Although unilateral posterior neck pain (UPNP) is more prevalent than central neck pain, little is known about how UPNP affects neck motion and the muscle activation pattern during prone neck extension.
OBJECTIVE:
To investigate whether deviation in neck motion and asymmetry of activation of the bilateral cervical paraspinal muscles occur during prone neck extension in subjects with UPNP compared to subjects without UPNP.
METHODS:
This study recruited 20 subjects with UPNP and 20 age- and sex-matched control subjects without such pain. Neck motion and muscle onset time during prone neck extension were measured using a three-dimensional motion-analysis system and surface electromyography.
RESULTS:
The deviation during prone neck extension was greater in the UPNP group than in the controls (p < 0.05). Compared with the controls, cervical extensor muscle activation in the UPNP group was significantly delayed on the painful side during prone neck extension (p < 0.05).
CONCLUSIONS:
Subjects with UPNP showed greater asymmetry of neck motion and muscle activation during prone neck extension compared with the controls. This suggests that UPNP has specific effects on neck motion asymmetry and the functions of the cervical extensors, triggering a need for specific evaluation and exercises in the management of patients with UPNP.
FejerR, KyvikKO, HartvigsenJ. The prevalence of neck pain in the world population: A systematic critical review of the literature. Eur Spine J2006; 15: 834-48.
2.
CoteP, CassidyJD, CarrollL. The saskatchewan health and back pain survey: The prevalence of neck pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976)1998; 23: 1689-98.
3.
O'LearyS, FallaD, ElliottJM, et al. Muscle dysfunction in cervical spine pain: Implications for assessment and management. J Orthop Sports Phys Ther2009; 39: 324-33.
4.
LeeH, NicholosonLL, AdamsRD, et al. Body chart pain location and side-specific physical impairment in subclinical neck pain. J Manipulative Physiol Ther2005; 28: 479-86.
5.
FryerG, AdamsJH. Magnetic resonance imaging of subjects with acute unilateral neck pain and restricted motion: A prospective case series. Spine J2011; 11: 171-6.
6.
SahrmannSA. Movement system impairment syndromes of the extremities, cervical and thoracic spines. 1st ed. New York: Mosby; 2011.
7.
ComerfordM, MottramS. Kinetic Control: The Management of Uncontrolled Movement. 1st ed. Australia: Churchill Livingstone; 2012.
8.
FallaD, JullG, RainoldiA, et al. Neck flexor muscle fatigue is side specific in patients with unilateral neck pain. Eur J Pain2004; 8: 71-7.
9.
RezasoltaniA, AhmadipoorA, Khademi-KalantariK, et al. The sign of unilateral neck semispinalis capitis muscle atrophy in patients with chronic non-specific neck pain. J Back Musculoskelet Rehabil2012; 25: 67-72.
10.
Fernández-de-las-PeñasC, Albert-SanchísJC, BuilM, BenitezJC, et al. Cross-sectional area of cervical multifidus muscle in females with chronic bilateral neck pain compared to controls. J Orthop Sports Phys Ther2008; 38: 175-80.
11.
TaimelaS, TakalaEP, AsklöfT, et al. Active treatment of chronic neck pain: a prospective randomized intervention. Spine (Phila Pa 1976)2000; 25: 1021-7.
12.
MalmströmEM, KarlbergM, FranssonPA, et al. Primary and coupled cervical movements: the effect of age, gender, and body mass index. A 3-dimensional movement analysis of a population without symptoms of neck disorders. Spine (Phila Pa 1976)2006; 31: E44-50.
13.
CagnieB, CoolsA, De LooseV, et al. Reliability and normative database of the Zebris cervical range-of-motion system in healthy controls with preliminary validation in a group of patients with neck pain. J Manipulative Physiol Ther2007; 30 450-5.
DvirZ, PrushanskyT. Reproducibility and instrument validity of a new ultrasonography-based system for measuring cervical spine kinematics. Clin Biomech (Bristol, Avon)2000; 15: 658-64.
16.
GombattoSP, CollinsDR, SahrmannSA, et al. Gender differences in pattern of hip and lumbopelvic rotation in people with low-back pain. Clin Biomech (Bristol, Avon)2006; 21: 263-71.
17.
De OliveiraAS, De Morais CarvalhoM, de BrumDP. Activation of the shoulder and arm muscles during axial load exercises on a stable base of support and on a medicine ball. J Electromyogr Kinesiol2008; 18: 472-9.
KhanAZ, BlohmG, McPeekRM, et al. Differential influence of attention on gaze and head movements. J Neurophysiol2009; 101: 198-206.
20.
ElliottJM, O'LearySP, CagnieB, et al. Craniocervical orientation affects muscle activation when exercising the cervical extensors in healthy subjects. Arch Phys Med Rehabil2010; 91: 1418-22.
21.
