Cervical Muscle Strength Research Articles

Influence of cervical muscle strength and pain severity on functional balance and limits of stability in elderly individuals with chronic nonspecific neck pain: a cross-sectional study

BackgroundChronic nonspecific neck pain (CNSNP) is a common musculoskeletal disorder, particularly in the elderly, leading to reduced cervical muscle strength, impaired functional balance, and decreased postural stability. This study investigated the correlation between cervical muscle strength, functional balance, and limits of stability (LOS) in elderly individuals with CNSNP. Additionally, it assessed the moderating effect of pain severity on the relationship between cervical muscle strength and these balance outcomes.MethodsA prospective study included a total of 186 participants, including 93 with CNSNP and 93 asymptomatic individuals, were recruited. Cervical flexor and extensor muscle strength were assessed using an ergoFET hand-held dynamometer. Functional balance was measured using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test, while LOS were evaluated using the Iso-Free machine.ResultsIndividuals with CNSNP exhibited significantly lower cervical flexor strength (32.45 ± 5.67 N vs. 40.75 ± 5.20 N, p < 0.001) and extensor strength (28.30 ± 6.05 N vs. 36.90 ± 5.90 N, p < 0.001) compared to asymptomatic individuals. Functional balance was also poorer in the CNSNP group, with lower BBS scores (47.85 ± 4.20 vs. 53.65 ± 3.85, p < 0.001) and slower TUG times (11.30 ± 2.05 s vs. 8.45 ± 1.80 s, p < 0.001). Cervical muscle strength showed moderate to strong positive correlations with LOS (r = 0.56 to 0.62, p < 0.001) and BBS (r = 0.48 to 0.53, p < 0.001). Pain severity significantly moderated the relationship between cervical muscle strength and functional balance (β = 0.20, p = 0.045) as well as LOS (β = 0.22, p = 0.038), suggesting that higher pain levels diminish the positive effects of muscle strength on balance.ConclusionCervical muscle strength plays a crucial role in maintaining functional balance and postural stability in elderly individuals with CNSNP. Pain severity moderates the relationship between cervical muscle strength and balance outcomes, emphasizing the importance of integrating muscle strengthening and pain management in rehabilitation programs for elderly individuals with CNSNP to optimize postural control and minimize fall risk.

Individuals with Temporomandibular Dysfunction show reduced strength of the cervical muscles

Introduction: The literature indicates that individuals with temporomandibular disorder (TMD) also present pain and changes in the posture of the cervical spine, but there are still few studies that have evaluated the strength of the cervical muscles. Objectives: To evaluate cervical muscle strength in young adults with and without temporomandibular disorders. Materials and Methods: Young adults aged 18 to 25 years from a private university, with and without a diagnosis of TMD and in good general health, participated in this study. Individuals with neck/head trauma were excluded; disc herniation and degeneration; systemic diseases such as fibromyalgia, lupus; pregnancy; anesthetic block during the last 3 months. Questionnaires with general data and the Fonseca Anamnestic Index were applied to evaluate the signs and symptoms of TMD and Neck Disability Index (NDI) to assess the level of disability related to pain in the cervical spine. The assessment of muscular strength of the cervical flexor and extensor muscles measured by maximal isometric voluntary contraction (MVIC) was performed using a manual dynamometer, model 2201163, Lafayette, IN, USA. Results: A higher frequency of signs and symptoms of moderate TMD was observed (53%). A reduction in muscle strength in the TMD group was identified in relation to the group without TMD for all movements, but a significant difference was observed only in the flexion movement. Conclusion: Individuals with TMD have lower muscle strength for all movements of the cervical spine compared to individuals who do not have the same condition, and this difference is significantly present for the flexion movement.

Increase in Strength After Multimodal Pain Management Concept in Patients with Cervical Radiculopathy-A Non-Randomized, Uncontrolled Clinical Trial.

