Impact of Isometric Contraction of Anterior Cervical Muscles on Cervical Lordosis

Fedorchuk, Curtis; McCoy, Matthew S.; Lightstone, Douglas Frank; Bak, David Andrew; Moser, Jacque; Kubricht, Brett; Packer, John G.; Walton, Dustin; Binongo, José

doi:10.3941/jrcr.v10i9.2885

Cited by 6 publications

(4 citation statements)

References 17 publications

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“…However, we found no statistically significant differences in the control group’s cervical lordosis who were subjected to neck stretches and IR; which should also reduce muscle spasm/tightness. The lack of a cause-and-effect association between muscle spasm and hypo-lordosis in our study is consistent with a study of acute and chronic neck pain patients by Helliwell et al [ 35 ] and with the biomechanical investigation performed by Fedorchuk et al [ 36 ].…”

Section: Discussionsupporting

confidence: 93%

The Efficacy of Cervical Lordosis Rehabilitation for Nerve Root Function and Pain in Cervical Spondylotic Radiculopathy: A Randomized Trial with 2-Year Follow-Up

Moustafa

Diab

Harrison

2022

JCM

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Sagittal cervical alignment is a clinically related feature in patients suffering from chronic cervical spondylotic radiculopathy (CSR). We designed this randomized trial to explore the effects of cervical lordosis (CL) correction in thirty chronic lower CSR patients with CL < 20°. Patients were assigned randomly into two equal groups, study (SG) and control (CG). Both groups received neck stretching and exercises and infrared radiation; additionally, the SG received cervical extension traction. Treatments were applied 3× per week for 10 weeks after which groups were followed for 3 months and 2 years. The amplitude of dermatomal somatosensory evoked potentials (DSSEPS), CL C2–C7, and pain scales (NRS) were measured. The SG had an increase in CL post-treatment (p < 0.0001), this was maintained at 3 months and 2 years. No statistical improvement in CL was found for the CG. A significant reduction in NRS for SG after 10 weeks of treatment with non-significant loss of change at 3 months and continued improvement at 2 years was found. CG had less significant improvement in post-treatment NRS; the 3-month and 2-year measures revealed significant worsening in NRS. An inverse linear correlation between increased CL and NRS was found (r = −0.49; p = 0.005) for both groups initially and maintained in SG at the final 2-year follow-up (r = −0.6; p = 0.01). At 10 weeks, we found significant improvements in DSSEPS for both groups (p < 0.0001). We identified a linear correlation between initial DSSEPs and CL for both groups (p < 0.0001), maintained only in the SG at the final follow-up for all levels (p < 0.0001). Improved CL in the SG correlated with significant improvements in nerve root function and pain rating in patients with CSR at short and long-term follow-up. These observed effects indicate that clinicians involved in the treatment of patients with symptoms of cervical degenerative disorders should add sagittal curve correction to their armamentarium of rehabilitation procedures for relevant patient populations.

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Section: Discussionsupporting

confidence: 93%

The Efficacy of Cervical Lordosis Rehabilitation for Nerve Root Function and Pain in Cervical Spondylotic Radiculopathy: A Randomized Trial with 2-Year Follow-Up

Moustafa

Diab

Harrison

2022

JCM

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“…Recently, for the cervical spine it was demonstrated that cervical spine alignment alterations (i.e. kyphosis) are not resulting from muscle spasms 39 ) ; in fact, muscle activity mostly increases the lordosis, not straightening it as traditionally assumed. For this reason, traditional treatments (not LET) aimed at the back muscles such as stretching, hot packs and interferential therapy may lessen pain, lessen disability and increase flexibility (albeit temporarily) but not affect the structural spine alignment.…”

