Cervical Pain
Conditions
Keywords
Sternocleidomastoid, Neck pain, EMG, Perceived Exertion, Thera-Band, Cervical Paraspinals
Brief summary
Cervical pain is a condition that affects 14.6% of all adults annually. Of this annual prevalence, 37.3% experience persistent neck pain with periodic recurring episodes. The purpose of this study is to compare muscle activation patterns of the cervical musculature during exercises with elastic versus manual resistance in a neck pain and asymptomatic populations. Methods: A convenience sample of 15 healthy, physically active participants and 15 current patients diagnosed with non-radicular cervical pain will be recruited. Exclusionary criteria will include: current cervical or upper extremity injury (healthy group), history of neck surgery, corticosteroid treatment within the last two weeks, and radicular signs or symptoms. Surface electromyography will be used to quantify the activity level of the bilateral SCM, AS, Cervical Paraspinal (CP), and the Upper Trapezius (UT) muscles while performing a series of 6 exercises with elastic resistance using Thera-Band® Resistance Bands and manual resistance. The area will be prepped and surface electrodes placed on the corresponding muscles. The movement will be standardized by using the peak activation (PA) of each muscle during full flexion-extension movement to create a percentage of peak activation (%PA). The testing battery will consist of 6 exercises with elastic resistance and manual resistance, totaling 12 different trials. Each trial will involve 5 repetitions, each held for 5 seconds. The exercises will include cervical: extension, flexion, left rotation, right rotation, left side bending, and right side bending. The men will use the green and women will use the red Thera-Band® Resistance Band. The order of exercises will be randomized in to two parts to minimize the effect of fatigue. First, cervical flexion and extension with manual and elastic resistance will be randomized. Secondly, the remaining 8 exercises will be randomized. Following each exercise, the patient will rate their perceived level of exertion on the Thera-band® Resistance Intensity Scale for Exercise (RISE).
Interventions
DEVICENeck exercises using both manual and Thera-Band elasatic resistance
Exercises will include cervical flexion and extension, and cervical right and left side-bending, and rotation. All 6 exercises will be done with both manual and elastic (Thera-Band) resistance.Manual Resistance is applied by the subject placing their own hand on their head and pushing in to it. Thera-Band bands will be used to provide elastic resistance
Sponsors
Sport and Spine Rehab Clinical Research Foundation
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* healthy physically active subjects (healthy group) * patients diagnosed with non-radicular cervical neck pain (neck pain group) * 18-65
Exclusion criteria
* current cervical or upper extremity injury (healthy group) * history of neck surgery * corticosteroid treatment within the last two weeks * radicular signs or symptoms
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percent of Peak Activation (%PA) | One 1 hour session | 8 muscles during 12 exercises were analyzed in 30 subjects, totaling 2880 data points. At the beginning of the study, peak activation (PA) was assessed for each muscle during full flexion-extension, used as a reference exercise. For each subject, the EMG signals of the muscles during the 12 exercises were smoothed, rectified and analyzed using a root-mean-square algorithm and the greatest activation of each muscle was used. After the PA for each muscle was determined, it was compared to the PA of the reference exercise for the respective muscle group, and expressed as a percent of the peak activation (%PA). In some cases the %PA is greater than 100%. This is possible as the PA was assessed during a full flexion-extension movement. During an exercise some muscles generated greater PA and therefore when the calculations were performed the %PA was greater than 100%. Due to the extensive amount of data, we have provided the Left Cervical Paraspinals %PA results for each exercise. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perceived Exertion | 12 exercises during one 1 hour session | Thera-Band(R) RISE (Resistance Intensity Scale for Exercise) Scale to measure amount of perceived exertion during resistance band exercises. Participants were asked to rate the intensity of an exercise on a scale from 0 to 10, 0 being no resistance and 10 being the maximum resistance. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Cervical Neck Pain Thera-Band elastic and manual resistance neck exercises for neck strengthening
Neck exercises using both manual and Thera-Band elasatic resistance: Exercises will include cervical flexion and extension, and cervical right and left side-bending, and rotation. All 6 exercises will be done with both manual and elastic (Thera-Band) resistance.Manual Resistance is applied by the subject placing their own hand on their head and pushing in to it. Thera-Band bands will be used to provide elastic resistance | 15 |
| Healthy Thera-Band elastic and manual resistance neck exercises for neck strengthening
Neck exercises using both manual and Thera-Band elasatic resistance: Exercises will include cervical flexion and extension, and cervical right and left side-bending, and rotation. All 6 exercises will be done with both manual and elastic (Thera-Band) resistance.Manual Resistance is applied by the subject placing their own hand on their head and pushing in to it. Thera-Band bands will be used to provide elastic resistance | 15 |
| Total | 30 |
Baseline characteristics
| Characteristic | Cervical Neck Pain | Healthy | Total |
|---|---|---|---|
| Age, Continuous | 31.8 years | 28.1 years | 29.95 years |
| Sex: Female, Male Female | 9 Participants | 6 Participants | 15 Participants |
| Sex: Female, Male Male | 6 Participants | 9 Participants | 15 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 15 | 0 / 15 |
| serious Total, serious adverse events | 0 / 15 | 0 / 15 |
Outcome results
Primary
Percent of Peak Activation (%PA)
8 muscles during 12 exercises were analyzed in 30 subjects, totaling 2880 data points. At the beginning of the study, peak activation (PA) was assessed for each muscle during full flexion-extension, used as a reference exercise. For each subject, the EMG signals of the muscles during the 12 exercises were smoothed, rectified and analyzed using a root-mean-square algorithm and the greatest activation of each muscle was used. After the PA for each muscle was determined, it was compared to the PA of the reference exercise for the respective muscle group, and expressed as a percent of the peak activation (%PA). In some cases the %PA is greater than 100%. This is possible as the PA was assessed during a full flexion-extension movement. During an exercise some muscles generated greater PA and therefore when the calculations were performed the %PA was greater than 100%. Due to the extensive amount of data, we have provided the Left Cervical Paraspinals %PA results for each exercise.
Time frame: One 1 hour session
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Cervical Pain | Percent of Peak Activation (%PA) | Flexion Manual | 51.72 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Extension Manual | 88.1 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Flexion Elastic | 65.68 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Extension Elastic | 60.60 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Right Rotation Manual | 61.02 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Left Rotation Manual | 108.44 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Right Rotation Elastic | 61.45 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Left Rotation Elastic | 81.53 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Right SideBending Manual | 62.33 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Left SideBending Manual | 100.10 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Right SideBending Elastic | 57.66 Percentage of Peak Activation (%PA) |
| Cervical Pain | Percent of Peak Activation (%PA) | Left SideBending Elastic | 55.44 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Right SideBending Elastic | 65.69 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Flexion Manual | 61.20 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Right Rotation Elastic | 70.70 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Extension Manual | 80.80 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Left SideBending Manual | 115.60 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Flexion Elastic | 86.81 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Left Rotation Elastic | 103.66 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Extension Elastic | 71.9 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Left SideBending Elastic | 84.95 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Right Rotation Manual | 68.99 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Right SideBending Manual | 66.48 Percentage of Peak Activation (%PA) |
| Healthy | Percent of Peak Activation (%PA) | Left Rotation Manual | 180.20 Percentage of Peak Activation (%PA) |
Secondary
Perceived Exertion
Thera-Band(R) RISE (Resistance Intensity Scale for Exercise) Scale to measure amount of perceived exertion during resistance band exercises. Participants were asked to rate the intensity of an exercise on a scale from 0 to 10, 0 being no resistance and 10 being the maximum resistance.
Time frame: 12 exercises during one 1 hour session
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Cervical Pain | Perceived Exertion | Right Rotation Elastic | 3.4 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Right Rotation Manual | 4.5 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Left Rotation Elastic | 4 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Flexion Elastic | 4.6 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Right SideBending Manual | 4.6 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Flexion Manual | 4.9 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Left SideBending Manual | 3.9 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Extension Elastic | 4.1 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Right SideBending Elastic | 4.1 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Left Rotation Manual | 4.5 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Left SideBending Elastic | 4.1 units on a scale, ranging from 0 to 10 |
| Cervical Pain | Perceived Exertion | Extension Manual | 3.5 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Left SideBending Elastic | 3.2 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Flexion Manual | 4.1 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Extension Manual | 3.5 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Flexion Elastic | 4.5 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Extension Elastic | 3.3 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Left Rotation Manual | 3.3 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Right Rotation Elastic | 3.1 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Left Rotation Elastic | 3.1 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Right SideBending Manual | 3.9 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Left SideBending Manual | 3.5 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Right SideBending Elastic | 3.5 units on a scale, ranging from 0 to 10 |
| Healthy | Perceived Exertion | Right Rotation Manual | 3.5 units on a scale, ranging from 0 to 10 |