Comparison of Muscle Fatigue, Strength, and Endurance in Adults with and without Chronic Neck Pain during Isometric Neck Extension

등척성 목 폄 시 만성 목 통증이 있는 환자와 정상인 간의 근육 피로도, 근력 및 지구력 비교

  • 박찬희 (연세대학교 물리치료학과)
  • Received : 2021.05.01
  • Accepted : 2021.06.05
  • Published : 2021.08.31

Abstract

Background: Chronic neck pain (CNP) is associated with weakness in the deep neck flexor muscles, a shortening of the neck extensors, and a reduction in endurance. In addition, muscle imbalance can lead to neck pain and musculoskeletal dysfunction. This study compared neck extensor muscle fatigue, muscle strength, and muscle endurance time between patients with CNP and healthy adults during isometric neck extension. Methods: Thirty participants (15 patients with CNP and 15 healthy adults) were recruited in this research. The outcome measures included splenius capitis (SC) muscle fatigue, isometric neck extensor strength, and muscle endurance. The independent T-test was used to compare the continuous dependent variables between the CNP group and the healthy group. Results: The independent T-test indicated that muscle fatigue in the left SC differed significantly between the CNP group and the healthy group. A significant difference was also noted in the isometric neck extensor and neck extensor strength between the groups. Conclusion: Our results provided promising clinical evidence that patients with CLP have reduced neck extensor strength and endurance and increased SC muscle fatigue, which results in neck pain.

