Dissertations / Theses on the topic 'Neck pain'
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Dimitriadis, Zacharias. "Respiratory dysfunction in chronic neck pain." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/respiratory-dysfunction-in-chronic-neck-pain(0b9355db-dab1-41b7-8f2f-e06f7ebd3855).html.
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Background: Patients with chronic neck pain have a number of factors that could constitute a predisposition for respiratory dysfunction. However, the existing evidence is limited and not well established, and many questions such as the association of neck pain deficits with respiratory function remain unanswered. Thus, the aim of this study was to investigate whether patients with chronic neck have accompanying respiratory dysfunction and which are the neck pain deficits which principally predispose to these respiratory disturbances.Methods: In this case-control observational study, 45 patients with chronic idiopathic neck pain (>6 months, at least once per week) and 45 healthy age-, gender-, height- and weight-matched controls were voluntarily recruited. A third group of 10 patients with chronic non-spinal musculoskeletal pain was also used, but only for future reference. Participants' neck muscle strength and endurance were measured by an isometric neck dynamometer and craniocervical flexion test respectively. Range of movement was assessed by using an ultrasound-based motion analysis system. Forward head posture was assessed by obtaining lateral photographs and calculating the craniovertebral angle. Disability and neck pain intensity were assessed through the Neck Disability Index and Visual Analogue Scale. Psychological assessment was performed by using the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale and the Tampa Scale for Kinesiophobia. Spirometry was used for assessing pulmonary volumes, flows and maximal voluntary ventilation. Respiratory muscle strength was assessed by using a mouth pressure meter. Finally, PaCO2 was assessed by using transcutaneous blood gas monitoring.Results: Patients with chronic neck pain were found to have weaker respiratory muscles than healthy controls (p<0.05). Their pulmonary volumes and maximal voluntary ventilation were also found to be reduced (p<0.05). Their mean respiratory flows were found to be unaffected (p>0.05), whereas their peak flows were reduced (p<0.05). Their partial pressure of carbon dioxide was also found to be affected (p<0.05), revealing existence of hypocapnia (PaCO2<35mmHg). The neck pain deficits that were found to be mostly correlated with these respiratory parameters were the neck muscle strength, neck muscle endurance, kinesiophobia, catastrophizing and pain intensity (r>0.3, p<0.05). Finally, the regression models revealed that neck pain deficits and especially neck muscle strength can provide a quite generalizable accurate estimation of this respiratory dysfunction (R2=0.28-0.52).Conclusions: Patients with chronic neck pain present dysfunction of their respiratory system which can be mainly manifested as respiratory weakness and/or hypocapnia. Pain intensity, neck muscle weakness, fatigue and kinesiophobia seem to be the most important deficits predisposing to this respiratory dysfunction. The understanding of this dysfunction could have a great impact on various clinical aspects notably patient assessment, rehabilitation and drug prescription. However, further research is suggested mainly directed towards optimizing treatment protocols and developing classification systems improving clinical reasoning.
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Kjellman, Görel. "Neck pain : analysis of prognostic factors and treatment effects /." Linköping : Univ, 2001. http://www.bibl.liu.se/liupubl/disp/disp2001/med662s.pdf.
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Panwalkar, Shilpa. "Work related neck pain amongst university administrative staff." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3168_1308296531.
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This study aimed at identifying the factors contributing towards work related neck pain amongst university administrative staff, its impact on everyday life activities and in turn its prevalence. A quantitative descriptive cross sectional study design was used amongst the administrative staff at the University of The Western Cape, South Africa. Data collection was carried out with the help of a questionnaire which was administered by the researcher in person. Data was analysed with both descriptive and inferential statistics using SPSS and SAS for windows. Chi-square test and logistic regression analysis was done. The results of this study revealed a very high prevalence of work related neck pain amongst university administrative staff.
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Auvinen, J. (Juha). "Neck, shoulder, and low back pain in adolescence." Doctoral thesis, University of Oulu, 2010. http://urn.fi/urn:isbn:9789514261664.
