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• W29178672 abstract "Neck pain affects a substantial number of the population and incurs significant costs to the community. Exercise interventions are deemed essential for the effective management of patients with neck pain. However, there is a lack of consensus on optimal exercise prescription. This results from a paucity of studies to quantify the precise nature of muscle impairment, which occurs in people with neck pain. Surface electromyography (sEMG) has been utilised to identify impairment of the superficial cervical flexor muscles. However, these investigations are infrequent and regular inconsistencies exist in the applied methodology. Furthermore, the inaccessibility of the deep cervical flexor muscles has rendered them inapplicable to conventional sEMG measures. The aims of this thesis were to develop a sEMG protocol for the assessment of the deep (longus colli and longus capitis) and superficial (sternocleidomastoid and anterior scalene) cervical flexor muscles and subsequently, to utilise this protocol to investigate cervical flexor muscle impairment in patients with chronic neck pain. Guidelines were developed for electrode placement over the superficial cervical flexor muscles and a novel technique was established to record deep cervical flexor EMG. The technique consisted of a nasopharyngeal application to position electrodes over the posterior mucosa of the oropharynx which overlies the longus capitis and longus colli muscles. A series of studies were conducted which investigated myoelectric manifestations of fatigue, patterns of muscle activation and neuromotor control of the cervical flexor muscles in patients with chronic neck pain. The results demonstrated the complex, multifaceted nature of cervical muscle impairment, which exists in people with a history of neck pain. Patients with neck pain displayed deficits in the motor control of the deep and superficial cervical flexor muscles characterised by a delay in onset of neck muscle contraction associated with movement of the upper limb. This finding indicates a significant deficit in the automatic motor command for feedforward control of the neck muscles in people with neck pain. Furthermore, people with neck pain demonstrated an altered pattern of muscle activation characterised by reduced deep cervical flexor EMG amplitude during a low load prescribed task and increased EMG amplitude of the superficial cervical flexor muscles during a low load prescribed task and low load functional task. Patients with neck pain also demonstrated greater fatigability of the superficial cervical flexor muscles during sustained isometric cervical flexion contractions. Whilst knowledge of the pathophysiology underlying cervical muscle dysfunction remains somewhat imprecise, the results of this thesis have contributed materially to our understanding of the impairment in the cervical muscles in people with neck pain. This thesis represents a substantial contribution towards the cumulative knowledge of neck pain in human society and leads to an improved understanding and direction for the physiotherapy management of this condition." @default.
• W29178672 created "2016-06-24" @default.
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• W29178672 date "2003-01-01" @default.
• W29178672 modified "2023-09-27" @default.
• W29178672 title "The application of surface electromyography for the assessment of cervical flexor muscle dysfunction in patients with neck pain" @default.
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