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Erschienen in: European Spine Journal 1/2013

01.01.2013 | Original Article

A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects

verfasst von: Nader Maroufi, Amir Ahmadi, Seyedeh Roghayeh Mousavi Khatir

Erschienen in: European Spine Journal | Ausgabe 1/2013

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Abstract

Purpose

The cervical flexion relaxation phenomenon (FRP) is a neck extensor myoelectric “silence” that occurs during complete cervical and lumbar flexion. In contrast to low back pain, the changes that occur during FRP in chronic neck pain (CNP) patients are still not clear. The aim of this study was to assess the characteristics of this phenomenon in the cervical region in CNP patients and controls.

Methods

Twenty-two women (23 ± 2.62 years) with chronic non-specific neck pain and 21 healthy women (23.4 ± 1.68 years) participated in this study. They accomplished a cervical flexion and extension from neutral position. Neck angle and surface electromyographic activity of cervical erector spinae (CES) and upper trapezius muscles were recorded. Appearance, onset and offset angle of the FRP were analysed and compared between the two groups.

Results

There were significant differences in the appearance of FRP between the two groups (P ≤ 0.001). The FRP in the CES muscles was observed in 85.7 % of healthy subjects and in 36.3 % of CNP patients, and no FRP was observed in the upper trapezius. Results of this study show that the onset and offset of FRP parameters were significantly different between the two groups (P ≤ 0.001).