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Abstract The etiology of musculoskeletal disorders remains largely unclear, pain being the predominant complaint. The prevalence of neck pain (NP), shoulder pain (SP), and low back pain (LBP) increases drastically during adolescence. Potentially modifiable risk factors of NP, SP, and LBP should be identified at that age. First, this study evaluated the prevalence of NP, SP, LBP and peripheral pains (upper or lower extremities) and the prevalence of multiple pains. Second, the study determined the role of a set of potentially modifiable risk factors for adolescents’ NP, SP, and LBP (physical activity, inactivity, sedentary activities in cross-sectional study design and quantity and quality of sleep in follow-up study design). The study population belongs to the 1986 Northern Finland Birth Cohort (NFBC 1986), consisting of 9,479 children with an expected date of birth between July 1, 1985 and June 30, 1986 in the two northernmost provinces of Finland, Oulu and Lapland. NP, SP, and LBP were common at the ages 16 and 18, while medical consultations for these pains were less frequent. The prevalence of pain increased with age. Peripheral pains were rare. Surprisingly many adolescents reported multiple musculoskeletal pains. Girls were more likely to report pain than boys. Both low and high level of physical activity, some risk sport activities, high amount of sedentary activities, and insufficient quantity and quality of sleep increased the risk of NP, SP, and LBP in adolescence. It may be possible to reduce the occurrence of musculoskeletal pain by having a positive impact on potentially modifiable risk factors, such as physical activity, sedentary activities and sleep hygiene. Therefore, intervention studies focusing on these factors are needed in the futureTiivistelmä Useimmiten tuki- ja liikuntaelinsairauksien tarkka syy jää epäselväksi ja kipu on niiden pääasiallinen ilmentymä. Niska-, hartia- ja alaselkäkipujen esiintyvyys väestössä nousee merkittävästi teini-iässä. Tämän vuoksi niska-, hartia- ja alaselkäkivun riskitekijöitä tulisikin tutkia nuoruudessa, jotta niihin päästäisiin vaikuttamaan ajoissa. Tässä väitöskirjassa selvitettiin niska-, hartia-, alaselkä- ja laaja-alaisten tuki- ja liikuntaelinkipujen esiintyvyyttä nuorilla. Päätavoite oli kuitenkin tutkia liikunnan, eri urheilulajien, liikkumattomuuden, istumisen ja unen laadun ja määrän yhteyttä niska-, hartia- ja alaselkäkipujen esiintyvyyteen. Tutkimusaineisto muodostui Pohjois-Suomen syntymäkohortin 1986 nuorista, joiden laskettu syntymäaika oli 1.7.1985–30.6.1986. Nuorille lähetettiin 16-vuotiaana postikysely, joka sisälsi tuki- ja liikuntaelinoirekyselyn, kysymyksiä liikunnan, istumisen ja unen määrästä ja laadusta, sekä muista elämäntavoista. Kahden vuoden kuluttua, 18-vuotiaana lähetettiin toinen kysely joka sisälsi mm. tuki- ja liikuntaelinoirekyselyn. Tulokset osoittavat että niska-, hartia- ja alaselkäkivut olivat yleisiä nuoruudessa, joskin hoitoa vaativat kivut ja raajojen kipuoireilu olivat harvinaisia. Laaja-alaiset tuki- ja liikuntaelinkivut olivat odotettua yleisempiä. Tytöt oireilivat enemmän kuin pojat ja oireilu lisääntyi iän myötä. Hyvin aktiivinen liikunnan harrastaminen (6h/vko tai enemmän ripeää liikuntaa) ja erityisesti tietyt riskilajit olivat yhteydessä suurempaan niska-, hartia- ja alaselkäkipujen esiintyvyyteen. Samoin suuri istumisen määrä, riittämätön uni ja huono unen laatu lisäsivät kipujen todennäköisyyttä. Nuorten tuki- ja liikuntaelinkipuja voitaisiin mahdollisesti vähentää vaikuttamalla muunneltavissa oleviin riskitekijöihin, kuten vähentämällä istumista, lisäämällä terveysliikuntaa, sekä parantamalla unitottumuksia. Tämän takia jatkossa tarvitaan näihin riskitekijöihin kohdistuvia interventiotutkimuksia
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Curtis, Sally Anne. "Superficial cervical muscle activation in chronic neck pain." Thesis, University of Southampton, 2010. https://eprints.soton.ac.uk/153893/.
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Chronic neck pain can occur in a proportion of individuals who have suffered a whiplash injury and also in individuals that have not experienced a trauma to the neck. The mechanisms that cause chronic pain are unclear, and whether they differ in traumatic or non-traumatic onset is unknown. A review of the background literature identified differences in muscle activation for individuals with chronic neck pain, following a whiplash injury and from a non traumatic onset, compared to healthy controls. However, differences in the combined action or synergy of superficial neck muscles in these chronic neck pain groups, during non-forced activities, had not been widely reported. A new methodology was developed to address this area of research. A pilot study was undertaken to establish the reliability of the method and to identify areas for refinement. The main study employed the refined methodology to determine possible differences in activation and synergies of the upper trapezius and sternocleidomastoid muscles, alongside correlations of subjective pain and fatigue with surface electromyographic measures, using linear array electrodes. Some differences in muscles activation and synergy were observed between the groups. Individuals showed different strengths of relationships between subjective and objective measures and different proportions of significant correlations were shown between groups.
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Grip, Helena. "Biomechanical assessment of head and neck movements in neck pain using 3D movement analysis." Doctoral thesis, Umeå : Umeå University, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1600.
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Richards, Karen Victoria. "An investigation of neck posture clusters; their relationship to neck pain and biopsychosocial factors." Thesis, Curtin University, 2016. http://hdl.handle.net/20.500.11937/54057.
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Persson, Liselott C. G. "Cervical radiculopathy effects of surgery, physiotherapy or cervical collar : a prospective, randomised study /." Lund : Dept. of Clinical Neuroscience, Division of Neurosurgery, Lund University, 1998. http://books.google.com/books?id=PMJrAAAAMAAJ.
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Grooten, Wim. "Work and neck/shoulder pain : risk and prognostic factors /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-848-7/.
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Äng, Björn. "Neck pain in air force pilots : on risk factors, neck motor function and an exercise intervention /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-168-5/.
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Röijezon, Ulrik. "Sensorimotor function in chronic neck pain : objective assessments and a novel method for neck coordination exercise." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-22674.
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Chronic neck pain is a widespread problem that causes individual suffering as well as large costs for the society. The knowledge about the pathophysiology is poor and therefore specific diagnosis and causal treatment are rare. Important knowledge for characterization of the disorders has been gained from research on sensorimotor functions in people with neck pain. Moreover, rehabilitation regimes including sensorimotor exercises indicate promising results. The main objectives of this thesis were to extend the knowledge on sensorimotor dysfunctions in chronic neck pain, and to develop a new exercise method for improving sensorimotor functions of the neck. The studies focused on aspects of postural control and movements of the arm and neck. These are vital functions for many activities of daily living. People with chronic (>3 months) neck pain were compared to healthy controls (CON). Neck pain related to trauma was referred to as whiplash associated disorders (WAD), while neck pain without association to trauma was referred to as non-specific (NS). Arm-functioning was assessed in a pointing task. WAD and NS had reduced pointing precision compared to CON. The reduced precision was associated with self-rated difficulties performing neck movements, physical functioning, and in WAD, also pain and balance disturbances. Postural control was assessed in quiet standing on a force platform without vision. The center of pressure signal was decomposed into it’s slow and fast components. WAD and NS were compared to CON. The results revealed an effect of age on the magnitude of the fast sway component, but no effect of group. The magnitude of the slow component was elevated in both WAD and NS. This increase was associated with self-rated balance disturbance, arm-functioning, difficulties to run and sensory alterations in WAD, while in NS, the increase in the slow sway component was associated with concurrent low back pain. Neck movements were assessed in a cervical axial rotation test with maximal speed. In total 8 variables representing basic kinematics, including variables reflecting movement smoothness and conjunct motions were calculated. NS were compared to CON. Linear discriminant modelling indicated Peak Speed and conjunct motions as significant classification variables that together had a sensitivity of 76.3% and specificity of 77.6%. Retest reliability was good for Peak Speed but poor for the measure of conjunct motions. Peak Speed was slower in NS compared to CON, and even slower in a sub-group of NS with concurrent low back pain. Reduced Peak Speed was associated with self-rated difficulties performing neck movements, car driving, running, sleeping disturbances and pain. The clinical applicability of a novel method for neck coordination exercise was assessed in a pilot study on persons with NS. The results supported the applicability and indicated positive effects of the exercise: reduced postural sway in quiet standing and increased smoothness in cervical rotations. Indications on improvement in self-rated disability and fear of movement were seen at six months follow up. In conclusion, sensorimotor functions can be altered in chronic neck pain, particularly in neck disorders with concurrent low back pain and WAD. The discriminative ability and clinical validity displayed in pointing precision, postural sway and cervical axial rotation speed imply that such tests can be valuable tools in the assessment of chronic neck pain patients, and for selecting and evaluating treatment interventions. Indications of improvements seen in the pilot-study support a future RCT.
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Holm, Lena. "Epidemiological aspects on pain in whiplash-associated disorders /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-083-1/.
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Chiu, Tai-wing. "The efficacy of exercise for patients with chronic neck pain /." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2520516x.
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Young, Sharon B. "The relationship of psychological factors and centralization of pain to disability due to neck pain." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2007. https://www.mhsl.uab.edu/dt/2009r/young.pdf.
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Fredriksson, Kerstin. "On causes of neck and shoulder pain in the general population : epidemiological studies on associations between workload and leisure-time activities, and disorders in the neck/shoulder region /." Stockholm : National Institute for Working Life (Arbetslivsinstitutet), 2000. http://diss.kib.ki.se/2000/91-7045-570-8/.
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Myran, Rigmor. "Post-traumatic neck pain. Epidemiological, neuro-radiological and clinical aspects." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for nevromedisin, 2010. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-11602.
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Voerman, Gerritje Evelien. "Musculoskeletal neck-shoulder pain a new ambulant myofeedback intervention approach /." Enschede : University of Twente [Host], 2007. http://doc.utwente.nl/57841.
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Crummey, Orla Mary. "A Comparison of the Experience of Neck and Back Pain." Thesis, Teesside University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517473.
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趙帶榮 and Tai-wing Chiu. "The efficacy of exercise for patients with chronic neck pain." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31243034.
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Svedmark, Åsa. "Neck pain in women : effect of tailored treatment and impact of work environment." Doctoral thesis, Umeå universitet, Fysioterapi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-139394.
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Introduction: Musculoskeletal pain is a common problem in the working population. In Sweden, 40% of women and 30% of men report suffering from neck and shoulder pain weekly. The underlying cause for neck pain is often not known and the treatment is commonly guided by the individual’s symptoms. However, there is a lack of knowledge on how to receive the best effect based on the individual’s symptoms and functional limitations, and therefore this has been scarcely evaluated in research. Furthermore, the impact of work exposure and stress on long-term treatment for persons with neck pain is not clear. Aims: To develop (paper 1) and to evaluate a decision model for tailored treatment in women with neck pain (paper 2). Moreover, to determine if risk factors at work and stress influence intermediate and long-term treatment results (paper 3). Further, to investigate if changes in self-reported pain and disabilities are associated with changes of physical test outcomes of the neck and shoulder region after treatment (paper 4). Methods: In an RCT, 120 working women with non-specific neck pain were randomized to three different groups – tailored treatment (TT), non-tailored treatment (NTT) or treatment-as-usual (TAU) for an 11 weeks intervention with short-term, intermediate-term and long-term follow-ups. The TT group was guided by a decision model with cut-off levels to indicate impairments. The NTT group received two established treatment components randomly from those not indicated, and TAU group did not receive any treatment within the study. The RCT primary outcomes were self-reported neck pain and neck disability. A linear mixed model was used for analysing the effects. One week after the end of intervention work exposure and stress were assessed at a work-place visit and associations to treatment results were tested for, and mixed models were used to estimate longitudinal associations. Associations between self-reported neck problems and physical outcomes were estimated with univariate and multiple regressions analysis. Results: No differences between TT and NTT were revealed for neck pain and disability. In comparison to TAU, the TT and NTT groups both showed improvements at short-term follow-up, but not at intermediate and long-term follow-up. High stress level and low self-estimated control at work were associated with more pain and disability at the intermediate and long-term follow-ups. After intervention and at the intermediate-term follow-up, reduced neck pain, disability and frequency of symptoms were associated with increased peak speed of head rotation and cervical range of motion. Conclusion: Tailored treatment according to the decision model was not superior to the non-tailored treatment in women with non-specific