Keywords

References

  1. Arimi SA, Ghamkhar L, Kahlaee AH. The relevance of proprioception to chronic neck pain: A correlational analysis of flexor muscle size and endurance, clinical neck pain characteristics, and proprioception. Pain Med. 2018;19(10):2077-2088. https://doi.org/10.1093/pm/pnx331.
  2. Boyd-Clark LC, Briggs CA, Galea MP. Comparative histochemical composition of muscle fibres in a pre and post vertebral muscle of the cervical spine. J Anat. 2001;199(6):709-716. https://doi.org/10.1046/j.1469-7580.2001.19960709.x.
  3. Cagnie B, Cools A, De Loose V, et al. Differences in isometric neck muscle strength between healthy controls and women with chronic neck pain: The use of a reliable measure ment. Arch Phys Med Rehabil. 2007; 88(11):1441-1445. https://doi.org/10.1016/j.apmr.2007.06.776.
  4. Cagnie B, O'Leary S. Elliott J, et al. Pain-induced changes in the activity of the cervical extensor muscles evaluated by muscle functional magnetic resonance imaging. Clin J Pain. 2011;27(5):392-397. https://doi.org/10.1097/AJP.0b013e31820e11a2.
  5. Cram, JR. Biofeedback Applications. Electromyography: Physiology, Engineering, and Noninvasive Applications. Hoboken (NJ): John Wiley & Sons, Inc. 2004;435-452.
  6. Fuller JR, Lomond KV, Fung J, et al. Posture-movement changes following repetitive motion-induced shoulder muscle fatigue. J Electromyogr Kinesiol. 2009;19(6):1043-1052. https://doi.org/10.1016/j.jelekin.2008.10.009.
  7. Falla D, Jull G, Rainoldi A, et al. Neck flexor muscle fatigue is side specific in patients with unilateral neck pain. Eur J Pain. 2004a;8(1):71-77. https://doi.org/10.1016/S1090-3081(03)00075-2.
  8. Falla D, Jull G, Hodges PW. Feed forward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res. 2004b;157(1):43-48. https://doi.org/10.1007/s00221-003-1814-9.
  9. Ghamkar L, Kahlaee AH, Nourbakhsh MR, et al. Relationship between proprioception and endurance functionality of the cervical flexor muscles in chronic neck pain and asymptomatic participants. J Manipulative Physiol Ther. 2018;41(2):129-136. https://doi.org/10.1016/j.jmpt.2017.08.006.
  10. Gogia PP, Sabbahi MA. Electromyographic analysis of neck muscle fatigue in patients with osteoarthritis of the cervical spine. Spine. 1994;19(5):502-506. https://doi.org/10.1097/00007632-199403000-00002.
  11. Griegel-Morris P, Larson K, Mueller-Klaus K, et al. Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther. 1992;72(6):425-431. https://doi.org/10.1093/ptj/72.6.425.
  12. Gwak, GT, Ahn SH, Kim JH, et al. Prediction model for the risk of scapular winging in young women based on the decision tree. Physical Therapy Korea. 2020;27(2):140-148. https://doi.org/10.12674/ptk.2020.27.2.140.
  13. Lee HJ, Nicholson LL, Adams RD. Neck muscle endurance, self-report, and range of motion data from subjects with treated and untreated neck pain. J Manipulative Physiol Ther. 2005;28(1):25-32. https://doi.org/10.1016/j.jmpt.2004.12.005.
  14. Lindstrom R, Schomacher J, Farina D, et al. Association between neck muscle coactivation, pain, and strength in women with neck pain. Man Ther. 2111;16(1):80-86. https://doi.org/10.1016/j.math.2010.07.006.
  15. Mannion AF, Dumas GA, Cooper RG, et al. Muscle fibre size and type distribution in thoracic and lumbar regions of erector spinae in healthy subjects without low back pain: Normal values and sex differences. J Anat. 1997;190(4):505-513. https://doi.org/10.1046/j.1469-7580.1997.19040505.x.
  16. Misailidou V, Malliou P, Beneka A, et al. Assessment of patients with neck pain: A review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010;9(2):49-59. https://doi.org/10.1016/j.jcm.2010.03.002.
  17. Oliveira AC, Silva AG. Neck muscle endurance and head posture: A comparison between adolescents with and without neck pain. Man Ther. 2016;22:62-67. https://doi.org/10.1016/j.math.2015.10.002.
  18. Peolsson A, Kjellman G. Neck muscle endurance in nonspecific patients with neck pain and in patients after anterior cervical decompression and fusion. J manipulative Physiol Ther. 2007;30(5):343-350. https://doi.org/10.1016/j.jmpt.2007.04.008.
  19. Rao R. Neck pain, cervical radiculopathy, and cervical myelopathy: Pathophysiology, natural history, and clinical evaluation. J Bone Joint Surg Am. 2002;84(10):1872-1881. https://doi.org/10.2106/00004623-200210000-00021.
  20. Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomatic women and men. Arch Phys Med Rehabil. 1997;78(11):1215-1223. https://doi.org/10.1016/s0003-9993(97)90335-x.
  21. Rezasoltani A, Ali-Reza A, Khosro KK, et al. Preliminary study of neck muscle size and strength measurements in females with chronic non-specific neck pain and healthy control subjects. Man Ther. 2010;15(4):400-403. https://doi.org/10.1016/j.math.2010.02.010.
  22. Roh HL, Lee DH. Effect of a home-based exercise program on elderly women's health. J Phys Ther Sci. 2012;24(5):449-453. https://doi.org/10.1589/jpts.24.449.
  23. Yoo WG, An DH. The relationship between the active cervical range of motion and changes in head and neck posture after continuous VDT work. Ind Health. 2009;47(2):183-188. https://doi.org/10.2486/indhealth.47.183.
  24. Solomon SR, Sawilowsky SS. Impact of rank-based normalizing transformations on the accuracy of test scores. Journal of Modern Applied Statistical Methods. 2009;8(2):448-462. https://doi.org/10.22237/jmasm/1257034080.
  25. Thorstensson A, Carlson H. Fibre types in human lumbar back muscles. Acta Physiol Scand. 1987;131(2):195-202. https://doi.org/10.1111/j.1748-1716.1987.tb08226.x.
  26. Travell J, Simons D. Myofascial Pain and Dysfunction; The Trigger Point Manual (the upper extremities). Williams & Wilkins. 2008.
  27. Vernon H, Mior S. The neck disability index: A study of reliability and validity. J manipulative Physiol Ther. 1991;14(7):409-415.
  28. Vollestad NK. Measurement of human muscle fatigue. J Neurosci Methods. 1997;74(2):219-227. https://doi.org/10.1016/s0165-0270(97)02251-6.
  29. Ylinen J, Salo P, Nykanen M, Kautiainen H, et al. Decreased isometric neck strength in women with chronic neck pain and the repeatability of neck strength measurements. Arch Phys Med Rehabil. 2004;85(8):1303-1308. https://doi.org/10.1016/j.apmr.2003.09.018.
  30. Zabihhosseinian M, Holmes MW, Ferguson B, et al. Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients. Clin Biomech. 2015;30(5):397-404. https://doi.org/10.1016/j.clinbiomech.2015.03.020.