scholarly journals EMG Analysis of Trunk Muscle Recruitment Patterns of Anticipatory Postural Adjustments during Unilateral Arm Flexion in Chronic Neck Pain Patients

2018 ◽  
Author(s):  
F Ghaffarinejad ◽  
A Kordi Yoosefinejad ◽  
S Pirouzi ◽  
A R Shakibafar ◽  
Z Bagheri ◽  
...  
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Anticipatory Postural Adjustments ◽  
Trunk Muscle ◽  
Trunk Muscles ◽  
Repeated Measure ◽  
Control Group ◽  
Onset Latency ◽  
Postural Adjustments ◽  
Recruitment Patterns

Introduction: EMG recruitment pattern of trunk muscles can change to compensate pain. One of these pattern alterations occurs in anticipatory postural adjustments (APAs) or feedforward activity of trunk muscles prior to arm movements. No study has determined the EMG pattern alterations of trunk muscle recruitments during the arm movement in patients with chronic neck pain (CNP). This study was examined the effect of CNP on EMG activities of trunk muscles for APAs during rapid arm flexion. Material and Methods: Sixteen patients with CNP for at least 3 months and sixteen healthy individuals matched in gender, age and weight were selected in this semi-experimental study. Surface EMG was utilized to evaluate 8 trunk muscles bilaterally and right anterior fibers of deltoid muscle during a unilateral rapid arm flexion. Anticipatory muscle activity was calculated by EMG onset latency of the trunk muscle from 100 ms before deltoid activity to 100 ms after it. Also, the values of root mean square (RMS) in 4 epochs around the onset of deltoid EMG were measured and compared. A two-tailed t-test and repeated-measure ANOVA were used for statistical analyses.Results: The onset latency of muscles in left and right side, except left erector spine muscle, in patients showed a significantly higher delay compared to healthy controls (P<0.05). The analysis of RMS in the 4 epochs revealed that in the control group, the values of RMS for rectus abdominus and erector spine in both sides, left external oblique and left transverse abdominus/internal oblique increased significantly during Epochs 3 and 4 , but in CNP subjects, the RMS of these muscles did not change significantly in 4 epochs.Conclusion: The patients with CNP had alterations in their recruitment patterns of particular trunk muscles in response to arm movement.Therefore, these patients have impaired motor control of trunk muscles during internal perturbation. These results indicated that not only the alterations in recruitment of trunk muscles occur, but also the intensity of their contractions decreases. In conclusion, CNP may alter in order to control the reactive forces resulting from limb movement. 

Fascial treatment versus manual therapy (HVLA) in patients with chronic neck pain: A randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Katrin Brück ◽  
Kirsten Jacobi ◽  
Tobias Schmidt
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Repeated Measures ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Severity Of Illness ◽  
Chronic Neck Pain ◽  
Secondary Outcome ◽  
Control Group ◽  
Industrialized Nations

BACKGROUND: Chronic neck pain (CNP) is a common health problem in western industrialized nations. In recent years, the fascial tissue has attracted the attention of therapists, and a treatment of the fasciae promises to be a meaningful approach in the therapy of patients with CNP. OBJECTIVE: The aim of this study was to investigate the effectiveness of a fascial treatment (FT) compared to manual therapy (MT) and to no intervention (control group, CG) in patients with CNP. METHODS: Sixty participants with CNP were randomized into three groups. Primary outcome parameters were pain intensity as measured by the visual analogue scale (VAS), and severity of illness as measured by the Neck Pain and Disability Scale (NPAD). Secondary outcome parameter was the range of motion (ROM) of the cervical spine. RESULTS: Repeated measures t-tests demonstrated significant decreases with medium to large effect sizes for the FT (VAS: dR⁢M= 1.14; NPAD: dR⁢M= 0.51) and for the MT (VAS: dR⁢M= 1.15; NPAD: dR⁢M= 0.72). CONCLUSION: Our results confirmed the effectiveness of MT on pain and severity of illness in the treatment of patients suffering from CNP. Furthermore, the results demonstrated the effectiveness and clinical relevance of FT for this population.

