title: The effect of training the deep cervical flexors on neck pain, neck mobility, and dizziness in a patient with chronic nonspecific neck pain after prolonged bed rest: a case report.
abstract: METHODS
  Case report.
  
  
  BACKGROUND
  Immobilization and chronic neck pain may cause a transformation of muscle tissue fibers. These changes affect the ability to effectively control 3-D movement of the cervical spine. This case report describes the effect of specific deep cervical flexor (DCF) musculature training in a patient with chronic neck pain and dizziness.
  
  
  METHODS
  A 19-year-old woman presented with a 24-month history of neck pain and dizziness. Symptoms started during a 2-month immobilization period while in the intensive care unit for the treatment of brainstem encephalitis. Outcome measures included pain level, limitations in activities, fear avoidance, range of motion, dizziness, and function of the DCFs. Treatment was aimed at restoring altered motor control of the neck muscles using DCF training integrated with functional activities for 10 treatment sessions over 12 weeks.
  
  
  RESULTS
  At the time of discharge, the patient reported full recovery and no restriction in her daily activities. Her score on the Neck Disability Index had improved by 28 points, active range of motion had increased, and her symptoms of dizziness were resolved. These results were maintained at 6-month follow-up.
  
  
  CONCLUSIONS
  This patient responded positively to DCF training, resulting in an increase in cervical spine range of motion and a reduction of dizziness, pain, and limitations in activities.
authors: Avans University of Applied Sciences, Breda, the Netherlands. marloesthoomes@me.com
authors: Marloes
authors: M
authors: Thoomes-de Graaf
authors: Maarten S
authors: MS
authors: Schmitt
mesh_terms: D001510:Bed Rest / Q000009:adverse effects*; D059350:Chronic Pain / Q000628:therapy; D004244:Dizziness / Q000209:etiology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D009334:Neck Muscles / Q000502:physiology*; D019547:Neck Pain / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D016059:Range of Motion, Articular / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult