's braking phases contribute to a greater or lesser NDI. So, it is concluded that functional regression models have greater predictive capacity than usual ones by considering practically all the information in the curve while allowing a physical interpretation of the results.
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Affiliation(s)
- Elisa Aragón-Basanta
- Camino de Vera s/n, Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, 46022, Valencia, Spain.
| | - William Venegas
- Facultad de Ingeniería Mecánica, Escuela Politécnica Nacional, PO-Box 17-01-2759, Quito, Ecuador
| | - Guillermo Ayala
- Avda Vicent Andrés Estellés 1, Departament of Statistics and Operation Research, Universitat de València, 46100, Burjasot, Spain
| | - Alvaro Page
- Camino de Vera s/n, Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, 46022, Valencia, Spain
| | - Pilar Serra-Añó
- Gascó Oliag 5, Departament of Physiotherapy, Universitat de València, 46010, Valencia, Spain
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Rahnama L, Saberi M, Kashfi P, Rahnama M, Karimi N, Geil MD. Effects of Two Exercise Programs on Neck Proprioception in Patients with Chronic Neck Pain: A Preliminary Randomized Clinical Trial. Med Sci (Basel) 2023; 11:56. [PMID: 37755160 PMCID: PMC10535186 DOI: 10.3390/medsci11030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare the effects of specific neck muscle training and general neck-shoulder exercises on neck proprioception, pain, and disability in patients with chronic non-specific neck pain. METHODS Twenty-five patients with chronic non-specific neck pain were recruited into this preliminary single-blinded randomized clinical trial. They were randomly assigned to either a specific neck exercise (n = 13, mean aged 24 years) or a general neck exercise group (n = 12, mean aged 25 years). Specific neck exercises included eye-head coordination and isometric deep neck muscle exercises. General neck exercises included neck and shoulder free range of motion and shoulder shrug. Pain, disability, and neck proprioception, which was determined using the joint repositioning error, were measured at baseline and after eight weeks of training in both groups. RESULTS Both training groups showed significant improvements in joint repositioning error (p < 0.001, F = 24.144, ES = 0.8), pain (p < 0.001, F = 61.118, ES = 0.31), and disability (p = 0.015, F = 6.937, ES = 0.60). However, the specific neck exercise group showed larger variability in joint repositioning error (p = 0.006, F = 0.20, F critical = 0.36). CONCLUSIONS Either specific neck exercise or a general neck-shoulder range of motion exercise could be effective in improving neck proprioception. Therefore, exercises could be recommended based on patient comfort and patients' specific limitations.
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Affiliation(s)
- Leila Rahnama
- School of Kinesiology, Nutrition & Food Science, California State University, Los Angeles, CA 90032, USA
| | - Manizheh Saberi
- Department of Physiotherapy, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran;
- Department of physiotherapy, National University of Medical Sciences, 28001 Madrid, Spain
| | - Pegah Kashfi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13871, Iran (N.K.)
| | - Mahsa Rahnama
- School of Medicine, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Noureddin Karimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13871, Iran (N.K.)
| | - Mark D. Geil
- Wellstar College of Health Professions and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA;
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Hernandez-Lucas P, Leirós-Rodríguez R, Lopez-Barreiro J, García-Soidán JL. Effects of back school-based intervention on non-specific neck pain in adults: a randomized controlled trial. BMC Sports Sci Med Rehabil 2023; 15:60. [PMID: 37069599 PMCID: PMC10111684 DOI: 10.1186/s13102-023-00666-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 03/31/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND Neck pain has a high prevalence and socioeconomic impact worldwide. The Back School consists of programs that include exercises and educational interventions to treat back pain. Accordingly, the main objective was to evaluate the effects of an intervention based on Back School on non-specific neck pain in an adult population. The secondary objectives were to analyze the effects on disability, quality of life and kinesiophobia. METHODS A randomized controlled trial was conducted with 58 participants with non-specific neck pain divided into two groups. The experimental group (EG) carried out the 8-week programme based on the Back School, (two sessions per week, for a total of 16 sessions, lasting 45 min). Of all the classes, 14 had a practical focus (strengthening and flexibility exercises) and the other two had a theoretical focus (concepts of anatomy and healthy lifestyle). The control group (CG) stated that they did not vary their lifestyle. The assessment instruments were: Visual Analogue Scale, Neck Disability Index, Short-Form Health Survey-36 and Tampa Scale of Kinesiophobia. RESULTS The EG reduced pain (-40 points, CI95% [-42 to -37], g = -1.03, p < 0.001), EG had less disability (-9.3 points, CI95% [-10.8 to -7.8], g = -1.22, p < 0.001), EG improved the physical dimension of the survey Short-Form Health Survey-36 (4.8 points, CI95% [4.1 to 5.5], g = 0.55, p = 0.01) but had not significant change in psychosocial dimension of the survey Short-Form Health Survey-36 and EG reduced Kinesiophobia (-10.8 points, CI95% [-12.3 to -9.3], g = -1.84, p < 0.001). The CG did not obtain significant results in any variable of the study. Significant differences in change between both groups were found on pain (-11 points, CI95% [5.6 to 16.6], p < 0.001, g = 1.04), disability (-4 points, CI95% [2.5 to 6.2], p < 0.001, g = 1.23), physical dimension of the survey Short-Form Health Survey-36 (3 points, CI95% [-4-4 to -2-5], p = 0.01, g = -1.88), and kinesiophobia ( 7 points, CI95%[-8.3 to -5.4], p < 0.001, g = 2.04), while no significant differences were found on psychosocial dimension of the survey Short-Form Health Survey-36 (-0.02, CI95% [-1.7 to 1.8], g = 0.01, p = 0.98). CONCLUSIONS The back school-based programme has beneficial effects on pain, neck disability, the physical dimension of quality of life and kinesiophobia in an adult population with non-specific neck pain. However, it did not lead to improvements in the psychosocial dimension of the participants' quality of life. This programme could be applied by health care providers with the aim of reducing the severe socio-economic impact of non-specific neck pain worldwide. TRIAL REGISTRATION IN CLINICALTRIALS.GOV: NCT05244876 (registered prospectively, date of registration: 17/02/2022).
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Affiliation(s)
- Pablo Hernandez-Lucas
- Faculty of Physiotherapy, University of Vigo, Campus A Xunqueira, Pontevedra, 36005, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, Ponferrada, 24401, Spain.
| | - Juan Lopez-Barreiro
- Faculty of Education and Sport Sciences, University of Vigo, Campus A Xunqueira, Pontevedra, 36005, Spain
| | - José L García-Soidán
- Faculty of Education and Sport Sciences, University of Vigo, Campus A Xunqueira, Pontevedra, 36005, Spain
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Srikrajang S, Kanlayanaphotporn R. Effects of active scapular correction on cervical range of motion, pain, and pressure pain threshold in patients with chronic neck pain and depressed scapula: a randomized controlled trial. J Man Manip Ther 2023; 31:24-31. [PMID: 35588354 PMCID: PMC9848379 DOI: 10.1080/10669817.2022.2077515] [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: 01/21/2023] Open
Abstract
BACKGROUND Correction of scapular alignment is advocated as a component for alleviating symptoms for patients with neck pain. OBJECTIVE The study aimed to examine the effect of active scapular correction on cervical range of motion (ROM), pain, and pressure pain threshold (PPT) in patients with chronic neck pain with depressed scapula. METHODS A randomized control trial research design was conducted. Twenty-eight participants with chronic neck pain and depressed scapula were randomly assigned to either the intervention (n = 14) or control (n = 14) group. Active cervical rotation ROM, pain at maximum cervical rotation, and PPT over the upper trapezius muscle region were measured at baseline and post active scapular correction. RESULTS The participants in the intervention group showed significantly greater active cervical rotation ROM and less pain at maximum cervical rotation than the control group, both on the ipsilateral (p < 0.01) and contralateral (p < 0.05) sides of the depressed scapula. No significant difference in PPT between the groups was demonstrated (p = 0.194). CONCLUSION Active scapular correction intervention resulted in an immediate increase in active cervical rotation ROM and a decrease in neck pain at maximum cervical rotation.