scholarly journals The Effects of Abdominal Hypopressive Training on Postural Control and Deep Trunk Muscle Activation: A Randomized Controlled Trial

2021 ◽  
Vol 18 (5) ◽  
pp. 2741
Author(s):  
María del Mar Moreno-Muñoz ◽  
Fidel Hita-Contreras ◽  
María Dolores Estudillo-Martínez ◽  
Agustín Aibar-Almazán ◽  
Yolanda Castellote-Caballero ◽  
...  
Keyword(s):  
Postural Control ◽  
Muscle Activation ◽  
Center Of Pressure ◽  
Controlled Trial ◽  
Trunk Muscle ◽  
Posture Control ◽  
Trunk Muscles ◽  
Control Group ◽  
Female Population ◽  
Imaging Results

Background: Abdominal Hypopressive Training (AHT) provides postural improvement, and enhances deep trunk muscle activation. However, until recently, there was a lack of scientific literature supporting these statements. The major purpose of this study was to investigate the effect of AHT on posture control and deep trunk muscle function. Methods: 125 female participants aged 18–60 were randomly allocated to the Experimental Group (EG), consisting of two sessions of 30 min per week for 8 weeks of AHT, or the Control Group (CG), who did not receive any treatment. Postural control was measured with a stabilometric platform to assess the static balance and the activation of deep trunk muscles (specifically the Transverse Abdominal muscle (TrA)), which was measured by real-time ultrasound imaging. Results: The groups were homogeneous at baseline. Statistical differences were identified between both groups after intervention in the Surface of the Center of Pressure (CoP) Open-Eyes (S-OE) (p = 0.001, Cohen’s d = 0.60) and the Velocity of CoP under both conditions; Open-Eyes (V-OE) (p = 0.001, Cohen´s d = 0.63) and Close-Eyes (V-CE) (p = 0.016, Cohen´s d = 0.016), with the EG achieving substantial improvements. Likewise, there were statistically significant differences between measurements over time for the EG on S-OE (p < 0.001, Cohen´s d = 0.99); V-OE (p = 0.038, Cohen´s d = 0.27); V-CE (p = 0.006, Cohen´s d = 0.39), anteroposterior movements of CoP with Open-Eyes (RMSY-OE) (p = 0.038, Cohen´s d = 0.60) and activity of TrA under contraction conditions (p < 0.001, Cohen´s d = 0.53). Conclusions: The application of eight weeks of AHT leads to positive outcomes in posture control, as well as an improvement in the deep trunk muscle contraction in the female population.

“Short- and mid-term effects of adding upper cervical manual therapy to a conventional physical therapy program in patients with chronic mechanical neck pain. Randomized controlled clinical trial.”

2020 ◽  
pp. 026921552096505
Author(s):  
Vanessa González-Rueda ◽  
Carlos López-de-Celis ◽  
Elena Bueno-Gracia ◽  
Jacobo Rodríguez-Sanz ◽  
Albert Pérez-Bellmunt ◽  
...  
Keyword(s):  
Neck Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Chronic Neck Pain ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Primary Care Center ◽  
Randomized Controlled ◽  
Upper Cervical

Objective: To evaluate the effect of adding an Upper Cervical Translatoric Mobilization (UCTM) or an Inhibitory Suboccipital Technique (IST) to a physiotherapy treatment in the symptomatology and function of mechanical chronic neck pain patients. Design: Randomized controlled trial. Setting: Primary Care Center in Cornellà, Spain. Subjects: 78 patients (64 women), with mean age (SD) of 59.96 (13.30) years with mechanical chronic neck pain were divided in three groups: control, IST and UCTM groups. Interventions: All groups received 15 physiotherapy sessions for three weeks. The UCTM and IST groups added 5 minutes of the assigned technique during six sessions. Main measures: Neck disability index (NDI) and numeric pain rating scale (NPRS) for neck pain were measured baseline, three-weeks and 15-weeks follow-up. Results: NDI (SD) at baseline, three-weeks and 15-weeks were 11.62 (7.08), 9.65 (6.25), 7.58 (5.64) for the control group, 14.38 (6.92), 8.50 (6.11), 7.12 (4.98) for the IST group and 13.19(7.23), 5.35(6.10), 4.35(2.76) for the UCTM group. NPRS (SD) at baseline, three-weeks and 15-weeks were 58.69 (19.46), 45.19 (23.43), 44.58 (24.08) for the control group; 64.08 (19.26), 42.19 (19.69), 34 (21.14) for the IST group; and 67.65 (20.65), 36.23 (20.10), 39.85 (25.44) for the UCTM group. Conclusions: Compared with no treatment, both forms of mobilization were associated with reduced disability at three weeks, and UCTM remained better than control at 15 weeks; there were no significant differences between the two mobilization groups. Trial registration: This study was registered in Clinicaltrials.gov (NCT02832232).

