An examination of the flexion-relaxation phenomenon in the cervical spine in lumbo-pelvic sitting

Burnett, Angus; O’Sullivan, Peter; Cañeiro, J P; Krug, Roberto Costa; Frank, Benedikt; Helgestad, Gry Wang

doi:10.1016/j.jelekin.2008.04.015

Cited by 38 publications

(30 citation statements)

References 28 publications

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“…any evidence of fracture, mechanical instability, radiculopathy or myelopathy) and excluded if their pain was greater than 30 mm based on the visual analog scale (VAS) during the assessment session. Moreover, the exclusion criteria for both the groups included spinal or shoulder trauma, surgery or any systemic disease and participated in strengthening exercise programmes for the neck muscles [22]. Anthropometric and clinical characteristics of the subjects are listed in Table 1.…”

Section: Participantsmentioning

confidence: 99%

“…From this position they were asked to maintain the starting position for 4 s (phase 1), complete cervical flexion for 4 s (phase 2), sustain cervical full flexion for 4 s (phase 3) and cervical extension with return to the starting position for 4 s (phase 4) [22]. Each subject performed three trials of this protocol.…”

Section: Participantsmentioning

confidence: 99%

“…The MVIC for CES muscles were obtained in sitting position, and for this reason a cuff was wrapped around the head which was connected to a stable attachment at the same height and subjects maximally pulled back on the wire [24]. In order to obtain MVIC for UTr in seated position, the subjects were asked to perform an isometric shoulder shrug [22]. For obtaining MVIC the subjects performed three repetitions for 5 s, and 2 min interval was considered between contractions to prevent muscle fatigue.…”

Section: Participantsmentioning

confidence: 99%

“…Bipolar disposal surface Ag-AgCl electrodes were applied bilaterally, 2 cm lateral to C4 spinous process for recording myoelectrical activity of CES muscles [25,26] and also were placed lateral to the half-way point of an imaginary line formed by the posterior aspect of the acromion and the spinous process of C7 for the UTr [22]. The electrodes were positioned in the direction of the muscle fibres.…”

Section: Instrumentationmentioning

confidence: 99%

“…However, in some studies the FRP appearance in the cervical spine was reported in all of the healthy subjects [6,30]. Burnett et al [22] reported that between 0 and 65 % of healthy subjects displayed the FRP, depending upon which method was used.…”

Section: Appearance Of Frpmentioning

confidence: 99%

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A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects

2012

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Purpose The cervical flexion relaxation phenomenon (FRP) is a neck extensor myoelectric ''silence'' that occurs during complete cervical and lumbar flexion. In contrast to low back pain, the changes that occur during FRP in chronic neck pain (CNP) patients are still not clear. The aim of this study was to assess the characteristics of this phenomenon in the cervical region in CNP patients and controls. Methods Twenty-two women (23 ± 2.62 years) with chronic non-specific neck pain and 21 healthy women (23.4 ± 1.68 years) participated in this study. They accomplished a cervical flexion and extension from neutral position. Neck angle and surface electromyographic activity of cervical erector spinae (CES) and upper trapezius muscles were recorded. Appearance, onset and offset angle of the FRP were analysed and compared between the two groups. Results There were significant differences in the appearance of FRP between the two groups (P B 0.001). The FRP in the CES muscles was observed in 85.7 % of healthy subjects and in 36.3 % of CNP patients, and no FRP was observed in the upper trapezius. Results of this study show that the onset and offset of FRP parameters were significantly different between the two groups (P B 0.001).Conclusions The results of the present study indicate that FRP in CNP patients was seen less than the healthy subjects, and moreover the FRP period was reduced in CNP patients. Our results also suggest that the changes in FRP of CNP patients may be due to the increased CES activity in these patients.

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Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Instrumentationmentioning

confidence: 99%

Section: Appearance Of Frpmentioning

confidence: 99%

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A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects

2012

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Quantitative identification and segmentation repeatability of thoracic spinal muscle morphology

Zhang

Shewchuk

et al. 2020

JOR Spine

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Objective: MRI derived spinal-muscle morphology measurements have potential diagnostic, prognostic, and therapeutic applications in spinal health. Muscle morphology in the thoracic spine is an important determinant of kyphosis severity in older adults. However, the literature on quantification of spinal muscles to date has been limited to cervical and lumbar regions. Hence, we aim to propose a method to quantitatively identify regions of interest of thoracic spinal muscle in axial MR images and investigate the repeatability of their measurements. Methods: Middle (T4-T5) and lower (T8-T9) thoracic levels of six healthy volunteers (age 26 ± 6 years) were imaged in an upright open scanner (0.5T MROpen, Paramed, Genoa, Italy). A descriptive methodology for defining the regions of interest of trapezius, erector spinae, and transversospinalis in axial MR images was developed. The guidelines for segmentation are laid out based on the points of origin and insertion, probable size, shape, and the position of the muscle groups relative to other recognizable anatomical landmarks as seen from typical axial MR images. 2D parameters such as muscle cross-sectional area (CSA) and muscle position (radius and angle) with respect to the vertebral body centroid were computed and 3D muscle geometries were generated. Intra and inter-rater segmentation repeatability was assessed with intraclass correlation coefficient (ICC (3,1)) for 2D parameters and with dice coefficient (DC) for 3D parameters. Results: Intra and inter-rater repeatability for 2D and 3D parameters for all muscles was generally good/excellent (average ICC (3,1) = 0.9 with ranges of 0.56-0.98; average DC = 0.92 with ranges from 0.85-0.95). Conclusion: The guidelines proposed are important for reliable MRI-based measurements and allow meaningful comparisons of muscle morphometry in the thoracic spine across different studies globally. Good segmentation repeatability suggests we can further investigate the effect of posture and spinal curvature on muscle morphology in the thoracic spine.

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Preliminary investigation of spinal level and postural effects on thoracic muscle morphology with upright openMRI

Zhang

Street

et al. 2021

JOR Spine

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Objective: Spinal-muscle morphological differences between weight-bearing and supine postures have potential diagnostic, prognostic, and therapeutic applications. While the focus to date has been on cervical and lumbar regions, recent findings have associated spinal deformity with smaller paraspinal musculature in the thoracic region. We aim to quantitatively investigate the morphology of trapezius (TZ), erector spinae (ES) and transversospinalis (TS) muscles in upright postures with open upright MRI and also determine the effect of level and posture on the morphological measures. Methods: Six healthy volunteers (age 26 ± 6 years) were imaged (0.5 T MROpen, Paramed, Genoa, Italy) in four postures (supine, standing, standing with 30 flexion, and sitting). Two regions of the thorax, middle (T4-T5), and lower (T8-T9), were scanned separately for each posture. 2D muscle parameters such as cross-sectional area (CSA) and position (radius and angle) with respect to the vertebral body centroid were measured for the three muscles. Effect of spinal level and posture on muscle parameters was examined using 2-way repeated measures ANOVA separately for T4-T5 and T8-T9 regions.

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An examination of the flexion-relaxation phenomenon in the cervical spine in lumbo-pelvic sitting

Cited by 38 publications

References 28 publications

A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects

A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects

Quantitative identification and segmentation repeatability of thoracic spinal muscle morphology

Preliminary investigation of spinal level and postural effects on thoracic muscle morphology with upright openMRI

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