Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지

The suggestion of Proper Pressure level in Cranio-Cervical Flexion Exercise for Deep Cervical Flexor by Ultrasonographic Measurement

초음파 영상을 통한 머리-목 굽힘 운동의 적정 수준 제시에 관한 연구

  • Jun, Deok-Hoon (Graduated school of Physical Therapy, Daegu University) ;
  • Fell, Dennis W. (Department of Physical Therapy, University of South Alabama) ;
  • Kim, Kyoung (Department of Physical Therapy, Daegu University)
  • 전덕훈 (대구대학교 일반대학원) ;
  • 데니스펠 (미국 남알라바마 대학교 물리치료학과) ;
  • 김경 (대구대학교 물리치료학과)
  • Received : 2011.11.14
  • Accepted : 2011.11.28
  • Published : 2011.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : Chronic cervical pain is a common source of disability in society. There has been no research regarding the amount of pressure for the deep cervical flexors during cranio-cervical flexion exercise (CCFE). The purpose of this study is to determine optimal pressure levels to facilitate deep cervical muscles (longus colli & longus capitis) during cranio-cervical flexion exercise, using ultrasound measurement of the muscles. Methods : Using a cross-sectional design, the study was performed in an experimental group of 19 subjects (7 men, 12 women) with no cervical pain. Participants were instructed to perform the CCFE, and during the five incremental stages of the test, changes in thickness, as compared to resting baseline values, were measured using ultrasonography for sternocleidomastoid muscle (SCM) and deep cervical muscles (DCF). Results : Both DCF and SCM muscles demonstrated an increase in recruitment with each progressive phase of the test. In comparing the different pressure increments, the most significant changes found in DCF thickness were between phase 2 and phase 3 (p<.05). However no differences were found between pressure increments for SCM thickness (p>.05). Conclusion : The results suggest 26 mm Hg as the optimal pressure level during cranio-cervical flexion exercise for facilitation of deep cervical flexor.

Keywords

References

  1. Andersson HI, Ejlertsson G, Leden I et al. Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization. Clin J Pain. 1993;9(3):174-82. https://doi.org/10.1097/00002508-199309000-00004
  2. Borghouts J, Janssen H, Koes B et al. The management of chronic neck pain in general practice. A retrospective study. Scand J Prim Health Care. 1999;17(4):215-20. https://doi.org/10.1080/028134399750002430
  3. Borghouts JA, Koes BW, Vondeling H et al. Cost-of-illness of neck pain in The Netherlands in 1996. Pain. 1999;80(3):629-36. https://doi.org/10.1016/S0304-3959(98)00268-1
  4. Bovim G, Schrader HSand T. Neck pain in the general population. Spine (Phila Pa 1976). 1994;19(12):1307-9. https://doi.org/10.1097/00007632-199406000-00001
  5. Brattberg G, Thorslund MWikman A. The prevalence of pain in a general population. The results of a postal survey in a county of Sweden. Pain. 1989;37(2):215-22. https://doi.org/10.1016/0304-3959(89)90133-4
  6. Cagnie B, Derese E, Vandamme L et al. Validity and reliability of ultrasonography for the longus colli in asymptomatic subjects. Man Ther. 2009;14(4):421-6. https://doi.org/10.1016/j.math.2008.07.007
  7. Cagnie B, Dirks R, Schouten M et al. Functional reorganization of cervical flexor activity because of induced muscle pain evaluated by muscle functional magnetic resonance imaging. Man Ther. 2011;16(5):470-5. https://doi.org/10.1016/j.math.2011.02.013
  8. Carroll LJ, Hogg-Johnson S, van der Velde G et al. Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008;33(4 Suppl):S75-82.
  9. Chiu TT, Law EYChiu TH. Performance of the craniocervical flexion test in subjects with and without chronic neck pain. J Orthop Sports Phys Ther. 2005;35(9):567-71.
  10. Cholewicki J, Panjabi MMKhachatryan A. Stabilizing function of trunk flexor-extensor muscles around a neutral spine posture. Spine (Phila Pa 1976). 1997;22(19):2207-12. https://doi.org/10.1097/00007632-199710010-00003
  11. Falla D, Bilenkij GJull G. Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine (Phila Pa 1976). 2004;29(13):1436-40. https://doi.org/10.1097/01.BRS.0000128759.02487.BF
  12. Falla D, Jull G, Dall'Alba P et al. An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Phys Ther. 2003;83(10):899-906.
  13. Falla D, Jull GHodges PW. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res. 2004;157(1):43-8. https://doi.org/10.1007/s00221-003-1814-9
  14. Falla DL, Campbell CD, Fagan AE et al. Relationship between cranio-cervical flexion range of motion and pressure change during the cranio-cervical flexion test. Man Ther. 2003;8(2):92-6. https://doi.org/10.1016/S1356-689X(03)00008-0
  15. Falla DL, Jull GAHodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine (Phila Pa 1976). 2004;29(19):2108-14. https://doi.org/10.1097/01.brs.0000141170.89317.0e
  16. Garrett TR, Youdas JWMadson TJ. Reliability of measuring forward head posture in a clinical setting. J Orthop Sports Phys Ther. 1993;17(3):155-60.
  17. Hanten WP, Lucio RM, Russell JL et al. Assessment of total head excursion and resting head posture. Arch Phys Med Rehabil. 1991;72(11):877-80. https://doi.org/10.1016/0003-9993(91)90003-2
  18. Hayashi N, Masumoto T, Abe O et al. Accuracy of abnormal paraspinal muscle findings on contrastenhanced MR images as indirect signs of unilateral cervical root-avulsion injury. Radiology. 2002;223(2):397-402. https://doi.org/10.1148/radiol.2232010857
  19. Hodges PW, Pengel LH, Herbert RD et al. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003;27(6):682-92. https://doi.org/10.1002/mus.10375
  20. Iizuka H, Nakajima T, Iizuka Y et al. Cervical malalignment after laminoplasty: relationship to deep extensor musculature of the cervical spine and neurological outcome. J Neurosurg Spine. 2007;7(6):610-4. https://doi.org/10.3171/SPI-07/12/610
  21. Javanshir K, Mohseni-Bandpei MA, Rezasoltani A et al. Ultrasonography of longus colli muscle: A reliability study on healthy subjects and patients with chronic neck pain. J Bodyw Mov Ther. 2011;15(1):50-6. https://doi.org/10.1016/j.jbmt.2009.07.005
  22. Jesus FM, Ferreira PHFerreira ML. Ultrasonographic measurement of neck muscle recruitment: a preliminary investigation. J Man Manip Ther. 2008;16(2):89-92. https://doi.org/10.1179/106698108790818486
  23. Jesus-Moraleida FR, Ferreira PH, Pereira LS et al. Ultrasonographic analysis of the neck flexor muscles in patients with chronic neck pain and changes after cervical spine mobilization. J Manipulative Physiol Ther. 2011;34(8):514-24. https://doi.org/10.1016/j.jmpt.2011.08.006
  24. Jull G, Barrett C, Magee R et al. Further characterisation of muscle dysfunction in cervical headache. Cephalalgia. 1999;19:179-85. https://doi.org/10.1046/j.1468-2982.1999.1903179.x
  25. Jull GA. Deep cervical neck flexor dysfunction in whiplash. Journal of Musculoskeletal. Pain. 2000;8:143-54.
  26. Jull G, Falla D, Treleaven J et al. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res. 2007;25(3):404-12. https://doi.org/10.1002/jor.20220
  27. Jull G, Kristjansson EDall'Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004;9(2):89-94. https://doi.org/10.1016/S1356-689X(03)00086-9
  28. Makela M, Heliovaara M, Sievers K et al. Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol. 1991;134(11):1356-67.
  29. O'Leary S, Falla D, Elliott JM et al. Muscle dysfunction in cervical spine pain: implications for assessment and management. J Orthop Sports Phys Ther. 2009;39(5):324-33.
  30. O'Leary S, Falla D, Jull G et al. Muscle specificity in tests of cervical flexor muscle performance. J Electromyogr Kinesiol. 2007;17(1):35-40. https://doi.org/10.1016/j.jelekin.2005.10.006
  31. Rezasoltani A, Ylinen JVihko V. Isometric cervical extension force and dimensions of semispinalis capitis muscle. J Rehabil Res Dev. 2002;39(3):423-8.
  32. Szeto GP, Straker LRaine S. A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. Appl Ergon. 2002;33(1):75-84. https://doi.org/10.1016/S0003-6870(01)00043-6
  33. Van K, Hides JARichardson CA. The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects. J Orthop Sports Phys Ther. 2006;36(12):920-5. https://doi.org/10.2519/jospt.2006.2304
  34. Weber Hellstenius SA. Recurrent neck pain and headaches in preadolescents associated with mechanical dysfunction of the cervical spine: a cross-sectional observational study with 131 students. J Manipulative Physiol Ther. 2009;32(8):625-34. https://doi.org/10.1016/j.jmpt.2009.08.025