Conclusions

The results of the present study indicate that FRP in CNP patients was seen less than the healthy subjects, and moreover the FRP period was reduced in CNP patients. Our results also suggest that the changes in FRP of CNP patients may be due to the increased CES activity in these patients.
Literatur
1.
Zurück zum Zitat Viljanen M, Malmivaara A, Uitti J, Rinne M, Palmroos P, Laippala P (2003) Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial. BMJ 327(7413):475. doi:10.1136/bmj.327.7413.475 PubMedCrossRef Viljanen M, Malmivaara A, Uitti J, Rinne M, Palmroos P, Laippala P (2003) Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial. BMJ 327(7413):475. doi:10.​1136/​bmj.​327.​7413.​475 PubMedCrossRef
2.
Zurück zum Zitat Ylinen J, Takala EP, Kautiainen H, Nykanen M, Hakkinen A, Pohjolainen T, Karppi SL, Airaksinen O (2004) Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. Eur J Pain 8(5):473–478. doi:10.1016/j.ejpain.2003.11.005 PubMedCrossRef Ylinen J, Takala EP, Kautiainen H, Nykanen M, Hakkinen A, Pohjolainen T, Karppi SL, Airaksinen O (2004) Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain. Eur J Pain 8(5):473–478. doi:10.​1016/​j.​ejpain.​2003.​11.​005 PubMedCrossRef
3.
Zurück zum Zitat Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, Hurwitz EL, Cote P, Nordin M, Peloso PM, Guzman J, Cassidy JD (2008) Course and prognostic factors for neck pain in the general population: results of the bone and joint decade 2000–2010 Task force on neck pain and its associated disorders. Spine (Phila Pa 1976) 33(4 Suppl):S75–S82. doi:10.1097/BRS.0b013e31816445be CrossRef Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, Hurwitz EL, Cote P, Nordin M, Peloso PM, Guzman J, Cassidy JD (2008) Course and prognostic factors for neck pain in the general population: results of the bone and joint decade 2000–2010 Task force on neck pain and its associated disorders. Spine (Phila Pa 1976) 33(4 Suppl):S75–S82. doi:10.​1097/​BRS.​0b013e31816445be​ CrossRef
4.
Zurück zum Zitat Hoving JL, Koes BW, de Vet HC, van der Windt DA, Assendelft WJ, van Mameren H, Deville WL, Pool JJ, Scholten RJ, Bouter LM (2002) Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial. Ann Intern Med 136(10):713–722. 200205210-00006 [pii] Hoving JL, Koes BW, de Vet HC, van der Windt DA, Assendelft WJ, van Mameren H, Deville WL, Pool JJ, Scholten RJ, Bouter LM (2002) Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain. A randomized, controlled trial. Ann Intern Med 136(10):713–722. 200205210-00006 [pii]
7.
8.
Zurück zum Zitat Gupta A (2001) Analyses of myo-electrical silence of erectors spinae. J Biomech 34(4):491–496. S002192900000213X [pii] Gupta A (2001) Analyses of myo-electrical silence of erectors spinae. J Biomech 34(4):491–496. S002192900000213X [pii]
9.
Zurück zum Zitat Floyd WF, Silver PH (1955) The function of the erectores spinae muscles in certain movements and postures in man. J Physiol 129(1):184–203PubMed Floyd WF, Silver PH (1955) The function of the erectores spinae muscles in certain movements and postures in man. J Physiol 129(1):184–203PubMed
11.
Zurück zum Zitat Andersson EA, Oddsson LI, Grundstrom H, Nilsson J, Thorstensson A (1996) EMG activities of the quadratus lumborum and erector spinae muscles during flexion–relaxation and other motor tasks. Clin Biomech (Bristol, Avon) 11(7):392–400. 0268003396000332 [pii] Andersson EA, Oddsson LI, Grundstrom H, Nilsson J, Thorstensson A (1996) EMG activities of the quadratus lumborum and erector spinae muscles during flexion–relaxation and other motor tasks. Clin Biomech (Bristol, Avon) 11(7):392–400. 0268003396000332 [pii]
12.
Zurück zum Zitat Callaghan JP, Dunk NM (2002) Examination of the flexion relaxation phenomenon in erector spinae muscles during short duration slumped sitting. Clin Biomech (Bristol, Avon) 17(5):353–360. S0268003302000232 [pii] Callaghan JP, Dunk NM (2002) Examination of the flexion relaxation phenomenon in erector spinae muscles during short duration slumped sitting. Clin Biomech (Bristol, Avon) 17(5):353–360. S0268003302000232 [pii]
13.