neck pain. One explanation for this can be the weak relationships found between neck pain and disability and physical test outcomes. Further, perceived stress and psychosocial work exposure were associated with self-reported neck problems and should be taken into account to optimize the effects in neck pain rehabilitation.Bakgrund: Nack- och skulder-smärta är ett vanligt tillstånd som förekommer över hela världen. I Sverige skattar 30-40% besvär från nacke och skuldror mätt under en veckas tid. Generellt rapporterar kvinnor mer nack- och skulder-besvär än män. I avhandlingen är det ospecifik nacksmärta som har studerats, det inkluderar inte t.ex. Whiplash-skador, diskbråck eller andra mer specifika diagnoser. Den bakomliggande orsaken till ospecifik nacksmärta är, precis som beteckningen antyder, ofta inte känd och individens symptom och funktion är istället vägledande i undersökning och behandling samt utvärdering av behandling. Studier har visat att i jämförelse med friska har individer med ospecifika nackbesvär ofta sämre muskulär nackstyrka, minskad rörlighet i nacken och är något långsammare vid test av huvudrörelser. Behandlingen riktar sig ofta mot något av dessa fynd med bl.a. styrketräning av nackmuskler och/eller manuella tekniker för rörelseökning. Studier har dock visat att behandlingen endast ger måttliga resultat och att de positiva resultaten bara är kortvariga. I kliniken försöker man individanpassa behandlingen utifrån patientens behov men det finns väldigt lite forskning om detta utan studier utvärderar likadan behandling för hela grupper. Det saknas fortfarande kunskaper om hur man på bästa sätt individanpassar behandling så att den blir skräddarsydd utifrån individens symptom och funktion samt utvärderar detta. Syftet med avhandlingen var att undersöka om en intervention med skräddarsydd behandling (som också innehöll specifik aktiv träning) utifrån en beslutsmodell med fysiska tester och frågor om symtom är effektivt för att uppnå positiva effekter i självskattad smärta och funktion (artikel 1 och 2). Den skräddarsydda behandlingen jämfördes mot en grupp som fick samma upplägg men inte skräddarsydd behandling. Vidare undersöktes om båda dessa behandlingsgrupper var effektivare än en grupp som inte fick någon behandling i studien. Dessutom undersöktes om påverkan från arbetsmiljön i form av fysisk och psykosocial belastning samt upplevd stress påverkade behandlingsresultaten efter interventionen (artikel 3). Slutligen undersöktes om de fysiska testerna och den självskattade smärtan, funktionen och symptomen hade koppling till varandra dels före interventionen och dels i termer av förändringar efter interventionen (artikel 4). Metod: I en randomiserad kontrollerad interventionsstudie (RCT) inkluderades 120 kvinnor i åldrarna 20-65, alla i arbete, och som hade ospecifika nackbesvär. De lottades till tre grupper, (1) skräddarsydd behandling (Tailore treatment, TT), (2) icke-skräddarsydd behandling (Non-tailored treatment, NTT) och (3) en kontrollgrupp (Treatment-as-usual, TAU) som inte fick någon behandling i studien men var fria att söka vård på egen hand. Kvinnorna i TT-gruppen fick behandlings-komponenter utifrån testresultaten i beslutsmodellen. Det kunde läggas till någon behandlingskomponent om det visade sig behövas utifrån individens behov i vardagen. Detta undersöktes genom en strukturerad intervju-teknik som kallas Problem Elicitation Technique (PET). Kvinnorna i NTT-gruppen fick två lottade behandlings-komponenter som inte matchade deras behov utifrån testerna i beslutsmodellen. För båda behandlings-grupperna var interventionen 11 veckor med inbokade behandlingstillfällen 2-3 gånger per vecka, samtliga tillfällen vägledda av fysioterapeut. Data för alla tre grupper samlades in innan interventionen samt 3, 9 och 15 månader efter start av interventionen. Gruppskillnaderna analyserades med en ”linear mixed model”. En vecka efter intervention gjordes ett arbetsplatsbesök hos individerna i alla tre grupper. En erfaren ergonom observerade individernas fysiska arbetsbelastning med ett ergonomiskt bedömningsinstrument, Quick Exposure Check (QEC), och individerna skattade också den psykosociala arbetsmiljön i ett frågeformulär, QPS Nordic, samt upplevd stress. För att undersöka om den fysiska och psykosociala arbetsbelastningen samt stress påverkade resultaten från interventionen analyserades data med linjär regression och mixed model. För att undersöka om de fysiska testerna och den självskattade smärtan, funktionen och symptomen hade något samband användes linjär regressionsanalys. Resultat: Att skräddarsy behandlingen utifrån den testade beslutsmodellen var inte effektivare än att inte skräddarsy. I jämförelse med kontrollgruppen självskattade båda behandlingsgrupperna mindre smärta, bättre funktion och mindre symptom efter interventionen. I de länge uppföljningarna (9 och 15 månader) var dock skillnaderna mellan grupperna inte längre signifikanta förutom att båda behandlingsgrupperna, till skillnad från kontrollgruppen, upplevde sig bättre än innan behandling. Det visade sig att