Superficial Muscles Research Articles

Relationship between muscle echo intensity on ultrasound and isokinetic strength of the three superficial quadriceps femoris muscles in healthy young adults.

[Purpose] The purpose of this study was to clarify the relationship between muscle echo intensity measured with ultrasound and the isokinetic strength of each of the three superficial quadriceps femoris muscles in healthy young adults. [Participants and Methods] We measured the echo intensity of the three superficial muscles of the quadriceps femoris in 25 healthy adults (10 males and 15 females; mean age, 22.3 years) using ultrasound. Moreover, we obtained the maximum force during isokinetic knee extension at 60°/s using an isokinetic dynamometer. [Results] In males and females, a significant negative correlation between echo intensity and muscle strength was found in the VM (r=−0.65 and r=−0.63, respectively). [Conclusion] In both males and females, only the muscle echo intensity of the vastus medialis was found to have a negative correlation with the maximum force during isokinetic knee extension at 60°/s. Our data lay the foundation for simplifying and rationally performing the measurement of muscle echo intensity of the quadriceps femoris. And it would therefore be sufficient to only measure the VM to clarify a relationship between EI and maximum isokinetic force in the quadriceps.

РАСПРЕДЕЛЕНИЕ УСИЛИЙ ЖЕВАТЕЛЬНЫХ МЫШЦ ЗУБОЧЕЛЮСТНОЙ СИСТЕМЫ ЧЕЛОВЕКА ПРИ АСИММЕТРИЧНОМ ТОНУСЕ ПОВЕРХНОСТНЫХ ЖЕВАТЕЛЬНЫХ МЫШЦ

The dentofacial system is closely related to the musculoskeletal, digestive, nervous, cardiovascular systems, etc. The functioning of the dentofacial system affects nutrition, breathing, swallowing, speech, hearing, etc., where occlusion is one of its main parameters. Many pathologies in the dentofacial system are also associated with a change in the efforts of the masticatory muscles, where hypertonicity of the superficial masticatory muscle is most common. The article considers an example of her hypertonicity by biomechanical modelling. For this, the problem of determining of the masticatory muscle efforts was solved at the maximum value of the force of compression of the jaws, which was 600 N. The cases were considered when the minimum possible value of the force of the superficial masticatory muscle was 70%, 80% and 90% of the maximum value. It was found that for the case while the minimum values of the efforts of all masticatory muscles do not exceed 50% of their maximum possible values, then the distribution of muscle efforts remains unchanged, i.e. the values of muscle efforts do not change. When at least one of the muscles exceeds its half of the maximum possible effort, it is observed that the efforts of the remaining muscles on the same side of the face decrease or remain approximately at the same level, and on the opposite side, the muscle efforts initially decrease, and at 80% and 90% of the maximum possible magnitude of the effort of the superficial chewing muscle increases again. In further works, various combinations of hypertonicity of the masticatory muscles, as well as the hypotonia of these muscles, are assumed.

Микроморфологическая характеристика поверхностной грудной мышцы у кур пород Куланги и Малайская бойцовая

On the basis of histological and micromorphometric studies, the general regularities and breed features of the structural organization of the superficial pectoral muscle in chickens of the meat production direction Kulangi and Malajskaya bojcovaya hens are presented. The age of the studied individuals was 1 and 29 days. The study evaluated the structural and morphometric parameters of not only the muscle fibers, but also the connective tissue component of the studied muscle. It is shown that representatives of fighting breeds of the meat direction of productivity are characterized by general patterns and distinctive features of the structure of the muscle tissue of the superficial pectoral muscle. The similarity of all the studied samples of muscle tissue in terms of area was revealed, which indicates that this feature has optimal values and is stable during ontogenesis. At the same time, the parameters of the thickness of the endomysium, peremysium, muscle fibers and their bundles had variable values in all the studied bird breeds on the 1st and 29th days of ontogenesis. The data obtained indicate the presence of both common morphological features of muscle tissue, genetically determined and stable regardless of productivity, and variable, which can change under the influence of selection. The results of the research are important for veterinary biology, industrial poultry farming, veterinary and sanitary expertise and can be used to improve the methods of breeding work.

Особенности строения скелетных мышц у кур Смена-8 и Андалузская голубая в отдельные сроки постэмбрионального онтогенеза

Histological and morphological characteristics of skeletal muscles in chickens of the meat direction of productivity Smena-8 and egg direction of productivity Andalusian blue on the 20th and 29th days of postembryonic development are presented. The skeletal striated muscle tissue of the studied bird obeys the general principles of myogenesis inherent in most animal species and is characterized by signs of a definitive structure. It is shown that on the 20th and 29th days of postembryonic ontogenesis in the Smena-8 cross and the Andalusian blue breed, the quadriceps femoris is ahead of the superficial pectoral muscle in terms of the thickness of muscle fibers. The thickness of the endomysium and perimysium in the connective tissue component of the superficial pectoral muscle in chickens of both directions of productivity prevails over that in the quadriceps femoris. Based on the obtained morphometric parameters of the structure of muscle fibers, the concept of myogenesis of skeletal muscles in agricultural poultry of egg and meat productivity directions is presented.

Identification of muscle innervation zones using linear electrode arrays: a fundamental step to measure fibers conduction velocity

Fiber conduction velocity (CV) is a parameter correlated to the physiological membrane properties of the skeletal muscle fibers. Changes in muscle fiber CV are correlated to the gradation of force and fatigue, and can be measured by means of surface electromyography EMG (sEMG). sEMG measurement of CV during muscle contractions requires the correct identification of the skeletal muscle innervation zone (IZ). In superficial muscles, IZ location can be detected using linear electrode arrays and visually identified as the point of inversion of the detected motor unit action potential (MUAP) propagation. In the present work, we present a method for the effective and fast detection of the IZ location, through the following procedures: (1) identification of the target superficial muscle considering the muscle fiber architecture; (2) electrode array selection based on interelectrode distance and number of electrodes; (3) subject training to perform submaximal isometric contractions of the target muscle/s; (4) electrode array positioning along the muscle surface to investigate the IZ position during the contractions by visual identification of MUAP patterns.

Results of treatment of arthrosis of the acromial-clavicular joint in patients with partial rupture of the supraspinatus muscle tendon

Introduction: Very often, partial tear tendons of the superficial shoulder muscle are combined with arthrosis of the clavicular-acromial joint. This is due to violations of the shoulder-patch rhythm, which in turn leads to a chronic overload of the clavicular-acromial joint and the progression of arthrosis in this joint. Aim: The purpose of the study is to improve the results of treatment of patients with injuries of the supraspinatus tendon against the background of deforming arthrosis of the clavicular-acromial joint. Material and methods: For the study a clinical group was assembled, which consisted of 84 patients with injuries of the tendon of the supraspinatus and deforming arthrosis of the clavicular-acromial joint 3–4 parts. All patients, depending on the treatment, were divided into two groups. Results and discussion: The consequences and influence of the arthrosis of the clavicular-acromial joint were determined. Movements of the joint were examined. The shoulder joint function was under control in the post-surgery period, which provided particular results and conclusions according to the comparative analysis of the two groups. Conclusions: Based on the provided results, it can be concluded that deforming arthrosis of the clavicular acromial joint can cause contracture in the shoulder joint in patients after the suture of the tendon of the abdominal muscle.

Concomitant Partial Achilles Tendon Rupture and Lateral Luxation of the Superficial Digital Flexor Muscle Tendon in a Dog

AbstractThe aim of this study was to report a posttraumatic partial Achilles tendon (AT) rupture associated with lateral luxation of the superficial digital flexor tendon (SDFT) in a Whippet. This article is a brief communication. A Whippet was presented with posttraumatic plantigrade stance and non-load-bearing lameness of the right pelvic limb. The objective findings consisted in partial AT rupture and SDFT lateral luxation. Surgical treatment ensued: tenorrhaphy of the torn tendons and calcaneo-tibial screw insertion for tarsal immobilization, followed by suturing of the SDFT retinaculum. A casting bandage was employed for additional immobilization. Nonetheless, a bandage complication prompted the premature removal of the fixation screw and casting wrap. Complete functional recovery was achieved by the 20th postoperative week. The simultaneous occurrence of SDFT luxation and partial AT tear has not been reported in the literature before. The long-term postoperative functional outcome was highly satisfactory.

Comparative characteristics of myohistogenesis of musculoskeletal tissue in hens and quails

A comprehensive comparative microscopic and morphometric study of the superficial pectoral (SPM) and quadriceps femoral (QFM) muscles in hens and quails in the early stages after hatching was performed. In the muscles, diameter of the muscle fiber, area of the muscle tissue, representation of the muscle and connective tissue components were determined. A set of general regularities and specific features of postembryonic myogenesis of the studied structures in hens and quails has been established. The peculiarities of SPM and QFM ultrastructure in quails of the Manchzhurskaya zolotistaya (Manchurian gold) breed were revealed. Representatives of both studied groups of birds are characterized by an increase in the muscle tissue area, the diameter of muscle fibers and their bundles. The difference is a more significant development of the quadriceps femoris in hens, and the superficial pectoral muscle in quails. It was found that quails, unlike hens, had thickening of the endomysium and perimysium in both muscles.

Микроморфологическая организация скелетных мышц у кур Б-56 «Корниш» и Юрловская голосистая

On the basis of histological and micromorphometric studies, the general patterns and breed features of the structural organization of the quadriceps femoral muscle and the superficial pectoral muscle in meat (B-56 «Cornish») and egg (Yurlovskaya golosistaya) productivity trends are presented. The bird was examined on the 20-th day of ontogenesis. The structural and morphometric parameters of muscle fibers and connective tissue component of the studied skeletal muscles were evaluated. It was found that the B-56 «Cornish» surpasses the Yurlovskaya golosistaya in terms of the thickness of muscle fibers and perimisium. At the same time, the opposite picture was revealed in terms of the thickness of the endomysium and bundles of muscle fibers. The data obtained indicate the variability of morphological features of muscle tissue, depending on the selection of a particular line and breed. The results of the research are important for the comparative and breed morphology of poultry, as well as for the veterinary and sanitary examination of chicken meat, in poultry farming to assess the purity of the breed.

Effect of cervical stabilizing exercise and abdominal stabilization on longus colli thickness and muscle activity of the sternocleidomastoid and scalene

Objective: This study aimed to investigate the relationship between cervical stabilizing exercise accompanied by abdominal stabilization and deep and superficial cervical flexor muscle atrophy, as increased activity in the former may prevent compensatory movement of the latter. Methods: We included 30 healthy adults in this study. Subjects either performed cervical stabilizing exercise as per the conventional method, with the hip and knee joints in the 90° position, or in conjunction with abdominal stabilization. We measured changes in the muscle activity of the SCM, scalene, RA, EO, and IO as well as the muscle thickness of the SCM, EO, IO, longus colli, and TrA. Results: Meanwhile, the muscle thickness of the longus colli increased to a greater extent following cervical stabilizing exercise accompanied by abdominal stabilization than after stabilization with the hip and knee joints in the 90° position or when using the conventional approach. Conclusion: Abdominal stabilization helps to improve the muscle strength of the longus colli by preventing compensation of the cervical flexor muscle through the provision of trunk stability and the avoidance of chest lift.

Immediate effect of muscle energy technique versus passive stretching for upper trapezius muscle on neck pain

<p class="abstract"><strong>Background:</strong> Neck pain is a common musculoskeletal problem in the General population. Upper trapezius is a superficial postural muscle that tends to get shortened due to overuse activity which causes neck pain and reduces neck mobility. The aim of this study was to compare the immediate effect of Muscle energy technique (MET) and passive stretching of upper trapezius muscle in neck pain patients.</p><p class="abstract"><strong>Methods:</strong> An experimental study was undertaken during period from March 2017 to March 2018. 358 participants with Neck pain were included in this study. Participants were divided in two groups: Group A received Hot pack and MET for upper Trapezius. Group B received Hot pack and Passive stretching for upper trapezius. Visual analogue scale (VAS) at end range of motion (ROM), same cervical side flexion and opposite side cervical rotation by goniometer and tape were taken as outcome measures. Participants were assessed prior to the treatment, immediately after the treatment and post 24 hours to see the carry over treatment.</p><p class="abstract"><strong>Results: </strong>Mann Whitney U test showed that VAS at end range of motion, opposite side cervical rotation and same side cervical side flexion had significant improvement in MET group as compared to passive stretching group (p<0.0001). Carry over effect was less significant with p<0.0001.</p><p class="abstract"><strong>Conclusions: </strong>A single session of MET for upper trapezius muscle reduced the pain intensity (VAS) and increased the cervical rotation and cervical side flexion.</p>

Comparison between Russian and Aussie currents in the grip strength and thickness muscles of the non-dominant hand: A double-blind, prospective, randomized-controlled study.

Objectives This study aims to compare the Russian and Aussie currents in the force gain and hypertrophy of the forearm muscles responsible for the grip. Patients and methods This double-blind, prospective, randomized-controlled study included a total of 30 healthy women (mean age: 20.2±1.7 years; range, 18 to 25 years) between May 2018 and July 2018. The participants were randomly divided into three groups: control group (CG, n=10), Aussie current group (ACG, n=10), and Russian current group (RCG, n=10). All three groups underwent a force test with a gripping dynamometer and the collection of images of the superficial and deep flexor muscles of the fingers with diagnostic ultrasound. The CG received a fictious current stimulus, while the other two groups received the designated stimuli from their currents. Further evaluations were performed after 24 h of the 12th application of the current. Results For grip, there were no significant differences in the moment of evaluation and interaction, while the effect size yielded certain points to advantages of force gain for the group using the RCG. The thickness of the superficial muscles showed a significant difference for the first evaluation between CG and RCG (p=0.014) and between RCG and ACG (p=0.010), indicating a larger effect size for RCG. Conclusion Our study results show that the Russian current is proven to be the mode which yields the most optimal results.

Myofascial Injection Using Fascial Layer-Specific Hydromanipulation Technique (FLuSH) and the Delineation of Multifactorial Myofascial Pain.

Background and objectives: The aims of this study were to delineate the contribution of specific fascial layers of the myofascial unit to myofascial pain and introduce the use of ultrasound-guided fascial layer-specific hydromanipulation (FLuSH) as a novel technique in the treatment of myofascial pain. Materials and Methods: The clinical data of 20 consecutive adult patients who underwent myofascial injections using FLuSH technique for the treatment of myofascial pain were reviewed. The FLuSH technique involved measuring the pain pressure threshold using an analog algometer initially and after each ultrasound guided injection of normal saline into the specific layers of the myofascial unit (superficial fascia, deep fascia, or muscle) in myofascial points corresponding with Centers of Coordination/Fusion (Fascial Manipulation®). The outcome measured was the change in pain pressure threshold after injection of each specific fascial layer. Results: Deep fascia was involved in 73%, superficial fascia in 55%, and muscle in 43% of points. A non-response to treatment of all three layers occurred in 10% of all injected points. The most common combinations of fascial layer involvement were deep fascia alone in 23%, deep fascia and superficial fascia in 22%, and deep fascia and muscle in 18% of injected points. Each individual had on average of 3.0 ± 1.2 different combinations of fascial layers contributing to myofascial pain. Conclusions: The data support the hypothesis that multiple fascial layers are responsible for myofascial pain. In particular, for a given patient, pain may develop from discrete combinations of fascial layers unique to each myofascial point. Non-response to treatment of the myofascial unit may represent a centralized pain process. Adequate treatment of myofascial pain may require treatment of each point as a distinct pathologic entity rather than uniformly in a given patient or across patients.

Influence of SUB-PRO probiotic on meat productivity of broiler chickens

We studied dynamics of live weight and morphological composition of carcasses in Ross 308 chickens at 1-, 21-, 28-, 34-, 38- and 42-day ages when SUB-PRO probiotic was included in the diet instead of Maxus G feed antibiotic in amount of 100 g/ton of feed. By the age of 42, chickens in the control group (I) reached a live weight of 2234 28.4 g, chickens in the experimental group (II) - 2329 27.3 g, and chickens who took feed antibiotic (III) - 2320 33.4 g. Live weight of chickens of the II group by the age of 42 days exceeded the I group by 95 g or 4.25 % (P 0.05), the III group - by 86 g or 3.85 %. In terms of carcass weight, the experimental group exceeded the control group by 4.60 % (P 0.05), group III - by 4.53 %. The meat productivity of chickens taking antibiotic was not studied further, since that had no practical significance. Over the entire period of rearing, the average daily gain in live weight in control chickens was 52.20 g, in the experimental chickens - 54.46 g. The relative muscle weight in broiler carcasses of the experimental group increased from 55.34 to 66.37 %v from 1 to 42 days of age, while the relative bone weight decreased from 33.23 to 16.78 %. By the age of 42, absolute muscle and bone weight had 123.47- and 51.91-fold increase, respectively, in comparison with diurnal weight. The data of anatomical cutting of chicken carcasses showed that, in terms of muscle and bone content, the most valuable were: breast - 84.63 and 8.25 %, thigh - 75.66 and 12.54 %, respectively; less valuable: drumstick - 67.86 and 20.98 %, wing - 50.58 and 33.53 %, respectively. Diameter of muscle fibers of superficial pectoralis muscle in 42-day-old broilers was 55.20 m; water content - 75.10 %, fat - 1.60 %, protein - 22.31 %. In terms of microbiological parameters, carcass meat meets the requirements of GOST 31468-2012 interstate standard. The inclusion of SUB-PRO probiotic in chicken diet instead of antibiotic does not reduce productivity, but excludes the negative consequences of antibiotic use.

The Effect of ICA and Non-negative Matrix Factorization Analysis for EMG Signals Recorded From Multi-Channel EMG Sensors.

Surface electromyography (EMG) measurements are affected by various noises such as power source and movement artifacts and adjacent muscle activities. Hardware solutions have been found that use multi-channel EMG signal to attenuate noise signals related to sensor positions. However, studies addressing the overcoming of crosstalk from EMG and the division of overlaid superficial and deep muscles are scarce. In this study, two signal decompositions—independent component analysis and non-negative matrix factorization—were used to create a low-dimensional input signal that divides noise, surface muscles, and deep muscles and utilizes them for movement classification based on direction. In the case of index finger movement, it was confirmed that the proposed decomposition method improved the classification performance with the least input dimensions. These results suggest a new method to analyze more dexterous movements of the hand by separating superficial and deep muscles in the future using multi-channel EMG signals.

Activation of Superficial and Deep Finger Flexors Through Transcutaneous Nerve Stimulation.

Functional electrical stimulation (FES) is a common technique to elicit muscle contraction and help improve muscle strength. Traditional FES over the muscle belly typically only activates superficial muscle regions. In the case of hand FES, this prevents the activation of the deeper flexor muscles which control the distal finger joints. Here, we evaluated whether an alternative transcutaneous nerve-bundle stimulation approach can activate both superficial and deep extrinsic finger flexors using a high-density stimulation grid. Transverse ultrasound of the forearm muscles was used to obtain cross-sectional images of the underlying finger flexors during stimulated finger flexions and kinematically-matched voluntary motions. Finger kinematics were recorded, and an image registration method was used to capture the large deformation of the muscle regions during each flexion. This deformation was used as a surrogate measure of the contraction of muscle tissue, and the regions of expanding tissue can identify activated muscles. The nerve-bundle stimulation elicited contractions in the superficial and deep finger flexors. Both separate and concurrent activation of these two muscles were observed. Joint kinematics of the fingers also matched the expected regions of muscle contractions. Our results showed that the nerve-bundle stimulation technique can activate the deep extrinsic finger flexors, which are typically not accessible via traditional surface FES. Our nerve-bundle stimulation method enables us to produce the full range of motion of different joints necessary for various functional grasps, which could benefit future neuroprosthetic applications.

Application Value of Real-Time Shear Wave Elastography in Diagnosing the Depth of Infiltrating Muscular Layer of Endometrial Cancer.

To explore the clinical value of real-time shear wave ultrasonic elastography in diagnosing the depth of infiltrating muscularis of endometrial cancer. Seventy-one patients with stage I endometrial cancer infiltrating the myometrium and 37 patients with normal physical examination were enrolled and divided into three groups: endometrial cancer superficial muscle infiltration group, endometrial cancer deep muscle infiltration group, and normal control group. After completing 2-dimensional ultrasound examination, each patient switched to the real-time shear wave elastography mode to measure the elasticity values Emax, Emean, and Esd. For control group, comparison of elastic modulus values between superficial muscular layer near the intimal surface and the deep muscular layer near the serosa surface showed no difference (P > 0.05). For endometrial cancer superficial muscular infiltration group, significant difference was found regarding the elastic modulus values of infiltrated muscular layer and uninfiltrated muscular layer (Emax and Emean) without difference for Esd (P > 0.05). A significant difference of elastic modulus was observed between control group and deep myometrial infiltration group (P < 0.05) without difference of Emean or Emax but with difference of Esd. The accuracy in diagnosing muscular layer infiltration was 78.9% for Emax cutoff and 82.5% for Emean cutoff. The rate of using Emax ≥32.22 kPa or Emean ≥27.54 kPa as the ultrasound standard for diagnosing myometrium infiltration was 92.9%. The accuracy for the diagnosis of muscular layer infiltration was 96.1% for Emax cutoff, 94.1% for Emean cutoff and 86.3% for Esd cutoff. Real-time shear wave elastography is helpful to determine the depth of infiltrating myometrium of endometrial cancer.

Assessing the Validity of Ultrasound Imaging of Wrist Muscle Moment Arms through an Agar Phantom Experiment and In Vivo Case Study

Joints in the human body utilize torque to create movement, where a force F acts at a distance, r, from a rotation point. In biomechanics, F is generated by muscles acting on the joint, and r is the distance between the joint’s center of rotation (COR) and the muscle line of action. This distance r is known as a geometric moment arm (GMA). Changes in GMAs may be correlated with loss of muscle and hand function in people due to aging, injury, or pathology. To comprehensively evaluate GMAs, efficient and inexpensive methods for measuring them in vivo are needed. Thus, this study explores whether ultrasound is a valid imaging modality for quantifying the GMA of muscles crossing the wrist. An agar-gel phantom was used to determine if distance measurements from 20 ultrasound images of the phantom were accurate compared to a set of four baseline distances. A subsequent in vivo case study explored whether ultrasound could measure GMAs within a human wrist. The capitate bone was defined as the wrist’s COR due to its central location in the joint, and the measured GMA was defined between this COR and the flexor digitorum superficialis (FDS) muscle. Both studies returned data that exhibited low measurement variability over consecutive days and provided reasonable proof that ultrasound can accurately measure wrist GMAs.&#x0D; Keywords: biomechanics, medical imaging, capitate, flexor digitorum superficialis

Revision surgery for carpal tunnel syndrome: a retrospective study comparing the combination of Canaletto® and Dynavisc® gel versus Dynavisc® gel alone

The aim of this study was to assess the value of using a Canaletto® implant in combination with a gel composed of carboxymethylcellulose and polyethylene oxide in the surgical treatment of recurrent carpal tunnel syndrome (CTS). The case series included 31 patients with 32 hands operated for the second time for recurrent (22 cases) or recalcitrant (9 cases) CTS by neurolysis. The average patient age was 62 years. Dynavisc® gel alone was applied around the median nerve in the first 16 cases (Group I). The Canaletto® implant combined with Dynavisc® gel was used in the last 16 cases (group II). With an average follow up of 8 months (for group I) and 11 months (for group II), the pre/postoperative variation in pain assessed with a visual analog scale was 1.38/10 (group I) and 2.04/10 (group II), the QuickDASH score was 20.1/100 (Group I) and 20.48/100 (Group II), grip strength was 8% (Group I) and 20% (Group II), sensory nerve conduction speed was 23.20 m/s (group I) and 15.51 m/s (group II) and distal motor latency was 1.55 m/s (group I) and 1.21 m/s (group II). Ten patients recovered from hypoesthesia in both groups, 6 patients in group I and 2 patients in group II regained good trophicity of their superficial thenar muscles. Two patients from group II had not improved clinically although their electromyography had become normal. One patient from group II suffered a postoperative infection that required removal of the Canaletto® implant. He subsequently improved slightly. Our study found that for recurrent or recalcitrant CTS, the combination of Dynavisc® anti-adhesion gel around the median nerve and a Canaletto implant® after neurolysis results in outcomes that are as good as Dynavisc® alone, with a significant improvement of the QuickDASH score without the Canaletto®. In conclusion, the use of Dynavisc® gel alone around the median nerve after neurolysis seems to be as effective as other techniques described in literature but less invasive or time-consuming, and not associated with donor site morbidity such as the flexor tendon sheath.

Does focus of attention alter craniocervical flexion test motor learning? A randomized controlled trial.

To evaluate the effects of three different foci of attention (internal, external and mixed) on motor learning using craniocervical flexion test in inexperienced participants. Ninety healthy young adults, with no experience in the task, practiced the craniocervical flexion test under three different focus of attention: a) Mixed Focus (internal plus external), b) Internal Focus, and c) External Focus. We assessed immediate, post-training, and retention (one week after the last training session) aspects of motor learning by quantifying (i) the activity of the superficial cervical flexors muscles, (ii) craniocervical range of motion, and (iii) the performance on the craniocervical flexion test. None of the groups showed any significant immediate, post-training, or retention effects on superficial neck flexors activity and craniocervical range of motion progression. At immediate assessment, mixed focus had greater craniocervical flexion performance than external (MD 0.9, 95%CI 0.2 to 1.5), and internal foci (MD 1.4, 95%CI 0.8 to 2.1). At post-training, mixed focus led to better craniocervical performance compared to external (MD 1.6, 95%CI 0.8 to 2.4) and internal foci (MD 2.7, 95%CI 1.9 to 3.5). External focus had better scores on the craniocervical flexion test performance than internal focus (MD 1.1, 95%CI 0.3 to 1.9). Results remained similar at retention, with mixed focus being superior to internal (MD 2.3, 95%CI 1.7 to 3) and external foci (MD 1.5, 95%CI 0.9 to 2.1) on craniocervical flexion test performance. Similarly, the performance on the craniocervical flexion test performance remained similar at retention between external and internal foci (MD 0.9, 95%CI 0.2 to 1.5). In inexperienced asymptomatic participants, different foci of attention were not able to change cervical muscle activity and craniocervical range of motion during the craniocervical flexion test. Mixed focus was better than external and internal focus on the craniocervical flexion test. These findings were retained after one week.