Background and Objective: Although multimodal pain therapy (MPT) is widely used in pain management for chronic cervical radiculopathy, its effect on increasing muscle strength in patients with cervical radiculopathy is not well documented. This study aimed to evaluate the impact of a structured multimodal pain management program on muscle strength in these patients, using objective strength measurements as indicators of therapeutic success. Materials and Methods: This non-randomized, uncontrolled, prospective clinical study initially included 35 patients, but 10 were excluded due to incomplete data, resulting in a final sample of 25 patients (14 women and 11 men, aged 42 to 84 years) with cervical radiculopathy who underwent a multimodal pain management program at a specialized orthopedic clinic. Muscle strength was measured at admission and discharge using a hand-held dynamometer. Pain levels were assessed with the Numeric Rating Scale. An uncontrolled study design was chosen for ethical reasons, as it was deemed inappropriate to form a control group that would be deprived of necessary anti-inflammatory or analgesic medications. Result: Significant improvements were observed in overall muscle strength, with an 11% increase from 114.78 kg to 127.41 kg (p = 0.003). The strongest increase in strength was observed in the proximal cervical muscle groups, with a notable 22.9% (p < 0.001)improvement in the muscles involved in cervical inclination. However, no significant strength gains were detected in the peripheral muscle groups of the upper arm. Pain scores on the NRS decreased by 54.2% (p < 0.001). Conclusions: This study demonstrates that a multimodal pain management approach leads to significant improvements in muscle strength and pain reduction in patients with cervical radiculopathy. The increase in cervical muscle strength is closely associated with pain relief and improved functional outcomes, highlighting the value of conservative pain management strategies for these patients.

Assessment of Cervical Joint Position Sense and Head Posture in Individuals With Myogenic Temporomandibular Dysfunctions and Identifying Related Factors: A Case-Control Study.

Temporomandibular dysfunctions (TMDs) have the potential to cause changes in cervical muscle strength, muscle endurance and position sense by changing muscle activation patterns, especially as a result of forward head posture. The effects of TMDs on cervical joint position sense (CJPS) and head posture remain controversial. The aim of this study was to evaluate the head posture and CJPS of individuals with TMDs and compare them with healthy individuals. This research, which was designed as a case-control study, was concluded with the inclusion of total of 84 participants (42 individuals diagnosed with myogenic TMDs, 42 controls). The assessment of participants included pain severity, neck and jaw functionality and disability, CJPS, head posture and temporomandibular joint (TMJ) range of motion (ROM). Individuals with TMDs exhibited higher angular deviation in CJPS during flexion and extension (p < 0.001). Additionally, individuals with TMDs demonstrated higher TMJ pain, limitation and dysfunction severity, as well as a more limited TMJ ROM (p < 0.001). Head posture was similar between groups (p > 0.05). There is a significant relationship between VAS-TMJ with VAS-cervical, FAI, NDI, JFLS-8 and TMJ ROM (p < 0.05). Moreover, a significant correlation was observed between NDI with FAI and TMJ ROM (p < 0.05). These results indicate that in addition to higher pain severity, disability and lower jaw ROM, CJPS of individuals with TMDs is also negatively affected. Also, parameters related to disability and functionality of cervical and TMJ were significantly correlated. Further studies are needed to determine the factors contributing to these results.

Neck Strength Variations in Dental Students with and without Neck Pain: A Longitudinal Study

Neck pain can induce specific motor responses and alterations in muscle strength. Therefore, this study aimed to investigate and compare the progression of cervical muscle strength within and between students with and without neck pain over the course of their first semester of clinical training. We used an online Nordic Musculoskeletal Questionnaire for group allocation, and neck strength in flexion, extension, and lateral flexion on both sides was measured using the KForce Bubble Pro hand-held dynamometer. Forty-four students were divided into neck pain (n = 21) and asymptomatic (n = 23) groups. Both groups increased neck strength by the end of the semester in flexion, extension, and left and right lateral flexion (p &lt; 0.001). Students experiencing neck pain showed a significantly lesser degree of improvement (p = 0.036) in right lateral flexion. The agonist/antagonist ratios revealed an enhanced role of neck extensors across both groups. Dental students showed overall increased cervical strength in their first semester of clinical training. Those with neck pain exhibited a diminished rate of strength gain in right lateral flexion when compared with students without pain by the semester’s end, suggesting different neuromuscular adjustments to clinical practice in students experiencing pain, which may lead to functional impairments in later training stages.

