DOI QR코드

DOI QR Code

Comparison of Muscle Thickness and Changing Ratio for Cervical Flexor Muscles During the Craniocervical Flexion Test Between Subjects With and Without Forward Head Posture

  • Lee, Jae-hyun (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Hwang, Ui-jae (Kinetic Ergocise Based on Movement Analysis Laboratory) ;
  • Kwon, Oh-yun (Kinetic Ergocise Based on Movement Analysis Laboratory)
  • Received : 2022.04.14
  • Accepted : 2022.05.04
  • Published : 2022.08.20

Abstract

Background: The craniocervical flexion test (CCFT) was developed for the activation and endurance of deep cervical flexors. However, the muscle thickness and muscle thickness changing ratio of the sternocleidomastoid (SCM) and deep cervical flexor (DCF) muscles in subjects with and without forward head posture (FHP) have not been reported. Objects: To determine the difference in thickness of the SCM and DCF muscles and the difference in the muscle thickness changing ratio between SCM, DCF, and DCF/SCM 20 mmHg and DCF/SCM 30 mmHg between subjects with and without FHP. Methods: Thirty subjects with and without FHP were enrolled. The muscle thickness of the SCM and DCF was measured when maintained at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg using a pressure biofeedback unit during the CCFT. Ultrasonography was used to capture images of SCM and DCF muscle thickness during the CCFT, which was calculated using the picture archiving and communication system (PACS). Results: We observed a significant difference within the pressure main effect between SCM and DCF at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg (p < 0.05). However, there was no significant difference in the muscle thickness and muscle thickness changing ratio for SCM and DCF during CCFT between subjects with and without FHP. Conclusion: There was no significant difference in the muscle thickness recruitment pattern during CCFT in posture changes between subjects with and without FHP.

