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

Jull, Gwendolen; Falla, Deborah

doi:10.1016/j.math.2016.05.336

Cited by 82 publications

(72 citation statements)

References 28 publications

(39 reference statements)

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“…The musculus scalenus anterior has a function in inspiration, as well as constituting superficial neck flexors with the musculus sternocleidomastoid. [3] Although not used directly during weight lifting exercises, the anterior scalene muscle and subclavian muscles have functions during deep inspiration. If neck flexion is performed at the same time as inspiration during weight lifting exercises in a supine position, the anterior scalene triangle, in particular, becomes smaller.…”

Section: Discussionmentioning

confidence: 99%

Chylothorax due to weight lifting: a rare etiology

Kolbas¹

2020

South Clin Ist Euras

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Chylothorax cases are associated with several etiologies. Non-Hodgkin lymphoma and intrathoracic surgical trauma are the most frequent reasons, but approximately 15% of the cases are idiopathic. Idiopathic chylothorax is thought to be related to minor trauma, and damage above the fifth thoracic vertebra is known to lead to left-sided effusion. In this report, we describe a left-sided chylothorax with an etiology that was finally identified by an in-depth interrogation of the patient's past medical history. Several days previously, while he was weight training with his left arm, he experienced serious pain in his scalenus anterior muscle area. We thought that overstretching of the subclavious and anterior scalenus muscle might have led to the rupture of the left lymphatic duct. Traumatic chylothorax after weight lifting is a rare entity. Awareness and a high degree of suspicion are important in cases of unusual pleural effusion.

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Section: Discussionmentioning

confidence: 99%

Chylothorax due to weight lifting: a rare etiology

Kolbas¹

2020

South Clin Ist Euras

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“…In this regard, it must be noted that the stabilizing effect arrives from static muscle contractions and the subsequent physiological effect might not be the same as from dynamic muscle contractions during the CE exercise [33][34][35]. Studies using wire electrodes to separate activity in the deep and superficial neck extensor muscles have pointed out the importance of activity specifically in the deep extensor muscles for patients with chronic neck pain [36]. Since surface EMG records from all of the underlying muscles, we cannot rule out that the same activity in SH and CE represent different contribution from the neck extensor muscles that may be of importance for specific patient groups.…”

Section: Main Findingmentioning

confidence: 99%

Electromyographic Evaluation of Specific Elastic Band Exercises Targeting Neck and Shoulder Muscle Activation

et al. 2020

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Background: Specific strength training at a high intensity is effective in reducing work related neck/shoulder pain. However, it remains to be documented as to which exercises most specifically target neck and shoulder muscles at high activation level while using simple equipment as e.g., elastic bands. We hypothezised that selected exercises would specifically target the respective muscles, as follows: (1) shrugs and reverse flyes: the upper trapezius muscle, (2) cervical extension and lateral flexion: the upper neck extensor muscle, and (3) cervical flexion and rotation: the sternocleidomastoideus muscle. Methods: Eleven healthy males (25.9 ± 1.4 years, BMI 24.3 ± 1.4) with no neck/shoulder pain (VAS = 0) performed the six exercises with elastic bands at 12RM (repetition maximum) and 20RM in a randomized order. Electromyography was bilaterally recorded from the three muscles and it was normalized to maximal voluntary activation (%MVE). Exercises that evoke more than 60%MVE were considered as high intensity activation. Results: High muscle activation level was attained during 12RM in the upper trapezius muscle during shrugs (100.3 ± 29.8%MVE) and reverse flyes (91.6 ± 32.8%MVE) and in the upper neck extensor muscle during cervical extension (67.6 ± 29.8%MVE) and shrugs (61.9 ± 16.8%MVE). In the sternocleidomastoideus muscle, the highest activity was recorded during cervical flexion (51.7 ± 16.4%MVE) but it did not exceed 60%MVE. The overall activity was ~10% higher during 12RM when compared to 20RM. Conclusion: The simple exercises shrugs and reverse flyes resulted in high intensity activation of both the upper trapezius and neck extensors, while no exercises activated sternocleidomastoideus at high intensity.

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“…Except for cervical kinematic and kinetic aberrations [12][13][14][15][16][17][18][19][20][21], previous electrophysiological findings have demonstrated the appearance of neuromuscular adaptations for patients with neck pain [22][23][24][25][26][27][28][29][30]. Increased activation of the superficial cervical flexor muscles and the upper trapezius [23][24][25][26][27]30] and reduced activation of the deep cervical flexor muscles [27][28][29] account for the compensatory modulation of hyper-activation of the superficial cervical flexor muscles for the weak or inhibited activation of the deep cervical flexor muscles in neck pain patients [25,26]. Also, patients with neck pain had neural recruitment strategies that showed relatively poor efficiency in the superficial flexor muscles when required motor tasks were executed [31,32], reflecting the phenomenon of greater fatigability of the superficial cervical flexor muscles [30,33].…”

Section: Introductionmentioning

confidence: 99%

Near-Infrared Spectroscopy for Monitoring Sternocleidomastoid Muscular Oxygenation during Isometric Flexion for Patients with Mild Nonspecific Neck Pain: A Pilot Study

Yang

Chen

et al. 2020

Sensors

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Since there is merit in noninvasive monitoring of muscular oxidative metabolism for near-infrared spectroscopy in a wide range of clinical scenarios, the present study attempted to evaluate the clinical usability for featuring the modulatory strategies of sternocleidomastoid muscular oxygenation using near-infrared spectroscopy in mild nonspecific neck pain patients. The muscular oxygenation variables of the dominant or affected sternocleidomastoid muscles of interest were extracted at 25% of the maximum voluntary isometric contraction from ten patients (5 males and 5 females, 23.6 ± 4.2 years) and asymptomatic individuals (6 males and 4 females, 24.0 ± 5.1 years) using near-infrared spectroscopy. Only a shorter half-deoxygenation time of oxygen saturation during a sternocleidomastoid isometric contraction was noted in patients compared to asymptomatic individuals (10.43 ± 1.79 s vs. 13.82 ± 1.42 s, p < 0.001). Even though the lack of statically significant differences in most of the muscular oxygenation variables failed to refine the definite pathogenic mechanisms underlying nonspecific neck pain, the findings of modulatory strategies of faster deoxygenation implied that near-infrared spectroscopy appears to have practical potential to provide relevant physiological information regarding muscular oxidative metabolism and constituted convincing preliminary evidences of the adaptive manipulations rather than pathological responses of oxidative metabolism capacity of sternocleidomastoid muscles in nonspecific neck patients with mild disability.

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

Cited by 82 publications

References 28 publications

Chylothorax due to weight lifting: a rare etiology

Chylothorax due to weight lifting: a rare etiology

Electromyographic Evaluation of Specific Elastic Band Exercises Targeting Neck and Shoulder Muscle Activation

Near-Infrared Spectroscopy for Monitoring Sternocleidomastoid Muscular Oxygenation during Isometric Flexion for Patients with Mild Nonspecific Neck Pain: A Pilot Study

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