upplevd hög stressnivå och låg kontroll på arbetet hade samband med mer självskattad nacksmärta, sämre funktion och lägre arbetsproduktivitet. De fysiska testerna och självskattade nackbesvär hade bara svaga samband. På baslinjenivå, innan interventionen, fanns det samband mellan hög nackstyrka och låg självskattad funktion och låg frekvens på symptomen, samt mellan att vara långsam i testet av snabba huvudrörelser och hög smärta. Efter interventionen hade individernas förändring i självskattad smärta fortfarande bara samband med snabba huvudrörelser. Förbättring i självskattad funktion och symptom hade samband till ökad hastighet i snabba huvudrörelser och ökat rörelseutslag nackrotation. Sammanfattning: För kvinnor i arbete med ospecifika nackbesvär var det inte mer effektivt att skräddarsy behandling/träning utifrån en beslutsmodell jämfört med att slumpmässigt välja ut behandlingskomponenter från samma behandlingsarsenal. En förklaring kan vara att det fanns endast låga samband mellan självskattad smärta och funktion och de fysiska testerna. Upplevd stress och kontroll i arbetet visade sig ha samband med självskattad smärta, funktion och arbetsproduktivitet och bör tas i beaktande i framtida interventioner för individer med nacksmärta.
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Kelson, Denean M. "Muscle Activation Patterns and Chronic Neck-Shoulder Pain in Computer Work." Thesis, Virginia Tech, 2018. http://hdl.handle.net/10919/83759.
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Prolonged computer work is associated with high rates of neck and shoulder pain symptoms, and as computers have become increasingly more common, it is becoming critical that we develop sustainable interventions targeting this issue. Static muscle contractions for prolonged periods often occur in the neck/shoulder during computer work and may underlie muscle pain development in spite of rather low relative muscle load levels. Causal mechanisms may include a stereotypical recruitment of low threshold motor units (activating type I muscle fibers), characterized by a lack of temporal as well as spatial variation in motor unit recruitment. Based on this theory, although studies have postulated that individuals with chronic neck-shoulder pain will show less variation in muscle activity compared to healthy individuals when engaged in repetitive/monotonous work, this has seldom been verified in empirical studies of actual computer work.
Studies have rarely addressed temporal patterns in muscle activation, even though there is a consensus that temporal activation patterns are important for understanding fatigue and maybe even risks of subsequent musculoskeletal disorders. This study applied exposure variation analysis (EVA) to study differences in temporal patterns of trapezius muscle activity as individuals with and without pain performed computer work. The aims of this study were to: Assess the reliability of EVA to measure variation in trapezius muscle activity in healthy individuals during the performance of computer work; Determine the extent to which healthy subjects differ from those with chronic pain in trapezius muscle activity patterns during computer work, measured using EVA.
Thirteen touch-typing, right-handed participants were recruited in this study (8 healthy; 5 chronic pain). The participants were asked to complete three 10-minute computer tasks (TYPE, CLICK and FORM) in two pacing conditions (self-paced, control-paced), with the healthy group completing two sessions and the pain group completing one. Activation of the upper trapezius muscle was measured using surface electromyography (EMG). EMG data were organized into 5x5 EVA matrices with five amplitude classes (0-6.67, 6.67-20, 20-46.67, 46.67-100, >100% Reference Voluntary Exertion) and five duration classes (0-
1, 1-3, 3-7, 7-15, >15 seconds). EVA marginal distributions (along both amplitude and duration classes) for each EVA class, as well as summary measures (mean and SD) of the marginal sums along each axis were computed. Finally, “resultant” mean and SD across all EVA cells were computed. The reliability in
EVA indices was estimated using intra-class correlation coefficients (ICC), coefficient of variation (CV) and standard error of measurement (SEM), computed from repeated measurements of healthy individuals (aim 1), and EVA indices were compared between groups (aim 2).
Reliability of EVA amplitude marginal sums ranged from moderate to high in the self-paced condition and low to moderate in the control-paced condition. The duration marginal sums were moderate in the self-paced condition and moderate to high in the control-paced condition. The summary measures (means and
SDs) were moderate to high in both the self-paced and control-paced condition. Group comparisons revealed that individuals with chronic pain spent longer durations of work time in higher EVA duration categories, exhibited larger means along the amplitude, duration and in the resultant, and higher EVA SD
in the amplitude and duration axes as compared to the healthy group.
To our knowledge, this is the first study to report on the reliability of EVA applied specifically to computer work. Furthermore, EVA was used to assess differences in muscle activation patterns as individuals with and without chronic pain engaged in computer work. Individuals in the pain group seemed to exhibit prolonged sustained activation of the trapezius muscle to a significantly greater extent than controls, even though they did not experience pain during the performance of the computer tasks (as obtained through self-reports). Thus, these altered muscle recruitment patterns observed in the pain subjects, even in the absence of task-based pain/discomfort, are suggestive of chronic motor control changes occurring in adaptation to pain, and may have implications for the etiology of neck and upper-limb musculoskeletal disorders.Master of Science
This study aims to assess the reliability of exposure variation analysis (EVA) to measure variation in trapezius muscle activity in healthy individuals during the performance of computer work, and to determine the extent to which healthy subjects differ from those with chronic pain in trapezius muscle activity patterns during computer work, measured using EVA. Muscle activation was recorded for eight healthy individual and five suffering from chronic neck-shoulder pain. The data were then categorized into amplitude and continuous time categories, and summary measures of resulting distributions were calculated. These measures were used to assess the reliability of participant responses to computer work of healthy individuals, as well as quantify differences between those with and without chronic pain. We found that individuals with pain activated their neck-shoulder muscles for longer continuous durations than healthy individuals, thus showing an inability to relax their muscles when performing work.
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Thompson, David. "Adjustment to chronic neck pain : the important role of cognitive factors." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/adjustment-to-chronic-neck-pain--the-important-role-of-cognitive-factors(11161f26-a707-40f9-9721-87b8cf2614c6).html.
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Chronic neck pain (CNP) is a common and disabling condition, accounting for substantial healthcare and societal costs. Previous studies have demonstrated that certain cognitive factors are related to levels of adjustment (levels of disability, pain and depression) in chronic pain conditions. However, this association has not been adequately explored in patients with CNP. The aim of study one was to determine the relationship between specific cognitive factors and levels of adjustment in participants with CNP. Furthermore, study two explored whether the relationship between the cognitive factors and levels of adjustment differed between those patients with idiopathic CNP and those with Chronic Whiplash Associated Disorder (CWAD). Finally, study three compared the efficacy of a physiotherapy led intervention, specifically designed to modify cognitive factors to a conventional physiotherapy intervention.Study one: Hierarchical multiple regression analyses were performed. Greater catastrophizing and lower functional self-efficacy beliefs were associated with greater levels of pain and disability. Additionally, lower functional self-efficacy beliefs were also associated with greater levels of depression. Study two: Data were dichotomised into two groups: those with CWAD and those with idiopathic CNP. T-tests were performed to compare differences in the cognitive scores and the same regression analyses as study one were performed for each sub-group. No significant differences existed between the two groups in terms of levels of pain, disability, depression or the cognitive factors. In both groups greater catastrophizing and lower functional self-efficacy beliefs were related to levels of disability. Likewise, lower self-efficacy beliefs were related to levels of depression in those participants with idiopathic CNP and those with CWAD. However, amongst those with idiopathic CNP, greater levels of catastrophizing and lower levels of pain vigilance and awareness were related to greater pain intensity. In contrast, amongst those with CWAD, none of the cognitive measures were significantly related to levels of pain intensity.Study three: Participants were randomly allocated to either a progressive neck exercise programme or an intervention which specifically targeted the modification of cognitive factors. T-tests revealed that treatment targeting cognitive factors resulted in greater improvements in pain and pain-related fear. Moreover, Χ2 tests revealed that a greater proportion of patients made clinically meaningful reductions in pain and disability in the group targeting cognitive factors. This thesis highlights that cognitive factors play an important role in determining levels of adjustment in patients with CNP. Furthermore, treatments designed to specifically target these factors result in superior clinical outcomes when compared to conventional physiotherapy interventions.
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Vangronsveld, Karoline Lisette Helena. "By accident pain catastrophizing and fear of movement in patients with neck pain after a motor vehicle accident /." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=9170.
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Rudolfsson, Thomas. "Sensorimotor control and cervical range of motion in women with chronic neck pain : Kinematic assessments and effects of neck coordination exercise." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96172.
