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Effects of Cervical Instability on Function of Deep Neck Flexor Muscle and Muscle Tonus of Neck Muscles

목 불안정성이 깊은목굽힘근의 기능과 목 근육들의 긴장도에 미치는 영향

  • Lee, Sung-Hyun (Dept. of Physical Therapy, Konyang University) ;
  • Seo, Dong-Kwon (Dept. of Physical Therapy, Konyang University)
  • 이성현 (건양대학교 의과학대학 물리치료학과) ;
  • 서동권 (건양대학교 의과학대학 물리치료학과)
  • Received : 2021.01.08
  • Accepted : 2021.02.19
  • Published : 2021.02.28

Abstract

Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.

References

  1. Aird L, Samuel D, Stokes M(2012). Quadriceps muscle tone, elasticity and stiffness in older males: reliability and symmetry using the MyotonPRO. Arch Gerontol Geriatr, 55(2), e31-e39. https://doi.org/10.1016/.archger.2012.03.005. https://doi.org/10.1016/.archger.2012.03.005
  2. Barton PM, Hayes KC(1996). Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache. Arch Phys Med Rehabil, 77(7), 680-687. https://doi.org/10.1016/s0003-9993(96)90008-8. https://doi.org/10.1016/s0003-9993(96)90008-8
  3. Chiu TT, Law EY, Chiu TH(2005). Performance of the craniocervical flexion test in subjects with and without chronic neck pain. J Orthop Sports Phys Ther, 35(9), 567-571. https://doi.org/10.2519/jospt.2005.35.9.567. https://doi.org/10.2519/jospt.2005.35.9.567
  4. Côte P, Cassidy JD, Carroll L(1998). The Saskatchewan health and back pain survey: the prevalence of neck pain and related disability in Saskatchewan adults. Spine, 23(15), 1689-1698. https://doi.org/10.1097/0007632-199808010-00015. https://doi.org/10.1097/0007632-199808010-00015
  5. Domenech MA, Sizer PS, Dedrick GS, et al(2011). The deep neck flexor endurance test: normative data scores in healthy adults. PMR, 3(2), 105-110. https://doi.org/0.1016/j.pmrj.2010.10.023. https://doi.org/10.1016/j.pmrj.2010.10.023
  6. Falla D, Jull G, Hodges PW(2004). Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res, 157(1), 43-48. https://doi.org/10.1007/s00221-003-1814-9. https://doi.org/10.1007/s00221-003-1814-9
  7. Falla D, Jull G, Russell T, et al(2007). Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther, 87(4), 408-417. https://doi.org/10.2522/tj.20060009. https://doi.org/10.2522/tj.20060009
  8. Finley MA, Lee RY(2003). Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors. Arch Phys Med Rehabil, 84(4), 563-568. https://doi.org/0.1053/apmr.2003.50087. https://doi.org/10.1053/apmr.2003.50087
  9. Florencio LL, Oliveira AS, Lemos TW, et al(2016). Patients with chronic, but not episodic, migraine display altered activity of their neck extensor muscles. J Electromyogr Kinesiol, 30, 66-72. https://doi.org/0.1016/j.jelekin.2016.06.003. https://doi.org/10.1016/j.jelekin.2016.06.003
  10. Ghamkhar L, Kahlaee AH(2017). Are ultrasonographic measures of cervical flexor muscles correlated with flexion endurance in chronic neck pain and asymptomatic participants?. Am J Phys Med Rehabil, 96(12), 874-880. https://doi.org/10.1097/PHM.0000000000000778. https://doi.org/10.1097/PHM.0000000000000778
  11. Harris KD, Heer DM, Roy TC, et al(2005). Reliability of a measurement of neck flexor muscle endurance. Phys Ther, 85(12), 1349-1355. https://doi.org/10.1093/tj/85.12.1349. https://doi.org/10.1093/tj/85.12.1349
  12. Jull GA, O'leary SP, Falla DL(2008). Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther, 31(7), 525-533. https://doi.org/10.1016/j.jmpt.2008.08.003. https://doi.org/10.1016/j.jmpt.2008.08.003
  13. Khayatzadeh S, Kalmanson OA, Schuit D, et al(2017). Cervical spine muscle-tendon unit length differences between neutral and forward head postures: biomechanical study using human cadaveric specimens. Phys Ther, 97(7), 756-766. https://doi.org/10.1093/ptj/zx040. https://doi.org/10.1093/ptj/zx040
  14. Kim MS(2015). Neck kinematics and sternocleidomastoid muscle activation during neck rotation in subjects with forward head posture. J Phys Ther Sci, 27(11), 3425-3428. https://doi.org/10.1589/jpts.27.3425. https://doi.org/10.1589/jpts.27.3425
  15. Kocur P, Grzeskowiak M, Wiernicka M, et al(2017). Effects of aging on mechanical properties of sternocleidomastoid and trapezius muscles during transition from lying to sitting position, a cross-sectional study. Arch Gerontol Geriatr, 70, 14-18. https://doi.org/0.1016/j.archger.2016.12.005. https://doi.org/10.1016/j.archger.2016.12.005
  16. Kristjansson E(2004). Reliability of ultrasonography for the cervical multifidus muscle in asymptomatic and symptomatic subjects. Man Ther, 9(2), 83-88. https://doi.org/10.1016/S1356-689X(03)00059-6. https://doi.org/10.1016/S1356-689X(03)00059-6
  17. Lee H, Lee Y, Jeong J, et al(2019). Correlation between tone of suboccipital muscle and endurance of deep neck flexor muscle according to angle changes in college students. J Korean Soc Phys Med, 14(2), 137-144. https://doi.org/10.13066/kspm.2019.14.2.137. https://doi.org/10.13066/kspm.2019.14.2.137
  18. Lyons C, Ross M, Elliott R, et al(2018). Atlantoaxial instability in a patient with neck pain and ankylosing spondylitis. Mil Med, 183(9-10), e654-e657. https://doi.org/10.1093/milmed/usy034. https://doi.org/10.1093/milmed/usy034
  19. Moreno AJ, Utrilla G, Marin J, et al(2018). Cervical spine assessment using passive and active mobilization recorded through an optical motion capture. J Chiropr Med, 17(3), 167-181. https://doi.org/10.1016/.jcm.2017.12.004. https://doi.org/10.1016/.jcm.2017.12.004
  20. Morningstar MW, Strauchman MN, Weeks DA(2003). Spinal manipulation and anterior headweighting for the correction of forward head posture and cervical hypolordosis: a pilot study. J Chiropr Med, 2(2), 51-54. https://doi.org/10.1016/S0899-3467(07)60042-1. https://doi.org/10.1016/S0899-3467(07)60042-1
  21. Naz I, Yildirim Y(2010). Investigation of the relationship between wearing glasses and deep cervical flexor endurance in patients with non-specific neck pain. J Back Musculoskelet Rehabil, 23(3), 143-149. https://doi.org/10.3233/BMR-2010-0263. https://doi.org/10.3233/BMR-2010-0263
  22. Ning X, Haddad O, Jin S, et al(2011). Influence of asymmetry on the flexion relaxation response of the low back musculature. Clin Biomech, 26(1), 35-39. https://doi.org/10.1016/j.clinbiomech.2010.08.012. https://doi.org/10.1016/j.clinbiomech.2010.08.012
  23. Oliveira AC, Silva AG(2016). Neck muscle endurance and head posture: a comparison between adolescents with and without neck pain. Man Ther, 22, 62-67. https://doi.org/10.1016/j.math.2015.10.002. https://doi.org/10.1016/j.math.2015.10.002
  24. Olson KA, Joder D(2001). Diagnosis and treatment of cervical spine clinical instability. J Orthop Sports Phys Ther, 31(4), 194-206. https://doi.org/10.2519/jospt.001.31.4.194. https://doi.org/10.2519/jospt.001.31.4.194
  25. Park SK, Yang DJ, Kim JH, et al(2017). Analysis of mechanical properties of cervical muscles in patients with cervicogenic headache. J Phys Ther Sci, 29(2), 332-335. https://doi.org/10.1589/jpts.29.332. https://doi.org/10.1589/jpts.29.332
  26. Smedmark V, Wallin M, Arvidsson I(2000). Inter-examiner reliability in assessing passive intervertebral motion of the cervical spine. Man Ther, 5(2), 97-101. https://doi.org/10.1054/math.2000.0234. https://doi.org/10.1054/math.2000.0234
  27. Song KJ, Choi BW, Choi BR, et al(2010). Cross-cultural adaptation and validation of the Korean version of the neck disability index. Spine, 35(20), E1045-1049. https://doi.org/10.1097/BRS.0b013e3181df78e9. https://doi.org/10.1097/BRS.0b013e3181df78e9
  28. Tsang SM, Szeto GP, Lee RY(2016). Relationship between neck acceleration and muscle activation in people with chronic neck pain: Implications for functional disability. Clin Biomech, 35, 27-36. https://doi.org/10.1016/.clinbiomech.2016.04.006. https://doi.org/10.1016/.clinbiomech.2016.04.006
  29. Yoo KT, Lee HS(2016). Effects of therapeutic exercise on posture, pain and asymmetric muscle activity in a patient with forward head posture: case report. J Korean Soc Phys Med, 11(1), 71-82. https://doi.org/10.13066/spm.2016.11.1.71. https://doi.org/10.13066/spm.2016.11.1.71