scholarly journals Does increased superficial neck flexor activity in the craniocervical flexion test reflect reduced deep flexor activity in people with neck pain?

2016 ◽  
Vol 25 ◽  
pp. 43-47 ◽  
Author(s):  
Gwendolen Jull ◽  
Deborah Falla
Keyword(s):  
2020 ◽  
Author(s):  
Gabriela F Carvalho ◽  
Samuel S Lodovichi ◽  
Carina F Pinheiro ◽  
Mariana T Benatto ◽  
Lidiane L Florencio ◽  
...  

Abstract Background: Migraine is related to musculoskeletal impairment of the neck and the chronicity of migraine is related to greater disability levels. However, it is not known if other forms of migraine, such as migraine with aura, is related to a different pattern of neck impairment.Objective: To assess the musculoskeletal and clinical aspects of the neck in patients with migraine with and without aura.Methods: Up to 125 consecutive patients diagnosed with migraine according to the ICHD-III were recruited from a tertiary headache clinic. Patients were classified by the presence of aura into two groups: migraine with aura (MA, n=37) and migraine without aura (MoA, n=88). The self-report of neck pain was assessed and patients completed the Neck Disability Index (NDI) questionnaire. Furthermore, patients performed the Flexion Rotation Test (FRT) and the Cranio-Cervical Flexion Test (CCFT). Results of all outcomes were contrasted between groups through Mann-Whitney and Qui-square tests.Results: There was no association between the presence of aura and self-report of neck pain (x²: 1.32, p=0.25). No differences were verified between groups regarding presence of neck disability (MA: 10.73, SD: 6.22; MoA: 9.63, SD:8.13, p=0.25) or disability severity (x²=6.17, p=0.10). Groups did not differ regarding the FRT (MA: 35.07°, SD: 7.90 and MoA: 34.60°, SD: 8.70, t=-0.22, p=0.83) and there was no association between positive FRT and presence of aura (x²=3.35, p=0.07). The CCFT did not demonstrate differences among the two groups either (x²=1.65, p=0.80).Conclusion: There is no association between migraine aura and presence or disability of neck pain, reduced superior cervical mobility or reduced neck performance. It is expected to find similar neck profile during the clinical assessment of patients with migraine with and without aura.


2005 ◽  
Vol 35 (9) ◽  
pp. 567-571 ◽  
Author(s):  
Thomas Tai Wing Chiu ◽  
Ellis Yuk Hung Law ◽  
Tony Hiu Fai Chiu

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019486 ◽  
Author(s):  
Francisco Xavier de Araujo ◽  
Giovanni Esteves Ferreira ◽  
Maurício Scholl Schell ◽  
Marcelo Peduzzi de Castro ◽  
Marcelo Faria Silva ◽  
...  

IntroductionNeck pain is the leading cause of years lived with disability worldwide and it accounts for high economic and societal burden. Altered activation of the neck muscles is a common musculoskeletal impairment presented by patients with neck pain. The craniocervical flexion test with pressure biofeedback unit has been widely used in clinical practice to assess function of deep neck flexor muscles. This systematic review will assess the measurement properties of the craniocervical flexion test for assessing deep cervical flexor muscles.Methods and analysisThis is a protocol for a systematic review that will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. MEDLINE (via PubMed), EMBASE, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus and Science Direct will be systematically searched from inception. Studies of any design that have investigated and reported at least one measurement property of the craniocervical flexion test for assessing the deep cervical flexor muscles will be included. All measurement properties will be considered as outcomes. Two reviewers will independently rate the risk of bias of individual studies using the updated COnsensus-based Standards for the selection of health Measurement Instruments risk of bias checklist. A structured narrative synthesis will be used for data analysis. Quantitative findings for each measurement property will be summarised. The overall rating for a measurement property will be classified as ‘positive’, ‘indeterminate’ or ‘negative’. The overall rating will be accompanied with a level of evidence.Ethics and disseminationEthical approval and patient consent are not required since this is a systematic review based on published studies. Findings will be submitted to a peer-reviewed journal for publication.PROSPERO registration numberCRD42017062175.


Cephalalgia ◽  
2019 ◽  
Vol 39 (12) ◽  
pp. 1500-1508 ◽  
Author(s):  
Marcela Mendes Bragatto ◽  
Débora Bevilaqua-Grossi ◽  
Mariana Tedeschi Benatto ◽  
Samuel Straceri Lodovichi ◽  
Carina Ferreira Pinheiro ◽  
...  

Objective To investigate the association between the presence of self-reported neck pain in patients with migraine and clinical features, upper cervical mobility, and neck muscle performance. Methods A total of 142 patients with migraine were recruited and stratified by the presence (n = 99) or absence of self-reported neck pain (n = 43). The clinical examination included the Migraine Disability Assessment, the 12-item Allodynia Symptom Checklist, a flexion rotation test, and the Craniocervical Flexion Test. Results Migraine-related disability was reported by more than 80% in both groups ( p = 0.82). However, there was a greater prevalence and severity of cutaneous allodynia observed in the group with neck pain ( p < 0.001). Reduced upper cervical mobility was verified in 67% of the patients with neck pain and in 41% of those without neck pain ( p = 0.005). In addition, 67% of the patients with neck pain and 40% without neck pain were not able to maintain the third stage of the Craniocervical Flexion Test without compensation ( p = 0.003). Conclusions The presence of self-reported neck pain in patients with migraine was associated with a poor clinical presentation regarding cutaneous allodynia, neck mobility, and muscle function. However, there were no differences in migraine-related disability.


Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 449
Author(s):  
Byoung-Kwon Lee ◽  
Dong-Kwon Seo

Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing gaze direction. We aimed to investigate how DNF and SCM activation varies according to gaze direction in the CCFT, and to prescribe the appropriate gaze direction for CNP. Twenty-eight CNP subjects had their maximum strength pressure level determined by CCFT for strength (20–~30 mmHg) and at each of the measured pressures, DNF and SCM thickness in each of four gaze directions (0°, 20°, 40°, and 60°) was measured by ultrasound imaging. The DNF to SCM ratio varied significantly according to gaze direction (p < 0.05), with gaze directions of 20° and 0° being significantly different from 40° (p < 0.05). Although there was no significant difference in DNF activation according to gaze direction, there was in SCM activation (p < 0.05), with SCM 60° significantly different from SCM 20° and SCM 40° (p < 0.05). In order to increase DNF activation efficiency during the CCFT, SCM activation should be controlled, and a gaze direction below 20° is the most efficient. This can inform DNF training of CNP patients in a clinical environment.


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