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Peolsson A, Bahat HS, German D, Peterson G. Results of neck-specific exercise for altered postural sway in individuals with chronic whiplash-associated disorders: a longitudinal case-control study. Sci Rep 2024; 14:15235. [PMID: 38956135 PMCID: PMC11220100 DOI: 10.1038/s41598-024-66176-w] [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: 12/21/2023] [Accepted: 06/27/2024] [Indexed: 07/04/2024] Open
Abstract
Postural sway has not been investigated before or after a neck exercise intervention in individuals with chronic whiplash-associated disorders (WAD). The aim of the study was to investigate postural sway in individuals with chronic WAD grades 2 and 3: (a) compared with healthy matched controls at baseline; (b) after three months of neck-specific exercise and (c) to investigate the correlation between postural sway with self-reported dizziness during motion and balance problems/unsteadiness. This is a longitudinal prospective experimental case-control intervention study. Individuals with WAD (n = 30) and age- and gender-matched healthy volunteers (n = 30) participated. Postural sway was assessed using an iPhone application. Measurements were carried out at baseline, and for those with WAD a second measurement was performed at the three-month follow-up when neck-specific exercise intervention ended. The WAD group performed significantly worse than the healthy group in both pathway and ellipse area double stance eyes closed at baseline (main outcome), but not at the three-month follow-up. The WAD group significantly improved after rehabilitation in both pathway double stance eyes closed and pathway single stance eyes open. The correlation between postural sway and self-rated dizziness during motion and balance problems was low to moderate. One may conclude that postural sway was improved after a neck-specific exercise programme. The study results strengthen earlier findings that individuals with WAD have worse balance outcome when they have to rely on neck proprioception (eyes closed). The study results may be important for the development of improved rehabilitation methods for WAD.
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Affiliation(s)
- Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden.
- Occupational and Environmental Medicine Centre, Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, Linköping, Sweden.
| | | | - Dmitry German
- Department of Physical Therapy, University of Haifa, Haifa, Israel
| | - Gunnel Peterson
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
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Phapatarinan K, Sremakaew M, Uthaikhup S. Stimulated cervical afferent input increases postural instability in older people with chronic neck pain: a cross-sectional study. BMC Geriatr 2024; 24:153. [PMID: 38355412 PMCID: PMC10865695 DOI: 10.1186/s12877-024-04695-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: 05/15/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Several potential causes can impair balance in older people. The neck torsion maneuver may be useful in demonstrating impaired balance caused by the stimulation of cervical proprioceptive input. Whereas evidence suggests impaired standing balance in older people with chronic neck pain, balance impairment during the neck torsion position and its relationship with clinical characteristics have not yet been investigated in this population. The aims of this study were to investigate whether the neck torsion position could significantly influence balance responses in older people with chronic non-specific neck pain and to determine the relationships between the balance responses and characteristics of neck pain. METHODS Sixty-eight older people (34 with chronic non-specific neck pain and 34 controls) participated in the study. Balance was tested using a force plate during comfortable stance with eyes open under four conditions: neutral head on a firm surface, neutral head on a soft surface, neck torsion to left and right on a firm surface and neck torsion to left and right on a soft surface. Balance outcomes were anterior-posterior (AP) and medial-lateral (ML) displacements, sway area and velocity. Characteristics of neck pain were intensity, duration and disability. RESULTS Overall, the neck pain group exhibited greater AP and ML displacements, sway area and velocity in the neck torsion position on firm and soft surfaces compared to controls (partial eta squared (η²p) = 0.06-0.15, p < 0.05). The neck pain group also had greater AP displacement, sway area and velocity in the neutral position on a soft surface compared to controls (η²p = 0.09-0.16, p < 0.05). For both groups, the neck torsion position displayed overall greater postural sway compared to the neutral position (η²p = 0.16-0.69, p < 0.05). There were no relationships between the postural sway outcomes and characteristics of neck pain (p > 0.05). CONCLUSION The neck torsion maneuver, stimulating the receptors resulted in increased postural sway in older people, with a more pronounced effect in those with neck pain. The study provides evidence supporting the use of neck torsion for assessing impaired balance related to abnormal cervical input in older people with chronic non-specific neck pain.
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Affiliation(s)
- Korawat Phapatarinan
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, 50200, Chiang Mai, Thailand
| | - Munlika Sremakaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, 50200, Chiang Mai, Thailand
| | - Sureeporn Uthaikhup
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, 50200, Chiang Mai, Thailand.
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Yilmaz K, Yazicioglu FG, Akkoyun Sert O, Ozturk B, Armutlu K, Yuce H. The effects of basic body awareness therapy on balance in patients with chronic neck pain: a randomised crossover trial. Somatosens Mot Res 2023; 40:147-155. [PMID: 36815247 DOI: 10.1080/08990220.2023.2181327] [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: 02/07/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE This study aimed to compare the effects of basic body awareness therapy (BBAT) and conventional treatments (CT) on balance in patients with chronic neck pain. METHODS Thirty-five patients with neck pain participated in this randomised two-period crossover trial. Patients were divided into A (BBAT/CT) (n = 17) and B (CT/BBAT) (n = 18) groups. Group A received BBAT twice a week for 6 weeks, whereas Group B received CT within the same parameters. After a 5-week washout period, the treatments received by the groups were changed. The primary outcome was balance, assessed via the sensory organisation test (SOT) using the computerised dynamic posturography device. The secondary outcome was pain assessed by the visual analogue scale. Assessments were performed before and after primary and secondary treatments. RESULTS In Group A, the SOT conditions 4, 5, 6; composites score; and visual and vestibular system scores increased after BBAT; however, only condition five scores and vestibular system scores increased (p < .05) in Group B, which started with CT. Within the groups, both treatments were effective for easing pain (p < .05). CONCLUSIONS Although patients who started the therapy with BBAT showed more improvement in balance, no differences were observed between the therapies.
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Affiliation(s)
- Kamil Yilmaz
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, KTO Karatay University, Konya, Turkey
| | - Fatma Gul Yazicioglu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ozlem Akkoyun Sert
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, KTO Karatay University, Konya, Turkey
| | - Burak Ozturk
- Department of Audiology, Faculty of Health Sciences, Izmir Bakircay University, İzmir, Turkey
| | - Kadriye Armutlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hamiyet Yuce
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balıkesir, Turkey
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Vishal K, Walkay A, Huixin T, Bhat VS, Neelapala YVR. The relationship between cervical spine range of motion and postural sway in mechanical neck pain: A cross-sectional study. Hong Kong Physiother J 2023; 43:129-135. [PMID: 37583925 PMCID: PMC10423670 DOI: 10.1142/s1013702523500142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 05/09/2023] [Indexed: 08/17/2023] Open
Abstract
Background Impairments in postural sway have been identified in people with mechanical neck pain. The influence of cervical spine range of motion (ROM) on postural sway is unclear in mechanical neck pain (MNP). Objective This study investigated the relationship between cervical spine range of motion (ROM) and postural sway in MNP. Methods The cervical ROM was measured using the Cervical Range of Motion (CROM) device. Standing postural sway characterised by mean centre of pressure (COP) measurements in the anterior posterior (AP) and medio-lateral direction with eyes closed and feet together condition was recorded on a posturography platform. Pearson product moment correlation coefficient was used to identify the relationship between cervical ROM and postural sway. Results Seventy-two MNP individuals (Mean age: 29 . 9 ± 11 . 7 ) of either sex (Male: Female = 23 : 49 ) were recruited. Overall, no statistically significant correlations were identified between cervical spine ROM in sagittal and frontal plane and postural sway (r values ranging from 0.00 to - 0 . 38 ; p-values > 0 . 05 ). However, a weak negative correlation was present between the cervical rotation and AP (r-value =- 0 . 23 ; p-value = 0 . 04 ) and mediolateral (r-value =- 0 . 38 ; p-value = 0 . 01 ) COP excursion. Conclusion The cervical spine ROM was found to have a weak relationship with postural sway in individuals with MNP. This suggests the investigation of other mechanisms especially muscle tension which might be responsible for altered postural sway in MNP.
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Affiliation(s)
- Kavitha Vishal
- Department of Physiotherapy, Manipal College of Health Professions Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashwini Walkay
- Department of Physiotherapy, Manipal College of Health Professions Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Teo Huixin
- Department of Physiotherapy, Manipal College of Health Professions Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Veena Suresh Bhat
- Department of Physiotherapy, Manipal College of Health Professions Manipal Academy of Higher Education, Manipal, Karnataka, India
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Visual, Vestibular, and Proprioceptive Dependency of the Control of Posture in Chronic Neck Pain Patients. Motor Control 2022; 26:362-377. [PMID: 35349979 DOI: 10.1123/mc.2021-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 11/18/2022]
Abstract
Sensory reweighting of postural control was compared in participants with and without neck pain. Center of pressure variables of 60 volunteers, the same in each group, were calculated under four standing conditions: (a) eyes open, neutral head posture; (b) foam interface, eyes open; (c) cervical extension, eyes open; and (d) cervical extension, eyes closed. All center of pressure variables except anterior posterior range/velocity increased significantly in Condition 2 compared with Conditions 1 and 3 (p < .001) and in Condition 4 compared with Conditions 1 and 3. The mediolateral range/velocity and path length in both groups, anterior posterior range in patients, and center of pressure area in the control group were significantly different between Conditions 2 and 4 (p < .001). No overweighting was observed on the vestibular or visual afferents in patients. Compensatory strategies seem to lie within the proprioceptive system.
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Effect of Combined Manual Therapy and Therapeutic Exercise Protocols on the Postural Stability of Patients with Non-Specific Chronic Neck Pain. A Secondary Analysis of Randomized Controlled Trial. J Clin Med 2021; 11:jcm11010084. [PMID: 35011823 PMCID: PMC8745098 DOI: 10.3390/jcm11010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Postural stability is a little-studied factor in non-specific chronic neck pain; the causes that can alter it are unknown. The relationship with chronic pain could be a determining factor for its deficit. The aim of this study was to investigate the relationship between sustained pain and a postural stability deficit. A randomized and blinded clinical trial (double-blind; placebo control; 12 weeks follow-up) was conducted with a total of 69 subjects divided into three groups, two experimental (manual therapy and specific exercise) and a control treatment, and carried out over a treatment period of three weeks with a follow-up after 12 weeks. Their postural stability was assessed through the overall balance index (OBI). The postural stability of subjects with non-specific chronic neck pain improved in the experimental treatments. There were no statistically significant differences between the experimental groups. This trial found that manual therapy and therapeutic exercise significantly improved OBI compared to the control group. Trial registration: Brazilian Clinical Trial Registry, RBR-2vj7sw.
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Wah SW, Puntumetakul R, Boucaut R. Effects of Proprioceptive and Craniocervical Flexor Training on Static Balance in University Student Smartphone Users with Balance Impairment: A Randomized Controlled Trial. J Pain Res 2021; 14:1935-1947. [PMID: 34234540 PMCID: PMC8242145 DOI: 10.2147/jpr.s312202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose University student smartphone users adopt flexed neck postures during smartphone use, creating an increased compressive load on their neck structures. This study was conducted to compare the effects of proprioceptive and craniocervical flexor training with a control group on static balance in a group of university student smartphone users with balance impairment. Methods A double-blinded, randomized controlled trial was conducted involving 42 university students (19.67±1.68 years old) with balance impairment. Participants were randomized into a proprioceptive training (ProT) group (n=14), a craniocervical flexor training (CCFT) group (n=14), and a control group (CG; n=14) for a 6-week intervention. The balance error scoring system (BESS), cervical joint position sense (CJPS), craniocervical flexion (CCF) test, and visual analog scale (VAS) for neck pain were evaluated using univariate analysis of covariance (ANCOVA). Results After 6 weeks of intervention, the ProT group showed significantly greater improvement of CJPS than the CG (p=0.000) and the CCFT group significantly improved of CCF test than CG (p=0.002). Findings, at 4 weeks after intervention, were (i) the ProT group had significantly more improvement in BESS than the CCFT group (p=0.014) and CG (p=0.003), (ii) the ProT group had significantly more improvement of CJPS than the CG (right and left rotate) (p=0.001, p=0.016, respectively) and CCFT group (right rotate) (p=0.004), (iii) the CCFT group had significantly more improvement of craniocervical flexor strength than CG (p=0.004), and (iv) the ProT group and CCFT group had significantly more decreased pain than CG (p=0.015, p=0.033, respectively). No adverse effects occurred during or after training in any group. Conclusion ProT is important for regaining static balance and CJPS, while CCFT improved craniocervical flexor strength. Moreover, both ProT and CCFT can reduce neck pain. We recommend performing ProT to improve static balance, CJPS and to reduce neck pain in smartphone users with static balance impairment. Clinical Trail Registration Number TCTR20190909003.
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Affiliation(s)
- Saw Wah Wah
- Human Movement Sciences, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand.,Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, 40002, Thailand.,School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Rose Boucaut
- International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, 5001, Australia.,University of South Australia: Allied Health and Human Performance, Adelaide, SA, 5001, Australia
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Fidalgo-Herrera A, Miangolarra-Page JC, Carratalá-Tejada M. Electromyographic traces of motor unit synchronization of fatigued lower limb muscles during gait. Hum Mov Sci 2020; 75:102750. [PMID: 33373857 DOI: 10.1016/j.humov.2020.102750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The study of the signal in the frequency domain has shown to be a good tool to identify muscular fatigue. Previous research has shown that the low frequency band and 40 Hz frequency band increase their relative intensity with the onset of fatigue. These findings were obtained in rectus femoris, but the behaviours of other muscles of the lower limb are unknown. In this article we explored the changes in the low frequency and 40 Hz frequency band of lower limb muscles with respect to fatigue. METHODS Thirty healthy subjects were recruited to analyse the electromyography (EMG) of biceps femoris, tibialis anterior and gastrocnemius medialis and lateralis of both legs during gait. Four two-minutes walks at a self-selected speed were recorded, the first two walks with a normal muscular function and the last two walks after a fatigue protocol. All the signals were decomposed using wavelet transformations. The signals were normalized in time and spectral intensities normalized to the sum of intensities in the frequency domain. Two frequency bands were studied in each walk: the 40-Hz (34-53 Hz) and the low frequency (< 25 Hz) bands. A ratio of the spectral intensities of those frequency bands at each walk was obtained by dividing the 40-Hz frequency band spectral intensity by the low frequency band spectral intensity. Statistical parametric mapping techniques were used to compare the ratios of the prefatigue walks against the postfatigue walks. RESULTS The results of the Statistical Non-Parametric Mapping (SnPM) analysis of all muscles depict a higher relative spectral intensity in the low frequency band in the comparison of fatigue versus prefatigue recordings except for the right gastrocnemius lateralis. The critical thresholds F* were exceeded by multiple suprathreshold clusters with p values <0.05, showing that the low frequency band increased its relative spectral intensity in the case of fatigue. CONCLUSION The obtained results suggest that the low frequency band increases its relative spectral intensity in all the studied muscles when fatigue onsets. This increase in relative spectral intensity may be linked to an increase in motor unit synchronization promoted by the central nervous system to ensure good motor control.
