The relationship between cervical flexor endurance, cervical extensor endurance, VAS, and disability in subjects with ne
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CHIROPRACTIC & MANUAL THERAPIES
RESEARCH
Open Access
The relationship between cervical flexor endurance, cervical extensor endurance, VAS, and disability in subjects with neck pain Sergio Parazza1, Carla Vanti2*, Caroline O’Reilly3, Jorge Hugo Villafañe4, José Miguel Tricás Moreno5 and Elena Estébanez De Miguel6
Abstract Background: Several tests have been suggested to assess the isometric endurance of the cervical flexor (NFME) and extensors (NEE) muscles. This study proposes to determine whether neck flexors endurance is related to extensor endurance, and whether cervical muscle endurance is related to disability, pain amount and pain stage in subjects with neck pain. Methods: Thirty subjects (18 women, 12 men, mean ± SD age: 43 ± 12 years) complaining of neck pain filled out the Visual Analogue Scale (VAS) and the Neck Pain and Disability Scale-Italian version (NPDS-I). They also completed the timed endurance tests for the cervical muscles. Results: The mean endurance was 246.7 ± 150 seconds for the NEE test, and 44.9 ± 25.3 seconds for the NMFE test. A significant correlation was found between the results of these two tests (r = 0.52, p = 0.003). A positive relationship was also found between VAS and NPDS-I (r = 0.549, p = 0.002). The endurance rates were similar for acute/subacute and chronic subjects, whereas males demonstrated significantly higher values compared to females in NFME test. Conclusions: These findings suggest that neck flexors and extensors endurance are correlated and that the cervical endurance is not significantly altered by the duration of symptoms in subjects with neck pain. Keywords: Neck pain, Physical endurance, Neck muscles, Isometric contraction, Measure
Introduction Neck pain (NP) is a condition that is becoming more and more widespread and its associated economic and social costs are ever-increasing [1]. Some possible factors are sedentary work, the increase in activities such as the use of personal computers and Internet, the use of motor vehicles, and changes of work type [2]. Some psychosocial factors are considered as the strongest prognostic factors for NP and contributing factors for slower or less complete recovery [3] and persistent pain [4]. Moreover, these factors influence the perception of pain and disability and decrease the self-efficacy perception [5]. * Correspondence: [email protected] 2 School of Physiotherapy, Alma Mater Studiorum, University of Bologna, via Tosarelli 144 40055, Castenaso, Bologna, Italy Full list of author information is available at the end of the article
According to various studies, in many cervical conditions such as whiplash associated disorders (WAD) or cervicogenic headache, a dysfunction of deep cervical flexors (DCF) such as longus colli and longus capitis can be found [6,7]. Other studies also describe the deep cervical extensors as being dysfunctional: especially semispinalis, sub-occipital and multifidus muscles [8-10]. From the literature, it seems that muscular dysfunction in the cervical spine refers to changes in structur
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