title: The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain.
abstract: Deep cervical flexor muscle (DCF) activation is impaired with neck pain. This study investigated the effects of low load cranio-cervical flexion (C-CF) and neck flexor strengthening exercises on spatial and temporal characteristics of DCF activation during a neck movement task and a task challenging the neck's postural stability. Forty-six chronic neck pain subjects were randomly assigned to an exercise group and undertook a 6-week training program. Electromyographic (EMG) activity was recorded from the DCF, sternocleidomastoid (SCM) and anterior scalene (AS) muscles pre and post intervention during the cranio-cervical flexion test (CCFT) and during perturbations induced by rapid, unilateral shoulder flexion and extension. C-CF training increased DCF EMG amplitude and decreased SCM and AS EMG amplitude across all stages of the CCFT (all P<0.05). No change occurred in DCF EMG amplitude following strength training. There was no significant between group difference in pre-post intervention change in relative latency of DCF but a greater proportion of the C-CF group shortened the relative latency between the activation of the deltoid and the DCF during rapid arm movement compared to the strength group (P<0.05). Specific low load C-CF exercise changes spatial and temporal characteristics of DCF activation which may partially explain its efficacy in rehabilitation.
authors.affiliation: Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072, Australia. g.jull@uq.edu.au
authors.forename: G A
authors.initials: GA
authors.lastname: Jull
authors.forename: D
authors.initials: D
authors.lastname: Falla
authors.forename: B
authors.initials: B
authors.lastname: Vicenzino
authors.forename: P W
authors.initials: PW
authors.lastname: Hodges
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D009068:Movement / Q000502:physiology; D009334:Neck Muscles / Q000503:physiopathology*; D019547:Neck Pain / Q000503:physiopathology* / Q000534:rehabilitation*; D010147:Pain Measurement; D011187:Posture / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome