한국전문물리치료학회지 (Physical Therapy Korea)

  • 제18권4호
  • /
  • Pages.1-10
  • /
  • 2011
  • /
  • 1225-8962(pISSN)
  • /
  • 2287-982X(eISSN)
한국전문물리치료학회 (Korean Research Society of Physical Therapy)
권호 표지

Effect of Deep Neck Flexor Performance on the Stability of the Cervical Spine in Subject With and Without Neck Pain

  • Kwon, Oh-Yun (Dept. of Physical Therapy, College of Health Science, Yonsei University, Dept. of Ergonomic Therapy, The Graduate School of Health and Environment, Yonsei University) ;
  • Lee, Won-Hwee (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Jung, Sung-Dae (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Kim, Si-Hyun (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Jung, Do-Heon (Dept. of Physical Therapy, The Graduate School, Yonsei University)
  • 투고 : 2011.10.04
  • 심사 : 2011.11.03
  • 발행 : 2011.11.19
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

This study compared the stability of the cervical spine according to the presence of neck pain and deep neck flexor performance. Thirty subjects with neck pain, and thirty subjects without neck pain were recruited for this study. The Cranio-cervical flexion (CCF) test was applied using a pressure biofeedback unit to classify the subjects into four subgroups; no cervical pain and good deep neck flexor performance (NG group), no cervical pain and poor deep neck flexor performance (NP group), cervical pain and good deep neck flexor performance (PG group), and cervical pain and poor deep neck flexor performance (PP group). The head sway angle was measured using a three-dimensional motion analysis system. A 3-kg weight was used for external perturbation with the subject sitting in a chair in the resting and erect head positions with voluntary contraction of the deep neck flexors. A one-way analysis of variance (ANOVA) was performed with a Bonferroni post hoc test. The deep neck flexor performance differed significantly among the four groups (p<.05). The NG group had significantly greater deep neck flexor performance than NP and PP groups. The stability of the cervical spine also differed significantly among the four groups in the resting head position (p<.05). The head sway angle was significantly smaller in NG group as compared with the other groups. The PP group had the greatest head sway angle in the resting head position. However, there was no significant difference in the stability of the cervical spine among the groups in the erect head position with voluntary contraction of deep neck flexors (p=.57). The results of this study suggest that the deep neck flexor performance is important for maintaining the stability of cervical spine from external perturbation.