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Affiliation(s)
- Siwaluk Srikrajang
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand,CONTACT Rotsalai Kanlayanaphotporn ; Department of Physical Therapy, Faculty of Allied Health Sciences Chulalongkorn University154 Rama 1, Soi Chula 12, Pathumwan, Bangkok, 10330, Thailand
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Cheragh ZA, Gandomi F, Sakinehpoor A. Effects of typing positions on the upper trapezius and neck extensor muscles electromyography in office employees: A single-blind cross-sectional study. Work 2023; 74:255-263. [PMID: 36214012 DOI: 10.3233/wor-210909] [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: 01/15/2023] Open
Abstract
BACKGROUND Holding incorrect postures over a long period could lead to chronic nonspecific neck pain (CNNP) in office employees. OBJECTIVE The present study aimed to evaluate the effects of different typing positions on the activity of the neck extensor and upper trapezius (UT) muscles of office employees diagnosed with CNNP. METHODS This assessor-blinded cross-sectional study was performed on 22 female subjects with the mean age of 39.95±5.30 years. The neck extensors and UT muscle activities of the participants were assessed in the upright, forward, and slouching postures by electromyography (EMG). In addition, neck proprioception and the performance of the cervical stabilizer muscles were evaluated using an inclinometer and biofeedback pressure unit, respectively. RESULTS A significant difference was observed between the cervical erector spine (CES) and UT muscle activities in the upright, forward, and slouching typing positions (P < 0.05). In addition, a difference was observed between the upright and slouching postures in these muscles. A positive correlation was denoted between CES muscle activity in the slouching and forward postures and the activation index of neck muscles (P < 0.05). Furthermore, a significant, negative correlation was observed between the UT muscle activity in the slouching posture and neck proprioception (P < 0.05). A positive correlation was also noted between the pain index and repositioning error rates (P < 0.05). CONCLUSION CES muscle activity increased in a forward head posture, which could damage neck proprioception through causing early fatigue and stimulating a cumulative damage cycle.
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Affiliation(s)
- Zahra Ataei Cheragh
- Sport Injuries and Corrective Exercises Department, Physical Education and Sport Sciences Faculty, Razi University, Kermanshah, Iran
| | - Farzaneh Gandomi
- Sport Injuries and Corrective Exercises Department, Physical Education and Sport Sciences Faculty, Razi University, Kermanshah, Iran
| | - Aynollah Sakinehpoor
- Sport Injuries and Corrective Exercises Department, Physical Education and Sport Sciences Faculty, Kharazmi University, Tehran, Iran
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Martins TS, Pinheiro-Araujo CF, Gorla C, Florencio LL, Martins J, Fernández-de-Las-Peñas C, Oliveira AS, Bevilaqua-Grossi D. Neck Strength Evaluated With Fixed and Portable Dynamometers in Asymptomatic Individuals: Correlation, Concurrent Validity, and Agreement. J Manipulative Physiol Ther 2022; 45:543-550. [PMID: 36517269 DOI: 10.1016/j.jmpt.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the correlation, concurrent validity, and agreement between the isometric cervical force measurements obtained with fixed and portable dynamometers in asymptomatic individuals. METHODS Fifty asymptomatic individuals performed 3 maximal isometric contractions for flexion, extension, and lateral flexion of the cervical spine using fixed and portable dynamometers. The correlation and concurrent validity for the measurements of the portable and fixed dynamometers were analyzed using Spearman's correlation coefficient and the intraclass correlation coefficient (ICC), respectively. The agreement between the force values of the portable and fixed dynamometers was measured using the Bland-Altman method. RESULTS Isometric cervical force measurements obtained with the fixed dynamometer and portable dynamometer showed a moderately to highly significant correlation for flexion (rs = 0.74), extension (rs = 0.82), right lateral flexion (rs = 0.74), and left lateral flexion (rs = 0.68). The concurrent validity was moderate to good for all measurements (ICC2,3 = 0.67-0.80). The fixed and portable dynamometers did not agree, with a significant mean difference between the methods of 2.8 kgf (95% confidence interval [CI], 2.1-3.4 kgf) for cervical flexion, 5.3 kgf (95% CI, 4.2-6.4 kgf) for extension, and 9.1 kgf (95% CI, 0.4-2.1 kgf) for left lateral flexion. The limits of agreement were broad for all movements, with errors that varied between 61% and 77% of the mean force obtained with the fixed dynamometer. CONCLUSION The neck strength measurements obtained with the fixed and portable dynamometers demonstrated high to moderate correlation and had moderate to good comparability for asymptomatic participants. However, they did not agree in that the 2 methods did not provide equivalent measurements, and, therefore, based on these findings, the same equipment should always be used when reassessing an individual.
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Affiliation(s)
- Tais S Martins
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carina F Pinheiro-Araujo
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Camila Gorla
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lidiane L Florencio
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine of the University of Rey Juan Carlos, Alrcorcón, Madrid, Spain.
| | - Jaqueline Martins
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine of the University of Rey Juan Carlos, Alrcorcón, Madrid, Spain
| | - Anamaria S Oliveira
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Dağ F, Taş S, Çimen ÖB. Pulmonary Functions in Patients With Chronic Neck Pain: A Case-Control Study. J Manipulative Physiol Ther 2022; 45:290-297. [DOI: 10.1016/j.jmpt.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 06/08/2021] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
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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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Radosher A, Kalichman L, Moshe S, Ezra D, Simonovich A, Droujin J, Alperovitch-Najenson D. Upper Quadrant Pain and Disability Associated with a Cross-Sectional Area of Deep and Superficial Neck Muscles: A Computed Tomography Study. Spine (Phila Pa 1976) 2022; 47:E249-E257. [PMID: 34265811 DOI: 10.1097/brs.0000000000004164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN An analytical cross-sectional computed tomography (CT) study. OBJECTIVE To investigate the association of the cross-sectional area (CSA) and density of neck muscles (sternocleidomastoid, upper trapezius, levator scapulae, anterior scalene, longus coli, longus capitis) with upper quadrant pain and disability. SUMMARY OF BACKGROUND DATA Neck pain, a common condition, causes substantial disability to individuals. The deep cervical flexor muscles are impaired in persons with neck pain. These muscles play a greater role in maintaining stable head postures, whereas, superficial muscles are responsible for peak exertions and reinforcing spinal stability at terminal head postures. METHODS Two hundred thirty consecutive individuals suffering from neck pain were referred to CT scans; 124/230 complied with the inclusion and exclusion criteria. Subjects were interviewed and the measurements of the CSA and muscle density were extracted from the scans. RESULTS Muscles associated with quick disability of the arms, shoulders, and hand questionnaire (QDASH) were the lateral posterior group (LPG) CSA C3-C4 on the right side (beta = -0.31, P = 0.029); the sternocleidomastoid (SCM) CSA C3-C4 on the left side (beta = 0.29, P = 0.031); the LPG CSA C3-C4 on the left side (beta = -0.49, P = 0.000); the LCM CSA C5-C6 on the right side (beta = -0.19, P = 0.049); the LPG CSA C5-C6 on the right side (beta = -0.36, P = 0.012); and the LPG CSA C5-C6 on the left side (beta = -0.42, P = 0.002). Further analyses with radiculopathy acting as an augmenting/enhancing variable (moderator), showed an increase in the model strength (r2 = 0.25) with a stronger prediction of pain and disability. Muscle measurements did not predict neck disability index (NDI) scores. CONCLUSION By using an accurate measuring tool, we found an association of the deep and superficial neck muscles' CSA with upper extremities' pain and disability. When performing manual work, a special load is placed on the shoulders and neck muscles. Future research should focus on examining the effectiveness of exercise-type intervention programs to strengthen the deep neck and upper extremities' muscles in order to prevent muscle fatigue.Level of Evidence: 2.
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Affiliation(s)
- Avital Radosher
- Department of Ergonomics, Israel Institute for Occupational Safety and Hygiene, Tel Aviv, Israel
| | - Leonid Kalichman
- Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shlomo Moshe
- Department of Occupational Medicine, Maccabi Healthcare Services, Rishon Lezion, Israel
| | - David Ezra
- School of Nursing Sciences, Academic College of Tel Aviv-Jaffa, Jaffa, Israel
| | - Azaria Simonovich
- Department of Radiology, Barzilai University Medical Center, Ashkelon, Israel
| | - Jonathan Droujin
- Department of Radiology, Barzilai University Medical Center, Ashkelon, Israel
| | - Deborah Alperovitch-Najenson
- Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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13
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ASLAN M, ALPTEKIN HK, ÖZDEN AV, VURAL M, SÜLEYMAN T, ÖNCÜ ALPTEKIN J. Comparison of short-term effects of chiropractic cervical manipulation and kinesio taping treatments for patients diagnosed with mechanical neck pain. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.19.04294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Tsang SMH, Szeto GPY, So BCL, Lau RWL, Tai JJ. Using cervical movement velocity to assist the prediction of pain and functional recovery for people with chronic mechanical neck pain. Clin Biomech (Bristol, Avon) 2022; 93:105607. [PMID: 35245780 DOI: 10.1016/j.clinbiomech.2022.105607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impaired cervical kinematics particularly the movement velocity had been consistently found in people with neck pain. The recovery and potential of cervical movement velocity in assisting the prediction of recovery in individuals with chronic neck pain remained unknown. This study investigated the application of cervical movement velocity to predict the outcomes of pain intensity and functional disability for a cohort of participants with chronic mechanical pain after completion of a 12-week intervention program. METHODS Cervical movement velocity when performing neck motions in the anatomical planes, pain intensity and functional disability score were assessed before and after the physiotherapy program. Correlations between kinematic and clinical outcomes, and validity of applying the peak velocity values of the cervical spine measured at baseline for prediction of recovery of pain and function after the physiotherapy program were examined (n = 68). FINDINGS Significant improvements were found in the peak values of cervical velocity in all movement planes, pain intensity and functional disability score at post-program reassessment (p < 0.001). Significant negative correlations between peak values of cervical movement velocity and pain intensity (for specific directions, r = -0.163 to -0.191), and functional disability were found (for all directions, r = -0.158 to -0.282). Area under the Receiver Operating Characteristics curve was >0.6 for cervical extension, flexion and right rotation velocity for predicting functional recovery post-program. INTERPRETATION These findings suggest that cervical velocity of selected planes measured at baseline may inform the prediction of recovery of functional disability but not pain intensity in people with chronic mechanical neck pain.
