Effects of Lower Trapezius Strengthening Exercises on Pain, Dysfunction, Posture Alignment, Muscle Thickness and Contraction Rate in Patients with Neck Pain; Randomized Controlled Trial

Sam-Ho Park, Myung-Mo Lee, Sam-Ho Park, Myung-Mo Lee

Abstract

BACKGROUND Neck pain is reported by many laborers who are at risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. This study examined the effects of a lower trapezius exercise program on neck pain patients. MATERIAL AND METHODS The design of this study was a randomized controlled trial. A total of 40 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=20) and control group (n=20) using randomization program. Both groups underwent a scapula and thoracic spine stabilization exercise program. In addition, the experimental group implemented the lower trapezius strengthening exercise program. All interventions were applied 3 times per week for 4 weeks. Visual Analogue Scale (VAS), Neck Disability Index (NDI), postural alignment, muscle thickness and contraction rate were compared to evaluate the effect on intervention. RESULTS Both groups showed significant differences in VAS, NDI, and postural alignment before and after intervention (P<0.05). In addition, the experimental group showed more significant difference in the amount of change in NDI and postural alignment values than the control group. The experimental group showed significant improvement in muscle thickness and contraction (P<0.05). CONCLUSIONS A lower trapezius strengthening exercise program is an effective method with clinical significance for reducing the level of neck dysfunction, and improving the postural alignment, muscle thickness, and contraction rate of the lower trapezius muscle.

Conflict of interest statement

Conflict of interest

None.

Figures

Figure 1
Figure 1
CONSORT flow chart.
Figure 2
Figure 2
(A–C) Scapula and thoracic spine stabilization exercise program.
Figure 3
Figure 3
(A–E) Lower trapezius strengthening exercise program.
Figure 4
Figure 4
Cranio-vertebral angle (CVA) and cranial rotation angle (CRA).
Figure 5
Figure 5
Muscle thickness measurement (A) and ultrasound images of lower trapezius muscle (B).

References

    1. Hoving JL, De Vet HC, Twisk JW, et al. Prognostic factors for neck pain in general practice. Pain. 2004;110:639–45.
    1. Korhonen T, Ketola R, Toivonen R, et al. Work related and individual predictors for incident neck pain among office employees working with video display units. Occup Environ Med. 2003;60:475–82.
    1. Kanchanomai S, Janwantanakul P, Pensri P, Jiamjarasrangsi W. Prevalence of and factors associated with musculoskeletal symptoms in the spine attributed to computer use in undergraduate students. Work. 2012;43:497–506.
    1. Falla D, Jull G, Russell T, et al. Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther. 2007;87:408–17.
    1. Jull G, Trott P, Potter H, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine (Phila Pa 1976) 2002;27:1835–43.
    1. Colby LA. Therapeutic exercise: Foundations and techniques. Philadelphia PA: FA Davis Company; 2007.
    1. Mekhora K, Liston C, Nanthavanij S, Cole JH. The effect of ergonomic intervention on discomfort in computer users with tension neck syndrome. Int J Ind Ergon. 2000;26:367–79.
    1. Janda V. Muscles and motor control in cervicogenic disorders Teoksessa Grant, R(toim) Physical Therapy of the Cervical and Thoracic Spine. Amsterdam: Elsevier Science; 2002.
    1. Page P. Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes. Int J Sports Phys Ther. 2011;6:51.
    1. Cools A, Declercq G, Cambier D, et al. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scand J Med Sci Sports. 2007;17:25–33.
    1. Wright EF, Domenech MA, Fischer JR., Jr Usefulness of posture training for patients with temporomandibular disorders. J Am Dent Assoc. 2000;131:202–10.
    1. Kendall FP, Mccreary EK, Provance PG. Muscles: Testing and function with posture and pain. Lippincott Williams & Wilkins; 2005.
    1. O’Sullivan C, Bentman S, Bennett K, Stokes M. Rehabilitative ultrasound imaging of the lower trapezius muscle: Technical description and reliability. J Orthop Sports Phys Ther. 2007;37:620–26.
    1. Mottram SL, Woledge RC, Morrissey D. Motion analysis study of a scapular orientation exercise and subjects’ ability to learn the exercise. Man Ther. 2009;14:13–18.
    1. Song WR, Kim SY, Jang HJ. A comparison of change in thickness for lower trapezius muscle during lower trapezius muscle isometric exercise and reliability of ultrasound imaging. Physical Therapy Korea. 2012;19:31–39.
    1. Salahzadeh Z, Maroufi N, Ahmadi A, et al. Assessment of forward head posture in females: Observational and photogrammetry methods. J Back Musculoskelet Rehabil. 2014;27:131–39.
    1. Nemmers TM, Miller JW, Hartman MD. Variability of the forward head posture in healthy community-dwelling older women. J Geriatr Phys Ther. 2009;32:10–14.
    1. Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.
    1. Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol. 2004;4:26.
    1. Arlotta M, Lovasco G, Mclean L. Selective recruitment of the lower fibers of the trapezius muscle. J Electromyogr Kinesiol. 2011;21:403–10.
    1. Sahrmann S. Diagnosis and treatment of movement impairment syndromes. Elsevier Health Sciences; 2001.
    1. Price DD, Staud R, Robinson ME. How should we use the visual analogue scale (VAS) in rehabilitation outcomes? II: Visual analogue scales as ratio scales: An alternative to the view of Kersten et al. J Rehabil Med. 2012;44(9):800–1. discussion 803–4.
    1. Boonstra AM, Preuper HRS, Reneman MF, et al. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31:165–69.
    1. Vernon H, Mior S. The Neck Disability Index: A study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409–15.
    1. Song KJ, Choi BW, Choi BR, Seo GB. Cross-cultural adaptation and validation of the Korean version of the neck disability index. Spine (Phila Pa 1976) 2010;35:E1045–49.
    1. Chiu CA, Li J, Hwang H, et al. Image capture device with integrated barcode scanning. Google Patents 2013
    1. Cuccia AM, Carola C. The measurement of craniocervical posture: A simple method to evaluate head position. Int J Pediatr Otorhinolaryngol. 2009;73:1732–36.
    1. Yamaguti WP, Claudino RC, Neto AP, et al. Diaphragmatic breathing training program improves abdominal motion during natural breathing in patients with chronic obstructive pulmonary disease: A randomized controlled trial. Arch Phys Med Rehabil. 2012;93:571–77.
    1. Arlotta M, LoVasco G, McLean L. Selective recruitment of the lower fibers of the trapezius muscle. J Electromyogr Kinesiol. 2011;21(3):403–10.
    1. David J, Modi S, Aluko A, et al. Chronic neck pain: A comparison of acupuncture treatment and physiotherapy. Br J Rheumatol. 1998;37:1118–22.
    1. Ylinen J, Nykänen M, Kautiainen H, Häkkinen A. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Man Ther. 2007;12:192–97.
    1. Andersen LL, Kjaer M, Sögaard K, et al. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis Rheum. 2008;59:84–91.
    1. Bronfort G, Evans R, Nelson B, et al. A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine (Phila Pa 1976) 2001;26:788–97.
    1. Chiu TT, Hui-Chan CW, Cheing G. A randomized clinical trial of TENS and exercise for patients with chronic neck pain. Clin Rehabil. 2005;19:850–60.
    1. Röijezon U, Björklund M, Bergenheim M, Djupsjöbacka M. A novel method for neck coordination exercise – a pilot study on persons with chronic non-specific neck pain. J Neuroeng Rehabil. 2008;5:36.
    1. Taimela S, Takala E-P, Asklöf T, et al. Active treatment of chronic neck pain: A prospective randomized intervention. Spine (Phila Pa 1976) 2000;25:1021–27.
    1. Ylinen J, Takala E-P, Nykänen M, et al. Active neck muscle training in the treatment of chronic neck pain in women: A randomized controlled trial. JAMA. 2003;289:2509–16.
    1. Tunwattanapong P, Kongkasuwan R, Kuptniratsaikul V. The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: A randomized controlled trial. Clin Rehabil. 2016;30:64–72.
    1. Chung SH, Her JG, Ko T, et al. Effects of exercise on deep cervical flexors in patients with chronic neck pain. Journal of Physical Therapy Science. 2012;24:629–32.
    1. Lin J-J, Lim HK, Soto-Quijano DA, et al. Altered patterns of muscle activation during performance of four functional tasks in patients with shoulder disorders: Interpretation from voluntary response index. J Electromyogr Kinesiol. 2006;16:458–68.
    1. Harman K, Hubley-Kozey CL, Butler H. Effectiveness of an exercise program to improve forward head posture in normal adults: A randomized, controlled 10-week trial. J Man Manip Ther. 2005;13:163–76.
    1. Koppenhaver SL, Hebert JJ, Fritz JM, et al. Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus muscles. Arch Phys Med Rehabil. 2009;90:87–94.
    1. Kristjansson E. Reliability of ultrasonography for the cervical multifidus muscle in asymptomatic and symptomatic subjects. Man Ther. 2004;9:83–88.
    1. Kermode F. Benefits of utilising real-time ultrasound imaging in the rehabilitation of the lumbar spine stabilising muscles following low back injury in the elite athlete – a single case study. Phys Ther Sport. 2004;5:13–16.
    1. Hodges P, Pengel L, Herbert R, Gandevia S. Measurement of muscle contraction with ultrasound imaging. Muscle Nerve. 2003;27:682–92.
    1. Saliba SA, Croy T, Guthrie R, et al. Differences in transverse abdominis activation with stable and unstable bridging exercises in individuals with low back pain. N Am J Sports Phys Ther. 2010;5:63–73.
    1. Reinold MM, Escamilla R, Wilk KE. Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. J Orthop Sports Phys Ther. 2009;39:105–17.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe