Purpose:To compare changes in flexor and extensor neck muscle endurance, electromyography, and ratings of fatigue and pain 14 weeks and 12 months after neck-specific training or prescribed physical activity in patients with cervical radiculopathy.
Methods:Patients were randomized to either neck-specific training with a cognitive behavioral approach, or prescribed self-mediated physical activity. Surface electromyography was recorded from the sternocleidomastoid, splenius capitis, upper and lower trapezius muscles bilaterally, during sub-maximal isometric endurance tests for neck extension and flexion. Out of 75 patients, 50 participated in the final analysis of endurance time, slope of the median frequency and amplitude of the electromyography signals, and fatigue and pain ratings.
Results:Neck flexion endurance improved significantly after training for groups. There was no significant change in the median frequency slope for any muscle in either group. Fatigue ratings were significantly lower for the extension tests for both groups at 14 weeks and 12 months. Neck pain intensity decreased significantly at 14 weeks and at 12 months. For the neck training group, the activation of the splenius capitis was significantly reduced during neck flexion at 14 weeks and at 12 months indicating reduced muscle co-activation.
Conclusions:Exercise, whether it was specific or general, increased neck flexor endurance, and reduced perceived fatigue and pain. The neck training group only had indications of reduced coactivation of antagonist muscles during neck flexion.