| 1. |
- Blomgren, Johannes, et al.
(författare)
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Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - London : BMC. - 1471-2474. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background:Neck pain is a major health issue with high rates of recurrence. It presents with a variety ofaltered sensorimotor functions. Exercise is a cornerstone of rehabilitation and many training methods areused. Exercise is evaluated in most randomized controlled trials on its pain relieving effects. No review hasassessed the effect of exercise on the altered physiological functions or determined if there are differentialeffects of particular training methods. This review investigated the effects of deep cervical flexor (DCF)training, a training method commonly used for patients with neck pain, and compared it to other trainingmethodsornotrainingonoutcomesofcervicalneuromuscular function, muscle size, kinematics and kinetics.Methods:Web of Science, Scopus, CINAHL, PubMed were searched from inception until January 2018. Twelverandomized controlled trials were included that compared DCF training as sole intervention to other trainingor no interventions in persons with neck pain. The Cochrane Risk of Bias tool was used to assess the methodquality. All outcome measures were analysed descriptively and meta-analyses were performed for measuresevaluated in three or more studies.Results:DCF training was compared to cervical endurance, strength, proprioception and mobility training,muscle stretching, and no intervention control groups. Physiological outcome measures includedneuromuscular co-ordination (craniocervical flexion test), functional tasks, muscle fatigability, muscle size,kinematics (joint position sense, posture and range of motion) and kinetics (strength, endurance andcontraction accuracy). Strong evidence was found for effectiveness of DCF training on neuromuscularcoordination, but it had no or small effects on strength and endurance at higher loads. DCF trainingimproved head and cervical posture, while evidence was limited or contradictory for other measures.Conclusions:DCF training can successfully address impaired neuromuscular coordination, but not cervicalflexor strength and endurance at higher contraction intensities. A multimodal training regime is proposedwhen the aim is to specifically address various impaired physiological functions associated with neck pain
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| 2. |
- Chen, Kenneth, et al.
(författare)
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Recommendations for Core Outcome Domain Set for Whiplash Associated Disorders (CATWAD)
- 2019
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Ingår i: Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 0749-8047 .- 1536-5409. ; 35:9, s. 727-736
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Inconsistent reporting of outcomes in clinical trials of treatments for Whiplash Associated Disorders (WAD) hinders effective data pooling and conclusions that can be drawn about the effectiveness of tested treatments. The aim of this study was to provide recommendations for core outcome domains that should be included in clinical trials of WAD. Methods: A three-step process was used. 1) A list of potential core outcome domains were identified from the published literature; 2) Researchers, health care providers, patients and insurance personnel participated and rated the importance of each domain via a three round Delphi survey. A priori criteria for consensus were established; 3) Experts comprising researchers, health care providers and a consumer representative participated in a multidisciplinary consensus meeting that made final decisions on the recommended core outcome domains. Results: The literature search identified 63 potential core domains. 223 participants were invited to partake in the Delphi surveys with 41.7% completing Round 1, 45.3% Round 2 and 51.4% Round 3. Eleven core domains met the criteria for inclusion across the entire sample. After the expert consensus meeting, six core domains were recommended: Physical Functioning, Perceived Recovery, Work and Social Functioning, Psychological Functioning, Quality of Life and Pain. Discussion: A 3-step process was used to recommend core outcome domains for clinical trials in WAD. Six core domains were recommended: Physical Functioning, Perceived Recovery, Work and Social Functioning, Psychological Functioning, Quality of Life and Pain. The next step is to determine the outcome measurement instruments for each of these domains.
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| 3. |
- Grip, Helena, et al.
(författare)
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Head eye co-ordination using simultaneous measurement of eye in head and head in space movements : potential for use in subjects with a whiplash injury.
- 2009
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Ingår i: Journal of clinical monitoring and computing. - : Springer. - 1387-1307 .- 1573-2614. ; 23:1, s. 31-40
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Describe reproducibility of a measurement method to investigate deficits in eye-head co-ordination. Methods. Combined recordings of head and eye rotation using wireless motion sensors and electro-oculography (EOG) were used as an initial step towards a method to quantify eye-head co-ordination deficits. Head rotation to the side during gaze fixation and sequential head and eye movements were studied on 20 asymptomatic control subjects and six subjects with chronic whiplash disorders. All included whiplash subjects reported eye disturbances according to a vision symptom questionnaire. Results. The trial-to-trial reproducibility was moderate to high for 24 of 28 variables (Intraclass Correlation Coefficient 0.44 to 0.87). Velocity gain (ratio of eye and head velocities) was on average close to unity in both groups. Head stability was high in control subjects, while three of six whiplash subjects demonstrated head instability during eye movement. Whiplash subjects also demonstrated a decreased range of head movement during gaze fixation and lower head velocities as compared with the asymptomatics. Conclusions. The method of combined head and eye motion appears to give accurate, repeatable measurements. Case studies of whiplash subjects indicated deficits in head eye co-ordination. The method could be useful in further clinical research into eye and head movement in those with neck disorders.
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| 4. |
- Jull, Gwendolen A, et al.
(författare)
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Toward optimal early management after whiplash injury to lessen the rate of transition to chronicity
- 2011
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 36:25 Suppl, s. S335-S342
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders.OBJECTIVE: To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity.SUMMARY OF BACKGROUND DATA: International figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients.METHODS: A group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash.RESULTS: It was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifiable prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identified included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the efficacy of stratified and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention.CONCLUSION: The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which reflect the potential multifaceted dimensions of an acute whiplash disorder.
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| 5. |
- Lam, Kwun N., et al.
(författare)
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Classification criteria for cervical radiculopathy: An international e-Delphi study
- 2022
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Ingår i: Musculoskeletal Science and Practice. - : Elsevier. - 2468-7812. ; 61
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Tidskriftsartikel (refereegranskat)abstract
- Background: Establishing a set of uniform classification criteria (CC) for cervical radiculopathy (CR) is required to aid future recruitment of homogenous populations to clinical trials.Objectives: To establish expert informed consensus on CC for CR.Design: A pre-defined four round e-Delphi study in accordance with the guidance on Conducting and Reporting Delphi Studies.Methods: Individuals with a background in physiotherapy who had authored two or more peer-reviewed publications on CR were invited to participate. The initial round asked opinions on CC for CR. Content analysis was performed on round one output and a list of discrete items generated forming the round two survey. In rounds two to four, participants were asked to rate the level of importance of each item on a six-point Likert scale. Data were analysed descriptively using median, interquartile range and percentage agreement. Items reaching pre-defined consensus criteria were carried forward to the next round. Items remaining after the fourth round constituted expert consensus on CC for CR.Results: Twelve participants participated with one drop out. The final round identified one inclusion CC and 12 exclusion CC. The inclusion CC that remained achieved 82% agreement and was a cluster criterion consisting of radicular pain with arm pain worse than neck pain; paraesthesia or numbness and/or weakness and/or altered reflex; MRI confirmed nerve root compression compatible with clinical finding.Conclusions: The CC identified can be used to inform eligibility criteria for future CR trials although caution should be practiced as consensus on measurement tools requires further investigation.
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| 6. |
- Landén Ludvigsson, Maria, et al.
(författare)
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Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders : A case-control ultrasound speckle tracking analysis
- 2016
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 21, s. 177-182
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Tidskriftsartikel (refereegranskat)abstract
- Background: Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood.Objectives: This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. Design and Methods: A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep).Results: The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01).Conclusion: This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius.
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| 7. |
- Marco, Barbero, et al.
(författare)
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Determining the level of cervical radiculopathy : Agreement between visual inspection of pain drawings and magnetic resonance imaging
- 2023
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Ingår i: Pain Practice. - : Wiley. - 1530-7085 .- 1533-2500. ; 23:1, s. 32-40
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims Pain drawings are commonly used in the clinical assessment of people with cervical radiculopathy. This study aimed to assess (1) the agreement of clinical interpretation of pain drawings and MRI findings in identifying the affected level of cervical radiculopathy, (2) the agreement of these predictions based on the pain drawing among four clinicians from two different professions (i.e., physiotherapy and surgery) and (3) the topographical pain distribution of people presenting with cervical radiculopathy (C4-C7). Methods Ninety-eight pain drawings were obtained from a baseline assessment of participants in a randomized clinical trial, in which single-level cervical radiculopathy was determined using MRI. Four experienced clinicians independently rated each pain drawing, attributing the pain distribution to a single nerve root (C4-C7). A post hoc analysis was performed to assess agreement. Outcome measures Percentage agreement and kappa values were used to assess the level of agreement. Topographic pain frequency maps were created for each cervical radiculopathy level as determined by MRI. Results The radiculopathy level determined from the pain drawings showed poor overall agreement with MRI (mean = 35.7%, K = -0.007 to 0.139). The inter-clinician agreement ranged from fair to moderate (K = 0.212-0.446). Topographic frequency maps revealed that pain distributions were widespread and overlapped markedly between patients presenting with different levels cervical radiculopathy. Conclusion This study revealed a lack of agreement between the segmental level affected determined from the patients pain drawing and the affected level as identified on MRI. The large overlap of pain and non-dermatomal distribution of pain reported by patients likely contributed to this result.