Section: Discussionmentioning

confidence: 99%

Restoring lumbar lordosis: a systematic review of controlled trials utilizing Chiropractic Bio Physics<sup>®</sup> (CBP<sup>®</sup>) non-surgical approach to increasing lumbar lordosis in the treatment of low back disorders

et al. 2020

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[Purpose] To systematically review controlled trial evidence for the use of lumbar extension traction by Chiropractic BioPhysics ® methods for the purpose of increasing lumbar lordosis in those with hypolordosis and low back disorders. [Methods] Literature searches were performed in Pubmed, PEDro, CINAHL, Cochrane, and ICL databases. Search terms included iterations related to the lumbar spine, low back pain and extension traction rehabilitation. [Results] Four articles detailing 2 randomized and 1 non-randomized trial were located. Trials demonstrated increases in radiographic measured lordosis of 7–11°, over 10–12 weeks, after 30–36 treatment sessions. Randomized trials demonstrated traction treated groups mostly maintained lordosis correction, pain relief, and disability after 6-months follow-up. The non-randomized trial showed lordosis and pain intensity were maintained with periodic maintenance care for 1.5 years. Importantly, control/comparison groups had no increase in lumbar lordosis. Randomized trials showed comparison groups receiving physiotherapy-less the traction, had temporary pain reduction during treatment that regressed towards baseline levels as early as 3-months after treatment. [Conclusion] Limited but good quality evidence substantiates that the use of extension traction methods in rehabilitation programs definitively increases lumbar hypolordosis. Preliminarily, these studies indicate these methods provide longer-term relief to patients with low back disorders versus conventional rehabilitation approaches tested.

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“…In fact, the Moustafa trials [49][50][51][52][53] were so designed to include physiotherapeutic methods that would relieve any muscle spasms, but comparison treated patients, not receiving CET, still did not achieve any improvements in lordosis. Also, Fedorchuk et al recently showed that cervical muscle engagement simulating muscle spasm most likely induces an increase in curvature, not a straightening of the cervical spine 76) .…”

Section: Discussionmentioning

confidence: 99%

Restoring cervical lordosis by cervical extension traction methods in the treatment of cervical spine disorders: a systematic review of controlled trials

Oakley¹,

Ehsani

Moustafa

et al. 2021

J Phys Ther Sci

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To systematically review the literature on the use of cervical extension traction methods for increasing cervical lordosis in those with hypolordosis and cervical spine disorders. [Methods] Literature searches for controlled clinical trials were performed in Pubmed, PEDro, Cochrane, and ICL databases. Search terms included iterations related to the cervical spine, neck pain and disorders, and extension traction rehabilitation. [Results] Of 1,001 initially located articles, 9 met the inclusion/exclusion criteria. The trials demonstrated increases in radiographically measured lordosis of 12-18°, over 5-15 weeks, after 15-60 treatment sessions. Untreated controls/ comparison groups not receiving extension traction showed no increase in cervical lordosis. Several trials demonstrated that both traction and comparison treatment groups experienced immediate pain relief. Traction treatment groups maintained their pain and disability improvements up to 1.5 years later. Comparative groups not receiving lordosis improvement experienced regression of symptoms towards pre-treatment values by 1 years' follow-up.[Conclusion] There are several high-quality controlled clinical trials substantiating that increasing cervical lordosis by extension traction as part of a spinal rehabilitation program reduces pain and disability and improves functional measures, and that these improvements are maintained long-term. Comparative groups who receive multimodal rehabilitation but not extension traction experience temporary relief that regresses after treatment cessation.

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Impact of Isometric Contraction of Anterior Cervical Muscles on Cervical Lordosis

Abstract: This study shows no evidence that hypertonicity, as seen in muscle spasms, of the muscles responsible for anterior head translation and anterior head flexion have a significant impact on cervical lordosis.

Cited by 6 publications

References 17 publications

The Efficacy of Cervical Lordosis Rehabilitation for Nerve Root Function and Pain in Cervical Spondylotic Radiculopathy: A Randomized Trial with 2-Year Follow-Up

The Efficacy of Cervical Lordosis Rehabilitation for Nerve Root Function and Pain in Cervical Spondylotic Radiculopathy: A Randomized Trial with 2-Year Follow-Up

Restoring lumbar lordosis: a systematic review of controlled trials utilizing Chiropractic Bio Physics<sup>®</sup> (CBP<sup>®</sup>) non-surgical approach to increasing lumbar lordosis in the treatment of low back disorders

Restoring cervical lordosis by cervical extension traction methods in the treatment of cervical spine disorders: a systematic review of controlled trials

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