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Affiliation(s)
- A Fidalgo-Herrera
- LAMBECOM, Universidad Rey Juan Carlos, Alcorcón, calle Atenas S/N, Madrid, Spain.
| | - J C Miangolarra-Page
- LAMBECOM, Universidad Rey Juan Carlos, Alcorcón, calle Atenas S/N, Madrid, Spain; Fuenlabrada's Clinical University Hospital, Fuenalbrada, Camino del Molino, 2, Madrid, Spain.
| | - M Carratalá-Tejada
- LAMBECOM, Universidad Rey Juan Carlos, Alcorcón, calle Atenas S/N, Madrid, Spain.
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SOYSAL TOMRUK M, KARA B. Kronik boyun ağrılı hastalarda Pilates egzersizlerinin ağrı, özürlülük ve postüral kontrole etkisi: randomize kontrollü çalışma. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.731554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hsu WL, Chen CP, Nikkhoo M, Lin CF, Ching CTS, Niu CC, Cheng CH. Fatigue changes neck muscle control and deteriorates postural stability during arm movement perturbations in patients with chronic neck pain. Spine J 2020; 20:530-537. [PMID: 31672689 DOI: 10.1016/j.spinee.2019.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/14/2019] [Accepted: 10/23/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND CONTEXT Multisensory afferent inputs to the cervical spine affect the generation of neck muscle control. Chronic neck pain (CNP) and muscle fatigue are factors that disturb somatosensory function. Whether they affect postural control under self-initiated perturbation in daily activities is still unclear. PURPOSE To investigate the effect of CNP and neck flexor muscle fatigue on muscle control strategy and postural control in young patients performing voluntary shoulder flexion movements. STUDY DESIGN Cross-sectional case-control study. PATIENT SAMPLE Twenty-five patients with CNP and 25 age-matched asymptomatic controls. OUTCOME MEASURES The postural sway, muscle onset time, and activation level of the erector spinae, rectus abdominal, semispinalis capitis (SSC), and sternocleidomastoid (SCM) muscles were recorded and analyzed using two-way ANOVA to evaluate the interaction of CNP and muscle fatigue on standing balance and muscle control upon self-initiated perturbations. METHODS All participants were instructed to perform shoulder flexion movements in the standing position before and after a neck flexor muscle fatigue exercise under either the eyes-open or eyes-closed condition. RESULTS The CNP group exhibited significantly larger body sway, greater neck muscle activation (SCM and SSC), and longer onset time of neck flexor muscle (SCM) compared with the control group. The CNP group also demonstrated a trend of greater postural sway and shorter muscle onset under the eyes-closed condition than those under the eyes-open condition. After muscle fatigue, the CNP group further exhibited (1) greater body sway during the eyes-open condition but decreased body sway during the eyes-closed condition, (2) higher activation of the neck flexor (SCM) and lower activation of the trunk extensor (erector spinae), and (3) early onset of the neck muscles (SCM and SSC). CONCLUSIONS CNP causes poor postural control and altered neck muscle control patterns. The addition of neck flexor muscle fatigue further decreases balance stability and provokes a protective neck muscle control strategy during the shoulder flexion movement. Those findings facilitate the understanding of the strategies adopted by patients and suggest that neck endurance training programs may be beneficial to improve whole postural control in patients with CNP.
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Affiliation(s)
- Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Carl Pc Chen
- Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Mohammad Nikkhoo
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Cheng-Feng Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Taiwan, ROC
| | - Congo Tak-Shing Ching
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Chi-Chien Niu
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, ROC; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC
| | - Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, ROC.
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Fidalgo-Herrera A, Miangolarra-Page J, Carratalá-Tejada M. Traces of muscular fatigue in the rectus femoris identified with surface electromyography and wavelets on normal gait. Physiother Theory Pract 2020; 38:211-225. [DOI: 10.1080/09593985.2020.1725945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alberto Fidalgo-Herrera
- Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Juan Miangolarra-Page
- Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Universidad Rey Juan Carlos, Alcorcón, Spain
- Departamento de Medicina Física y Rehabilitación, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - Maria Carratalá-Tejada
- Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Universidad Rey Juan Carlos, Alcorcón, Spain
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Variability of neck and trunk movement during single- and dual-task gait in people with chronic neck pain. Clin Biomech (Bristol, Avon) 2020; 72:31-36. [PMID: 31809920 DOI: 10.1016/j.clinbiomech.2019.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/10/2019] [Accepted: 11/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous findings reported that people with chronic neck pain walk with reduced range trunk rotation, especially when walking in more challenging conditions. Quantification of the quality of neck and trunk movement during gait could provide further insight into biomechanical changes that occur in people with neck pain. This study uniquely compared the variability of trunk and neck rotation during single-task and dual-task gait in people with chronic neck pain and asymptomatic individuals. METHODS An observational case-control study was conducted on 20 asymptomatic individuals and 24 people with chronic neck pain of idiopathic or traumatic origin. Participants performed rectilinear walking whilst keeping the head in a neutral position (single-task) and whilst rotating the head at a natural speed (dual-task). Trunk and head rotation angles were averaged across gait cycles for the task trials. The data were normalised in time, and the average variability of angular distribution along the normalised cycle was extracted. The Tampa Scale for Kinesiophobia was used to assess fear of movement. FINDINGS During single-task gait, there were no group differences for the variability of trunk (p = 0.862) or neck (p = 0.427) rotation. For dual-task gait, there was no difference between groups for the variability of neck rotation (p = 0.636), however, the participants with neck pain displayed reduced variability of trunk rotation (p = 0.021). The neck pain group also walked at a significantly slower speed during dual-task gait (p = 0.043) compared to asymptomatic individuals and the speed of their gait was associated with the extent of fear of movement. INTERPRETATION The strategy observed in participants with chronic neck pain likely reflects adaptive behaviour when faced with more challenging conditions for postural control.
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Lascurain-Aguirrebeña I, Newham DJ, Irazusta J, Seco J, Critchley DJ. Reliability of a Method to Measure Neck Surface Electromyography, Kinematics, and Pain Occurrence in Participants With Neck Pain. J Manipulative Physiol Ther 2019; 41:413-424. [PMID: 30041737 DOI: 10.1016/j.jmpt.2017.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 08/11/2017] [Accepted: 10/19/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To investigate the reliability of a novel method to measure neck surface electromyography (SEMG), kinematics, and pain during active movements in participants with neck pain. METHODS This test-retest study evaluated 23 participants with chronic neck pain. Each was measured twice within a single session. Three-dimensional kinematics and SEMG were recorded in 10° increments during forward and side flexion, extension, and rotation of the neck. Neck position during pain occurrence was also measured. RESULTS Intraclass correlation coefficients were >0.80 for 96% and 100% of SEMG and kinematic data, respectively. The percentage of standard error of the measurement (SEM) values were <25% for 91% of all SEMG measures; most were <15%, and some were <10%. For ranges of motion in the primary plane, percentage of SEM values were all <6% (SEM 1°-3°). Intraclass correlation coefficients for neck position during pain occurrence were all >0.60, except for right rotation (0.48) (SEM values 2°-8°). Pain occurred approximately 59% to 75% into the total range of motion and persisted to its end. CONCLUSIONS This methodology showed good reliability. It may be suitable for neck pain subclassification to evaluate the effects of treatment on pain, kinematics, and muscle activity during functional neck movements. The point of pain occurrence suggests increasing mechanical load on tissues may be one of the causative factors for movement-associated neck pain.
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Affiliation(s)
- Ion Lascurain-Aguirrebeña
- School of Population Sciences and Health Services Research, King's College London, London, United Kingdom; Department of Physiology, University of the Basque Country, Leioa, Spain.
| | - Di J Newham
- Centre of Human & Aerospace Physiological Sciences, King's College London, London, United Kingdom
| | - Jon Irazusta
- Department of Physiology, University of the Basque Country, Leioa, Spain
| | - Jesús Seco
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Duncan J Critchley
- School of Population Sciences and Health Services Research, King's College London, London, United Kingdom
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Sekiguchi Y, Muramatsu K, Tamaki T, Ikutomo M, Kurosawa K. Motor cortex somatotopic presentation after restriction of neck movement in rats. J Phys Ther Sci 2019; 31:785-789. [PMID: 31645807 PMCID: PMC6801342 DOI: 10.1589/jpts.31.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/04/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] In this study, we aimed to investigate the effects of neck movement
restriction on somatotopic mapping of the motor cortex. We restricted cervical extension
for two weeks and investigated the effects on motor cortex somatic representation in rats.
[Subjects and Methods] We placed six Wistar rats into each of three groups: (i) the
experimental group, in which cervical extension was restricted; (ii) the sham group, in
which cervical movement was not restricted, but a splint was placed in the shoulder
girdle; and (iii) the control group. After cervical immobilization for two weeks, we
evaluated the motor cortex somatic representation using intra-cortical micro-stimulation.
[Results] In the experimental group, the areas of the cervical and vibrissal domains of
the motor cortex decreased by approximately 50%, and the forelimb domain showed slight
reduction. In addition, a trunk domain formed at the locus of the vibrissal area. There
were no differences between the sham and control groups. [Conclusion] Restriction of
cervical extension for two weeks resulted in changes in motor cortex somatic
representation. Reversible changes occurred in cortical areas that controlled the neck and
parts of the body involved in cervical movement.
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Affiliation(s)
- Yoshihito Sekiguchi
- Department of Physical Therapy, Health Science University: 7187 Kodachi, Fujikawaguchiko-machi, Yamanashi 401-0380, Japan
| | - Ken Muramatsu
- Department of Physical Therapy, Kyorin University, Japan
| | - Toru Tamaki
- Department of Physical Therapy, Health Science University: 7187 Kodachi, Fujikawaguchiko-machi, Yamanashi 401-0380, Japan
| | - Masako Ikutomo
- Department of Physical Therapy, University of Tokyo Health Sciences, Japan
| | - Kazuo Kurosawa
- Department of Physical Therapy, International University of Health and Welfare, Japan
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15
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Miranda IF, Wagner Neto ES, Dhein W, Brodt GA, Loss JF. Individuals With Chronic Neck Pain Have Lower Neck Strength Than Healthy Controls: A Systematic Review With Meta-Analysis. J Manipulative Physiol Ther 2019; 42:608-622. [DOI: 10.1016/j.jmpt.2018.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/06/2018] [Accepted: 12/19/2018] [Indexed: 10/25/2022]
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Sekiguchi Y, Muramatsu K, Tamaki T, Ikutomo M, Kurosawa K. Neck and trunk representations in the primary motor cortex in rats. J Phys Ther Sci 2019; 31:608-611. [PMID: 31527994 PMCID: PMC6698462 DOI: 10.1589/jpts.31.608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/05/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The neck and trunk play crucial roles in body movement and are extremely important areas of treatment for physical therapists. However, many aspects of the neural basis of this motor control remain unknown. Therefore, we investigated the distribution and electrophysiological properties of the neck and trunk in the primary motor cortex in rats. [Subjects and Methods] Using intracortical microstimulation, we investigated the somatotopic representation and movements induced by electrical stimulation of the neck and truck areas of the motor cortex in 8 Wistar rats. [Results] We determined that the neck and trunk areas are located separately on the rostral and caudal sides of the motor cortex, respectively. The neck area was significantly larger in size, while the threshold was significantly larger for the trunk area. Stimulation of the neck area with a current higher than the threshold induced movement of the forelimbs, jaw, trunk, and whiskers. However, stimulation of the trunk area did not result in movement in sites other than the trunk. [Conclusion] During movement, the respective activities of the neck and trunk are interdependent. However, due to the separate locations of these areas in the motor cortex, their properties differ greatly.
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Affiliation(s)
- Yoshihito Sekiguchi
- Department of Physical Therapy, Health Science University: 7187 Kodachi, Fujikawaguchiko-machi, Yamanashi 401-0380, Japan
| | - Ken Muramatsu
- Department of Physical Therapy, Kyorin University, Japan
| | - Toru Tamaki
- Department of Physical Therapy, Health Science University: 7187 Kodachi, Fujikawaguchiko-machi, Yamanashi 401-0380, Japan
| | - Masako Ikutomo
- Department of Physical Therapy, University of Tokyo Health Sciences, Japan
| | - Kazuo Kurosawa
- Department of Physical Therapy, International University of Health and Welfare, Japan
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17
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Amaral G, Martins H, Silva AG. Postural control in subclinical neck pain: a comparative study on the effect of pain and measurement procedures. Scand J Pain 2019; 18:295-302. [PMID: 29794294 DOI: 10.1515/sjpain-2017-0172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/06/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS This study investigated whether young university students with neck pain (NP) have postural control deficits when compared to sex and age-matched asymptomatic subjects. METHODS Centre of pressure (COP) sway area, velocity, anterior-posterior and mediolateral distances were measured in participants with (n=27) and without (n=27) neck pain for different combinations of static standing (narrow stance, tandem stance and single leg stance) and measurement time (90, 60, 30 and 15 s) with eyes closed using a force plate. Additionally, static and dynamic clinical tests of postural control were used. RESULTS No significant between group differences were found for the COP measurements (p>0.05). However, individuals with subclinical NP were more likely to fail the 90 s tandem test (p<0.05) in the force plate and univariate comparisons revealed significant between group differences in the tandem and single leg stance clinical test measurements. CONCLUSIONS Taken together, the inconsistent results might suggest an emerging postural control deficit in university students with low disability and low intensity chronic idiopathic NP.
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Affiliation(s)
- Gabriela Amaral
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Helena Martins
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.,Center for Health Technology and Services Research (CINTESIS.UA), Aveiro, Portugal, Phone: +234401558, extension: 23899, Fax: +234401597
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18
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Alsultan F, Cescon C, De Nunzio AM, Barbero M, Heneghan NR, Rushton A, Falla D. Variability of the helical axis during active cervical movements in people with chronic neck pain. Clin Biomech (Bristol, Avon) 2019; 62:50-57. [PMID: 30690409 DOI: 10.1016/j.clinbiomech.2019.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent work described parameters of the helical axis in asymptomatic people with potential for investigating kinematic changes in the cervical region. This approach could provide novel information on movement variability in people with neck pain, however this has never been investigated. This study aimed to investigate movement variability during active neck movements performed at different speeds in people with and without chronic neck pain. METHODS This observational case-control study examined 18 participants with chronic neck pain of either idiopathic or traumatic origin and 18 gender-matched asymptomatic participants. Cervical kinematics were captured with 3D motion capture as people with and without chronic neck pain performed flexion-extension, bilateral lateral flexion and bilateral rotation at different speeds (natural, slow, and fast). The mean distance and mean angle parameters of the helical axis were extracted to describe 3D motion and quantify movement variability. FINDINGS A smaller mean distance was observed in those with neck pain compared to the asymptomatic participants during flexion-extension (P = 0.019) and rotation movements (P = 0.007). The neck pain group displayed smaller values for the mean angle during rotation movements with different speeds (P = 0.01). These findings indicate less variable movement for those with neck pain relative to the asymptomatic participants. No difference in the mean angle was observed between groups for flexion-extension and lateral flexion. INTERPRETATION The findings reiterate the importance of data derived from kinematic measures, and its potential for providing clinicians with further insight into the quality of active neck movements in people with chronic neck pain.
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Affiliation(s)
- Feras Alsultan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK; Physical Therapy Department, College of Medical Rehabilitation, Qassim University, Buraidah, Saudi Arabia
| | - Corrado Cescon
- Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Alessandro Marco De Nunzio
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Marco Barbero
- Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
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19
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Beinert K, Sofsky M, Trojan J. Train the brain! Immediate sensorimotor effects of mentally-performed flexor exercises in patients with neck pain. A pilot study. Eur J Phys Rehabil Med 2019; 55:63-70. [DOI: 10.23736/s1973-9087.18.05118-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Gomes PKA, Silva RBC, de Freitas IMD, Gomes CAFDP, Souza CDS, de Sousa NTA, Dibai-Filho AV. Evaluation of Postural Balance and Articular Mobility of the Lower Limbs in Chronic Neck Pain Patients by Means of Low-Cost Clinical Tests. J Manipulative Physiol Ther 2018; 41:658-664. [PMID: 30573196 DOI: 10.1016/j.jmpt.2018.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/30/2018] [Accepted: 03/30/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to correlate measurements of chronic neck pain with the balance and mobility of the lower limbs and to compare these variables between individuals with chronic neck pain and asymptomatic participants. METHODS This was a blinded cross-sectional study. Participants with chronic neck pain (n = 30) and asymptomatic participants (n = 30) were included in the study. To measure pain in the neck region, the Numeric Rating Scale, Neck Disability Index, and Pain-Related Catastrophizing Thoughts Scale were applied. The assessment of postural balance and mobility of the lower limbs was made using the Timed Up and Go Test, Functional Reach Test (FRT), Lateral Reach Test, and 30-second Chair Stand Test. RESULTS No statistically (P > .05) and clinically (d < 0.50) significant differences were identified for the variables tested here. However, regarding the correlations, a significant association was identified only between the intensity of pain during cervical movements and FRT (r = -0.312). CONCLUSION Young adults with chronic neck pain present changes in static balance measured by means of the FRT; that is, the higher the intensity of pain, the lower the anteroposterior excursion of the body during the execution of the test.
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21
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Hirata RP, Christensen SW, Agger S, Svindt M, Røssner N, Abildgaard J, Vuillerme N, Graven-Nielsen T. Light Touch Contact Improves Pain-Evoked Postural Instability During Quiet Standing. PAIN MEDICINE 2018; 19:2487-2495. [PMID: 29481664 DOI: 10.1093/pm/pny015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective To investigate if attention to additional sensory information from the fingertip can improve postural stability during pain, which is known to impair balance. Methods In 16 healthy volunteers, experimental pain was induced by intramuscular injection of hypertonic saline in the right vastus medialis muscle (isotonic saline used as nonpainful control, intramuscular injection in the same location). Pain intensity was assessed on an 11-point numeric rating scale (NRS; 0 representing "no pain" and 10 "maximum pain"). Subjects were asked to stand as still as possible on a force plate for 40 seconds with their eyes closed. Their postural stability was quantified by the area and velocity of center of pressure (CoP) displacement. The CoP was recorded with and without pain during two different conditions: 1) no touch and 2) the subjects were asked to lightly touch a curtain with their right index finger and focus their attention on keeping it as still as possible. Results Hypertonic injections induced higher NRS scores compared with control injections (P < 0.05). During the hypertonic injection condition, the CoP area and velocity in both directions increased during no touch compared with the light touch condition (P < 0.05). No differences were found during light touch between the hypertonic and isotonic injection conditions. Although experimental knee-related pain impaired postural stability, lightly touching a curtain with the fingertip decreased postural sway during painful conditions. Conclusions Providing additional sensory information while pain patients are performing balance exercises may improve postural stability and increase the quality of exercise, consequent rehabilitation protocols, and clinical outcomes.
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Affiliation(s)
- Rogerio P Hirata
- SMI®.,Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Steffan W Christensen
- SMI®.,Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Simone Agger
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Mikkel Svindt
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Nicklas Røssner
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jesper Abildgaard
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Nicolas Vuillerme
- University of Grenoble Alpes, AGEIS, and Institut Universitaire de France, La Tronche, France
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The characteristics and correlative research of “Jin Shang” associated with chronic neck pain in young adults based on ultrasound imaging. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2018. [DOI: 10.1016/j.jtcms.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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23
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Lascurain-Aguirrebeña I, Newham DJ, Galarraga-Gallastegui B, Critchley DJ. Differences in neck surface electromyography, kinematics and pain occurrence during physiological neck movements between neck pain and asymptomatic participants. A cross-sectional study. Clin Biomech (Bristol, Avon) 2018; 57:1-9. [PMID: 29864606 DOI: 10.1016/j.clinbiomech.2018.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 04/25/2018] [Accepted: 05/21/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neck pain has been associated with altered muscle activity and impaired kinematics. Patients frequently report pain during physiological neck movements. Previously, the average muscle activity during these movements has been measured. However, muscle activity is modulated by the position in the range of movement, hence the study of neck muscle activity in discrete sections of the range of movement is warranted. Evidence is conflicting regarding range of movement restriction in neck pain. No study has assessed the point in the range of movement at which pain occurs. This study aimed to investigate neck kinematics, muscle activity and pain during physiological neck movements in participants with and without neck pain. METHODS Neck kinematics and surface electromyography were recorded continuously and analysed in 10° increments during forward and side flexion, extension and rotation of the neck in 20 neck pain and 20 asymptomatic participants. Point of pain occurrence in the range of movement was recorded. FINDINGS Neck pain participants demonstrated significantly lower activity of scalene during flexion and extension, and a non-significant higher activity in sternocleidomastoids during rotation. No differences in neck kinematics were observed. 65% of neck pain participants reported pain during at least one neck movement. Pain was reported in the last ≈20-40% of the range of movement. INTERPRETATION Exercises used in current practice to minimise scalene activity may not be appropriate for all neck pain patients. Restricted range of movement is not a consistent feature of neck pain. Movement associated neck pain is present at the end of range of movement, which has implications for the study of neck pain and rehabilitation.