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| 8. |
- Peolsson, Anneli, et al.
(författare)
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Cervical Muscle Activity During Loaded Arm Lifts in Patients 10 Years Postsurgery for Cervical Disc Disease
- 2013
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Ingår i: Journal of Manipulative and Physiological Therapeutics. - : Elsevier. - 0161-4754 .- 1532-6586. ; 36:5, s. 292-299
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe purpose of this study was to compare the mechanical activity of the neck muscles during loaded arm lifting tasks in individuals with long-standing disability after anterior cervical decompression and fusion (ACDF) with that of healthy controls.MethodsTen individuals (mean age, 60 years; SD, 7.1) who underwent ACDF (10-13 years previously) for cervical disc disease and 10 healthy age- and sex-matched controls participated in the study. Ultrasonography was used to investigate the degree of deformation and deformation rate of ventral and dorsal neck muscles at the C4 segmental level during a single (1 × arm flexion to 120°) and repeated (10 × arm flexion to 90°) loaded arm elevation condition.ResultsThe ACDF group showed greater deformation and deformation rate of the longus capitis (P = .02) and deformation rate of the sternocleidomastoid (P = .04) during the 120° arm lift. For repeated 90° arm lift, there was a significant group effect with higher deformation rate values observed in the longus capitis (P = .005-.01) and multifidus (P = .03) muscles in the ACDF group. Muscle behavior did not change the repeated arm lifts (no group × time interactions) for either the ventral or the dorsal muscles.ConclusionsFor study participants, greater muscle mechanical activity levels were observed in the ventral and multifidus muscles of patients with persistent symptoms after ACDF. These differences may indicate altered motor strategy in this patient group when performing the upper limb task and may need to be considered when prescribing exercise for postsurgical rehabilitation.
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| 9. |
- Peolsson, Anneli, et al.
(författare)
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Does posture of the cervical spine influence dorsal neck muscle activity when lifting?
- 2014
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Ingår i: Manual Therapy. - : Elsevier. - 1356-689X .- 1532-2769. ; 19:1, s. 32-36
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have shown that postural orientations of the neck, such as flexed or forward head postures, are associated with heightened activity of the dorsal neck muscles. While these studies describe the impact of variations in neck posture alone, there is scant literature regarding the effect of neck posture on muscle activity when combined with upper limb activities such as lifting. The purpose of this study was to evaluate the effect of three different neck postures on the activity of the different layers of the dorsal neck muscles during a lifting task. Ultrasound measurements of dorsal neck muscle deformation were compared over two time points (rest, during lift) during a lifting task performed in three different neck postural conditions (neutral, flexed and forward head posture) in 21 healthy subjects. Data were analysed by post-process speckle tracking analysis. Results demonstrated significantly greater muscle deformation induced by flexed and forward head postures, compared to the neutral posture, for all dorsal neck muscles at rest (p < 0.05). Significant condition by time interactions associated with the lift was observed for four out of the five dorsal muscles (p < 0.02). These findings demonstrate that posture of the cervical spine influenced the level of muscle deformation not only at rest, but also when lifting. The findings of the study suggest that neck posture should be considered during the evaluation or design of lifting activities as it may contribute to excessive demands on dorsal neck muscles with potential detrimental consequences. (C) 2013 Elsevier Ltd. All rights reserved.
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| 10. |
- Peolsson, Anneli, et al.
(författare)
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Is there a difference in the pattern of muscle activity when performing neck exercises with a guild board versus a pulley?
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 45:9, s. 900-905
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Guild boards and pulleys are apparatus commonly used to train cervical muscle function for their purported benefit in facilitating activity of the deeper muscle layers, although this effect has not been substantiated. The objective of this study was to compare the activity of the different layers of cervical muscles when performing exercise with these 2 types of apparatus.Subjects: A total of 19 healthy persons (mean age 28 years, (standard deviation 7 years).Design: Ultrasound measurements of muscle deformation and deformation rate were recorded from the dorsal and ventral neck muscle layers during extension and flexion exercises. Pulley exercises were performed in the upright sitting position against a standardized resistance (men 2 kg, women 1 kg) and guild board exercises at an angle of 45 degrees.Results: The dorsal muscles generally showed greater levels of deformation and deformation rate during exercise with the guild board compared with the pulley system (p<0.05), but with no significant differences in relative activity between the deep and superficial muscle layers (condition x muscle interaction (p>0.05)). No differences were observed for the ventral muscles between exercise methods (p>0.05).Conclusion: While both exercise methods appear to train cervical muscle function, neither appear to be more selective in facilitating deep cervical muscle activity, probably as they involve very similar cervical kinematics.
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