Relationships among head posture, pain intensity, disability and deep cervical flexor muscle performance in subjects with postural neck pain

Purpose: This randomized trial study compared the efficacy of pressure-biofeedback guided deep cervical flexor training as an adjunct with conventional exercise on pain and muscle performance in visually displayed terminal operators. Methods: A total of 50 (22 men and 28 women) patients with neck pain participated in the study. Patients were randomly placed into two groups: a biofeedback group (n = 25) and a control group (n = 25). The biofeedback group received pressure-biofeedback guided deep cervical flexor training program for 5 days a week for 6 weeks, whereas the control group received an exercise program only. Results: On intergroup comparisons, the deep cervical flexor performance in biofeedback group, at the end of 6th week was significantly higher than those of control group (p < 0.01). Pain intensity was also significantly reduced in biofeedback group when compared to control group at the end of trial (p < 0.004). Conclusion: The addition of pressure-biofeedback to a 6-week conventional program appeared to increase deep cervical flexor muscle performance, compared to the exercise program alone for people with reduced muscle performance.

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Effect of chronic neck pain on balance, cervical proprioception, head posture, and deep neck flexor muscle endurance in the elderly

The Turkish Journal of Geriatrics ◽

10.31086/tjgeri.2019.89 ◽

2019 ◽

Vol 22 (2) ◽

pp. 163-171

Author(s):

Serbay ŞEKERÖZ ◽

Emine ASLAN TELCİ ◽

Nuray AKKAYA

Keyword(s):

Neck Pain ◽

Chronic Neck Pain ◽

The Elderly ◽

Muscle Endurance ◽

Flexor Muscle ◽

Head Posture

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Effect of Deep Cervical Flexor Muscle Training Using Pressure Biofeedback on Pain and Forward Head Posture in School Teachers with Neck Pain: An Observational Study

BioMed Research International ◽

10.1155/2021/5588580 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Ahmad H. Alghadir ◽

Zaheen A. Iqbal

Keyword(s):

Observational Study ◽

Neck Pain ◽

Online Teaching ◽

Medical Center ◽

Muscle Training ◽

Flexor Muscle ◽

School Teachers ◽

Forward Head Posture ◽

Head Posture ◽

Pressure Biofeedback

Background. Teaching is one of the professions where incidence and prevalence of neck pain is high. Prolonged use of computers, which has further increased due to online teaching amid pandemic, is known to cause neck pain and alter posture, while people with forward head posture (FHP) are prone to develop neck pain and related disability. Research has shown that impairment of deep cervical flexor (DCF) muscles leads to insufficiency in coordination, activation, overload, and poor support on cervical structures that further lead to development of neck pain and altered neck posture. The objective of this study was to see the effect of DCF muscle training using pressure biofeedback on pain and FHP in school teachers with neck pain. Methods. This observational study was conducted at medical center in school premises. Fifty-five school teachers aged between 25 and 40 years with experience of more than 5 years were invited to participate in this study. Subjects were divided in two groups. Both the groups received conventional exercises while in experimental group DCF muscle training using pressure biofeedback was given additionally. Pain and FHP were assessed using NPRS and cranio-vertebral angle using digital photograph technique, respectively, at baseline and end of four weeks of treatment. Results. Although pain and FHP improved in both the groups, mean improvement in both the measures was more in the group that also received DCF training using pressure biofeedback. Conclusions. This study shows that although pain and FHP improved following conventional exercises in school teachers with neck pain, mean improvement was more significant among those who received additional DCF muscle training using pressure biofeedback.

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A New Method of Isometric Dynamometry for the Craniocervical Flexor Muscles

Physical Therapy ◽

10.1093/ptj/85.6.556 ◽

2005 ◽

Vol 85 (6) ◽

pp. 556-564 ◽

Cited By ~ 32

Author(s):

Shaun P O'Leary ◽

Bill T Vicenzino ◽

Gwendolen A Jull

Keyword(s):

Neck Pain ◽

Intraclass Correlation ◽

New Method ◽

Muscle Performance ◽

Neutral Position ◽

Flexor Muscle ◽

Maximal Voluntary Isometric Contraction ◽

Good Reliability ◽

Flexor Muscles ◽

History Of

Abstract Background and Purpose. A new method of dynamometry has been developed to measure the performance of the craniocervical (CC) flexor muscles by recording the torque that these muscles exert on the cranium around the CC junction. This report describes the method, the specifications of the instrument, and the preliminary reliability data. Subjects and Methods. For the reliability study, 20 subjects (12 subjects with a history of neck pain, 8 subjects without a history of neck pain) performed, on 2 occasions, maximal voluntary isometric contraction (MVIC) tests of CC flexion in 3 positions within the range of CC flexion and submaximal sustained tests (20% and 50% of MVIC) in the middle range of CC flexion (craniocervical neutral position). Reliability coefficients were calculated to establish the test-retest reliability of the measurements. Results. The method demonstrated good reliability over 2 sessions in the measurement of MVIC (intraclass correlation coefficient [ICC]=.79–.93, SEM=0.6–1.4 N·m) and in the measurement of steadiness (standard deviation of torque amplitude) of a sustained contraction at 20% of MVIC (ICC=.74–.80, SEM=0.01 N·m), but not at 50% of MVIC (ICC=.07–.76, SEM=0.04–0.13 N·m). Discussion and Conclusion. The new dynamometry method appears to have potential clinical application in the measurement of craniocervical flexor muscle performance.

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Impact of Cervical Spine Rehabilitation on Temporomandibular Joint Functioning in Patients with Idiopathic Neck Pain

BioMed Research International ◽

10.1155/2021/6886373 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Łukasz Oleksy ◽

Renata Kielnar ◽

Anna Mika ◽

Agnieszka Jankowicz-Szymańska ◽

Dorota Bylina ◽

...

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Pain Intensity ◽

Range Of Motion ◽

Temporomandibular Joint ◽

Clinical Condition ◽

Rehabilitation Programme ◽

Cervical Region ◽

Head Posture ◽

Tmj Pain

Objective. The aim of this study was to assess the effectiveness of a 3-week rehabilitation programme focusing only on the cervical region, pain intensity, range of motion in the cervical spine, head posture, and temporomandibular joint (TMJ) functioning in subjects with idiopathic neck pain who did not report TMJ pain. Design. A parallel group trial with follow-up. Methods. The study included 60 participants divided into 2 groups: experimental: n = 25 , 27-57 years old, experiencing idiopathic neck pain and who underwent a 3-week rehabilitation programme, and the control, n = 35 , 27-47 years, who were cervical pain-free. At baseline and after 3 weeks of treatment in the experimental group and with a 3-week time interval in the control group, pain intensity, head posture in the sagittal plane, range of motion in the cervical spine, and TMJ functioning were evaluated. Results. After 3 weeks of rehabilitation, there was a significant decrease in pain intensity, improved range of motion of the cervical spine and head posture, and improved clinical condition of TMJ in participants with idiopathic neck pain who did not report TMJ pain. Conclusion. The study suggested that idiopathic neck pain is associated with limited range of motion in the cervical spine, incorrect head posture, and TMJ dysfunction. Our data suggests that therapy focusing only on the cervical region may improve the clinical condition of the TMJ in subjects with idiopathic neck pain who do not report TMJ pain. These observations could be helpful in physiotherapeutic treatment of neck and craniofacial area dysfunctions. This trial is registered with ISRCTN Registry ISRCTN14511735.

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Cervical Headache: An Investigation of Natural Head Posture and Upper Cervical Flexor Muscle Performance

Cephalalgia ◽

10.1046/j.1468-2982.1993.1304272.x ◽

1993 ◽

Vol 13 (4) ◽

pp. 272-284 ◽

Cited By ~ 271

Author(s):

Dean H Watson ◽

Patricia H Trott

Keyword(s):

Significant Relationship ◽

Isometric Strength ◽

Muscle Performance ◽

Endurance Capacity ◽

Flexor Muscle ◽

Forward Head Posture ◽

Head Posture ◽

Flexor Muscles ◽

Upper Cervical ◽

Cervical Posture

In this study, 60 female subjects, aged between 25 and 40 years, were divided into two equal groups on the basis of absence or presence of headache. A passive accessory intervertebral mobility (PAIVM) examination was performed to confirm an upper cervical articular cause of the subjects' headache and a questionnaire was used to establish a profile of the headache population. Measurements of cranio-cervical posture and isometric strength and endurance of the upper cervical flexor muscles were compared between the two groups of subjects. The headache group was found to be significantly different from the non-headache group in respect to forward head posture (FHP) ( t = -5.98, p < 0.00005), less isometric strength ( t = 3.43, p < 0.001) and less endurance ( t = 8.71, p < 0.0005) of the upper cervical flexors. A statistically significant relationship was also established between natural head posture and isometric endurance of the upper cervical flexor musculature which demonstrated that FHP corresponded with a low endurance capacity (c2 = 13.2; p < 0.01). The outcome of this study highlights the need to screen for cervical etiology in patients who are suspected of suffering from common migraine.

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Effectiveness of Kinaesthetic Exercise program on Position Sense, Pain, and Disability in Chronic Neck Pain Patients with Cervical Spondylosis – A Randomized Comparative Trial

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-1290-9556 ◽

2020 ◽

Author(s):

Ravi Shankar Yerragonda Reddy ◽

Arun G Maiya ◽

Sharath Kumar Rao ◽

Khalid A Alahmari ◽

Jaya Shanker Tedla ◽

...

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Cervical Spondylosis ◽

Chronic Neck Pain ◽

Position Sense ◽

Study Group ◽

Position Errors ◽

Flexion Extension ◽

Comparative Group ◽

Neck Disability

Abstract Background Chronic neck pain (CNP) is a significant health problem with only a few evidence-based treatment options. There is growing evidence for the effectiveness of kinaesthetic rehabilitation in musculoskeletal disorders. This study aims to assess kinaesthetic exercise programs' efficacy on cervical position sense, pain, and disability in subjects with cervical spondylosis (CS). Methods CNP subjects (>3 months) with a diagnosis of CS were randomly assigned to either a study group (n=125) who received kinesthetic exercises or to a comparative group (n=125) who received isometric neck exercises and deep cervical flexor (DCF) strengthening exercises. Both group subjects participated in the individualized training program for 24 sessions in 6 weeks. The outcome measures were cervical joint position errors (JPE’s) in flexion, extension, rotation left and right, pain intensity, and neck disability. Results All outcomes were improved significantly from baseline to post 24 sessions of intervention. When compared between groups, there was a significant reduction in JPE’s in flexion (mean difference [MD]= 071, CI=0.22–1.20, p=0.001), extension (MD=1.26, CI=0.70–1.81, p< 0.001) and right rotation (MD=1.08, CI=0.58–1.58, p<0.001), pain intensity (MD=1.58, CI=1.09–2.08, p<0.001), and neck disability (MD=10.27, CI=7.42–13.12, p<0.001) after 24 sessions of intervention favoring the study group. Conclusion Study group subjects who received kinesthetic rehabilitation showed more significant improvements in terms of improved proprioception, decreased pain intensity and disability following 24 sessions of interventions compared with the comparative group.

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