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Context Sagittal-plane cervical spine alignment has emerged as one of the most important clinical outcomes in health care. Nevertheless, the quantity and quality of research on the role that cervical sagittal alignment plays in improving sensorimotor and autonomic nervous functions are limited. Objective To investigate the immediate and long-term effects of cervical lordosis restoration and correction of anterior head translation (AHT) on pain, disability, autonomic nervous system function, and cervical sensorimotor control in athletes with chronic nonspecific neck pain. Design Randomized controlled clinical trial. Setting University research laboratory. Patients or Other Participants A total of 110 patients (59 males, 51 females) with chronic nonspecific neck pain and a defined hypolordotic cervical spine and AHT posture. Intervention(s) Patients were randomly assigned to the control or intervention group. Both groups received a multimodal program; the intervention group also received Denneroll cervical traction. Treatments were applied 3 times per week for 10 weeks. Main Outcome Measure(s) Outcome measures were cervical lordosis from C2 to C7, AHT, neck disability index, pain intensity, smooth pursuit neck torsion test, overall stability index, left and right rotation repositioning accuracy, and amplitude and latency of skin sympathetic response. The measures were assessed 3 times: at baseline, after 10 weeks of treatment, and at 1-year follow-up. Results The general linear model with repeated measures indicated group × time effects in favor of the intervention group for the following management outcomes: cervical lordosis, AHT, neck disability index, pain intensity, smooth pursuit neck torsion test, overall stability index, left and right rotation repositioning accuracy, and amplitude and latency of the skin sympathetic response (P values < .001). Conclusions Restoration of cervical sagittal alignment in the athletic population had a direct influence on pain, disability, autonomic nervous system dysfunction, and sensorimotor control. Our results should guide treatment planning for athletes and optimize their recovery time.

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Fibromyalgia syndrome (FMS) is a common condition lacking strong diagnostic criteria; these criteria continue to evolve as more and more studies are performed to explore it. This investigation sought to identify whether participants with FMS have more frequent and larger postural/spinal displacements in comparison to a matched control group without the condition of FMS. A total of 67 adults (55 females) out of 380 participants with FMS were recruited. Participants with FMS were sex- and age-matched with 67 asymptomatic participants (controls) without FMS. We used a three-dimensional (3D) postural assessment device (Formetric system) to analyze five posture variables in each participant in both groups: (1) thoracic kyphotic angle, (2) trunk imbalance, (3) trunk inclination, (4) lumbar lordotic angle, and (5) vertebral rotation. In order to determine whether 3D postural measures could predict the likelihood of a participant having FMS, we applied the matched-pairs binary logistic regression analysis. The 3D posture measures identified statistically and clinically significant differences between the FMS and control groups for each of the five posture variables measured (p < 0.001). For three out of five posture measurements assessed, the binary logistic regression identified there was an increased probability of having FMS with an increased: (1) thoracic kyphotic angle proportional odds ratio [Prop OR] = 1.76 (95% CI = 1.03, 3.02); (2) sagittal imbalance Prop OR = 1.54 (95% CI = 0.973, 2.459); and (3) surface rotation Prop OR = 7.9 (95% CI = 1.494, 41.97). We identified no significant probability of having FMS for the following two postural measurements: (1) coronal balance (p = 0.50) and (2) lumbar lordotic angle (p = 0.10). Our study’s findings suggest there is a strong relationship between 3D spinal misalignment and the diagnosis of FMS. In fact, our results support that thoracic kyphotic angle, sagittal imbalance, and surface rotation are predictors of having FMS.

This study measured the effect of different durations of stretching (15 s, 30 s, 60 s and no stretching) of the mus cles around the neck and shoulders in 100 participants with chronic myofascial pain syndrome. The outcome mea sures assessed the effect on neural function. The results show that stretching for 30 s was the optimal time, for achieving stretching benefits and minimizing the negative effects on the neural function of the involved nerve roots and central nervous system. Stretching for a longer time negatively affected the neural function, but decreased the pain level, while stretching for a shorter time did not ac hieve the optimal muscle length after stretching. Objective: To explore the effect of variable durations of stretching on neural function, pain, and algomet ric pressure in patients with chronic myofascial pain syndrome. Design: Randomized controlled trial. Patients: A total of 100 participants diagnosed with chronic myofascial pain syndrome were randomly assigned to a control group or 1 of 3 intervention groups. Methods: The 3 experimental groups received dif ferent durations of cervical spine stretching: 15, 30 or 60 s. The control group did not stretch. Primary outcome measures included peaktopeak somatosensoryevoked potential for dermatomes C6, C7 and C8. Secondary outcome measures included central somatosensory conduction time (N13-N20), pain intensity, and pressurepain threshold algometric measurements. All outcome measures were assessed immediately after and 2 h after the treatment session. Results: Post hoc analysis indicated that stretching for 60 s significantly decreased the dermatomal amplitude for C6, C7 and C8 (p < 0.001) and signif icantly increased the central conduction time, indi cating negative effect (p < 0.001). Stretching for 30 and 60 s resulted in greater improvement in pain in tensity and algometric pressure than stretching for 15 s or no stretch (control) p < 0.001. Conclusion: Stretching cervical muscles involved in chronic myofascial pain syndrome for 30 s was opti mal in achieving stretching benefits and minimizing the negative effects on the neural function of the in volved nerve roots and central nervous system.