Background & Aims

Chronic neck pain is one of the most prevalent musculoskeletal issues in the world. Pain induces muscle imbalance, which often initiates “vicious circle” of pain. Subsequent to muscle imbalance, there arise impaired movement patterns and postural changes, along with faulty motor learning. However, adaptations to pain and compensatory strategies vary among individuals.
This study aims to investigate differences in patterns and timing of cervical muscle activation in individuals, both with and without chronic neck pain, particularly during Janda’s cervical flexion movement pattern test.

Methods

Ten young individuals with chronic neck pain (9 females and 1 male, age: 24.9±1.64, Neck Disability Index: 10.4±3.47, Visual Analogue Scale: 2.83±1.54) and fourteen age-matched asymptomatic individuals as controls (9 females and 5 males, age: 2.58±2.1) were recruited. Participants performed maximum isometric voluntary contraction and Janda’s cervical flexion movement pattern test, with muscle activation measured through surface electromyography (EMG) in bilateral suprahyoid, infrahyoid, sternocleidomastoid, scalene, and upper trapezius muscles. Kruskal-Wallis One-Way ANOVA was used to analyze the patterns and onset time of neck muscle activation during the cervical flexion movement within each participant.

Results

In muscle activation patterns, five in the chronic neck pain (CNP) group exhibited the same pattern as the control group, with significantly higher mean normalized EMG values in SCM and scalene compared to trapezius (p < 0.05). Additionally, three in the CNP group demonstrated significantly higher mean normalized EMG values in infrahyoid, along with SCM and scalene, compared to trapezius (p < 0.05). Furthermore, two in the CNP group did not exhibit significant differences among the muscles (p > 0.05). Regarding the muscle activation sequence, three in the CNP showed that infrahyoid and suprahyoid activated earlier than SCM and scalene. In contrast, thirteen in the control group displayed a different pattern, with SCM and scalene activating significantly earlier than trapezius and suprahyoid (p < 0.05). Four in the CNP exhibited a similar activation sequence to the control group. Moreover, three in the CNP group demonstrated different patterns in terms of muscle activation sequence.

Conclusions

The presence of chronic neck pain altered the patterns and sequences of muscle activation. Increased muscle activation and early contraction of the hyoid muscles, as well as the SCM and scalene muscles, were observed in some subjects. These changes indicate that adaptations to pain and compensatory strategies vary from person to person.

References

Lund, J. P., Donga, R., Widmer, C. G., & Stohler, C. S. (1991). The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. Canadian journal of physiology and pharmacology, 69(5), 683–694. https://doi.org/10.1139/y91-102
Page, P., Frank, C. C., & Lardner, R. (2009). Assessment and treatment of muscle imbalance : The Janda approach (1st ed). Champaign. Il: Human Kinetics.
Summers, S. J., Chipchase, L. S., Hirata, R., Graven-Nielsen, T., Cavaleri, R., & Schabrun, S. M. (2019). Motor adaptation varies between individuals in the transition to sustained pain. Pain, 160(9), 2115-2125. https://doi.org/10.1097/j.pain.0000000000001604

Presenting Author

Hirofumi Sageshima

Poster Authors

Hirofumi Sageshima

MSc

Faculty of Physical Education and Sport, Charles University

Lead Author

E-mail

Dagmar Pavl?

Faculty of Physical Education and Sport, Charles University

Lead Author

E-mail

Klára Novotová

Faculty of Physical Education and Sport, Charles University

Lead Author

E-mail

David Pánek

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Neck Pain