키워드

참고문헌

  1. Armstrong BS, McNair PJ, Williams M. Head and neck position sense in whiplash patients and healthy in whiplash patients and healthy individuals and the effect of the cranio-cervical flexion action. Clin Biomech. 2005;20:675-684. https://doi.org/10.1016/j.clinbiomech.2005.03.009
  2. Cagnie B, D'Hooge R, Achten E, et al. A magnetic resonance imaging investigation into the function of the deep cervical flexors during the performance of craniocervical flexion. J Manipulative Physiol Ther. 2010;33(4): 286-291. https://doi.org/10.1016/j.jmpt.2010.03.010
  3. Cagnie B, Dolphens M, Peeters I, et al. Use of Muscle functional magnetic resonance imaging to compare cervical flexor activity between patients with whiplash-associated disorders and people who are healthy. Phys Ther. 2010b;90(8):1157-1164. https://doi.org/10.2522/ptj.20090351
  4. Chiu TT, Law EY, Chiu TH. Performance of the craniocervical flexion test in subjects with and without chronic neck pain. J Orthop Sports Phys Ther. 2005;35:567-571. https://doi.org/10.2519/jospt.2005.35.9.567
  5. Conley MS, Meyer RA, Bloomberg JJ, et al. Noninvasive analysis of human neck muscle function. Spine (Phila Pa 1976). 1995;20(23):2505-2512. https://doi.org/10.1097/00007632-199512000-00009
  6. Cote JN, Patenaude I, St-Onge N, et al. Whiplash-associated disorders affect postural reactions to antero-posterior support translations during sitting. Gait Posture. 2009;29:603-611. https://doi.org/10.1016/j.gaitpost.2008.12.014
  7. Falla D. Unravelling the complexity of muscle impairment in chronic neck pain. Man Ther. 2004;9(3);125-133. https://doi.org/10.1016/j.math.2004.05.003
  8. Falla D, Farina D. Neura and muscular factors associated with motor impairment in neck pain. Curr Rheumatol Rep. 2007;9(6):497-502. https://doi.org/10.1007/s11926-007-0080-4
  9. Falla D, Jull G, Dall'Alba P, et al. An electromyographic activity of the deep cervical flexor muscles in performance of craniocervical flexion. Phys Ther. 2003;83(10):899-906.
  10. Falla D, O'leary S, Farina D, et al. Associaton between intensity of pain and impairment in onset and activation of the deep cervical flexors in patients with persistent neck pain. Clin J Pain. 2011;27(4):309-314. https://doi.org/10.1097/AJP.0b013e31820212cf
  11. Falla D, Rainoldi A, Jull G, et al. Lack of correlation between sternocleidomastoid and scalene muscle fatigability and duration of symptoms in chronic neck pain patients. Neurophysiol Clin. 2004a;34(3-4):159-165. https://doi.org/10.1016/j.neucli.2004.04.004
  12. Falla DL, Jull GA, Hodges 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). 2004b;29(19):2108-2114. https://doi.org/10.1097/01.brs.0000141170.89317.0e
  13. Fernandez-de-las-Penas C, Perez-de-Heredia M, Molero-Sanchez A, et al. Performance of the craniocervical flexion test, forward head posture, and headache clinical parameters in patients with chronic tension-type headache: A pilot study. J Orthop Sports Phys Ther. 2007;37(2):33-39. https://doi.org/10.2519/jospt.2007.2401
  14. 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)50-56. https://doi.org/10.1016/j.jbmt.2009.07.005
  15. Jesus FM, Ferreira PH, Ferreira 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
  16. Jull GA, Barrett C, Magee R, et al. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia. 1999;19(3):179-185. https://doi.org/10.1046/j.1468-2982.1999.1903179.x
  17. Jull GA, Kristjansson E, Dall'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
  18. Jull GA. Deep cervical flexor muscle dysfunction in whiplash. J Musculoskelet Pain. 2000; 8:143-154.
  19. Jull GA, Falla D, Vicenzino B, et al. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009;14(6):696-701. https://doi.org/10.1016/j.math.2009.05.004
  20. Lincoln J. Case report. Clinical instability of the upper cervical spine. Man Ther. 2000;5(1):41-46. https://doi.org/10.1054/math.1999.0219
  21. Madeleine P, Prietzel H, Svarrer H, et al. Quantitative posturography in altered sensory conditions: A way to assess balance instability in patients with chronic whiplash injury. Arch Phys Med Rehabil. 2004;85(3):432-438. https://doi.org/10.1016/j.apmr.2003.03.003
  22. Mayoux-Benhamou MA, Revel M, Vallee C, et al. Longus colli has a postural function on cervical curvature. Surg Radiol Anat. 1994;16(4):367-371. https://doi.org/10.1007/BF01627655
  23. Medina JM, Valovich McLeod TC, Howell SK, et al. Timing of neuromuscular activation of the quadriceps and hamstrings prior to landing in high school male athletes, female athletes, and female non-athetes. J Electromyogr Kinesiol. 2008;18(4):591-597. https://doi.org/10.1016/j.jelekin.2006.11.009
  24. Michaelson P, Michaelson M, Jaric S, et al. Certical posture and head stability in patients with chronic neck pain. J Rehabil Med. 2003;35(5):229-235. https://doi.org/10.1080/16501970306093
  25. O'Leary S, Falla D, Jull G. The relationship between superficial muscle activity during the cranio-cervical flexion test and clinical features in patients with chronic neck pain. Man Ther. 2011;16(5)452-455. https://doi.org/10.1016/j.math.2011.02.008
  26. O'Leary S, Jull G, Kim M, et al. Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain. Man Ther. 2007;12:34-39. https://doi.org/10.1016/j.math.2006.02.010
  27. Olson KA, Joder D. Diagnosis and treatment of cervical spine clinical instability. J Orthop Sports Phys Ther. 2001;31(4):194-206. https://doi.org/10.2519/jospt.2001.31.4.194
  28. Otis CA. Kinesiology: The mechanics and the pathomechanics of human movement. Philadelphia, Lippincott Williams & Willkins, 2004.
  29. Panjabi MM, Cholewicki J, Nibu K, et al. Critical load of the human cervical spine: An in vitro experimental study. Clin Biomech. 1998;13(1):11-17. https://doi.org/10.1016/S0268-0033(97)00057-0
  30. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-389. https://doi.org/10.1097/00002517-199212000-00001
  31. Peolsson M, Brodin LA, Peolsson A. Tissue motion pattern of ventral neck muscles investigated by tissue velocity ultrasonography imaging. Eur J Appl Physiol. 2010;109(5):899-908. https://doi.org/10.1007/s00421-010-1420-z
  32. Roijezon U, Bjorklund M, Bergenheim M, et al. A novel method for neck coordination exercise - a pilot study on persons with chronic non-specific neck pain. J Neuroeng Rehabil. 2008;5:36. https://doi.org/10.1186/1743-0003-5-36
  33. Roijezon U, Bjorklund M, Djupsjobacka M. The slow and fast components of postural sway in chronic neck pain. Man Ther. 2011;16(3):273-378. https://doi.org/10.1016/j.math.2010.11.008
  34. Ryan ED, Herda TJ, Costa PB, et al. Passive properties of the muscle-tendon unit: The influence of muscle cross-sectional area. Muscle Nerve. 2009;39(2):227-229. https://doi.org/10.1002/mus.21218
  35. Sahrmann SA. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. St. Louis, Elsevier, 2011.
  36. Stemper BD, Yoganadan N, Cusick JF, et al. Stabilizing effect of precontracted neck musculature in whiplash. Spine (Phila Pa 1976). 2006;31(20):E733-E738. https://doi.org/10.1097/01.brs.0000240210.23617.e7
  37. Vasavada AN, Li S, Delp SL. Influence of muscle morphometry and moment arms on the moment-generating capacity of human neck muscles. Spine (Phila Pa 1976). 1998;23(4):412-422. https://doi.org/10.1097/00007632-199802150-00002