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Affiliation(s)
- Ion Lascurain-Aguirrebeña
- School of Population Sciences and Health Services Research, Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, United Kingdom; Department of Physiology, Faculty of Medicine & Odontology, University of the Basque Country, Leioa 48940, Spain.
| | - Di J Newham
- Centre of Human & Aerospace Physiological Sciences, Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, United Kingdom.
| | | | - Duncan J Critchley
- School of Population Sciences and Health Services Research, Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, United Kingdom.
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Dibai-Filho AV, de Jesus Guirro RR, Rezende MS, Rangon FB, Ferreira VTK, de Oliveira Guirro EC. Analysis of peak plantar pressure and center of pressure oscillation in individuals with chronic neck pain: A cross-sectional study. J Back Musculoskelet Rehabil 2017; 30:1259-1264. [PMID: 28946519 DOI: 10.3233/bmr-169629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Baropodometric evaluation has been used in research and clinical environments by professionals who are working on the physical rehabilitation of patients. However, to date, there is no published data on the use of baropodometry in patients with chronic neck pain. OBJECTIVE To analyze peak plantar pressure and center of pressure oscillation in individuals with chronic neck pain compared to a control group. METHODS This was a blind cross-sectional study. It included 44 participants of both genders, between 18 and 45 years old, distributed into a chronic neck pain group (n= 22) and a control group (n= 22). Participants were assessed by means of baropodometry, the Numeric Rating Scale, the Neck Disability Index, and the Pain-Related Self Statement Scale. The Mann-Whitney test was used for comparison of baropodometric variables between the two groups, and the Spearman correlation coefficient was used to check possible associations between the variables. RESULTS No significant differences (p> 0.05) in peak plantar pressure or center of pressure oscillation were detected in the comparisons between the chronic neck pain and control groups. In addition, no significant correlation was observed (p> 0.05) between baropodometric variables and neck pain. CONCLUSION Individuals with chronic neck pain with mild disability did not differ from a control group in terms of peak plantar pressure or center of pressure oscillation.
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25
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Ritzmann R, Freyler K, Werkhausen A, Gollhofer A. Changes in Balance Strategy and Neuromuscular Control during a Fatiguing Balance Task-A Study in Perturbed Unilateral Stance. Front Hum Neurosci 2016; 10:289. [PMID: 27378886 PMCID: PMC4906883 DOI: 10.3389/fnhum.2016.00289] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 05/30/2016] [Indexed: 11/29/2022] Open
Abstract
Fatigue impairs sensorimotor performance, reduces spinal reflexes and affects the interaction of antagonistic muscles in complex motor tasks. Although there is literature dealing with the interference of fatigue and postural control, the interpretation is confounded by the variety of paradigms used to study it. This study aimed to evaluate the effects of postural fatigue on balance control and strategy, as well as on neuromuscular modulation, in response to postural perturbation (PERT) during a fatiguing balance task. A fatigue protocol consisting of continuous exposure to perturbations until exhaustion was executed in 24 subjects. Number of failed attempts, paths of center of pressure displacement (COP), ankle, knee, and hip joint kinematics, electromyographic activity of the soleus (SOL), tibialis anterior (TA), rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF), and gluteus maximus muscles (GM) and spinal excitability of SOL at the peak of the short-latency responses (SLR) were recorded after posterior PERT. The co-contraction index (CCI) was calculated for TA_SOL, VL_BF and RF_GM. (1) The number of failed attempts significantly increased while COP amplitude and velocity, as well as angular excursion at the ankle, knee and hip joints, decreased with fatigue (P < 0.05). (2) Concomitantly, CCI of SOL_TA, VL_BF and RF_GM increased and spinal excitability in SOL declined. (3) Adaptations progressively augmented with progressing exhaustion and occurred in the distal prior to proximal segment. Distinctly deteriorated balance ability was accompanied by a modified neuromuscular control—the increase in co-contraction reflected by simultaneously activated antagonists is accompanied by smaller knee and hip joint excursions, indicating an elevated level of articular stiffness. These changes may be associated with an exaggerated postural rigidity and could have caused the delayed and reduced postural reactions that are reflected in the changes in COP displacement when compensating for sudden PERT. The reduction in spinal excitability may either be caused by fatigue itself or by an increase in reciprocal inhibition due to augmented TA activity.
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Affiliation(s)
- Ramona Ritzmann
- Department of Sports and Sports Science, University of Freiburg Freiburg, Germany
| | - Kathrin Freyler
- Department of Sports and Sports Science, University of Freiburg Freiburg, Germany
| | - Amelie Werkhausen
- Department of Physical Performance, Norwegian School of Sport Sciences Oslo, Norway
| | - Albert Gollhofer
- Department of Sports and Sports Science, University of Freiburg Freiburg, Germany
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