Effects of Specific Training for Deep Neck Muscle

Effects of Specific Training of Deep Cervical Muscles in Chronic Mechanical Neck Pain

Recent studies indicate that the patients with chronic neck pain present decreased activation and weak of neck muscles, especially deep flexor and extensor muscles. Alterations of deep are associated with pain and impairment of neck function in chronic neck pain.

Exercise is known to be an important component of treatment programs for patients with neck pain. Recently, many studies have focused on specific training on deep cervical muscles, especially deep cervical flexor and deep cervical extensor muscles.Numerous studies using cranio-cervical flexor exercise as a treatment have revealed reduction on pain, neck disability, changing in activation of deep cervical flexor muscles. Further, the cervical extensor muscles are believed to be equally important for the rehabilitation of patients with neck pain. However, the retention effect of semispinalis cervicis exercise is unknown. Therefore, the semispinalis cervicis exercise still need more evidence to support clinically effects.

The current study will be conducted to fill the gap of the previous study in immediately, short, and long term effects of semispinalis cervicis exercise in chronic neck pain.

Study Overview

• Status: Unknown
• Conditions: Neck Pain
• Intervention / Treatment: Other: semispinalis cervicis resisted exercise; Other: cranio-cervical flexion exercise; Other: usual care

Detailed Description

Neck pain is a second the most common problems in musculoskeletal problems the low back pain in general population.The prevalence of neck pain at the some point in their lifetime in general population had been reported to be between 43 to 66.7 percent.the neck problems could be involved physical function, psychological function and social function. The economic burden for neck pain is very high.Recent studies indicate that the patients with chronic neck pain present decreased activation and weak of neck muscles, especially deep flexor and extensor muscles. Alterations of deep are associated with pain and impairment of neck function in chronic neck pain.Recently, many studies have focused on specific training on deep cervical muscles, especially deep cervical flexor and deep cervical extensor muscles. The specific training on deep cervical muscles aims to improve control strategy, improve activation of deep cervical flexor muscles to optimize movement control of segmental motion of the cervical spine. Numerous studies using cranio-cervical flexor exercise as a treatment have revealed reduction on pain, neck disability, changing in activation of deep and superficial cervical flexor muscles. Further, the cervical extensor muscles are believed to be equally important for the rehabilitation of patients with neck pain. So, the activation of the deep cervical extensors should be emphasized for the management in people with neck pain. Schomacher et al (2012) suggested that isometric resisted exercise at the second cervical vertebra can improve semispinalis cervicis muscle activity in neck pain patients. However, the retention effect of semispinalis cervicis exercise is unknown. Therefore, the semispinalis cervicis exercise still need more evidence to support clinically effects. The current study will be conducted to fill the gap of the previous study in immediately, short, and long term effects of semispinalis cervicis exercise in chronic neck pain.

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Thailand
  • Khon Kaen
    • Muang, Khon Kaen, Thailand, 40002
      • Recruiting
      • Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University
      • Contact: Thavatchai Suvarnnato, M.Sc. PT; Phone Number: +66890092175; Email: suvarnnato@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 59 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Chronic mechanical neck pain
• Aged between 18 to 59 years
• The symptom more than three months in duration
• A baseline the Thai version of Neck Disability Index (NDI-TH) score of 10 percent or greater

Exclusion Criteria:

• a previous history of whiplash injury
• a previous history injury to the cervical and thoracic spine
• diagnosed with osteoporosis, malignancy or other spinal inflection
• a positive vertebro-basilar artery insufficient test
• diagnosed with cervical radiculopathy and/or myelopathy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: semispinalis cervicis resisted exercise; semispinalis cervicis resisted exercise 2 times/week, 6 weeks duration	Other: semispinalis cervicis resisted exercise; semispinalis cervicis resisted exercise, 2 time per week, 6 weeks duration
EXPERIMENTAL: cranio-cervical flexion exercise; cranio-cervical flexion exercise 2 times/week, 6 weeks duration	Other: cranio-cervical flexion exercise; cranio-cervical flexion exercise, 2 time per week, 6 weeks duration
ACTIVE_COMPARATOR: usual care; Usual care 2 times/week, 6 weeks duration	Other: usual care; usual care, 2 time per week, 6 weeks duration

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Neck Disability Index	Up to 3-months after the last intervention session

Collaborators and Investigators

• Sponsor: Khon Kaen University
• Investigators: Principal Investigator: Thavatchai Suvarnnato, M.Sc. PT, Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University

Publications and helpful links

General Publications

• Falla D, O'Leary S, Farina D, Jull G. The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain. Clin J Pain. 2012 Sep;28(7):628-34. doi: 10.1097/AJP.0b013e31823e9378.
• Schomacher J, Petzke F, Falla D. Localised resistance selectively activates the semispinalis cervicis muscle in patients with neck pain. Man Ther. 2012 Dec;17(6):544-8. doi: 10.1016/j.math.2012.05.012. Epub 2012 Jun 22.
• Suvarnnato T, Puntumetakul R, Uthaikhup S, Boucaut R. Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial. J Pain Res. 2019 Mar 7;12:915-925. doi: 10.2147/JPR.S190125. eCollection 2019.

Study record dates

Study Major Dates

• Study Start: November 1, 2015
• Primary Completion (ANTICIPATED): June 1, 2017
• Study Completion (ANTICIPATED): December 1, 2017

Study Registration Dates

• First Submitted: January 11, 2016
• First Submitted That Met QC Criteria: January 12, 2016
• First Posted (ESTIMATE): January 14, 2016

Study Record Updates

• Last Update Posted (ESTIMATE): February 15, 2016
• Last Update Submitted That Met QC Criteria: February 12, 2016
• Last Verified: February 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: TSuvarnnato

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED