Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients

Jull, Gwendolen; Kristjansson, Eythor; Dall'Alba, Paul

doi:10.1016/s1356-689x(03)00086-9

Cited by 390 publications

(297 citation statements)

References 16 publications

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“…Nevertheless, this alteration in motor control strategy can provide the basis for chronicity and perpetuation of symptoms [33]. Additionally, neuromuscular changes that are seen in patients with CNP may be associated with inhibition in the activity of deep neck muscles and excitation of superficial muscles [5,33,34]. Although this study did not measure deep cervical muscle myoelectric activity, reduced activity of deep neck muscles and the inadequacy of these elements to create the extensor torque required to counteract with gravity during flexion may cause disturbances in the load transfer from surface neck muscles and loss of relaxation of these surface muscles.…”

Section: Appearance Of Frpmentioning

confidence: 99%

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: Appearance Of Frpmentioning

confidence: 99%

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

2012

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“…Researchers at the University of Queensland developed the cranio-cervical flexion test (CCFT), which uses a pressure biofeedback unit (PBU) to measure DNF strength 7) . Since only the neck, and not the head, is bent, this test method is said to be adequate for assessing the anatomical activities of deep muscles such as the longus colli and the longus capitis rather than the activities of the sternocleidomastoid (SCM) and the anterior scalenus, which are surface muscles 8) . In this study, the CCFT was modified in order to examine the functions of the DNF 9) .…”

Section: Introductionmentioning

confidence: 99%

Correlations between Cervical Lordosis, Forward Head Posture, Cervical ROM and the Strength and Endurance of the Deep Neck Flexor Muscles in College Students

2012

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Abstract. [Purpose] This study was conducted in order to examine the correlations between cervical lordosis angles (Absolute Rotation Angle, ARA, forward head posture, FHP, Anterior Weight Bearing, AWB), the range of flexion and extension (RFEM), the strength and endurance of the deep neck flexor (DNF) and cervical pain. [Subjects] The study enrolled 24 university students (female: 12, male:12) aged in their 20s.[Methods] ARA, AWB and RFEM were analyzed using radiographs of lateral views. Strength and endurance were assessed using a Pressure Biofeedback Unit (PBU) and cervical pain and physical functions were assessed using the Neck Disability Index (NDI).[Results]As ARA increased, extension and RFEM also increased, and as AWB decreased, extension and endurance increased. As extension increased, RFEM and endurance increased and NDI decreased. As flexion became larger, RFEM and NDI increased, and as RFEM increased, endurance increased.[Conclusion] The study results indicate that the posture of the cervical spine affects the endurance rather than the strength of the DNF. Therefore, as therapeutic interventions to enhance the endurance of the DNF, posture control to reduce AWB and approaches to increase extension and RFEM should be considered.

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“…Then the subjects pressed the pressure biofeedback stabilizer, located under the neck, maximally with craniocervical flexion, to measure the maximum contraction. After resting for 1 minute and 30 seconds, the time during which 50% of the maximum contraction could be maintained was measured using a stop-watch 11) . The measurement was repeated 3 times, using seconds as the measurement unit, and the mean of the measured values was recorded.…”

Section: Methodsmentioning

confidence: 99%

Effects of the Inclusion Thoracic Mobilization into Cranio-Cervical Flexor Exercise in Patients with Chronic Neck Pain

Jeong

Lee

2010

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to investigate whether a cranio-cervical flexor exercise and thoracic mobilization are effective for muscular endurance (Endurance), visual analog scale (VAS) pain, and neck disability index (NDI) of patients with chronic neck pain.[Subjects] The subjects in this study were 53 patients who had chronic neck pain.[Methods] The experimental group (n=27) did both cranio-cervical flexor exercises and thoracic mobilizations and the control group (n=26) did cranio-cervical flexor exercises.[Results] A paired t-test analysis revealed significant pre-post score changes within both groups. The 2-way group time interaction for the repeated measures ANOVA was statistically significant for Endurance, VAS and NDI. The experimental group showed greater improvement in Endurance, with a between-group difference of 14.26 seconds, VAS pain, with a between-group difference of 2.02 points, and NDI, with a between-group difference of 2.07 points.[Conclusion] These results suggest that the combination of thoracic mobilization with cranio-cervical flexor exercise was more effective at increasing Endurance and reducing VAS pain and NDI.

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Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients

Cited by 390 publications

References 16 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

Correlations between Cervical Lordosis, Forward Head Posture, Cervical ROM and the Strength and Endurance of the Deep Neck Flexor Muscles in College Students

Effects of the Inclusion Thoracic Mobilization into Cranio-Cervical Flexor Exercise in Patients with Chronic Neck Pain

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