THE ACUTE EFFECT OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION ON CERVICAL RANGE OF MOTION, STRENGTH, AND PROPRIOCEPTION

Purpose: This double-blind randomized controlled study aimed to investigate the acute influence of two different proprioceptive neuromuscular facilitation (PNF) exercise, targeting stretching and strengthening, on cervical proprioception, range of motion (ROM) and strength among healthy university students. Methods: Healthy subjects were randomly divided into three groups as PNF stretching (PNFS) (n=36), resistive PNF pattern (PNFP) (n=35), and control group (CG) (n=33) which received only passive range of motion (ROM) exercises without causing any stretch. All participants were assessed in terms of cervical proprioception, ROM and muscle strength before and after one intervention session. Results: Within-group analysis of the PNFS group showed a significant difference only in extension proprioception and right rotation ROM (p≤0.05) while the PNFP group showed a significant difference in extension, right rotation, right and left lateral flexion proprioception; extension and right rotation ROM, and right and left rotation muscle strength (p≤0.05). For the CG, the within-group analysis showed a significant difference in flexion, extension, right rotation and right lateral flexion proprioception, extension, and left and right lateral flexion ROM (p≤0.05). Between-group analysis showed a significant difference only in cervical flexion proprioception (p=0.023) for PNFP over the CG. Conclusion: Although a lack of significant difference found in the between-group analysis, the within-group analysis showed that PNF patterns applied with resistance may be a promising technique to improve cervical proprioception, muscle strength and ROM.

The Effect of Exercise-Induced Central Fatigue on Cervical Spine Joint Position Error, Strength, and Endurance.

Fatigue is common in sports, impairing performance and increasing injury risk, yet little is known regarding fatigue and concussion. Impaired neck neuromuscular function may contribute to concussion at baseline, where central fatigue may further impair neck function resulting in increased concussion risk. These effects may be magnified in athletes with a history of concussion. To determine the effect of exercise induced central fatigue on neck joint position error, strength, and endurance in healthy subjects and those with a history of concussion. The investigators hypothesized that EICF would have a negative effect on all variables. Healthy subjects were examined using a single factor, within-subjects repeated measures design. Concussion history subjects were examined using a single-subject design. Nineteen healthy subjects and five subjects with a history of concussion were recruited for the study. Cervical joint position error, muscle strength, and neck flexor endurance were tested before and after exercise induced fatigue. There was a significant increase in constant (p = 0.0027) and absolute joint position error (JPE) (p < 0.001); decrease in neck flexor endurance (p < 0.001); and decrease neck strength into cervical flexion (p = 0.01) in healthy subjects following fatigue. Among concussion history subjects, five demonstrated a significant increase in absolute and constant JPE (p < 0.05); four demonstrated a significant decrease in neck flexor endurance (p < 0.05); one in neck flexion muscle strength (p < 0.05); and three in neck extension and rotation muscle strength (p < 0.05) following fatigue. Cervical neuromuscular function deteriorated following fatigue in healthy subjects. Resulting impairments may affect force alterations in cervical control, potentially increasing concussion risk. Concussion history subjects descriptively demonstrated similar results, however further research should examine formal comparisons involving subjects with and without concussion history. 3b.

A Profile of Isometric Cervical Strength in Elite Professional Male Rugby Players.

OBJECTIVES: To (1) provide position-specific normative data for isometric cervical muscle strength and endurance in professional, male rugby players and (2) assess the relationship between age, height, weight, and playing position with cervical muscle strength and endurance. DESIGN: Cross-sectional study. METHODS: Professional rugby players completed peak isometric cervical strength testing followed by a test of cervical muscle endurance. Descriptive statistics for continuous variables with strength normalized to body weight were performed. Multiple linear regression was used to estimate associations between strength measurements. RESULTS: In total, 136 players participated including front-row forwards (27%), other forwards (28%), and backs (45%). Front-row forwards had significantly greater peak isometric cervical muscle strength than other position groups, with backs having the lowest strength. Extension produced the highest force for all 3 position groups (429 N ± 104 N), whereas flexion produced the least (275 N ± 65 N). Age was associated with increased isometric cervical muscle strength. There was a statistically significant relationship between peak flexion strength and flexion endurance (P = .003). The average time for the endurance tests were 55.7 (±17.1) seconds and 52.9 (±20.1) seconds for extension and flexion, respectively. Other forwards had lower cervical extension muscle endurance than backs and front-row forwards. CONCLUSIONS: Normative values for peak and endurance isometric strength in professional rugby players illustrate significant differences between playing position. Consider age, body weight, and intraindividual variability when interpreting cervical strength and endurance results. J Orthop Sports Phys Ther 2024;54(3):1-8. Epub 29 January 2024. doi:10.2519/jospt.2024.11830.