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Affiliation(s)
- Sharon M H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Grace P Y Szeto
- School of Medical and Health Sciences, Tung Wah College, Hong Kong
| | - Billy C L So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Rufina W L Lau
- School of Medical and Health Sciences, Tung Wah College, Hong Kong
| | - Jay J Tai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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15
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Multanen J, Häkkinen A, Kautiainen H, Ylinen J. Associations of neck muscle strength and cervical spine mobility with future neck pain and disability: a prospective 16-year study. BMC Musculoskelet Disord 2021; 22:911. [PMID: 34715847 PMCID: PMC8556991 DOI: 10.1186/s12891-021-04807-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Neck pain has been associated with weaker neck muscle strength and decreased cervical spine range of motion. However, whether neck muscle strength or cervical spine mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical spine mobility are associated with future neck pain and related disability in women pain-free at baseline. Methods Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 years later to determine whether any subjects had experienced neck pain and related disability. Linear regression analysis adjusted for age and body mass index was used to determine to what extent baseline neck strength and PROM values were associated with future neck pain and related disability assessed using the Neck Disability Index (NDI). Results The regression analysis Beta coefficient remained below 0.1 for all the neck strength and PROM values, indicating no association between neck pain and related disability. Of the 149 (68%) responders, mean NDI was lowest (3.3, SD 3.8) in participants who had experienced no neck pain (n = 50), second lowest (7.7, SD 7.1) in those who had experienced occasional neck pain (n = 94), and highest (19.6, SD 22.0) in those who had experienced chronic neck pain (n = 5). Conclusions This 16-year prospective study found no evidence for an association between either neck muscle strength or mobility and the occurrence in later life of neck pain and disability. Therefore, screening healthy subjects for weaker neck muscle strength or poorer cervical spine mobility cannot be recommended for preventive purposes.
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Affiliation(s)
- Juhani Multanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland. .,Department of Physical Medicine and Rehabilitation, Central Finland Hospital, Jyväskylä, Finland.
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Hospital, Jyväskylä, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Jari Ylinen
- Department of Physical Medicine and Rehabilitation, Central Finland Hospital, Jyväskylä, Finland
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16
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Modarresi S, Lukacs MJ, Ghodrati M, Salim S, MacDermid JC, Walton DM. A Systematic Review and Synthesis of Psychometric Properties of the Numeric Pain Rating Scale and the Visual Analog Scale for Use in People With Neck Pain. Clin J Pain 2021; 38:132-148. [PMID: 34699406 DOI: 10.1097/ajp.0000000000000999] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To conduct a systematic search and synthesis of evidence about the measurement properties of the Numeric Pain Rating Scale (NPRS) and the Visual Analog Scale (VAS) as patient-reported outcome measures in neck pain research. METHODS AND MATERIALS CINAHL, Embase, PsychInfo, and MedLine databases were searched to identify studies evaluating the psychometric properties of the NPRS and the VAS used in samples of which >50% of participants were people with neck pain. Quality and consistency of findings were synthesized to arrive at recommendations. RESULTS A total of 46 manuscripts were included. Syntheses indicated high-to-moderate-quality evidence of good-to-excellent (intraclass correlation coefficient 0.58 to 0.93) test-retest reliability over an interval of 7 hours to 4 weeks. Moderate evidence of a clinically important difference of 1.5 to 2.5 points was found, while minimum detectable change ranged from 2.6 to 4.1 points. Moderate evidence of a moderate association (r=0.48 to 0.54) between the NPRS or VAS and the Neck Disability Index. Findings from other patient-reported outcomes indicated stronger associations with ratings of physical function than emotional status. There is limited research addressing the extent that these measures reflect outcomes that are important to patients. DISCUSSION It is clear NPRS and the VAS ratings are feasible to implement, provide reliable scores and relate to multi-item patient-reported outcome measures. Responsiveness (meaningful change) of the scales and interpretation of change scores requires further refinement. The NPRS can be a useful single-item assessment complimenting more comprehensive multi-item patient-reported outcome measures in neck pain research and practice.
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Affiliation(s)
- Shirin Modarresi
- School of Physical Therapy
- Department of Health and Rehabilitation Sciences, Western University, London
| | - Michael J Lukacs
- Department of Health and Rehabilitation Sciences, Western University, London
| | - Maryam Ghodrati
- Department of Health and Rehabilitation Sciences, Western University, London
| | - Shahan Salim
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Joy C MacDermid
- School of Physical Therapy
- Department of Health and Rehabilitation Sciences, Western University, London
| | - David M Walton
- School of Physical Therapy
- Department of Health and Rehabilitation Sciences, Western University, London
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17
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Hürer C, Angın E, Tüzün EH. Effectiveness of clinical Pilates and home exercises in sagittal cervical disorientation: randomized controlled study. J Comp Eff Res 2021; 10:365-380. [PMID: 33706543 DOI: 10.2217/cer-2020-0186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To compare effects of clinical Pilates and home exercises on postural disorders, strength and endurance of deep cervical flexors (DCF), cervical range of motion (CROM), pain intensity and functional disability in sagittal cervical disorientation. Patients & methods: Fourty six patients were included and divided into two groups. Clinical Pilates group performed stabilization based exercise and home exercise group performed conventional exercises. Results: Craniovertebral, head tilt, cervicothoracic angles and strength and endurance of DCF muscles had improvement in favor of clinical Pilates group (p < 0.05). There was no difference between groups in terms of right-left acromial distance, pain intensity, functional disability and CROM parameters (p > 0.05). Conclusion: Clinical Pilates exercises have been found to provide clinically significant improvements in craniovertebral, head tilt, cervicothoracic angles and strength and endurance of DCF muscles. However, in the increase of CROM, decreasing pain severity and functional impairment parameters there was no superiority of both exercise training. Clinical trial registration number: NCT03352921 (Clinicaltrials.gov).
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Affiliation(s)
- Cemaliye Hürer
- Physiotherapy & Rehabilitation Faculty, Hacettepe University, Ankara, Turkey
| | - Ender Angın
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta 99628, Cyprus
| | - Emine Handan Tüzün
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta 99628, Cyprus
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18
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Park KN, Jung DY, Kim SH. Trapezius and serratus anterior muscle strength in violinists with unilateral neck pain. J Back Musculoskelet Rehabil 2020; 33:631-636. [PMID: 31594199 DOI: 10.3233/bmr-181147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Weakness of the trapezius and serratus anterior (SA) muscle may be a risk factor for unilateral neck pain. OBJECTIVE This study examined the trapezius (upper, middle, and lower) and SA muscle strength ipsilateral and contralateral to the painful side in violinists with unilateral neck pain. METHOD Twenty-six female violinists with unilateral neck pain participated in this study. Participants reported the pain intensity and duration and completed the Neck Disability Index (NDI). The strengths of the upper (UT), middle (MT), and lower (LT) trapezius and SA muscles were measured using a handheld dynamometer. Paired t-test was used to compare the strength of the muscles between ipsilateral and contralateral to the painful side within subjects. The relationship between pain intensity, pain duration, and neck disability and strength deficit of the muscle was demonstrated by Pearson's correlation and Spearman's rank correlation. RESULTS The strengths of the UT, MT, LT, and SA muscles were significantly decreased on the painful side compared with the contralateral side (P< 0.05). Except for correlations between pain intensity and percent strength deficit of the UT and between pain duration and percent strength deficit of the MT (P< 0.05), there were no significant associations between pain intensity, pain duration, or NDI and the percent strength deficit of the UT, MT, LT and SA muscles (P> 0.05). CONCLUSIONS These results suggest that decreased UT, MT, LT, and SA muscle strength on the side of the pain should be considered in the rehabilitation of violinists with unilateral neck pain.
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Affiliation(s)
- Kyue-Nam Park
- Department of Physical Therapy, Jeonju University, Jeonju-si, Jeonrabuk-do, South Korea
| | - Do-Young Jung
- Department of Physical Therapy, College of Health and Welfare, Joongbu University, Geumsan-gun, Chungcheongnam-do, South Korea
| | - Si-Hyun Kim
- Department of Physical Therapy, Sangji University, Wonju-si, South Korea
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19
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Measuring upper limb disability for patients with neck pain: Evaluation of the feasibility of the single arm military press (SAMP) test. Musculoskelet Sci Pract 2020; 50:102254. [PMID: 32932051 DOI: 10.1016/j.msksp.2020.102254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Non-specific neck pain (NSNP) is frequently associated with upper limb disability (ULD). Consequently, evaluation of ULD using an outcome measure is necessary during the management of patients with NSNP. The Single Arm Military Press (SAMP) test is a performance-based ULD measure developed for populations with neck pain. During the SAMP test, patients are asked to repeatedly lift a weight above their head for 30 s. The number of repetitions is counted. Its clinical utility in a patient group is still unknown. OBJECTIVE This study investigates the feasibility of the SAMP test from patients and clinicians' perspectives. METHODS Seventy female patients with NSNP were randomly allocated into one of three groups. Participants in each group completed the SAMP test using one of three proposed weights (½kg, 1 kg or 1½kg). The feasibility of the SAMP test was established using structured qualitative exit feedback interviews for patients and administrating clinicians. RESULTS Participants using ½kg achieved the highest number of repetitions, but a high proportion reported the weight as extremely light, whereas those who tested using the 1½kg achieved the lowest number of repetitions and participants reported the weight as being heavy. Participants tested using 1 kg achieved an average number of repetitions and a high proportion reported the weight as acceptably heavy. Clinicians and patients reported that the SAMP test was efficient and convenient. CONCLUSION The 1 kg SAMP test is feasible for use in female patients with NSNP. The measurement properties of the SAMP test should be determined in a patient group.
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20
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Murray M, Lange B, Søgaard K, Sjøgaard G. The Effect of Physical Exercise Training on Neck and Shoulder Muscle Function Among Military Helicopter Pilots and Crew: A Secondary Analysis of a Randomized Controlled Trial. Front Public Health 2020; 8:546286. [PMID: 33330303 PMCID: PMC7719717 DOI: 10.3389/fpubh.2020.546286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/27/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: This study presents secondary outcome analyses, in terms of muscle function [i.e., maximal voluntary contraction (MVC) and rate of torque development (RTD)] from a parallel group, single blinded, randomized controlled trial introducing a physical exercise training intervention aiming to reduce neck pain among military helicopter pilots and crew-members. Methods: Participants (50 pilots, 58 crew-members) were recruited from the Royal Danish Air Force and randomized to either an exercise-training-group (ETG; n = 35) or a reference-group (REF; n = 34). Participants in ETG received 20 weeks of self-administered exercise training specifically tailored to target the neck and shoulder muscles. REF received no training. Outcome: (1) MVC was measured for cervical extension and flexion as well as shoulder elevation and abduction, (2) RTD was measured for cervical extension and flexion. Adherence to training was self-reported and categorized as regular if performed at least once a week. Results: MVC for cervical extension was significantly increased at follow-up in ETG (37.5 ± 11.2 Nm at baseline, change: 2.1 ± 8.3 Nm) compared to REF (38.1 ± 10.7 Nm at baseline, change: -2.4 ± 6.8 Nm) according to intension-to-treat analysis (p = 0.018). Likewise, RTD was significantly increased in ETG for cervical extension (149.6 ± 63.3 Nm/s at baseline, change: 14.7 ± 49.0 Nm/s) compared to REF (165.4 ± 84.7 Nm/s at baseline, change: -16.9±70.9 Nm/s) (p = 0.034). The cervical extension/flexion MVC-ratio was significantly different at follow-up (p = 0.039) between ETG (1.5 ± 0.5 at baseline, change: -0.0 ± 0.3) compared to REF (1.5 ± 0.5 at baseline, change: -0.2 ± 0.4). Per-protocol analysis of MVC, including only participants in ETG with regular training adherence (n = 10), showed a significant increase for cervical extension (33.2 ± 7.3 Nm at baseline, change: 6.0 ± 5.4 Nm) and shoulder elevation right side (143.0 ± 25.8 Nm at baseline, change: 15.8 ± 18.1 Nm). Conclusion: Physical exercise training significantly improved MVC and RTD in the upper neck extensors. Only approximately 1/3 of participants in ETG adhered to training regularly, which likely attenuated the effectiveness of the training intervention on neck and shoulder muscle function. Future studies should focus on the practical implementation of self-administered exercise training to improve adherence.
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Affiliation(s)
- Mike Murray
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Britt Lange
- Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Odense, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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21
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Ghorbani F, Kamyab M, Azadinia F. Smartphone Applications as a Suitable Alternative to CROM Device and Inclinometers in Assessing the Cervical Range of Motion in Patients With Nonspecific Neck Pain. J Chiropr Med 2020; 19:38-48. [PMID: 33192190 DOI: 10.1016/j.jcm.2019.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/14/2019] [Accepted: 10/22/2019] [Indexed: 11/25/2022] Open
Abstract
Objective The purpose of this study was to compare the reliabilities of the cervical range-of-motion (CROM) device and a dual digital inclinometer (as accepted clinical tools) and iPhone or Android smartphone applications (clinometer and compass; as new technologies) in measuring cervical range of motion in patients with neck pain. Methods Twenty participants (13 women, 7 men; age 19-33 years) with neck pain persisting for at least 4 weeks were enrolled. Neck movements were measured in each participant using 4 noninvasive devices in random order. Results The CROM device showed excellent intra- and interrater reliabilities in assessing cervical range of motion except in right rotation for which it showed moderate intrarater reliability. The dual digital inclinometer demonstrated moderate to excellent intra- and interrater reliabilities. Cervical range of motion measurements using iPhone applications showed good to excellent intra- and interrater reliabilities, whereas Android applications had poor to excellent intra- and interrater reliabilities. Based on the validity results, all assessment tools differed from the CROM device depending on the direction of movement, although the iPhone applications showed fewer differences than the other 2 devices. Conclusion Generally, the CROM device showed the highest reproducibility, and iPhone applications showed more acceptable intra- and interrater reliabilities than the digital inclinometer and Android applications. The clinometer application of smartphones could be reliable in measuring frontal and sagittal cervical range of motion in patients with neck pain and in a sitting position. However, the compass application of the iPhone showed acceptable results, whereas that of the Android device could not be recommended for clinical use.
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Affiliation(s)
- Faezeh Ghorbani
- Orthotics and Prosthetics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Kamyab
- Orthotics and Prosthetics Department, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Azadinia
- Orthotics and Prosthetics Department, Iran University of Medical Sciences, Tehran, Iran
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22
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De Pauw R, Coppieters I, Caeyenberghs K, Kregel J, Aerts H, Lenoir D, Cagnie B. Associations between brain morphology and motor performance in chronic neck pain: A whole-brain surface-based morphometry approach. Hum Brain Mapp 2019; 40:4266-4278. [PMID: 31222905 DOI: 10.1002/hbm.24700] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/27/2019] [Accepted: 05/29/2019] [Indexed: 12/15/2022] Open
Abstract
Changes in brain morphology are hypothesized to be an underlying process that drive the widespread pain and motor impairment in patients with chronic neck pain. However, no earlier research assessed whole-brain cortical morphology in these patients. This case-control study assesses group-differences in whole-brain morphology between female healthy controls (HC; n = 34), and female patients with chronic idiopathic neck pain (CINP; n = 37) and whiplash-associated disorders (CWAD; n = 39). Additionally, the associations between whole-brain morphology and motor performance including balance, strength, and neuromuscular control were assessed. Cortical volume, thickness, and surface area were derived from high resolution T1-weighted images. T2*-weighted images were obtained to exclude traumatic brain injury. Vertex-wise general-linear-model-analysis revealed cortical thickening in the left precuneus and increased volume in the left superior parietal gyrus of patients with CINP compared to HC, and cortical thickening of the left superior parietal gyrus compared to HC and CWAD. Patients with CWAD showed a smaller cortical volume in the right precentral and superior temporal gyrus compared to HC. ANCOVA-analysis revealed worse neuromuscular control in CWAD compared to HC and CINP, and in CINP compared to HC. Patients with CWAD showed decreased levels of strength and sway area compared to CINP and HC. Partial correlation analysis revealed significant associations between the volume of the precentral gyrus, and neuromuscular control and strength together with an association between the volume of the superior temporal gyrus and strength. Our results emphasize the role of altered gray matter alterations in women with chronic neck pain, and its association with pain and motor impairment.