scholarly journals Effect of Neck Exercise on Sitting Posture in Patients With Chronic Neck Pain

2007 ◽  
Vol 87 (4) ◽  
pp. 408-417 ◽  
Author(s):  
Deborah Falla ◽  
Gwendolen Jull ◽  
Trevor Russell ◽  
Bill Vicenzino ◽  
Paul Hodges
Keyword(s):  
Neck Pain ◽  
Exercise Intervention ◽  
Exercise Program ◽  
Chronic Neck Pain ◽  
Control Group ◽  
Upright Posture ◽  
Sitting Posture ◽  
Control Subjects ◽  
Significant Difference ◽  
Flexor Muscles

Background and PurposePoor sitting posture has been implicated in the development and perpetuation of neck pain symptoms. This study had 2 purposes: (1) to compare change in cervical and thoracic posture during a distracting task between subjects with chronic neck pain and control subjects and (2) to compare the effects of 2 different neck exercise regimens on the ability of people with neck pain to maintain an upright cervical and thoracic posture during this task.SubjectsFifty-eight subjects with chronic, nonsevere neck pain and 10 control subjects participated in the study.MethodChange in cervical and thoracic posture from an upright posture was measured every 2 minutes during a 10-minute computer task. Following baseline measurements, the subjects with neck pain were randomized into one of two 6-week exercise intervention groups: a group that received training of the craniocervical flexor muscles or a group that received endurance-strength training of the cervical flexor muscles. The primary outcomes following intervention were changes in the angle of cervical and thoracic posture during the computer task.ResultsSubjects with neck pain demonstrated a change in cervical angle across the duration of the task (mean=4.4°; 95% confidence interval [CI]=3.3–5.4), consistent with a more forward head posture. No significant difference was observed for the change in cervical angle across the duration of the task for the control group subjects (mean=2.2°; 95% CI=1.0–3.4). Following intervention, the craniocervical flexor training group demonstrated a significant reduction in the change of cervical angle across the duration of the computer task.Discussion and ConclusionThis study showed that people with chronic neck pain demonstrate a reduced ability to maintain an upright posture when distracted. Following intervention with an exercise program targeted at training the craniocervical flexor muscles, subjects with neck pain demonstrated an improved ability to maintain a neutral cervical posture during prolonged sitting.

scholarly journals Isokinetic Muscle Strength and Postural Sway of Recreationally Active Older Adults vs. Master Road Runners

2021 ◽  
Vol 12 ◽  
Author(s):  
Henrique V. Taveira ◽  
Claudio A. B. de Lira ◽  
Marilia S. Andrade ◽  
Ricardo B. Viana ◽  
Hirofumi Tanaka ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Postural Control ◽  
Elderly People ◽  
Center Of Pressure ◽  
Average Power ◽  
Trunk Muscle ◽  
Trunk Muscles ◽  
Control Group ◽  
Physically Active ◽  
Trunk Muscle Strength

Trunk muscle strength and control is an important prerequisite for everyday activities among elderly people decreasing the predisposition to falls. High levels of physical exercise performed by older athletes could offer benefits to core/trunk muscle strength and postural control compared with recreational physical activities and among elderly people with lower levels of physical activity. The present study aimed to compare trunk muscle strength and postural control of older running athletes vs. older physically active adults. Participants were master road runners (RUN, n = 15, six women, 64.3 ± 3.6 years) and physically active elderly (control group, CON, n = 15, six women, 65.4 ± 5.0 years) people that were submitted to the evaluations: esthesiometer, posturography (force plate), and isokinetic test (Biodex dynamometer) of trunk muscle extension and flexion. RUN presented higher values for relative peak torque of trunk extensor muscles at 60°/s (p = 0.046) and 180°/s (p = 0.007) and relative average power during trunk extension at 60°/s (p = 0.008) and 180°/s (p = 0.004) compared to CON. CON had a higher medial-lateral oscillation speed of the center of pressure in the stable condition with eyes closed (p = 0.004) compared to RUN. RUN presented higher isokinetic torque of extensor trunk muscles and better postural control than CON. This supposedly could help with postural control and balance and contribute to the prevention of falls among the elderly. The practice of running systematically by master athletes may partially explained our findings.

scholarly journals Effect of Combined Manual Therapy and Therapeutic Exercise Protocols on the Postural Stability of Patients with Non-Specific Chronic Neck Pain. A Secondary Analysis of Randomized Controlled Trial

2021 ◽  
Vol 11 (1) ◽  
pp. 84
Author(s):  
Carlos Bernal-Utrera ◽  
Ernesto Anarte-Lazo ◽  
Juan Jose Gonzalez-Gerez ◽  
Manuel Saavedra-Hernandez ◽  
Elena De-La-Barrera-Aranda ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Manual Therapy ◽  
Postural Stability ◽  
Chronic Neck Pain ◽  
Control Group ◽  
Placebo Control ◽  
Therapeutic Exercise ◽  
The Relationship

Postural stability is a little-studied factor in non-specific chronic neck pain; the causes that can alter it are unknown. The relationship with chronic pain could be a determining factor for its deficit. The aim of this study was to investigate the relationship between sustained pain and a postural stability deficit. A randomized and blinded clinical trial (double-blind; placebo control; 12 weeks follow-up) was conducted with a total of 69 subjects divided into three groups, two experimental (manual therapy and specific exercise) and a control treatment, and carried out over a treatment period of three weeks with a follow-up after 12 weeks. Their postural stability was assessed through the overall balance index (OBI). The postural stability of subjects with non-specific chronic neck pain improved in the experimental treatments. There were no statistically significant differences between the experimental groups. This trial found that manual therapy and therapeutic exercise significantly improved OBI compared to the control group. Trial registration: Brazilian Clinical Trial Registry, RBR-2vj7sw.

scholarly journals Clinical and radiological cervical spine evaluation in retired professional rugby players

2015 ◽  
Vol 23 (5) ◽  
pp. 551-557 ◽  
Author(s):  
David Brauge ◽  
Cyrille Delpierre ◽  
Philippe Adam ◽  
Jean Christophe Sol ◽  
Pierre Bernard ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Japanese Orthopaedic Association ◽  
Chronic Neck Pain ◽  
Control Group ◽  
Foraminal Stenosis ◽  
Mri Studies ◽  
Significant Difference ◽  
Degenerative Cervical Spine ◽  
Rugby Players

OBJECT Acute cervical spine injuries have been extensively studied in high-level contact sports. However, the relation between the appearance of degenerative cervical spine disease and the exposure to repeated trauma in such sports as rugby is still unclear. Using clinical and MRI evaluation, we aimed to determine if former professional rugby players had more serious degenerative cervical spine symptoms than the general population. METHODS Two groups, one composed of 101 former rugby players (all men, mean age 40.3 years, range 35–47 years, SD 2.3 years) and the other of 85 male volunteers serving as a control group (mean age 41.6 years, range 35–49 years, SD 4.5 years) were studied. The former rugby players were evaluated on average 5.8 years after retirement (range 1–16 years, SD 3.5 years). The groups were matched in terms of sex, age, job, current sports training, and smoking habits. Each participant received a complete neurological evaluation. Clinical symptoms were evaluated using the Japanese Orthopaedic Association (JOA) questionnaire, and chronic neck pain was specifically evaluated using a visual analog scale (VAS) and the Neck Disability Index (NDI). Overall, 25 MRI studies were performed in each group. MRI studies, including dynamic sequences, focused on degenerative lesions (Matsumoto score and canal diameter) and on muscular and medullary morphological analysis. RESULTS Significantly more former rugby players than controls complained of chronic neck pain (51 [50.50%] of 101 vs 27 [31.76%] of 85, p = 0.01). Rugby players also had significant reductions of neck mobility. Nevertheless, in those complaining of pain, there was no statistically significant difference between groups with respect to VAS and NDI scores (p = 0.57). On MRI, former rugby players had a narrower vertebral canal (on average 0.88 ± 0.167 cm vs 0.99 ± 0.130 cm, p = 0.007) and more foraminal stenosis (p = 0.01). No significant difference in the Matsumoto score was found between the 2 groups with respect to other degenerative lesions. Former rugby players had more often undergone surgery for a degenerative condition than had members of the control group (10 cases vs 0 in the control group, p = 0.0021). CONCLUSIONS A few years after retirement, former professional rugby players seem to have more frequent cervical spine pain and MRI degenerative lesions, such as foraminal stenosis and narrowing of the spinal canal, compared with controls who had not been professional rugby players. A longer evaluation is necessary to determine if these findings persist over time.

scholarly journals A Novel Viewpoint on the Anticipatory Postural Adjustments During Gait Initiation

2021 ◽  
Vol 15 ◽  
Author(s):  
Veronica Farinelli ◽  
Francesco Bolzoni ◽  
Silvia Maria Marchese ◽  
Roberto Esposti ◽  
Paolo Cavallari
Keyword(s):  
Center Of Pressure ◽  
Force Plate ◽  
Anticipatory Postural Adjustments ◽  
The Body ◽  
Erector Spinae ◽  
Trunk Muscles ◽  
Gait Initiation ◽  
Concentrated Force ◽  
Postural Adjustments ◽  
Leg Muscles

Anticipatory postural adjustments (APAs) are the coordinated muscular activities that precede the voluntary movements to counteract the associated postural perturbations. Many studies about gait initiation call APAs those activities that precede the heel-off of the leading foot, thus taking heel-off as the onset of voluntary movement. In particular, leg muscles drive the center of pressure (CoP) both laterally, to shift the body weight over the trailing foot and backward, to create a disequilibrium torque pushing forward the center of mass (CoM). However, since subjects want to propel their body rather than lift their foot, the onset of gait should be the CoM displacement, which starts with the backward CoP shift. If so, the leg muscles driving such a shift are the prime movers. Moreover, since the disequilibrium torque is mechanically equivalent to a forward force acting at the pelvis level, APAs should be required to link the body segments to the pelvis: distributing such concentrated force throughout the body would make all segments move homogeneously. In the aim of testing this hypothesis, we analyzed gait initiation in 15 right-footed healthy subjects, searching for activities in trunk muscles that precede the onset of the backward CoP shift. Subjects stood on a force plate for about 10 s and then started walking at their natural speed. A minimum of 10 trials were collected. A force plate measured the CoP position while wireless probes recorded the electromyographic activities. Recordings ascertained that at gait onset APAs develop in trunk muscles. On the right side, Rectus Abdominis and Obliquus Abdominis were activated in 11 and 13 subjects, respectively, starting on average 33 and 54 ms before the CoP shift; Erector Spinae (ES) at L2 and T3 levels was instead inhibited (9 and 7 subjects, 104 and 120 ms). On the contralateral side, the same muscles showed excitatory APAs (abdominals in 11 and 12 subjects, 27 and 82 ms; ES in 10 and 7 subjects, 75 and 32 ms). The results of this study provide a novel framework for distinguishing postural from voluntary actions, which may be relevant for the diagnosis and rehabilitation of gait disorders.

scholarly journals Efficacy of Dynamic Neuromuscular Stabilization Breathing Exercises on Chest Mobility, Trunk Muscles, and Thoracic Kyphosis: A Randomized Controlled 6-Week Trial

