Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

Abstract

Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs). Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI) score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM) was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67) completed the study. Neck disability and neck pain were improved over time between and within groups (p < 0.05). However, no differences were found within and between the therapeutic groups (p < 0.05) in the tested muscles' PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

Effectiveness of an Eye‐Cervical Re‐Education Program in Chronic Neck Pain: A Randomized Clinical Trial

“…e results obtained in our study regarding the sensation of pain in the MTrPs do not coincide with the findings of Llunch et al [26] and Bobos et al [27] is discrepancy may be because proprioceptive exercises, which consist of craniocervical flexion training, did not have an eye-neck coordination component. Moreover, Izquierdo et al [17] compared two proprioceptive programs: craniocervical flexion training versus proprioceptive training that includes oculomotor exercises.…”

“…Previously, only three studies have investigated the effects of proprioceptive exercises on hyperalgesia of the superficial cervical musculature [17,26,27].…”

Effectiveness and optimal dosage of exercise training for chronic non-specific neck pain: A systematic review with a narrative synthesis

“…Multiple reports of the same trial were collated for Waling et al, 2002 [48-50], Bobos PLOS ONE et al, 2016 [51,52], Ylinen et al, 2007 [53-56], and Chiu et al, 2005 [57, 58]. Data extraction was completed for 26 trials [13,14,49,51,54,57,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78]. https://doi.org/10.1371/journal.pone.0234511.g001 Table 1.…”

“…Exercise training classifications, definitions, and example exercises. [59,60,63]; upper limb exercises [49,68]; motor control + pillar exercises [71]; motor control + segmental exercises [63,64]; motor control + segmental exercises + another intervention [51,57]; motor control + segmental + pillar exercises [69]; pillar exercises + another intervention [77,78]; pillar + upper limb exercises [61]; pillar + upper limb exercises + another…”

Systematic review of the measurement properties of performance-based functional tests in patients with neck disorders

“…Outcome measures are a crucial component in monitoring patients with neck pain to determine the effects of treatment,11 12 evaluation of interventions, guiding return to work and justifying treatment 13 14. Several self-reported outcome measures currently exist to assess disability and function in those with neck pain (eg, the Neck Disability Index-NDI) 13.…”