Deep Neck Flexor Research Articles

The effect of deep neck flexor endurance on craniovertebral angle changes and neck and shoulder muscle activities during a computer task

ABSTRACT The deep neck flexors are important for maintaining neck posture by stabilizing and supporting it through low-intensity contraction, ensuring static endurance. The subjects performed computer tasks after having their deep neck flexor endurance measured using a pressure biofeedback unit. The craniovertebral angle (CVA) and the muscle activities were measured while participants were completing computer tasks for 10 min. The deep neck flexor endurance was significantly negatively correlated with CVA changes at 0–2 min. The deep neck flexor endurance was significantly negatively correlated with sternocleidomastoid muscle and upper trapezius activity at 0–2 min. The deep neck flexor endurance negatively predicted CVA changes at 0–2 min and explained 28.8% of the variance in the CVA changes. The lower the deep neck flexor endurance, the earlier the simultaneous changes occurred in the CVA and the neck and shoulder muscle activities during computer tasks.

Effects of the combination of traditional Thai massage, scapular stabilization exercise, and chest mobilization in subjects with forward head posture: a single-blinded randomized clinical trial

BackgroundForward head posture (FHP) is a common condition where the head appears to be positioned in front of the vertical midline of the body. FHP is associated with shortening of the neck extensors and pectoral muscles, and the deep neck flexors and shoulder retractors are weakened. FHP is also found to cause decreases in respiratory function. Few clinical trials have investigated the effects of combination treatments to alleviate these problems. The aim of this study was to examine the effects of combination of traditional Thai massage, scapular stabilization exercise, and chest mobilization on forward head angle (FHA), forced vital capacity (FVC), and cervical flexion in subjects with FHP.MethodsForty-eight subjects with FHP were randomly allocated to a treatment group receiving a Combination of Traditional Thai massage, Scapular stabilization exercise, and Chest mobilization (CTSC group) (n = 24) and a control group (relaxed by lying supine) (n = 24). FHA, FVC, and cervical flexion were measured before and after the four-week intervention (Week 4) and one month after the intervention period (Week 8).ResultsThe CTSC group showed statistically significantly greater improvement in FHA and cervical flexion than the control group at Week 4 (FHA, mean difference − 6.05; 95% CI − 8.03, − 4.07; cervical flexion, mean difference 6.84; 95% CI 3.14, 10.55) and Week 8 (FHA, mean difference − 4.64; 95% CI ( − 6.71, − 2.58); cervical flexion, mean difference 5.21; 95% CI 0.84, 9.58). There were no significant between-group differences in FVC at week 4 (mean difference 0.09; 95% CI − 0.06, 0.23) and week 8 (mean difference 0.04; 95% CI − 0.11, 0.19).ConclusionThis study showed that CTSC had a positive effect on FHA and cervical flexion in subjects with FHP.Trial registration: Thai Clinical Trials Registry (TCTR) (Identification number: TCTR20211119001), registered 19 November 2021; https://www.thaiclinicaltrials.org/show/TCTR20211119001.

Effect of instrument-assisted soft tissue mobilization combined with exercise therapy on pain and muscle endurance in patients with chronic neck pain: a randomized controlled study

ABSTRACT Objectives The use of instrument-assisted soft tissue mobilization (IASTM) has been documented to be effective for improving pain and function, but it is unclear whether it helps improve muscle performance in musculoskeletal diseases. This study investigated the effects of IASTM combined with exercise therapy on muscle endurance and pain intensity in patients with chronic neck pain. Methods Forty-eight individuals with chronic neck pain were randomly divided into exercise therapy (ET, n = 24) and combined therapy (CT, n = 24) groups. For 4 weeks, each group underwent exercise therapy 3 days a week for a total of 12 sessions. The ET group received exercise therapy only. The CT group received IASTM combined with exercise therapy twice per week for a total of 8 sessions. The muscle endurance of the participants was assessed with the Deep Neck Flexor Muscle Endurance (DNFE) test and pain intensity with Visual Analogue Scale (VAS) at baseline and post-treatment. Results While both groups showed significant improvement in pain intensity (p < 0.05), the CT group showed a greater effect size for pain (CT group: Cohen’s d = 3.28; ET group: Cohen’s d = 2.12). The CT group showed significant improvement for muscle endurance (p < 0.05), whereas the ET group did not (p > 0.05). Conclusion In the current study, the IASTM intervention combined with ET improved pain and muscular endurance in participants with chronic neck pain compared to exercise therapy alone. As an alternative method, IASTM intervention before exercise seems to increase the short-term recovery effect in chronic neck pain conditions.

Cervicogenic headache

IntroductionCervicogenic headache, first proposed as a distinct headache in 1983, is a secondary headache to a primary cervical musculoskeletal disorder. Research into physical impairments was integral to clinical diagnosis and to develop and test research informed conservative management as the first line approach. PurposeThis narrative presents an overview of the body of cervicogenic headache research from our laboratory which was undertaken in the context of a broad program of research into neck pain disorders. ImplicationsEarly research validated manual examination of the upper cervical segments against anaesthetic nerve blocks, which was vital to clinical diagnosis of cervicogenic headache. Further studies identified reduced cervical motion, altered motor control of the neck flexors, reduced strength of flexor and extensor muscles, and occasional presentation of mechanosensitivity of the upper cervical dura. Single measures are variable and not reliable in diagnosis. We proved that a pattern of reduced motion, upper cervical joint signs and impaired deep neck flexor function accurately identified cervicogenic headache and differentiated it from migraine and tension-type headache. The pattern was validated against placebo controlled diagnostic nerve blocks. A large multicentre clinical trial determined that a combined program of manipulative therapy and motor control exercise is effective in the management of cervicogenic headache and outcomes are maintained in the long term.More specific research into cervical related sensorimotor controlled is warranted in cervicogenic headache. Further adequately powered clinical trials of current research informed multimodal programs are advocated to further strengthen the evidence base for conservative management of cervicogenic headache.

필라테스 호흡을 적용한 목 안정화운동이 전방머리자세의 근지구력과 손의 악력에 미치는 영향

Objective: The purpose of this study was to compare the effect on the cranio-cervical flexion exercise which is a neck stabilization exercise, and cranio-cervical flexion exercise applying Pilates breathing on neck muscle endurance, pain, and grip strength. Method: This study was conducted for 8 weeks, 30 minutes twice a week for 27 people, The control group performed cranio-cervical flexion exercise which is a neck stabilization exercise, and the experimental group performed cranio-cervical flexion exercise applying Pilates breathing. Visual Analog Scale was used to evaluate pain, a pressure biofeedback instrument and a stop-watch were used to evaluate the muscle endurance of deep neck flexor muscles, and a Jamar Hand evaluation kit was used to evaluate hand pressure. In this data, Kolmogorov-Smirnov was used to assume the normality of all dependent variables, and descriptive statistics were used for the general characteristics of the subjects. ANCOVA statistical method was used to verify validity, and the significance level was p&lt;.05. Results: There were significant differences in muscle endurance, pain, and grip strength in the group applying Pilates breathing in the cranio-cervical flexion exercise of the neck stability exercises. Conclusion: In the group of applying Pilates breathing in the cranio-cervical flexion exercise of the neck stability exercises, neck muscle endurance and hand grip strength increased and pain decreased.

Immediate neck hypoalgesic effects of craniocervical flexion exercises and cervical retraction exercises among individuals with non-acute neck pain and a directional preference for retraction or extension: preliminary pretest-posttest randomized experimental design

ABSTRACT Background Selective deep neck flexor muscle activation through craniocervical flexion exercises has been considered to be different from cervical retraction exercises. Objective To compare the immediate analgesic effect of craniocervical flexion versus cervical retraction exercises in individuals with nonacute, directional preference (DP) for cervical retraction or extension Methods A two-arm, assessor-blinded, pretest-posttest randomized experiment was conducted. Participants were randomly assigned to either craniocervical flexion or cervical retraction exercises and those who were confirmed at the post-intervention examination to have a DP for cervical retraction or extension were analyzed. The primary outcome measure was pressure pain thresholds at the C2 and C5-C6 levels. Results A total of 10 (mean age = 20.6 years) and nine participants (mean age = 19.4 years) undertook craniocervical flexion and retraction exercises, respectively. One-way analysis of variance demonstrated no statistically significant (p > 0.05) interaction effect regardless of the neck level. In the pre-post change percentages, retraction exercises provided greater analgesic effects compared to craniocervical flexion exercises at the C2 (Hedges’ g = 0.679) and C5-C6 levels (g = 0.637). Conclusion This study showed a comparable or greater immediate neck analgesic effect from cervical retraction exercises compared to craniocervical flexion exercises in individuals with a DP for cervical retraction or extension.

Pain, deep neck flexors performance, disability, and head posture in individuals with temporomandibular disorder with and without otological complaints.

Otological complaints (OC) are highly prevalent in subjects with temporomandibular disorders (TMD) and so is the risk of neck dysfunctions. To evaluate pain, deep neck flexor (DNF) performance, disability, and head and neck posture of individuals with TMD with and without OC. In this cross-sectional study, 57 individuals were divided into a group with TMD and OC (n= 31) and a group with TMD without OC (n= 26). Self-reported pain intensity, masticatory and neck muscles pressure pain thresholds, DNF performance, neck disability, and head and neck posture were evaluated. Data were compared between groups using the independent t test and Mann-Whitney test with Bonferroni correction for multiple comparisons. Effect sizes were evaluated using Cohen's index. The TMD with OC group presented less muscle activation [26 (24-28) vs. 24 (24-26) mmHg; p< 0.05], less endurance [105 (46-140) vs. 44 (28-78) points; p< 0.05], and greater neck disability (8.15 ± 5.89 vs. 13.32 ± 6.36 points; p< 0.05). No significant difference was observed in self-reported pain, head and neck posture, or pressure pain thresholds. Individuals with TMD with OC presented decreased DNF performance and increased neck disability compared to individuals with TMD without OC.

Improvement in the Contraction of the Transversus Abdominis Following Lumbo-Pelvic Manipulation – A Case Study

As a clinician, everyone undergoes a difficult time in clinical decision-making when attempting to apply a clinical prediction rule for manipulation (Flynn et al., 2002; Childs et al., 2004) to a patient with a history and physical examination consistent with clinical lumbar instability (Hicks et al., 2005). The effect on neural pathways associated with manipulation has been suggested as one possible mechanism that may improve muscle performance (Pickar, 2002) and patient symptoms. Support exists for an association between spinal manipulation and improved muscle function in the quadriceps (Suter et al., 1999), the erector spinae (Keller and Colloca, 2000), and the deep neck flexors (Sterling et al., 2001). Therefore, it is reasonable to hypothesize that spinal manipulation, by a reflexogenic mechanism, may improve the performance of the deep trunk stabilizers. In turn, improved relaxation and contractility of the lumbar multifidus and the transversus abdominis (TrA) theoretically could lead to improved functional stability of the spine through enhancement of the neurological and active subsystems as defined by Panjabi (1992a, b). This single case study describes changes observed in the TrA musculature pre- to post-manipulation in a patient that presented with a clinical paradox (symptoms suggestive of clinical lumbar instability but also meeting the clinical prediction rule to succeed with lumbar manipulation therapy). Real-time ultrasound imaging (USI) was used to describe the changes in the TrA musculature..

Assessment of stiffness of the superficial neck muscles in female office workers with impaired endurance of deep neck flexors: a case-control study

IntroductionThe objective of this study was to assess the muscle stiffness parameter in the sternocleidomastoid (SCM) and upper trapezius (UT) in a group of office workers who did not attain the norm in the deep endurance flexor test (DEFT).MethodsIn this case-control study, the myotonometric muscle stiffness parameter (MyotonPro, Tallin, Estonia) was compared in the SCM and UT muscles in a group of female office workers who were unable to achieve the norm in the DEFT, i.e. the research group (RG), in comparison to the control group (CON) who attained the norm during the test. Subjects were matched in terms of their gender, age, BMI, nature and duration of their work, as well as the pain intensity and craniovertebral angle.ResultsSubjects in the RG had significantly higher stiffness of the UT (by 8.8%, 291.4 ± 36.5 in RG and 265.9 ± 25.6 in CON; p = 0.015, t = 2.29) and SCM (by 7.3%, 291.4 ± 36.5 in RG and 265.9 ± 25.6 in CON; p = 0.37, t = 1.85) myofascial tissue in comparison with the CON. The magnitude of the effects of the stiffness of the tested muscles on the results obtained by DEFT was stronger in the UT (Cohen’s d = 0.82, large effect size) than the SCM (Cohen’s d = 0.61, medium effect size).ConclusionsThe women who did not attain the norm in the DEFT had greater stiffness of the superficial UT and SCM muscles. Future studies should evaluate whether SCM and UT stiffness reduction therapy will improve the deep endurance flexor test results.

Corrigendum: Effects of breathing re-education on endurance, strength of deep neck flexors and pulmonary function in patients with chronic neck pain: A randomised controlled trial

The South African Journal of Physiotherapy is the official scholarly refereed journal of the South African Society of Physiotherapy. It aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions both nationally and internationally.

탄성밴드와 짐볼을 이용한 목 어깨안정화 운동이 경부 통증 및 경부 정렬에 미치는 영향

The purpose of this study was to analyze the effect of neck and shoulder stabilization exercises using thera-bands and gym balls on neck pain relief, strength of deep cervical flexor, and cervical alignment in college students with forward neck position. For this purpose, the exercise program was performed twice a week for 8 weeks and was divided into a thera-band group (11 individuals), a gym ball group (11 individuals), and a combined group using thera-band and gym ball (11 individuals). The Visual Analogue Scale (VAS), Neck Disability Index (NDI), strength of deep cervical flexor, Craniovertebral Angle (CVA), and Cranial Rotation Angle (CRA) were measured at week 0, week 4, and week 8, respectively. According to the results of the study, firstly, VAS, NDI, strength of deep cervical flexor and CVA improved significantly as the term of training increased in every group, but combined group showed the fastest and most significant improvements at week 8 compared to week 4. Second, CRA decreased significantly as the term of training increased in every group. However, at weeks 4 and 8 of exercise, the rate of decline was significantly faster for combined group and gym ball group than for thera-band group. To summarize the results, when neck and shoulder stabilization exercises using thera-band and gym ball were used on patients with neck pain due to frontal head position, positive results were shown in reducing neck pain, increasing the strength of the deep neck flexor and improving cervical spine alignment. Moreover, the group of combined intervention not only improved strength but also motor-sensory skills, which showed better results than single exercise trainig group, leading to implementation of combined training significant.

Deep Cervical Muscles and Functionality in Patients with Chronic Tension-Type Headache: An Observational Study.

Background and objectives: Chronic tension-type headache (TTH) is the type of headache with the highest prevalence. The involvement of musculoskeletal structures in TTH is supported by evidence in the scientific literature. Among these, deep cervical muscle strength appears to be related to the function of the cervical spine and the clinical characteristics of TTH. This study aimed to correlate anatomical, functional, and psychological variables in patients with TTH. Materials and methods: An observational descriptive study was carried out with 22 participants diagnosed with TTH for at least six months. The characteristics of headaches, including ultrasound-based deep neck flexor and extensor muscle thickness, range of motion (ROM), and pressure pain threshold (PPT), were recorded. We also conducted the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Craniocervical Flexion Test (CCFT). Results: Moderate–large negative correlations were found between the PVAQ and the muscle thickness of right deep flexors contracted (r = −0.52; p = 0.01), left multifidus contracted (r = −0.44; p = 0.04), right multifidus at rest (r = −0.48; p = 0.02), and right multifidus contracted (r = −0.45; p = 0.04). Moderate–large positive correlations were found between the CCFT score and the left cervical rotation ROM (r = 0.53; p = 0.01), right cervical rotation ROM (r = 0.48; p = 0.03), muscle thickness of left multifidus contracted (r = 0.50; p = 0.02), and muscle thickness of right multifidus at rest (r = 0.51; p = 0.02). The muscle thickness of the contracted right deep cervical flexors showed a moderate negative correlation with headache intensity (r = −0.464; p = 0.03). No correlations were found between PPT and the rest of the variables analyzed. Conclusions: In patients with TTH, a higher thickness of deep cervical muscles was associated with higher ROM and higher scores in the CCFT. In turn, the thickness of deep cervical muscles showed negative correlations with pain hypervigilance and headache intensity. These results contribute to a better understanding of the physical and psychosocial factors contributing to the development of TTH, which is useful for implementing appropriate prevention and treatment measures.

To Study the Effects of Deep Neck Flexor Strengthening Exercises and Mckenzie Neck Exercises on Smart Phone Users Suffering From Neck Pain: A Comparative Study

Smartphone has become an integral part of our lives, they generally have a small screen because of which it is more likely to induce a slouched posture creating a line of sight mostly below eye level, formulating an improper posture when used for a prolonged period of time, for example, forward head posture (FHP) leading to neck pain. The purpose of the study is to compare the effectiveness of Deep neck flexor strengthening exercises with that of McKenzie neck extension exercises on smartphone users suffering from neck pain. It is a comparative experimental study. This study included (N=40) subjects with neck pain within the age group of 25-45 years. They arerandomly assigned into 2 groups (Group A and B). Group A had 20 (N=20) subjects who are treated with Deep neck flexor strengthening exercises, Group B had 20 (N=20) who are treated with McKenzie neck extension exercises. The subjects were given intervention 5 days a week for 6 weeks. For within-group analysis Paired sample t-test was used and to analyze between-group variables Independent sample t-test was done. Between DNF and McK groups no significant difference was found in NDI(p&lt;1.18 ) and SFMPQ(p &lt;1.17) while all outcome measures showed a significant difference in both DNF and McK groups(p=0.00)within the groups The results indicated that although both the treatment techniques, DNF and McK are effective in alleviating the neck pain in Smartphone users in terms of decreasing pain intensity and increasing functional ability as there was a significant difference within the two groups, but there was no significant difference between the DNF and McK group in decreasing pain intensity, increasing functional ability

Correlation of Intensity of Pain, Functional Disability and Deep Neck Flexor Endurance in Individual with Chronic Non-Specific Neck Pain: An Observational Study

Background: Musculoskeletal deficits of the craniocervical region play an important role in causing various cervical disorders. Cervical disorders and neck pain are almost as prevalent as low back pain and like low back pain; in most of the cases it is difficult to determine the actual cause of neck pain hence it is regarded as “non-specific neck pain”. This study was conducted to determine the correlation between deep neck flexor endurance, the intensity of pain, and functional disability in individuals with chronic non-specific neck pain. Materials and methods: A cross-sectional observational study was conducted on twenty individuals with chronic non-specific neck pain. Numerical Pain Rating Scale (NPRS), Neck Disability Index (NDI), and Craniocervical Flexion Test (CCFT) were used to measure neck pain intensity, neck disability, and deep neck flexor endurance respectively. The correlation was found using the Pearson Correlation Coefficient test. Result: The results showed that there was a positive correlation found between NPRS and NDI, and CCFT has negative correlations with NPRS and NDI respectively. Conclusion: The findings suggest that the lesser deep neck flexor endurance corresponded to greater neck pain intensity and disability. Keywords: cervical spine, neck disability index, neck pain, craniocervical flexion test, deep neck flexors endurance, correlation.

The effect of McKenzie protocol vs. deep neck flexor and scapulothoracic exercises in subjects with chronic neck pain - a randomized controlled study.

This study investigated the impact of McKenzie exercises against deep neck flexor (DNF) combined with scapulothoracic exercises on improving pain severity, cervical mobility, and functional disability. Fifty-five subjects suffering from chronic neck pain participated in this randomized controlled study. They were randomly assigned to three groups; the DNF group, which was treated by traditional physical therapy (i.e., physical therapy agents, stretching, and isometric exercises), combined with DNF, and scapulothoracic exercises; the McKenzie group, treated by traditional physical therapy, combined with McKenzie exercises; and finally, a control group, treated by traditional physical therapy. Before and after 6 weeks of treatment, they were assessed for neck pain severity, cervical range of motion (ROM), and functional disability using a visual analog scale (VAS), a gravity-reference goniometer, and the Copenhagen neck functional disability scale (CNFDS), respectively. Compared to baseline, all groups showed a significant decrease in neck pain severity and disability (p <0.05), and there was a significant increase in neck flexion/extension, lateral right flexion/left flexion, and right/left rotation ROMs (p<0.05). The improvement of the McKenzie group was significantly higher than the DNF group, and control group. Moreover, the improvement of the DNF group was significantly higher than the control group (p<0.05). The McKenzie exercises were better than DNF combined with scapulothoracic exercises to treat neck pain, functional disability, and mobility.

Blended-Learning Pain Neuroscience Education and Exercise in High School Students With Chronic Neck Pain: A Randomized Controlled Trial.

Pain neuroscience education (PNE) and exercise have emerged as potential interventions in adolescents with chronic pain; however, very few studies have explored their effectiveness. Blended-learning approaches combining face-to-face and online educational sessions have also emerged as facilitating methods of health education. This study aimed to compare the effectiveness of exercises and PNE versus exercise alone in adolescents with chronic neck pain (NP). A randomized controlled trial with 6-month follow-up was conducted in 2 high schools. Over 8weeks, a total of 127 adolescents with chronic NP were randomly allocated to either (1) perform functional and region-specific exercises, including generalized neuromuscular control, endurance, and strength exercises, as well as exercises targeting the deep neck flexor and extensor muscles and scapular stabilizer muscles; or (2) perform the same exercise-based intervention plus PNE. Pain intensity (primary outcome), disability, sleep, catastrophizing, fear of movement, self-efficacy, and knowledge of pain neuroscience were assessed at baseline, postintervention, and 6-month follow-up. Neck and scapular muscle endurance and pressure pain thresholds were assessed at baseline and postintervention. Patient's Global Impression of Change was assessed postintervention and at 6-month follow-up. There was a significant decrease in pain intensity from baseline to postintervention and from baseline to follow-up in both groups, but there were no between-group differences or interactions between time and groups. These results were similar for the secondary outcomes, except for knowledge of pain neuroscience, for which a significant group and time interaction was found. Exercise and exercise plus PNE were similarly effective in treating adolescents with chronic NP, and the results were maintained for up to 6months. Further studies are needed to explore the effect of these interventions for longer follow-ups.

TIDAK ADA PERBEDAAN PENGARUH DEEP NECK FLEXORS STRENGTHENING EXERCISE DENGAN SCAPULAR STABILIZATION EXERCISE UNTUK PERBAIKAN FORWARD HEAD POSTURE

Background: One of the posture disorders experienced by adolescents is forward head posture. Methods:This research uses quasi experimental group with two group pre-test post-test design. Research sample population is 15–17 years old students with 16 persons on each groups. The 1stgroup given deep neck flexor strengthening exercise and the 2ndgroup given scapular stabilization exercise.Intervention is performed 9 times with 3 times repetition in a week. The measurement of this research is craniovertebral angle. Normality test used Shapiro-wilk test, homogeneity test used wilcoxon test, and the test of difference of intervention impact given is performed by mann whitney test. Result: The value of intervention impact test of 1stgroup is p=0,000, the 2ndgroup test results the value of p=0,000. The result of both diference impact, results value of p=0,597. Conclusion: There is no difference between twointervention

Screening for Upper Cross Syndrome in Asymptomatic Individuals

Upper cross syndrome (UCS) refers to tightness of muscles such as pectoralis major, upper trapezius and levator scapulae and weakness of deep neck flexors, scalene, rhomboids, serratus anterior, middle and lower trapezius. Poor posture is associated with imbalance created in musculoskeletal system and common condition to be reported as upper cross syndrome. It is commonly seen in people with forward head posture, desk job workers, dentist, beauticians etc. The resulting clinical presentation is complaint of pain in neck and shoulder, cervicogenic headache, hunched upper-back and rounded shoulder. Children are not as proactive today and the rate of the UCS is on the rise. This deviated posture and sedentary lifestyle continues, where it progresses more as the age progresses in adulthood. To screen, detect, early treat as well as prevent upper cross syndrome in young individuals. Asymptomatic individual with 20-40 years of age group was explained about the procedure before commencement of the study. Posture was screened using REEDCO Posture Assessment Scale was used for evaluation. Assessment of muscle tightness and weakness was evaluated using muscle length tests and manual muscle testing. From the current study we conclude that prevalence of UCS is significantly less in asymptomatic individuals as compared to symptomatic. Although it is very important to practice good posture in daily routine in order prevent early signs of UCS. The parameters of outcome measures were analyzed by descriptive statistics only. Based on previous data we conclude that it is essential to screen asymptomatic individual to looks for signs of UCS for early detection, prevention and treatment. Keywords: Upper Cross Syndrome, Manual Muscle Testing, Muscle Length Testing.

Are neck pain, disability, and deep neck flexor performance the same for the different types of temporomandibular disorders?

ABSTRACT Objective To evaluate neck pain, disability, and deep neck flexor (DNF) performance of individuals with temporomandibular disorders (TMD). Methods Eighty individuals were divided into the following: arthrogenic TMD (n = 40), myogenic TMD (n = 12), and mixed TMD (n = 28). Neck pain intensity, neck disability, and DNF performance were evaluated. Results Individuals with arthrogenic TMD reported lower intensity of neck pain when compared to mixed TMD (p = 0.01). Individuals with arthrogenic TMD had less neck disability than individuals with myogenic TMD (p = 0.037) and mixed TMD (p < 0.001). A moderate positive correlation was found between neck pain and neck disability (p < 0.001). No differences were found for DNF performance. Conclusion Neck pain and disability differs according to subtype of TMD, but performance of the deep neck flexors does not. Neck pain intensity and neck disability were correlated in patients with TMD.

To Compare the Effectiveness of Muscle Energy Technique and Deep Neck Flexors Training on Pain, Range of Motion and Functional Disability in Patients with Mechanical Neck Pain

The goal of this study was to examine the effectiveness of muscular energy method with deep neck flexors training on pain, range of motion, and functional impairment in individuals with mechanical neck pain. This randomized controlled trial was carried out at the Mayo Hospital's OPD physiotherapy department in Lahore. In this study, 30 patients were chosen at random and divided into two groups: Group 1 was treated with deep neck flexors training, while Group 2 was treated with muscular energy method (post isometric relaxation). Every patient signed a Performa and gave their informed permission. The questioner used to collect data was based on the NDI, Visual analogue scale (VAS), and Ranges of motion (flexion, extension, rotation, and side bending at neck). Patients in group 1 showed marked improvement as compared to group 2. Both groups showed improvement but group 1 showed statistically more improvement (p value&lt;or =to 0.05). It is concluded from the study that, patients with mechanical neck pain, when treated by deep neck flexors training showed a significant treatment outcome when analyzed on VAS, NDI, and Goniometer for ROM. When Group 1 and 2 were compared, it was seen that Group 1 showed more significant results than group 2.