Cervical Muscle Activity During Loaded Arm Lifts in Patients 10 Years Postsurgery for Cervical Disc Disease

Abstract

Neck muscle activity during loaded arm lifts 2 Practice of applications• Evaluating potential impairments in individuals with persistent disorders following cervical surgery will permit a more structured approach to rehabilitative exercise for this understudied group.• Greater muscle mechanical activity levels were observed in the ventral muscles and dorsal multifidus muscle of patients with persistent symptoms following anterior cervical decompression and fusion.• The differences may indicate an altered motor strategy in this group when performing the upper limb task.• The altered motor strategy need to be considered when prescribing exercise for their rehabilitation.Neck muscle activity during loaded arm lifts 3 ABSTRACT Objective: To compare the mechanical activity of the neck muscles during loaded arm lifting tasks in individuals with longstanding disability after anterior cervical decompression and fusion (ACDF) to that of healthy controls.Methods: Ten individuals (mean age 60 years; SD 7.1) who underwent ACDF (10-13 years previously) for cervical disc disease and 10 healthy age-and gender-matched controls participated in the study. Ultrasonography were used to investigate the degree of deformation and deformation rate of ventral and dorsal neck muscles at the C4-segmental level during a single (1 x arm flexion to 120°) and repeated (10 x arm flexion to 90°) loaded arm elevation condition. Results:The ACDF group demonstrated greater deformation and deformation rate of the longus capitis (p=0.02) as well as deformation rate of the sternocleidomastoid (p=0.04) during the 120° arm lift. For repeated 90° arm lift, there was a significant effect of group with higher deformation rate values observed in the longus capitis (p=0.005-0.01) and multifidus (p=0.03) muscles in the ACDF group. Muscle behavior did not change the repeated arm lifts (no group x time interactions) for either the ventral or dorsal muscles. Conclusions:Greater muscle mechanical activity levels were observed in the ventral muscles as well as the multifidus muscle, of patients with persistent symptoms following ACDF.These differences may be indicative of an altered motor strategy in this patient group when performing the upper limb task and may need to be considered when prescribing exercise for their rehabilitation.

Differences in Cervical Multifidus Muscle Thickness During Isometric Contraction of Shoulder Muscles: A Comparison Between Patients With Chronic Neck Pain and Healthy Controls

“…27 Our results also support those of Cagnie et al, 28 who showed a reduced activity of the CMM during a cervical extension task in an experimentally pain-induced condition when compared with a no-pain condition. However, our results are not in line with the results of the study conducted by Peolsson et al, 18 who found a greater deformation rate of the CMM during a loaded arm lifting task in participants with long-standing pain than in healthy individuals. Because it was demonstrated that there is a linear correlation between the degree of muscle contraction and the corresponding degree of muscle deformation, we can conclude that the greater muscle deformation rate in participants underwent anterior cervical decompression and fusion in the study by Peolsson et al indicates a higher muscle contraction in such participants.…”

“…This finding is consistent with previous reports that the deep neck extensor muscles including CMM are activated during a lifting task to support the cervical spine. 18 A novel aspect of this study was evaluating differences of the thickness of CMM during isometric contraction of the shoulder muscles between participants with CMNP and healthy controls. According to our results, the interaction of force by group was significant for the CMM thickness.…”

“…Lee et al 17 reported changes in CMM thickness as an effect of isometric head extension at different levels of the cervical spine in healthy participants. Peolsson et al 18 measured the different activity patterns of cervical muscles, especially for the CMM, during a loaded arm lifting task between healthy participants and patients with long-standing neck pain. What these studies did not investigate, however, is the behavior of the CMM contraction and how it responds to different amounts of force exerted by the shoulder muscles and also the different movement directions of the upper extremities.…”

“…[18][19][20] Among these, ultrasound imaging is recognized as a reliable and valid method of muscle function evaluation in real time. 9,[21][22][23] In recent research studies, the interest in ultrasonography measurement of muscle dimensions has greatly increased.…”

Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers

“…However, for a deeper understanding of muscle function the coordination between different muscle layers needs to be examined in future studies. 47 …”