title: Force production and EMG activity of neck muscles in adolescent headache.
abstract: OBJECTIVE
  This study compared the maximal force, EMG/force ratio and co-activation characteristics of the neck-shoulder muscles between 30 adolescents with migraine-type headache, 29 with tension-type headache, and 30 headache-free controls.
  
  
  METHODS
  Force was measured with surface electromyography (EMG) from the cervical erector spinae (CES), the sternocleidomastoid (SCM) and trapezius muscles during the maximal isometric neck flexion, neck extension and shoulder flexion.
  
  
  RESULTS
  Girls with migraine-type headache had higher EMG/force ratios between the EMG of the left agonist SCM muscle and the corresponding maximal neck flexion (p = 0.030) and neck rotation force to the right side (p = 0.024) than the girls with tension-type headache. Migrainous girls had more co-activation of right antagonist CES muscle during maximal neck flexion force than the girls without headache (p = 0.015). Neck force production showed no significant differences between girls. Girls with tension-type headache displayed lower left shoulder flexion force than girls with migraine-type headache (p = 0.005) or with no headache (p = 0.005). In boys, no significant differences were observed.
  
  
  CONCLUSIONS
  Girls with tension-type headache and migraine-type headache have differences in neuromuscular function in the neck-shoulder muscles. The data amplify our knowledge of the neck-shoulder muscle dysfunction in adolescent headache, and may encourage the use of specific rehabilitation methods in the management of different types of headache.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Turku University Central Hospital, Turku, Finland. airi.oksanen@tyks.fi
authors.forename: Airi
authors.initials: A
authors.lastname: Oksanen
authors.forename: Tapani
authors.initials: T
authors.lastname: Pöyhönen
authors.forename: Jari J
authors.initials: JJ
authors.lastname: Ylinen
authors.forename: Liisa
authors.initials: L
authors.lastname: Metsähonkala
authors.forename: Pirjo
authors.initials: P
authors.lastname: Anttila
authors.forename: Katri
authors.initials: K
authors.lastname: Laimi
authors.forename: Heikki
authors.initials: H
authors.lastname: Hiekkanen
authors.forename: Minna
authors.initials: M
authors.lastname: Aromaa
authors.forename: Jouko J
authors.initials: JJ
authors.lastname: Salminen
authors.forename: Matti
authors.initials: M
authors.lastname: Sillanpää
mesh_terms: D000293:Adolescent; D002648:Child; D004576:Electromyography; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology* / Q000534:rehabilitation; D009334:Neck Muscles / Q000503:physiopathology*; D018781:Tension-Type Headache / Q000503:physiopathology* / Q000534:rehabilitation