Investigation of Relationships Between Pain Intensity, Cervical Muscle Strength, Proprioception and Balance in Individuals with Chronic Neck Pain

Amaç: Çalışmanın amacı, kronik boyun ağrısı (KBA) olan bireylerde ağrı şiddeti, servikal kas kuvveti, propriosepsiyon ve denge arasındaki ilişkileri incelemekti. &#x0D; Gereç Yöntem: Çalışmaya 45 KBA’lı birey ve 46 boyun ağrısı olmayan sağlıklı birey dahil edildi. KBA’lı bireylerde istirahat ve aktivite sırasındaki boyun ağrısı şiddetleri görsel analog skala ile, her iki gruptaki bireylerin servikal fleksör ve ekstansör kas kuvveti izometrik dinamometre ile, servikal bölge propriosepsiyon duyusu servikal eklem pozisyon hata testi ile ve statik ve dinamik denge Biodex denge sistemi ile değerlendirildi. &#x0D; Sonuçlar: Sağlıklı bireylerle karşılaştırıldığında KBA’lı bireylerin servikal fleksör ve ekstansör kas kuvvetlerinin daha düşük, servikal bölge propriosepsiyonunun ve statik ve dinamik dengelerinin daha kötü olduğu bulundu (p

Association between Cervical Muscle Weakness and Functional Limitations due to Headache in Doctors

Background: Headaches and neck discomfort are prevalent issues, particularly among healthcare professionals, and are often related to muscular weaknesses and postural anomalies. The intricate relationship between cervical muscle strength and the frequency and intensity of headaches necessitates a deeper understanding for effective management and treatment strategies. Objective: The primary objective of this study was to investigate the association between cervical muscle weakness and functional limitations due to headaches in doctors, considering the impact of long working hours and the physical demands of the medical profession. Methods: A cross-sectional study was conducted among doctors working at Akhtar Saeed Trust Hospital, Farooq Hospital, and AMDC in Lahore from June to December 2022. Participants with conditions like fibromyalgia, history of head and neck trauma, or degenerative cervical spine disease were excluded. The strength of cervical muscles was assessed using Manual Muscle Testing, and the intensity of headaches was evaluated using the Headache Impact Test (HIT-6) questionnaire. The sample size was calculated to be approximately 150, with data analysis performed using SPSS version 25. The study employed descriptive statistics, Chi-square tests, and parametric tests to analyze the data. Results: The study found significant correlations between cervical muscle strength and headache impact. Among participants with moderate cervical flexor strength, HIT scoring ranged from 30 in the 36-50 range to 28 in the 60-78 range. For strong cervical flexors, the range was 34 in the 36-50 to 6 in the 60-78 range. Similar patterns were observed in cervical extensors and side flexors. The Chi-square values were significant across all muscle groups (18.45 for flexors, 32.164 for extensors, 50.175 for right side flexors, and 45.30 for left side flexors), all with a p-value of 0.000. Conclusion: The study demonstrates a significant association between cervical muscle strength and the impact of headaches, indicating that weaker cervical muscles are associated with higher headache frequency and severity. These findings suggest the need for targeted muscle strengthening and posture correction interventions among doctors to mitigate the risks of headache and neck discomfort.

Efficacy of ultrasound therapy with neck retraction exercises vs. ultrasound therapy with deep cervical flexor training for excessive screen time users: a pilot randomized controlled study.

[Purpose] To compare the effectiveness of ultrasound therapy in combination with neck retraction exercises and deep cervical flexor training on pain, forward head posture, and deep cervical flexor muscle strength in excessive screen time users. [Participants and Methods] This 4-week intervention study included 36 participants with forward head posture, categorized into three groups: 1) ultrasound therapy with neck retraction exercises 2) ultrasound therapy with deep cervical flexor training, and 3) a control group. The outcomes were pain, forward head posture, and strength of the deep cervical flexor muscles. [Results] The strength of the deep cervical flexor muscles exhibited a notable increase, indicating a relatively higher mean value in the first intervention group. Upon follow-up, significant changes in all outcomes were observed between the first intervention group and the control group. Also, significant differences were revealed in the deep cervical flexor muscles between the second intervention group and the control group. [Conclusion] Ultrasound therapy with neck retraction exercises could have a more positive effect on pain, forward head posture, and strength of the deep cervical flexor muscles in comparison to ultrasound therapy with deep cervical flexor training for excessive screen time users.

Normative value of deep neck flexors muscle strength measurement using pressure biofeedback unit and sphygmomanometer: An observational study

PurposeTo find out the normative value of deep neck flexor muscles strength using pressure biofeedback unit and sphygmomanometer. MethodsThe healthy individuals both male and female aged between 18 and 25 years were recruited by stratified random sampling method from a tertiary hospital. The procedure is performed with the patient in supine lying with the neck in a neutral position. To check strength, pressure biofeedback unit and sphygmomanometer were placed under occiput and ask the individual to do the movement is genteelly and slowly as a head nodding action (chin tuck). The performance was scored via the pressure level that patient achieves 3 repetitions for 10 s hold and interval timing for 10 s. And the pressure biofeedback unit and sphygmomanometer inflated with 40 mmHg and took three reading respectively. ResultOur result shows, in decreased of deep neck cervical flexor muscle Strength with age group 21 (20–22) in normal adult and underweight with age group 21 (19–23) and with BMI 21 (20.1–22.4) and 16.6 (16.1–17.6) respectively. In our study, the deep neck flexor strength of overweight adults with age group 22 (21–23) and with BMI 27.8 (25.9–29.4) is stronger is than the normal and underweight adults. ConclusionThe study concluded that the maximal Deep neck cervical flexor strength of overweight Adults is stronger than normal and underweight Adults. The difference is maintained in all age groups. The maximal Deep neck cervical flexor strength, for flexion is developed at neutral position of neck.

Intra-operative Neurophysiological Monitoring in Patients Undergoing Posterior Spinal Correction Surgery with Pre-operative Neurological Deficit: Its Feasibility and High-risk Factors for Failed Monitoring.

Considering spinal deformity patients with pre-operative neurological deficit were associated with more intra-operative iatrogenic neurological complications than those without, intra-operative neurophysiological monitoring (IONM) has been used for detecting possible iatrogenic injury timely. However, the IONM waveforms are often unreliable. To analyze the performance of intra-operative neurophysiological monitoring (IONM) including somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) in patients with pre-operative neurological deficit undergoing posterior spinal correction surgery, and to identify the high-risk factors for failed IONM. Patients with pre-operative neurological deficit undergoing posterior spinal correction surgery between October 2017 and January 2022 were retrospectively reviewed. The presence or absence of SEP and MEP of target muscles were separately recorded. The P37/N50 latency and amplitude of SEP, and the MEP amplitude were measured. Any IONM alerts were also recorded. The IONM performance was compared among patients with different etiologies, levels responsible for neurological deficit, and strength of IONM-target muscles. Patients' demographics were analyzed using the descriptive statistics and were presented with mean ± standard deviation. Comparison analysis was performed using χ2 -test and statistically significant difference was defined as p < 0.05. A total of 270 patients (147 males, 123 females) with an average age of 48.4 ± 36.7 years were involved. The SEP records were available in 371 (68.7%) lower extremities while MEP records were available in 418 (77.4%). SEP alerts were reported in 31 lower extremities and MEP alerts in 22, and new neurological deficit at post-operation was observed in 11. The etiologies of neuromuscular and syndromic indicated relatively lower success rates of IONM, which were 44.1% and 40.5% for SEP, and 58.8% and 59.5% for MEP (p < 0.001). In addition, patients with pre-operative neurological deficit caused by cervical spine and muscle strength lower than grade 4 suffered from higher risk of failed IONM waveforms (p < 0.001). Patients with pre-operative neurological deficit suffered from a higher incidence of failed IONM results. The high-risk for failed IONM waveforms included the neuromuscular and syndromic etiologies, neurological deficit caused by cervical spine, muscle strength lower than grade 4 in patients with pre-operative neurological deficit undergoing posterior spinal correction surgery.

Cervical proprioception in Parkinson's disease and its correlation with manual dexterity function.

Cervical proprioception has a crucial role in posture and movement control. The study aimed to determine the relationship of cervical proprioception, cervical muscle strength and endurance with manual dexterity and hand strength in individuals with idiopathic Parkinson's disease (PD). Twenty individuals with PD (mean age:63.9 years) and 20 healthy individuals as a control group (mean age: 61.9 years) were recruited. Cervical joint position error (JPE), static endurance of neck muscles, activation of deep cervical flexor muscles (Craniocervical Flexion Test-CCFT), manual dexterity using Purdue Pegboard Test (PPT), cognitive and motor task on PPT, finger tapping test (FTT) and pinch-grip strength were assessed. Cervical JPE was significantly higher in individuals with PD than controls (p<0.05). The strength and endurance of the cervical muscles were significantly decreased in individuals with PD (p<0.05). There was a significant negative correlation of cervical JPE measurements with PPT, cognitive and motor tasks on PPT in the PD group (p<0.05). There was a significant negative correlation of the endurance of cervical flexor muscles with PPT and cognitive task on PPT (p<0.05). In addition, a significant positive correlation was found between cervical flexor endurance and hand strength in the PD group (p<0.05). Cervical proprioception and the strength and endurance of cervical muscles decrease in individuals with PD compared to healthy individuals. Impairment of cervical proprioception appears to be associated with poorer upper extremity performance. Detailed evaluation of the cervical region in PD may be useful in determining the factors affecting upper extremity function.

Effects of Neck Flexor Training Program on Cervical Spine Normalization, Muscle Strength, and Pain in Women

Effects of Neck Flexor Training Program on Cervical Spine Normalization, Muscle Strength, and Pain in Women

Effects of Kendall Exercise vs. Gong’s Mobilization on Pain, Range of Motion, Function, and Strength in Cases With Text Neck Syndrome

Objectives: To determine the impact of Kendall versus Gong’s intervention according to pain sensation, range of movement, function, strength, and posture in cases with text neck syndrome. Methods: This randomized clinical trial recruited a sample of 24 patients with text neck syndrome from Fatima Hospital, Sargodha, Pakistan from January to April 2021. The samples were randomly divided into 2 groups using the envelope method. Group A received Kendall’s intervention while group B received Gong’s mobilization. The intervention was performed in 18 sessions for each patient during 6 weeks i.e. 3 per week. Neck disability index, numeric pain rating scale, cervical range of motion (ROM), cranio-vertebral angle (CVA), rounded shoulder angle (RSA), and modified sphygmomanometer test were used to collect data. All outcomes were measured at baseline and six weeks after intervention and analyzed using SPSS software, version 23. T-test was used to analyze within and between-group differences, and P&lt;0.05 was considered significant. Results: A significant difference with P&lt;0.05 was observed for within and between group statistics. Gong’s mobilization showed more effectiveness (P&lt;0.001) for all output measures depending on differences between mean scores. Discussion: The study concluded that both Kendall’s exercise and Gong’s mobilization were useful in the reduction of pain and functional disability; improvement in cervical range and strength of cervical muscles. However, Gong’s mobilization was superior to Kendall’s exercise in improving text neck syndrome for outcome measures, including neck pain, disability, craniovertebral angle, rounded shoulder angle, cervical range of motion (ROM), and cervical muscle strength.

Reference Values for Cervical Muscle Strength in Healthy Women Using a Hand-Held Dynamometer and the Association with Age and Anthropometric Variables.

Knowledge of reference values for cervical muscle strength is a key tool for clinicians to use as a clinical reference measure and to establish goals during rehabilitation. The objective was to establish reference values for the maximal strength of cervical muscles in healthy women using a handheld dynamometer and verify the association of cervical muscle strength with age and anthropometric measurements. A hundred women were classified into four groups (n = 25) according to age: 18-29 years, 30-39 years, 40-49 years, and 50-60 years. Maximal muscle strength of the cervical spine was measured using a Lafayette® handheld dynamometer for flexion, extension, and bilateral lateral flexion. No differences in cervical muscle strength were observed among the groups (p > 0.05). However, the 18-29-year-old group took less time to reach the peak of force for flexion than the 50-60-year-old group. Moderate correlations were observed between cervical flexor strength and weight, body mass index, and neck circumference, and between cervical extensor strength and weight and body mass index (r = 0.43-0.55; p < 0.05). Reference values for cervical muscle strength in healthy women were established using a handheld dynamometer, and the association between muscle strength and anthropometric data was moderate.

Cervical sensitivity, range of motion and strength in individuals with shoulder pain: A cross-sectional case control study

ObjectivesTo assess whether cervical sensitivity, range of motion (ROM) and strength are impaired in individuals with shoulder pain and how they interact with sociodemographic and clinical data. MethodsForty-eight individuals with shoulder pain and 48 asymptomatic matched ones were included. Pressure pain thresholds (PPTs) in cervical region and tibialis anterior muscles, ROM of cervical flexion, extension, lateral flexions and rotations and cervical muscle strength of flexion, extension and lateral flexions were assessed. Between-groups comparisons and a logistic multiple regression model were performed. ResultsThe symptomatic group showed lower and not meaningful PPTs in trapezius of the unaffected/unmatched side, both sternocleidomastoid muscles, and tibialis anterior and reduced ROM in cervical extension (MD = −9.00°) when compared to the asymptomatic group. No differences were identified in muscle strength. Reduced PPT of the trapezius and reduced cervical extension ROM together accounted for 40.2% of the variance of the chance of presenting shoulder pain. ConclusionIndividuals with shoulder pain have more, but not clinically relevant, cervical sensitivity and lower cervical extension than asymptomatic individuals. The lower the PPT of the upper trapezius and the cervical extension ROM, the higher was the chance to present shoulder pain. Regional interdependence between cervical spine and shoulder may explain cervical physical function alterations in shoulder pain.

Assessment of pain, scapulothoracic muscle strength, endurance and scapular dyskinesis in individuals with and without nonspecific chronic neck pain: A cross-sectional study

IntroductionThis study is aimed to evaluate pain, muscle strength, scapular muscular endurance and scapular kinesis in individuals with Nonspecific Chronic Neck Pain and to compare them with asymptomatic individuals. In addition, to investigate the effect of mechanical changes in the scapular region on neck pain. Method40 individuals who applied to Kırıkkale University Faculty of Medicine Hospital Physical Therapy and Rehabilitation Center and diagnosed with NSCNP and 40 asymptomatic individuals for the control group were included the study. Pain was evaluated with Visual Analogue Scale, pain threshold and pain tolerance with algometer, cervical deep flexor group muscle strength with Stabilizer Pressure Biofeedback device, and neck and scapulothoracic muscle strength with Hand Held Dynamometer. Scapular Dyskinesia Test, Scapular Depression Test and Lateral Scapular Slide Test were used to evaluate scapular kinesis. A timer was used to evaluate scapular muscular endurance. ResultPain threshold and pain tolerance values of the NSCNP group were lower (p < 0.05). Muscle strength around neck and scapulothoracic region of the NSCNP group were lower than the asymptomatic individuals (p < 0.05). NSCNP group had more scapular dyskinesia (p < 0.05). Scapular muscular endurance values of the NSCNP group were lower (p < 0.05). ConclusionAs a result, pain threshold and pain tolerance decreased, muscle strength of the neck region and the scapular region decreased, scapular endurance values decreased and the incidence of scapular dyskinesia increased in the individuals with NSCNP compared to the asymptomatic individuals. It is thought that our study will provide a different perspective in the evaluation of neck pain and including the scapular region to the evaluations.

Effects of manual therapy combined with therapeutic exercise versus routine physical therapy on brain biomarkers in patients with chronic non-specific neck pain in Thailand: a study protocol for a single-blinded randomised controlled trial

IntroductionStructural brain alterations in pain-related areas have been demonstrated in patients with non-specific neck pain. While manual therapy combined with therapeutic exercise is an effective management for neck pain, its...