Keywords

References

  1. Bokaee F, Rezasoltani A, Manshadi FD, Naimi SS, Baghban AA, Azimi H. Comparison of cervical muscle thickness between asymptomatic women with and without forward head posture. Braz J Phys Ther 2017;21(3):206-11. https://doi.org/10.1016/j.bjpt.2017.04.003
  2. Yip CH, Chiu TT, Poon AT. The relationship between head posture and severity and disability of patients with neck pain. Man Ther 2008;13(2):148-54. https://doi.org/10.1016/j.math.2006.11.002
  3. Gonzalez HE, Manns A. Forward head posture: its structural and functional influence on the stomatognathic system, a conceptual study. Cranio 1996;14(1):71-80. https://doi.org/10.1080/08869634.1996.11745952
  4. Patwardhan AG, Khayatzadeh S, Havey RM, Voronov LI, Smith ZA, Kalmanson O, et al. Cervical sagittal balance: a biomechanical perspective can help clinical practice. Eur Spine J 2018;27(Suppl 1):25-38. https://doi.org/10.1007/s00586-017-5367-1
  5. Khayatzadeh S, Kalmanson OA, Schuit D, Havey RM, Voronov LI, Ghanayem AJ, et al. Cervical spine muscle-tendon unit length differences between neutral and forward head postures: biomechanical study using human cadaveric specimens. Phys Ther 2017;97(7):756-66. https://doi.org/10.1093/ptj/pzx040
  6. Janda V. Muscles and motor control in cervicogenic disorders. In: Grant R, editor. Physical therapy of the cervical and thoracic spine. Edinburgh: Churchill Livingstone; 1994.
  7. Jull GA, O'Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther 2008;31(7):525-33. https://doi.org/10.1016/j.jmpt.2008.08.003
  8. Jull G, 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
  9. 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):412-22. https://doi.org/10.1097/00007632-199802150-00002
  10. 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
  11. Hodges PW, Pengel LH, Herbert RD, Gandevia SC. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve 2003;27(6):682-92. https://doi.org/10.1002/mus.10375
  12. Bunce SM, Moore AP, Hough AD. M-mode ultrasound: a reliable measure of transversus abdominis thickness? Clin Biomech (Bristol, Avon) 2002;17(4):315-7. https://doi.org/10.1016/S0268-0033(02)00011-6
  13. Hides J, Wilson S, Stanton W, McMahon S, Keto H, McMahon K, et al. An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall. Spine (Phila Pa 1976) 2006;31(6):E175-8. https://doi.org/10.1097/01.brs.0000202740.86338.df
  14. Falla D, Jull G, Dall'Alba P, Rainoldi A, Merletti R. An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Phys Ther 2003;83(10):899-906. https://doi.org/10.1093/ptj/83.10.899
  15. 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) 2004;29(19):2108-14. https://doi.org/10.1097/01.brs.0000141170.89317.0e
  16. Jull GA, Falla D, Vicenzino B, Hodges PW. 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
  17. Jung S, Kwon O, Choi K, Ha S, Kim S, Jeon I, et al. Comparison of the thickness of the neck flexor muscles of subjects with and without a forward head posture on the two initial head positions during cranio-cervical flexion exercise. Phys Ther Korea 2015;22(4):44-50. https://doi.org/10.12674/ptk.2015.22.4.044
  18. Karimi N, Rezasoltani A, Rahnama L, Noori-Kochi F, Jaberzadeh S. Ultrasonographic analysis of dorsal neck muscles thickness changes induced by isometric contraction of shoulder muscles: a comparison between patients with chronic neck pain and healthy controls. Man Ther 2016;22:174-8. https://doi.org/10.1016/j.math.2015.12.004
  19. Bokaee F, Dehghan Manshadi F. Performance of Longus Colli muscle in women with and without forward head posture. Muscles Ligaments Tendons J 2021;11(1):193-200. https://doi.org/10.32098/mltj.01.2021.20
  20. Ruivo RM, Pezarat-Correia P, Carita AI. Effects of a resistance and stretching training program on forward head and protracted shoulder posture in adolescents. J Manipulative Physiol Ther 2017;40(1):1-10. https://doi.org/10.1016/j.jmpt.2016.10.005
  21. Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, et al. Assessment of forward head posture in females: observational and photogrammetry methods. J Back Musculoskelet Rehabil 2014;27(2):131-9. https://doi.org/10.3233/bmr-130426
  22. Kim BB, Lee JH, Jeong HJ, Cynn HS. Effects of suboccipital release with craniocervical flexion exercise on craniocervical alignment and extrinsic cervical muscle activity in subjects with forward head posture. J Electromyogr Kinesiol 2016;30:31-7. https://doi.org/10.1016/j.jelekin.2016.05.007
  23. Neumann D. Kinesiology of the musculoskeletal system: foundations for rehabilitation. Elsevier Health Sciences; 2016.
  24. Sahrmann S. Movement system impairment syndromes of the extremities, cervical and thoracic spines. Elsevier Health Sciences; 2010.
  25. Kendall FP, McCreary EK, Provance PG, Rodgers M, Romani WA. Muscles: testing and testing and function with posture and pain. Baltimore: Lippincott Williams & Wilkins; 1993.
  26. 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(9):567-71. https://doi.org/10.2519/jospt.2005.35.9.567
  27. Ishida H, Suehiro T, Kurozumi C, Ono K, Ando S, Watanabe S. Correlation between neck slope angle and deep cervical flexor muscle thickness in healthy participants. J Bodyw Mov Ther 2015;19(4):717-21. https://doi.org/10.1016/j.jbmt.2015.04.001
  28. Richards KV, Beales DJ, Smith AJ, O'Sullivan PB, Straker LM. Neck posture clusters and their association with biopsychosocial factors and neck pain in Australian adolescents. Phys Ther 2016;96(10):1576-87. https://doi.org/10.2522/ptj.20150660
  29. Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Curr Rev Musculoskelet Med 2019;12(4):562-77. https://doi.org/10.1007/s12178-019-09594-y
  30. Daffin L, Stuelcken M, Sayers M. Internal and external sagittal craniovertebral alignment: a comparison between radiological and photogrammetric approaches in asymptomatic participants. Musculoskelet Sci Pract 2019;43:12-7. https://doi.org/10.1016/j.msksp.2019.05.003