ThomasJS, FranceCR. Pain-related fear is associated with avoidance of spinal motion during recovery from low back pain. Spine (Phila Pa 1976)2007; 32: E460-6.
22.
LeeHY, WangJD, YaoG, et al. Association between cervicocephalic kinesthetic sensibility and frequency of subclinical neck pain. Man Ther2008; 13: 419-25.
23.
PereiraMJJullGA, TreleavenJM. Self-reported driving habits in subjects with persistent whiplash-associated disorder: relationship to sensorimotor and psychologic features. Arch Phys Med Rehabil2008; 89: 1097-102.
24.
TreleavenJ, LowChoyN, DarnellR, et al. Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma. Arch Phys Med Rehabil2008; 89: 522-30.
25.
KristjanssonE, OddsdottirGL. ``The Fly'': A new clinical assessment and treatment method for deficits of movement control in the cervical spine: Reliability and validity. Spine (Phila Pa 1976)2010; 35: E1298-305.
26.
HurleyMV, NewhamDJ. The influence of arthrogenous muscle inhibition on quadriceps rehabilitation of patients with early, unilateral osteoarthritic knees. Br J Rheumatol1993; 32: 127-31.
FreemanS, MasciaA, McGillS. Arthrogenic neuromusculature inhibition: a foundational investigation of existence in the hip joint. Clin Biomech (Bristol, Avon)2013; 28: 171-7.
29.
McVeyED, PalmieriRM, DochertyCL, et al. Arthrogenic muscle inhibition in the leg muscles of subjects exhibiting functional ankle instability. Foot Ankle Int2005; 26: 1055-61.
30.
HallgrenRC, GreenmanPE, RechtienJJ. Atrophy of suboccipital muscles in patients with chronic pain: A pilot study. J Am Osteopath Assoc1994; 12: 1032-8.
31.
McPartlandJM, BrodeurRR, HallgrenRC. Chronic neck pain, standing balance, and suboccipital muscle atrophy - A pilot study. J Manipulative Physiol Ther1997; 20: 24-9.
32.
FakhranS, QuC, AlhilaliLM. Effect of the suboccipital musculature on symptom severity and recovery after mild traumatic brain injury. Am J Neuroradiol2016; 24: in press.
33.
HagenKB, Harms-RingdahlK, EngerNO, et al. Relationship between subjective neck disorders and cervical spine mobility and motion related pain in male machine operators. Spine (Phila Pa 1976)1997; 22: 1501-7.
34.
LeeH, NicholsonLL, AdamsRD. Neck muscle endurance, self-report, and range of motion data from subjects with treated and untreated neck pain. J Manipulative Physiol Ther2005; 28: 25-32.
35.
WoodhouseA, VasseljenO. Altered motor control patterns in whiplash and chronic neck pain. BMC Musculoskelet Disord2008; 9: 90.
36.
YlinenJ, TakalaEP, KautiainenH, et al. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. Eur J Pain2004; 8: 473-8.
37.
RudolfssonT, BjörklundM, DjupsjöbackaM. Range of motion in the upper and lower cervical spine in people with chronic neck pain. Man Ther2012; 17: 53-9.
38.
TakeshimaT, OmokawaS, TakaokaT, et al. Sagittal alignment of cervical flexion and extension: lateral radiographic analysis. Spine (Phila Pa 1976)2002; 27: E348-55.
39.
LinCC, LuTW, WangTM, et al. In vivo three-dimensional intervertebral kinematics of the subaxial cervical spine during seated axial rotation and lateral bending via a fluoroscopy-to-CT registration approach. J Biomech2014; 47: 3310-7.
40.
IshiiT, MukaiY, HosonoN, et al. Kinematics of the upper cervical spine in rotation: in vivo three-dimensional analysis. Spine (Phila Pa 1976)2004; 29: E139-44.
41.
CookC, HegedusE, ShowalterC, et al. Coupling behavior of the cervical spine: a systematic review of the literature. J Manipulative Physiol Ther2006; 29: 570-5.
42.
WhiteAA, PanjabiMM. Clinical Biomechanics of the Spine. Amsterdam: Lippincott - the Health Professions Publisher of Harper & Row; 1990.
43.
WalmsleyRP, KimberP, CulhamE. The effect of initial head position on active cervical axial rotation range of motion in two age populations. Spine (Phila Pa 1976)1996; 21: 2435-42.
44.
DugaillyPM, SobczakS, LubansuA, et al. Validation protocol for assessing the upper cervical spine kinematics and helical axis: An in vivo preliminary analysis for axial rotation, modeling, and motion representation. J Craniovertebr Junction Spine2013; 4: 10-5.
45.
TakatoriR, TokunagaD, HaseH, et al. Three-dimensional morphology and kinematics of the craniovertebral junction in rheumatoid arthritis. Spine (Phila Pa 1976)2010; 35: E1278-84.