Zurück zum Zitat Kippers V, Parker AW (1984) Posture related to myoelectric silence of erectores spinae during trunk flexion. Spine (Phila Pa 1976) 9(7):740–745CrossRef Kippers V, Parker AW (1984) Posture related to myoelectric silence of erectores spinae during trunk flexion. Spine (Phila Pa 1976) 9(7):740–745CrossRef
15.
Zurück zum Zitat Geisser ME, Haig AJ, Wallbom AS, Wiggert EA (2004) Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. Clin J Pain 20(2):61–69PubMedCrossRef Geisser ME, Haig AJ, Wallbom AS, Wiggert EA (2004) Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. Clin J Pain 20(2):61–69PubMedCrossRef
16.
Zurück zum Zitat Neblett R, Mayer TG, Gatchel RJ, Keeley J, Proctor T, Anagnostis C (2003) Quantifying the lumbar flexion–relaxation phenomenon: theory, normative data, and clinical applications. Spine (Phila Pa 1976) 28(13):1435–1446. doi:10.1097/01.BRS.0000067085.46840.5A Neblett R, Mayer TG, Gatchel RJ, Keeley J, Proctor T, Anagnostis C (2003) Quantifying the lumbar flexion–relaxation phenomenon: theory, normative data, and clinical applications. Spine (Phila Pa 1976) 28(13):1435–1446. doi:10.​1097/​01.​BRS.​0000067085.​46840.​5A
17.
Zurück zum Zitat Shirado O, Ito T, Kaneda K, Strax TE (1995) Flexion–relaxation phenomenon in the back muscles. A comparative study between healthy subjects and patients with chronic low back pain. Am J Phys Med Rehabil 74(2):139–144PubMedCrossRef Shirado O, Ito T, Kaneda K, Strax TE (1995) Flexion–relaxation phenomenon in the back muscles. A comparative study between healthy subjects and patients with chronic low back pain. Am J Phys Med Rehabil 74(2):139–144PubMedCrossRef
18.
Zurück zum Zitat Sihvonen T, Partanen J, Hanninen O, Soimakallio S (1991) Electric behavior of low back muscles during lumbar pelvic rhythm in low back pain patients and healthy controls. Arch Phys Med Rehabil 72(13):1080–1087PubMed Sihvonen T, Partanen J, Hanninen O, Soimakallio S (1991) Electric behavior of low back muscles during lumbar pelvic rhythm in low back pain patients and healthy controls. Arch Phys Med Rehabil 72(13):1080–1087PubMed
20.
Zurück zum Zitat Murphy BA, Marshall PW, Taylor HH (2010) The cervical flexion–relaxation ratio: reproducibility and comparison between chronic neck pain patients and controls. Spine (Phila Pa 1976) 35(24):2103–2108. doi:10.1097/BRS.0b013e3181cbc7d8 CrossRef Murphy BA, Marshall PW, Taylor HH (2010) The cervical flexion–relaxation ratio: reproducibility and comparison between chronic neck pain patients and controls. Spine (Phila Pa 1976) 35(24):2103–2108. doi:10.​1097/​BRS.​0b013e3181cbc7d8​ CrossRef
21.
Zurück zum Zitat Yoo WG, Park SY, Lee MR (2011) Relationship between active cervical range of motion and flexion–relaxation ratio in asymptomatic computer workers. J Physiol Anthropol 30(5):203–207. JST.JSTAGE/jpa2/30.203 [pii] Yoo WG, Park SY, Lee MR (2011) Relationship between active cervical range of motion and flexion–relaxation ratio in asymptomatic computer workers. J Physiol Anthropol 30(5):203–207. JST.JSTAGE/jpa2/30.203 [pii]
23.
Zurück zum Zitat Sarti MA, Lison JF, Monfort M, Fuster MA (2001) Response of the flexion–relaxation phenomenon relative to the lumbar motion to load and speed. Spine (Phila Pa 1976) 26(18):E421–E426CrossRef Sarti MA, Lison JF, Monfort M, Fuster MA (2001) Response of the flexion–relaxation phenomenon relative to the lumbar motion to load and speed. Spine (Phila Pa 1976) 26(18):E421–E426CrossRef
24.
Zurück zum Zitat Netto KJ, Burnett AF (2006) Reliability of normalisation methods for EMG analysis of neck muscles. Work 26(2):123–130PubMed Netto KJ, Burnett AF (2006) Reliability of normalisation methods for EMG analysis of neck muscles. Work 26(2):123–130PubMed
25.
26.
Zurück zum Zitat Sommerich CM, Joines SM, Hermans V, Moon SD (2000) Use of surface electromyography to estimate neck muscle activity. J Electromyogr Kinesiol 10(6):377–398. S105064110000033X [pii] Sommerich CM, Joines SM, Hermans V, Moon SD (2000) Use of surface electromyography to estimate neck muscle activity. J Electromyogr Kinesiol 10(6):377–398. S105064110000033X [pii]
27.
Zurück zum Zitat Mathieu PA, Fortin M (2000) EMG and kinematics of normal subjects performing trunkflexion/extensions freely in space. J Electromyogr Kinesiol 10(3):197–209. S1050-6411(00)00008-0 [pii] Mathieu PA, Fortin M (2000) EMG and kinematics of normal subjects performing trunkflexion/extensions freely in space. J Electromyogr Kinesiol 10(3):197–209. S1050-6411(00)00008-0 [pii]
29.
Zurück zum Zitat Pialasse JP, Dubois JD, Choquette MH, Lafond D, Descarreaux M (2009) Kinematic and electromyographic parameters of the cervical flexion–relaxation phenomenon: the effect of trunk positioning. Ann Phys Rehabil Med 52(1):49–58. doi:10.1016/j.rehab.2008.10.002 PubMed Pialasse JP, Dubois JD, Choquette MH, Lafond D, Descarreaux M (2009) Kinematic and electromyographic parameters of the cervical flexion–relaxation phenomenon: the effect of trunk positioning. Ann Phys Rehabil Med 52(1):49–58. doi:10.​1016/​j.​rehab.​2008.​10.​002 PubMed
30.
Zurück zum Zitat Meyer JJ, Berk RJ, Anderson AV (1993) Recruitment patterns in the cervical paraspinal muscles during cervical forward flexion: evidence of cervical flexion–relaxation. Electromyogr Clin Neurophysiol 33(4):217–223PubMed Meyer JJ, Berk RJ, Anderson AV (1993) Recruitment patterns in the cervical paraspinal muscles during cervical forward flexion: evidence of cervical flexion–relaxation. Electromyogr Clin Neurophysiol 33(4):217–223PubMed
31.
Zurück zum Zitat Panjabi MM (1992) The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 5(4):383–389 (Discussion 397)PubMedCrossRef Panjabi MM (1992) The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 5(4):383–389 (Discussion 397)PubMedCrossRef
32.
Zurück zum Zitat Johnston V, Jull G, Darnell R, Jimmieson NL, Souvlis T (2008) Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain. Eur J Appl Physiol 103(3):253–264. doi:10.1007/s00421-008-0696-8 PubMedCrossRef Johnston V, Jull G, Darnell R, Jimmieson NL, Souvlis T (2008) Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain. Eur J Appl Physiol 103(3):253–264. doi:10.​1007/​s00421-008-0696-8 PubMedCrossRef
36.
Zurück zum Zitat Indahl A, Kaigle AM, Reikeras O, Holm SH (1997) Interaction between the porcine lumbar intervertebral disc, zygapophysial joints, and paraspinal muscles. Spine (Phila Pa 1976) 22(24):2834–2840CrossRef Indahl A, Kaigle AM, Reikeras O, Holm SH (1997) Interaction between the porcine lumbar intervertebral disc, zygapophysial joints, and paraspinal muscles. Spine (Phila Pa 1976) 22(24):2834–2840CrossRef
38.
Zurück zum Zitat Falla D, Bilenkij G, Jull G (2004) Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine (Phila Pa 1976) 29(13):1436–1440. 00007632-200407010-00011 [pii] Falla D, Bilenkij G, Jull G (2004) Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine (Phila Pa 1976) 29(13):1436–1440. 00007632-200407010-00011 [pii]
40.
Zurück zum Zitat lee m, Yoo W, An D, Kim M, Oh J (2011) The effect of backpack loads on FRR (Flexion–relaxation Ratio) in the cervical spine. J Phys Ther Sci 23(4):599–601CrossRef lee m, Yoo W, An D, Kim M, Oh J (2011) The effect of backpack loads on FRR (Flexion–relaxation Ratio) in the cervical spine. J Phys Ther Sci 23(4):599–601CrossRef
41.
Zurück zum Zitat Watson PJ, Booker CK, Main CJ, Chen AC (1997) Surface electromyography in the identification of chronic low back pain patients: the development of the flexion relaxation ratio. Clin Biomech (Bristol, Avon) 12(3):165–171. S026800339700065X [pii] Watson PJ, Booker CK, Main CJ, Chen AC (1997) Surface electromyography in the identification of chronic low back pain patients: the development of the flexion relaxation ratio. Clin Biomech (Bristol, Avon) 12(3):165–171. S026800339700065X [pii]
Metadaten
Titel
A comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjects
verfasst von
Nader Maroufi
Amir Ahmadi
Seyedeh Roghayeh Mousavi Khatir
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
European Spine Journal / Ausgabe 1/2013
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2517-3

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