2020 ◽  
Vol 18 (3) ◽  
pp. 329-336
Author(s):  
Nasser Mohammad Rahimi ◽  
◽  
Reza Mahdavinejad ◽  
Seyyed Reza Attarzadeh Hosseini ◽  
Hossein Negahban ◽  
...  
Keyword(s):  
Thoracic Kyphosis ◽  
Exercise Group ◽  
Trunk Muscle ◽  
Trunk Muscles ◽  
Muscle Endurance ◽  
Control Group ◽  
Breathing Exercise ◽  
Breathing Exercises ◽  
Randomized Controlled ◽  
Post Test

Objectives: Dynamic Neuromuscular Stabilization (DNS) approach evaluates and activates the spinal stabilizers to optimize the performance of posture and respiratory system. This study investigated the effects of DNS breathing exercises on upper and lower chest wall mobility (UCM and LCM), trunk extensor endurance, and thoracic kyphosis in a group of sedentary students with poor posture. Methods: In this randomized, controlled 6-week trial, 52 participants were randomly divided into two groups: a DNS breathing exercise group (n=26) and a control group (n=26). First, a pre-test of the UCM, LCM, trunk muscle endurance and thoracic kyphosis was done on each participant in random order. DNS breathing exercise protocol (six times a week for six weeks) was implemented and after its completion, all post-test parameters were taken. Descriptive statistical and the paired-sample t test were used to analyze the obtained data. Results: Significant improvements were observed in the post-test compared with pre-test in DNS breathing exercise group in UCM (6.2±1.6 vs 4.4±0.9 cm, P<0.001), LCM (7.7±1.7 vs 5.5±1.0 cm, P<0.001), trunk muscle endurance (110.1±33.5 vs 88.7±34.1 s, P<0.001), and thoracic kyphosis (146.9±5.5 vs 142.7±4.0 degree, P<0.001). In contrast, the change in these parameters in the control group was not statistically significant. Discussion: DNS breathing exercise with a focus on the integrated spinal stabilizing system and breathing techniques is an effective protocol to significantly improve UCM and LCM, trunk muscle endurance, and thoracic kyphosis. It is suggested that DNS breathing exercises be introduced to improve chest mobility and posture and provide physiological stabilization for the overall health and performance of student

Evidence for constancy in the modularity of trunk muscle activity preceding reaching: Implications for the role of preparatory postural activity.

2021 ◽  
Author(s):  
Alexander Stamenkovic ◽  
Lena H Ting ◽  
Paul J Stapley
Keyword(s):  
Muscle Activity ◽  
Center Of Mass ◽  
Trunk Muscle ◽  
Trunk Muscles ◽  
Equilibrium Constraints ◽  
Postural Adjustments ◽  
Postural Activity ◽  
Postural Muscle ◽  
Mass Displacement ◽  
Base Of Support

Postural muscle activity precedes voluntary movements of the upper limbs. The traditional view of this activity is that it anticipates perturbations to balance caused by the movement of a limb. However, findings from reach-based paradigms have shown that postural adjustments can initiate center of mass displacement for mobility, rather than minimize its displacement for stability. Within this context, altering reaching distance beyond the base of support would place increasing constraints on equilibrium during stance. If the underlying composition of anticipatory postural activity is linked to stability, coordination between muscles (i.e., motor modules) may evolve differently as equilibrium constraints increase. We analyzed the composition of motor modules in functional trunk muscles as participants performed multi-directional reaching movements to targets within and beyond arm's length. Bilateral trunk and reaching arm muscle activity were recorded. Despite different trunk requirements necessary for successful movement, and the changing biomechanical (i.e. postural) constraints that accompany alterations in reach distance, Non-negative Matrix Factorization identified functional motor modules derived from preparatory trunk muscle activity that shared common features. Relative similarity in modular weightings (i.e., composition) and spatial activation profiles that reflect movement goals across tasks necessitating differing levels of trunk involvement provides evidence that preparatory postural adjustments are linked to the same task priorities (i.e. movement generation rather than stability).

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