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Affiliation(s)
- Robby De Pauw
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Iris Coppieters
- Physiotherapy- Human Physiology- and Anatomy KIMA, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group
| | - Karen Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | - Jeroen Kregel
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Physiotherapy- Human Physiology- and Anatomy KIMA, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group
| | - Hannelore Aerts
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Dorine Lenoir
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Physiotherapy- Human Physiology- and Anatomy KIMA, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group
| | - Barbara Cagnie
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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23
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Aimi M, Schmit EFD, Ribeiro RP, Candotti CT. Posture, muscle endurance and ROM in individuals with and without neck pain. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Factors such as postural changes, reduced neck muscle endurance and reduced range of motion (ROM) are common characteristics attributed to people with neck pain. Objective: (a) Identify differences in postural, muscular endurance and ROM characteristics between individuals with and without neck pain and (b) relate the presence and intensity of neck pain with the characteristics of static posture, muscular endurance and cervical ROM. Method: A cross-sectional study with 60 subjects equally divided into two groups with respect to the presence of neck pain carrying out the following evaluations: (1) static postural evaluation by digital photogrammetry; (2) the neck flexor endurance test; and (3) evaluation of cervical ROM using a fleximeter. The data were analyzed with independent t-tests, the Mann-Whitney U test, and the Spearman and Tau of Kendall correlation tests (α < 0.05). Results: There were no statistical differences between individuals with and without neck pain regarding the postural, muscle endurance and cervical ROM characteristics. No statistically significant correlations were found between pain and posture, muscle endurance and cervical ROM. Conclusion: Individuals with neck pain do not appear to present differences in their postural, neck flexor muscle endurance or cervical ROM characteristics when compared to individuals without neck pain, and neck pain appears to be unrelated to these variables.
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Affiliation(s)
- Mateus Aimi
- Universidade Federal do Rio Grande do Sul, Brazil
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24
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Tolentino GDA, Bevilaqua-Grossi D, Carvalho GF, Carnevalli APDO, Dach F, Florencio LL. Relationship Between Headaches and Neck Pain Characteristics With Neck Muscle Strength. J Manipulative Physiol Ther 2018; 41:650-657. [PMID: 30573197 DOI: 10.1016/j.jmpt.2018.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 04/05/2018] [Accepted: 04/05/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the correlations between neck muscle strength and pain features, such as neck-related disability, neck pain frequency and intensity, and headache frequency in women with headache. METHODS Seventy women with migraine between 18 and 55 years of age diagnosed according to International Headache Society criteria were assessed. Participants provided clinical information regarding neck pain and headache. The Neck Disability Index was used to assess neck-related disability, and neck muscle strength was assessed via maximum voluntary contraction during flexion, extension, and lateral flexion with a handheld dynamometer. The correlation was verified with Spearman's correlation coefficient (ρ). Multiple linear regression was performed to verify whether the clinical variables could predict the strength of neck muscles. All calculations were performed adopting a level of significance of 0.05. RESULTS Neck extensor strength was negatively correlated with all clinical variables (ρrange = -.24 to -.32, p < .05); lateral flexor strength was negatively correlated with headache frequency, neck pain intensity, and neck-related disability (ρrange = -.27 to -.39, p < .05); and flexor strength also correlated negatively with neck pain intensity and related disability (ρr = -.26 to -.29, p < .05). Headache frequency and neck pain intensity were identified as significant predictors of the strength variability in extension (R2 = 0.16, p < .05) and in lateral flexion (R2 = 0.18, p < .05). CONCLUSIONS For the women with migraine in this study, correlations of headache and neck pain with neck muscle strength features were weakly to moderately negative. Headache frequency and neck pain intensity may influence a small proportion of the strength variability in extension and lateral flexion.
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Affiliation(s)
- Gabriella de Almeida Tolentino
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gabriela Ferreira Carvalho
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana Paula de Oliveira Carnevalli
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Lidiane Lima Florencio
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Madrid, Spain.
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Fortin M, Wilk N, Dobrescu O, Martel P, Santaguida C, Weber MH. Relationship between cervical muscle morphology evaluated by MRI, cervical muscle strength and functional outcomes in patients with degenerative cervical myelopathy. Musculoskelet Sci Pract 2018; 38:1-7. [PMID: 30059855 DOI: 10.1016/j.msksp.2018.07.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/11/2018] [Accepted: 07/14/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Cervical muscle alterations have been reported in patients with chronic neck pain, but the assessment of muscle morphology and strength has been overlooked in patients with degenerative cervical myelopathy (DCM). OBJECTIVES This study aimed to investigate the relationship between cervical muscle degenerative changes observed on MRI, muscle strength and symptoms severity in patients diagnosed with DCM. DESIGN Observational study. METHODS Cervical muscle measurements of total cross-sectional area (CSA), functional CSA (fat free area, FCSA) and ratio of FCSA/CSA (e.g. fatty infiltration) were obtained from T2-weighted axial MR images from C2-C3 to C6-C7 in 20 patients. Muscle strength was assessed manually using a microFET2 dynamometer. The association between cervical muscle morphology parameters, muscle strength, symptoms severity and functional status was investigated. RESULTS Greater mean CSA and FCSA was associated with greater overall muscle strength. The mean FCSA explained 37%, 76%, 39%, 20% and 65% of the total variance in flexion, extension, right-side bending, left-side bending and overall muscle strength, respectively. The mean ratio of FCSA/CSA was not significantly associated with cervical muscle strength in any direction. However, greater FCSA/CSA ratio (e.g. less fatty infiltration) was associated with lower disability score (p = 0.02, R2 = 0.20). CONCLUSIONS Cervical muscle lean muscle mass was positively associated with cervical muscle strength in patients with DCM. Moreover, greater fatty infiltration in the cervical extensor muscles was associated with lower functional score. Such findings suggest that clinicians should pay greater attention to cervical muscle morphology and function in patients with DCM.
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Affiliation(s)
- Maryse Fortin
- McGill University Health Centre, Montreal General Hospital Site, Department of Orthopedic Surgery, Montreal, Quebec, Canada; PERFORM Centre, Concordia University, Montreal, Quebec, Canada.
| | - Nikola Wilk
- McGill University, Faculty of Medicine, Montreal, Quebec, Canada
| | | | - Philippe Martel
- McGill University Health Centre, Montreal General Hospital Site, Department of Orthopedic Surgery, Montreal, Quebec, Canada
| | - Carlo Santaguida
- McGill University, Faculty of Medicine, Department of Neurology and Neurosurgery, Montreal, Quebec, Canada
| | - Michael H Weber
- McGill University Health Centre, Montreal General Hospital Site, Department of Orthopedic Surgery, Montreal, Quebec, Canada
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De Rosario H, Vivas MJ, Sinovas MI, Page Á. Relationship between neck motion and self-reported pain in patients with whiplash associated disorders during the acute phase. Musculoskelet Sci Pract 2018; 38:23-29. [PMID: 30218881 DOI: 10.1016/j.msksp.2018.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/23/2018] [Accepted: 09/03/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Biomechanical measures quantify motor control and functional deficits in Whiplash Associated Disorders (WAD), but few studies relate those measures to the clinical scales that are routinely used to assess patients. Most studies are limited to chronic neck pain, and report poor to moderate correlations. OBJECTIVE To define a statistical model that relates measures of neck kinematics with clinical scales of neck pain, in WAD patients during the rehabilitation process in the acute phase (less than 3 months since the accident). METHODS 96 WAD patients self-assessed their pain using VAS and NPQ, and passed neck motion tests as part of their rehabilitation program. Four regression models were fitted to analyze the effects of the measured kinematic parameters and subject-specific characteristics on VAS and NPQ. Model errors were compared to minimal clinically significant differences. RESULTS Multiple correlation coefficients of the models were between 0.74 and 0.90. More than 66% of that correlation was accounted for by subject-specific factors, and most of the other half by the measured kinematic parameters. Range of motion of flexion-extension and axial rotation, and harmonicity of flexion-extension, where the variables most consistently related to the decrease of pain. The error of the models was within the MCSD in more than 50% of the observations. CONCLUSIONS Part of the individual progression of pain and pain-related disability in acute WAD patients, as rated by NPQ and VAS, can be mapped to objective kinematic parameters of neck mobility tests, like ranges of motion, velocities, repeatability and harmonicity of movements.
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Affiliation(s)
- Helios De Rosario
- Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Valencia, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - María José Vivas
- Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Valencia, Spain
| | - María Isabel Sinovas
- Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Valencia, Spain
| | - Álvaro Page
- Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Valencia, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain
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Vannebo KT, Iversen VM, Fimland MS, Mork PJ. Test-retest reliability of a handheld dynamometer for measurement of isometric cervical muscle strength. J Back Musculoskelet Rehabil 2018. [PMID: 29526841 DOI: 10.3233/bmr-170829] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND There is a lack of test-retest reliability studies of measurements of cervical muscle strength, taking into account gender and possible learning effects. OBJECTIVE To investigate test-retest reliability of measurement of maximal isometric cervical muscle strength by handheld dynamometry. METHODS Thirty women (age 20-58 years) and 28 men (age 20-60 years) participated in the study. Maximal isometric strength (neck flexion, neck extension, and right/left lateral flexion) was measured on three separate days at least five days apart by one evaluator. RESULTS Intra-rater consistency tended to improve from day 1-2 measurements to day 2-3 measurements in both women and men. In women, the intra-class correlation coefficients (ICC) for day 2 to day 3 measurements were 0.91 (95% confidence interval [CI], 0.82-0.95) for neck flexion, 0.88 (95% CI, 0.76-0.94) for neck extension, 0.84 (95% CI, 0.68-0.92) for right lateral flexion, and 0.89 (95% CI, 0.78-0.95) for left lateral flexion. The corresponding ICCs among men were 0.86 (95% CI, 0.72-0.93) for neck flexion, 0.93 (95% CI, 0.85-0.97) for neck extension, 0.82 (95% CI, 0.65-0.91) for right lateral flexion and 0.73 (95% CI, 0.50-0.87) for left lateral flexion. CONCLUSION This study describes a reliable and easy-to-administer test for assessing maximal isometric cervical muscle strength.
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Affiliation(s)
- Katrine Tranaas Vannebo
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vegard Moe Iversen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Amiri Arimi S, Mohseni Bandpei MA, Rezasoltani A, Peolsson A, Mohammadi M. Multifidus muscle size changes at different directions of head and neck movements in females with unilateral chronic non-specific neck pain and healthy subjects using ultrasonography. J Bodyw Mov Ther 2018; 22:560-565. [PMID: 30100277 DOI: 10.1016/j.jbmt.2017.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to compare the dimensions of cervical multifidus muscle (CMM) in different conditions. METHODS Twenty five women with neck pain and 25 healthy subjects participated in this study. The dimensions of the CMM were measured at rest, 50% and 100% maximum isometric voluntary contraction (MIVC) at six directions of neck movements, using ultrasonography. RESULTS The size of multifidus was smaller in patients than healthy individuals at rest state (P < 0.05). A significant smaller CMM dimension was found in the affected side compared with unaffected side in patients group (P < 0.05). The result of ANOVA for MLD showed a significant difference for contraction levels (P < 0.001) and neck movements (P < 0.001) in both groups. The MLD of the CMM was significantly different between CMM at rest and 50%, and 100% MIVC (P < 0.001). No significant differences were found between the groups at 50% and 100% MIVC (P > 0.05 in both instances). The most prominent CMM size change was observed during neck extension, flexion, ipsilateral lateral-flexion, and ipsilateral rotation, respectively (P < 0.05). CONCLUSIONS Results of the present study indicate that the size of CMM was decreased in patients with neck pain in rest state. The size of CMM changes in all directions of neck movements, although the most prominent was during neck extension. This points out CMM stabilization role's in different directions of neck movements.
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Affiliation(s)
- Somayeh Amiri Arimi
- Shahid Beheshti University of Medical Sciences, Physiotherapy Research Center, School of Rehabilitation, Department of Physiotherapy, Tehran, Iran; University of Social Welfare and Rehabilitation Sciences, Department of Physiotherapy, Tehran, Iran
| | - Mohammad Ali Mohseni Bandpei
- Pediatric Neurorehabilitation Research Center, Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
| | - Asghar Rezasoltani
- Shahid Beheshti University of Medical Sciences, Physiotherapy Research Centre, School of Rehabilitation, Tehran, Iran.
| | - Anneli Peolsson
- Linköping University, Department of Medical and Health Sciences, Physiotherapy, Linköping, Sweden
| | - Masumeh Mohammadi
- Shahid Beheshti University of Medical Sciences, Physiotherapy Research Center, School of Rehabilitation, Department of Physiotherapy, Tehran, Iran
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Park KN, Kwon OY, Kim SJ, Kim SH. Asymmetry of neck motion and activation of the cervical paraspinal muscles during prone neck extension in subjects with unilateral posterior neck pain. J Back Musculoskelet Rehabil 2018; 30:751-758. [PMID: 28372307 DOI: 10.3233/bmr-150378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although unilateral posterior neck pain (UPNP) is more prevalent than central neck pain, little is known about how UPNP affects neck motion and the muscle activation pattern during prone neck extension. OBJECTIVE To investigate whether deviation in neck motion and asymmetry of activation of the bilateral cervical paraspinal muscles occur during prone neck extension in subjects with UPNP compared to subjects without UPNP. METHODS This study recruited 20 subjects with UPNP and 20 age- and sex-matched control subjects without such pain. Neck motion and muscle onset time during prone neck extension were measured using a three-dimensional motion-analysis system and surface electromyography. RESULTS The deviation during prone neck extension was greater in the UPNP group than in the controls (p < 0.05). Compared with the controls, cervical extensor muscle activation in the UPNP group was significantly delayed on the painful side during prone neck extension (p < 0.05). CONCLUSIONS Subjects with UPNP showed greater asymmetry of neck motion and muscle activation during prone neck extension compared with the controls. This suggests that UPNP has specific effects on neck motion asymmetry and the functions of the cervical extensors, triggering a need for specific evaluation and exercises in the management of patients with UPNP.
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Affiliation(s)
- Kyue-Nam Park
- Department of Physical Therapy, College of Medical Science, Jeonju University, Korea
| | - Oh-Yun Kwon
- Laboratory of Kinetic Ergocise Based on Movement Analysis, Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Korea
| | | | - Si-Hyun Kim
- Department of Physical Therapy, Yonsei University, Wonju, Korea
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Modifiable individual and work-related factors associated with neck pain in 740 office workers: a cross-sectional study. Braz J Phys Ther 2018; 22:318-327. [PMID: 29606511 DOI: 10.1016/j.bjpt.2018.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Office workers have the highest incidence of neck pain of all occupations. However, the relationship between symptoms and the risk factors is unclear. OBJECTIVE To examine the relationship between self-reported neck pain with a comprehensive range of individual and work-related risk factors. METHODS This study utilised a cross-sectional study design. Office workers with and without neck pain (n=763) were recruited. Participants completed a survey which included a Pain Numerical Rating Scale (dependent variable), and measures of independent variables including demographic, individual, work-related factors, neck/shoulder muscle strength, endurance, and range of motion (ROM). The relationships between the independent and dependent variables were analysed in a logistic regression model. RESULTS Neck pain was significantly associated with more senior occupational categories, working more than six hours per day on the computer, female sex, greater fear avoidance beliefs for work, greater psychological distress, and reduced cervical flexion ROM. The low severity of neck pain of the participants in this study may limit a robust determination of their association with the risk factor variables, but the studied sample is a realistic representation of the office worker population. CONCLUSION Several potentially modifiable individual and work-related factors were identified to be associated with the presence of self-reported neck pain in office workers. Future studies will be needed to investigate whether strategies to alter these modifiable risk factors translate to changes in neck pain. TRIAL REGISTRATION ACTRN12612001154897 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363209).
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31
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Cheever KM, Myrer JW, Johnson AW, Fellingham GW. Understanding the complete pathophysiology of chronic mild to moderate neck pain: Implications for the inclusion of a comprehensive sensorimotor evaluation. J Back Musculoskelet Rehabil 2017; 30:991-997. [PMID: 28505953 DOI: 10.3233/bmr-169535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Inconsistencies in the literature concerning the effect of neck pain have led to a lack of understanding concerning the complete pathophysiology of neck pain. While the effect of neck pain on motor function as measured by active range of motion and isometric neck strength is well documented the effect of neck pain on sensory measures such as tactical acuity and neck reposition error (NRE) remain poorly understood. OBJECTIVE The purpose of this study was to evaluate a combined sensorimotor evaluation to explore the potential benefits of incorporating both sensory and motor task into a physical evaluation of neck pain suffers to gain an added knowledge of the complete pathophysiology of their health status. METHODS A cross-sectional study that measured neck joint reposition error, tactical acuity, neck isometric strength and range of motion in 40 volunteer participants (22 pain, 18 control). RESULTS A statistically significant increase in NRE in flexion (2.75∘± 1.52∘ vs. 4.53∘± 1.74∘ and in extension (3.78∘± 1.95∘ vs 5.77∘± 2.73∘ in participants suffering from neck pain was observed. Additionally, the dermatome C5 was found to be the most affected. No differences were found in neck strength or neck range of motion between healthy controls and patients with chronic moderate neck pain.
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Affiliation(s)
- Kelly M Cheever
- Department of Kinesiology, Temple University, Philadelphia, PA, USA
| | - J William Myrer
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
| | - A Wayne Johnson
- Department of Exercise Sciences, Brigham Young University, Provo, UT, USA
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López-de-Uralde-Villanueva I, Sollano-Vallez E, Del Corral T. Reduction of cervical and respiratory muscle strength in patients with chronic nonspecific neck pain and having moderate to severe disability. Disabil Rehabil 2017; 40:2495-2504. [DOI: 10.1080/09638288.2017.1337239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ibai López-de-Uralde-Villanueva
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Auto´noma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de investigación para la salud (IdiPAZ), Hospital La Paz, Madrid, Spain
| | - Ernesto Sollano-Vallez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Auto´noma de Madrid, Madrid, Spain
| | - Tamara Del Corral
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Auto´noma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Tsang SMH, Szeto GPY, Lee RYW. Relationship between neck acceleration and muscle activation in people with chronic neck pain: Implications for functional disability. Clin Biomech (Bristol, Avon) 2016; 35:27-36. [PMID: 27116562 DOI: 10.1016/j.clinbiomech.2016.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/05/2016] [Accepted: 04/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous study has found that people with chronic neck pain moved with a consistently compromised acceleration/deceleration at their cervical and thoracic spines. This study examined the strength of the association between the electromyographic activities and the acceleration/deceleration of the cervical and thoracic spine, and its correlation with the functional disabilities in individuals with neck pain. METHODS Time history of the cervical and thoracic acceleration/deceleration and EMG activity was acquired in thirty-four subjects with chronic neck pain and thirty-four age- and gender-matched asymptomatic subjects during active neck movements. The strength of the association between the electromyographic activity of spinal muscles and the cervical and thoracic acceleration/deceleration was determined using cross-correlation method. Relationship between the strength of this association and the severity of the functional disabilities in neck pain group was examined using correlation analysis. FINDINGS The strength of the association between cervical and thoracic acceleration/deceleration and electromyographic activities was significantly lower in neck pain group. Significant negative correlations were found between the functional disability level and the strength of this defined association in the symptomatic group. INTERPRETATION The compromised capability of the spinal muscles to produce acceleration/deceleration in the neck pain group may imply an impaired electromechanical coupling of these spinal muscles when performing neck movements. Significant negative correlation of the degree of functional disabilities suggests that the present approach can be used as an objective and specific evaluation of the dynamic performance of the spinal muscles and its relationship with the functional disabilities in neck pain subjects.
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Affiliation(s)
- Sharon M H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Grace P Y Szeto
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Raymond Y W Lee
- School of Applied Sciences, London South Bank University, United Kingdom.
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Pasinato F, Bordin J, Santos-Couto-Paz CC, Souza JA, Corrêa ECR. Cervical-scapular muscles strength and severity of temporomandibular disorder in women with mechanical neck pain. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/0103-5150.029.002.ao05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Changes in cervical muscle function have been observed in patients with neck pain (NP) and TMD. However, the relationship between TMD severity and neck muscle strength in the presence/absence of NP is unknown. Objective: To determine the prevalence of TMD in women with and without mechanical NP and assess the cervical-scapular muscle strength and its association with TMD severity. Methods: Fifteen volunteers without neck pain (CG) and 14 women with mechanical neck pain (NPG) took part and were selected by the Neck Disability Index. The diagnosis and severity of TMD were determined by the Research Diagnostic Criteria for TMD and Temporomandibular Index (TI), respectively. The strength of the upper trapezius muscle, and cervical flexor and extensor muscles was measured by digital hand dynamometer. Results: 64.5% of women with NP and 33.3% without NP were diagnosed with TMD (p = 0.095). The NPG showed lower strength of the cervical flexor (p = 0.044) and extensor (p=0.006) muscles, and higher TI (p = 0.038) than in the CG. It was also verified moderate negative correlation between TI and the strength of dominant (p = 0.046, r = -0.547) and non-dominant (p = 0.007, r = -0.695) upper trapezius, and cervical flexors (p = 0.023, r = -0.606) in the NPG. Conclusion: There was no difference in the prevalence of TMD in women with and without NP. However, women with NP have lower cervical muscle strength - compared to those without NP - which was associated with greater severity of TMD. Thus, in women with NP associated with TMD, it is advisable to assess and address the severity of this dysfunction and identify the cervical-scapular muscles compromise.
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Choi SY, Choi JH. The effects of cervical traction, cranial rhythmic impulse, and Mckenzie exercise on headache and cervical muscle stiffness in episodic tension-type headache patients. J Phys Ther Sci 2016; 28:837-43. [PMID: 27134368 PMCID: PMC4842449 DOI: 10.1589/jpts.28.837] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine the effects of cervical traction
treatment, cranial rhythmic impulse treatment, a manual therapy, and McKenzie exercise, a
dynamic strengthening exercise, on patients who have the neck muscle stiffness of the
infrequent episodic tension-type (IETTH) headache and frequent episodic tension-type
headache(FETTH), as well as to provide the basic materials for clinical interventions.
[Subjects] Twenty-seven subjects (males: 15, females: 12) who were diagnosed with IETTH
and FETTH after treatment by a neurologist were divided into three groups: (a cervical
traction group (CTG, n=9), a cranial rhythmic contractiongroup (CRIG, n=9), and a McKenzie
exercise group (MEG, n=9). An intervention was conducted for each group and the
differences in their degrees of neck pain and changes in muscle tone were observed.
[Results] In the within-group comparison of each group, headache significantly decreased
in CTG. According to the results of the analysis of the muscle tone of the upper
trapezius, there was a statistically significant difference in MEG on the right side and
in CRIG on the left side. According to the results of the analysis of the muscle tone of
the sternocleidomastoid muscle, there was a statistically significant difference in MEG on
the right side and in CRIG on the left side. [Conclusion] In the comparison of the
splenius capitis muscle between the groups, there was a statistically significant
difference on the right side. Hence, compared to the other methods, cervical traction is
concluded to be more effective at reducing headaches in IETTH and FETTH patients.
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Affiliation(s)
- Sung-Yong Choi
- Department of Physical Therapy, Namseoul University: 21 Maeju-ri, Sungwan-eup, Seobuk-Gu, Chonan-Si 331-707, Republic of Korea
| | - Jung-Hyun Choi
- Department of Physical Therapy, Namseoul University: 21 Maeju-ri, Sungwan-eup, Seobuk-Gu, Chonan-Si 331-707, Republic of Korea
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Hip Strength Testing of Soccer Players With Long-Standing Hip and Groin Pain: What are the Clinical Implications of Pain During Testing? Clin J Sport Med 2016. [PMID: 26204042 DOI: 10.1097/jsm.0000000000000227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate whether self-reported pain during hip strength testing correlates to a large degree with hip muscle strength in soccer players with long-standing unilateral hip and groin pain. DESIGN Cross-sectional study. SETTING Clinical assessments at Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. PARTICIPANTS Twenty-four male soccer players with unilateral long-standing hip and groin pain. INTERVENTIONS The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion, adduction, abduction, isometric hip flexion-modified Thomas test, and eccentric hip adduction). MAIN OUTCOME MEASURES Muscle strength was measured with a hand-held dynamometer, and the players rated the pain during testing on a numerical rating scale (0-10). RESULTS In 4 tests (isometric hip adduction, abduction, flexion, and eccentric adduction), no significant correlations were found between pain during testing and hip muscle strength (Spearman rho = -0.28 to 0.06, P = 0.09-0.39). Isometric hip flexion (modified Thomas test position) showed a moderate negative correlation between pain and hip muscle strength (Spearman rho = -0.44, P = 0.016). CONCLUSIONS Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain.
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Karimi N, Rezasoltani A, Rahnama L, Noori-Kochi F, Jaberzadeh S. Ultrasonographic analysis of dorsal neck muscles thickness changes induced by isometric contraction of shoulder muscles: A comparison between patients with chronic neck pain and healthy controls. ACTA ACUST UNITED AC 2016; 22:174-8. [DOI: 10.1016/j.math.2015.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 12/01/2015] [Accepted: 12/12/2015] [Indexed: 10/22/2022]
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Taouk CM, Desa VG, Leaver AM. Clinical and radiological assessment of the cervical extensor muscles in people with neck pain. A narrative review. PHYSICAL THERAPY REVIEWS 2015. [DOI: 10.1080/10833196.2015.1125586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mohammad WS, Hamza HH, ElSais WM. Assessment of neck pain and cervical mobility among female computer workers at Hail University. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2015; 21:105-10. [DOI: 10.1080/10803548.2015.1017952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rahnama L, Rezasoltani A, Zavieh MK, NooriKochi F, Baghban AA. Differences in Cervical Multifidus Muscle Thickness During Isometric Contraction of Shoulder Muscles: A Comparison Between Patients With Chronic Neck Pain and Healthy Controls. J Manipulative Physiol Ther 2015; 38:210-7. [DOI: 10.1016/j.jmpt.2014.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 11/06/2014] [Accepted: 11/10/2014] [Indexed: 10/23/2022]
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Carvalho GF, Chaves TC, Gonçalves MC, Florencio LL, Braz CA, Dach F, de Las Peñas CF, Bevilaqua-Grossi D. Comparison Between Neck Pain Disability and Cervical Range of Motion in Patients With Episodic and Chronic Migraine: A Cross-Sectional Study. J Manipulative Physiol Ther 2014; 37:641-6. [DOI: 10.1016/j.jmpt.2014.09.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/09/2014] [Accepted: 05/21/2014] [Indexed: 11/30/2022]
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Kinematic effect of Chinese herbal fomentation on patients with chronic neck pain. Chin J Integr Med 2014; 20:917-22. [DOI: 10.1007/s11655-014-2010-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Indexed: 11/26/2022]
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Lauche R, Cramer H, Langhorst J, Michalsen A, Dobos GJ. Reliability and validity of the pain on movement questionnaire (POM) in chronic neck pain. PAIN MEDICINE 2014; 15:1850-6. [PMID: 25138685 DOI: 10.1111/pme.12534] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This analysis aimed to determine reliability, validity, and responsiveness of the pain on movement (POM) questionnaire, an instrument developed to determine pain intensity induced by head movement. DESIGN Data from nine randomized controlled trials for the treatment of chronic nonspecific neck pain were reanalyzed to determine reliability and validity of the POM questionnaire. METHODS POM was assessed as ratings of pain intensity induced by head movement in six different directions. The instrument's structure was assessed using a factor analysis. Reliability (internal consistency) was determined using Cronbach's alpha, and validity (convergent validity) was determined by correlating the POM with pain at rest on a visual analog scale (VAS), the neck disability index (NDI), quality of life (short-form 36 health survey questionnaire [SF-36]) and range of motion. Responsiveness was indicated by sensitivity to changes over time in a subsample of 49 patients. RESULTS Overall, 482 patients (mean age 50.3 ± 12.4 years, 72.3% female) were included in the analysis, and 458 of them provided complete data set for the POM. Average POM was 43.9 ± 20.8 mm on the VAS. The POM showed very good reliability as indicated by high internal consistency and moderate validity as indicated by significant correlations with the pain at rest, the NDI, and the SF-36. No correlations were found for POM with range of motion. The POM further proved to be responsive as it was sensitive to changes over time, and those changes were correlated to changes in pain intensity and NDI. CONCLUSIONS The POM seems to be a reliable and valid instrument to assess POM in patients with chronic nonspecific neck pain.
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Affiliation(s)
- Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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The effects of isometric contraction of shoulder muscles on cervical multifidus muscle dimensions in healthy office workers. J Bodyw Mov Ther 2014; 18:383-9. [DOI: 10.1016/j.jbmt.2013.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 10/22/2013] [Accepted: 11/01/2013] [Indexed: 11/23/2022]
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Sarig Bahat H, Weiss PL(T, Sprecher E, Krasovsky A, Laufer Y. Do neck kinematics correlate with pain intensity, neck disability or with fear of motion? ACTA ACUST UNITED AC 2014; 19:252-8. [DOI: 10.1016/j.math.2013.10.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 10/17/2013] [Accepted: 10/23/2013] [Indexed: 11/30/2022]
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Is one better than another?: A randomized clinical trial of manual therapy for patients with chronic neck pain. ACTA ACUST UNITED AC 2014; 19:215-21. [DOI: 10.1016/j.math.2013.12.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 11/19/2013] [Accepted: 12/13/2013] [Indexed: 11/23/2022]
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Physical dysfunction and nonorganic signs in patients with chronic neck pain: exploratory study into interobserver reliability and construct validity. J Orthop Sports Phys Ther 2014; 44:366-76. [PMID: 24730436 DOI: 10.2519/jospt.2014.4715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Repeated-measurement design. OBJECTIVES To explore interobserver reliability of the modified physical dysfunction severity (mPDS) as a measure for impairment of the cervical spine and the modified cervical nonorganic signs (mcNOS) as a measure for behavioral signs, and to explore construct validity of the mPDS and mcNOS. BACKGROUND The PDS has been used for evaluation of treatment efficacy in controlled trials in primary care. The cervical nonorganic signs were developed to assess illness behavior in patients with neck pain. METHODS Two observers independently assessed the mPDS and mcNOS in 51 patients with chronic neck pain in an outpatient tertiary rehabilitation setting, with a 3-week interval between assessments. Interobserver reliability for total scores of the mPDS and mcNOS was expressed as an intraclass correlation coefficient. Interobserver agreement for individual mcNOS tests was calculated as absolute agreement and Cohen kappa. Construct validity was expressed as Spearman correlation between the mPDS and mcNOS with the Neck Pain and Disability Scale and numeric pain rating scale for pain. RESULTS The interobserver reliability of the mPDS and mcNOS had intraclass correlation coefficients of 0.72 and 0.78, respectively. Agreement for individual mcNOS tests ranged from 63% to 88%, and kappa values ranged from 0.14 to 0.54. Correlation with the Neck Pain and Disability Scale was 0.26 for the mPDS and 0.49 for the mcNOS, and the correlation with the numeric pain rating scale was 0.32 for the mPDS and 0.37 for the mcNOS. CONCLUSION Interobserver reliability of both the mPDS and mcNOS was acceptable. The interobserver agreement for the individual mcNOS tests ranged from poor to acceptable. Construct validity of the mPDS and mcNOS appeared satisfactory.
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Thorborg K, Branci S, Nielsen MP, Tang L, Nielsen MB, Hölmich P. Eccentric and Isometric Hip Adduction Strength in Male Soccer Players With and Without Adductor-Related Groin Pain: An Assessor-Blinded Comparison. Orthop J Sports Med 2014; 2:2325967114521778. [PMID: 26535298 PMCID: PMC4555615 DOI: 10.1177/2325967114521778] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Adductor-related pain is the most common clinical finding in soccer players with groin pain and can be a long-standing problem affecting physical function and performance. Hip adductor weakness has been suggested to be associated with this clinical entity, although it has never been investigated. PURPOSE To investigate whether isometric and eccentric hip strength are decreased in soccer players with adductor-related groin pain compared with asymptomatic soccer controls. The hypothesis was that players with adductor-related groin pain would have lower isometric and eccentric hip adduction strength than players without adductor-related groin pain. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Male elite and subelite players from 40 teams were contacted. In total, 28 soccer players with adductor-related groin pain and 16 soccer players without adductor-related groin pain (asymptomatic controls) were included in the study. In primary analysis, the dominant legs of 21 soccer players with adductor-related groin pain (≥4 weeks duration) were compared with the dominant legs of 16 asymptomatic controls using a cross-sectional design. The mean age of the symptomatic players was 24.5 ± 2.5 years, and the mean age of the asymptomatic controls was 22.9 ± 2.4 years. Isometric hip strength (adduction, abduction, and flexion) and eccentric hip strength (adduction) were assessed with a handheld dynamometer using reliable test procedures and a blinded assessor. RESULTS Eccentric hip adduction strength was lower in soccer players with adductor-related groin pain in the dominant leg (n = 21) compared with asymptomatic controls (n = 16), namely 2.47 ± 0.49 versus 3.12 ± 0.43 N·m/kg, respectively (P < .001). No other hip strength differences were observed between symptomatic players and asymptomatic controls for the dominant leg (P = .35-.84). CONCLUSION Large eccentric hip adduction strength deficits were found in soccer players with adductor-related groin pain compared with asymptomatic soccer players, while no isometric strength differences were observed between the groups.
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Affiliation(s)
- Kristian Thorborg
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark. ; Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C) and Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Sonia Branci
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark. ; Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Martin Peter Nielsen
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Lars Tang
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark. ; Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C) and Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | | | - Per Hölmich
- Sports Orthopaedic Research Center, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark
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Evaluation of pain and function after two home exercise programs in a clinical trial on women with chronic neck pain - with special emphasises on completers and responders. BMC Musculoskelet Disord 2014; 15:6. [PMID: 24400934 PMCID: PMC3893583 DOI: 10.1186/1471-2474-15-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Accepted: 01/03/2014] [Indexed: 11/10/2022] Open
Abstract
Background Different types of exercises can help manage chronic neck pain. Supervised exercise interventions are widely used, but these protocols require substantial resources. The aim of this trial, which focused on adherence, was to evaluate two home exercise interventions. Methods This parallel group randomized controlled trial included 57 women randomly allocated into two groups – a strength training group (STRENGTH, 34 subjects) and a stretching group (STRETCH, 23 subjects). The interventions focused on the neck and shoulder muscles and lasted for 12 months. The STRENGTH group performed weight training and ended each session with stretching exercises. These stretching exercises constituted the entirety of the STRETCH group’s training session. Both groups were instructed to exercise three times per week. All the participants kept an exercise diary. In addition, all participants were offered support via phone and e-mail. The primary outcomes were pain intensity and function. The trial included a four- to six-month and a twelve-month follow-up. A completer in this study exercised at least 1,5 times per week during eight unbroken weeks. A responder in this study reported clinically significant improvements on pain and function. The statistical analyses used the Mann Whitney U-test, Wilcoxon signed-rank test, and X2 test. Results At four- to six-months, the numbers of completers were 19 in the STRENGTH group and 17 in the STRETCH group. At twelve months, the corresponding numbers were 11 (STRENGTH) and 10 (STRETCH). At four- to six-months, the proportions of subjects reporting clinically important changes (STRENGTH and STRETCH) were for neck pain: 47% and 41%, shoulder pain: 47% and 47%, function: 37% and 29%. At twelve months, the corresponding numbers were for neck pain: 45% and 40%, shoulder pain: 55% and 50%, function: 55% and 20%. Conclusions No differences in the two primary outcomes between the two interventions were found, a finding that may be due to the insufficient statistical power of the study. Both interventions based on home exercises improved the two primary outcomes, but the adherences were relatively low. Future studies should investigate ways to improve adherence to home exercise treatments. Trial registration ClinicalTrials.gov Id: NCT01876680
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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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