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Introduction: Neck pain is a common problem in society and is more prevalent among women. The consequences of neck pain for the individual often include activity and participation limitations, thus affecting many dimensions of life. There is still a lack of understanding of the underlying mechanisms of the disorder and likewise of efficient rehabilitation for people with neck pain. However, coordination exercises have shown promising short-term effects. To carry this line of research forward, there is a need to improve methods for objective characterization of impairments and to investigate novel methods of rehabilitation. Aims: To characterize impairments of active cervical range of motion of the upper and lower cervical levels in women with chronic neck pain with a novel method (Study I and II) and identify the influence of head posture and movement strategies (Study II). Further, to investigate the effects of a novel method for neck coordination exercise on sensorimotor function and neck pain (study III) and the consistencies of motor variability metrics in a goal directed arm movement task to aid the design of future clinical research (Study IV). Methods: All studies were laboratory based with kinematic assessments of neck movements (Study I-III), balance (Study III) and goal directed arm movements (Study III, IV). The studies had designs that were: cross-sectional (I and II), randomized controlled trial (III) or test-retest reliability study (IV). Participants in Study I (n=135) and II (n=160) were women with chronic non-specific neck pain and healthy controls. In Study III, women with chronic non-specific neck pain (n=108) were randomized into three different individually supervised 11 week interventions. Study IV included healthy women (n=14). Results: It was found that cervical range of motion impairments in women with non-specific neck pain were direction- and level-specific; impairments were greater in extension in the upper and flexion in the lower levels of the cervical spine. The magnitude of impairments in range of motion was associated to self-ratings of functioning and health. Possible group differences in natural head posture were rejected as a cause for the direction specific effects. Neither could the effects be explained by a strategy to minimize torque in the cervical spine during movement execution. The neck coordination training was not superior to strength training (best-available) and massage treatment (sham) in improving sensorimotor functions or pain according to short-term and 6 months follow ups. The results from the study of the goal directed movement task showed that between and within-subject sizes of most motor variability metrics were too large to make the test suitable for application in clinical research. Conclusions: Women with chronic non-specific neck pain have direction- and level-specific impairments in cervical sagittal range of motion. The underlying causes of these specific impairments remains unresolved, but the direction specific impairments are not related to natural head posture. The clinical validity of the method of characterization of cervical range of motion was supported and it can be useful in future clinical research. The novel method of neck coordination exercise showed no advantages on sensorimotor functions or pain compared with best-available treatment in women with chronic non-specific neck pain.Långvarig smärta i nacken är vanligt förekommande och orsakar både personligt lidande och stora kostnader för samhället. Långvariga nackbesvär är vanligare hos kvinnor än hos män. Det saknas kunskap om effektiva rehabiliteringsmetoder, men forskning har indikerat att träning som förbättrar nackens koordination kan vara effektivt. För att uppnå bättre rehabiliteringsresultat är det viktigt att utveckla metoder för att objektivt mäta funktionsnedsättningar och att utveckla samt utvärdera nya rehabiliteringsmetoder. Syftet med avhandlingen kan sammanfattas i tre delar: Att detaljerat mäta nedsättningar i nackens rörelseomfång hos kvinnor med långvarig nacksmärta; att utvärdera effekten av en ny metod för nackkoordinationsträning på rörelsefunktion och smärta hos kvinnor med långvarig nacksmärta; samt att utvärdera ett nytt test för att mäta precision och koordination vid målriktade armrörelser och ämnat för framtida klinisk forskning. Resultaten visade att kvinnor med långvarig nacksmärta hade specifika nedsättningar i nacken rörelseomfång; i övre nackregionen var bakåtböjning mer begränsad medan i nedre nackregionen var framåtböjning mer begränsad. Vi kunde utesluta att resultaten berodde på skillnader i huvudets normala hållning. Graden av rörelsebegränsning i nacken uppvisade samband med personernas självskattade funktion, symtom och hälsa. Nackkoordinationsträningen var inte var bättre än styrketräning eller massage för att förbättra rörelsefunktion eller för att minska smärta. Det nya testet för armrörelser var inte lämpat för kliniska studier av rörelseprecision. Slutsatserna från avhandlingsarbetet är att kvinnor med långvarig nacksmärta har begränsningar i nackens rörelseomfång vid framåt- och bakåtböjning av huvudet som är specifika vad gäller nivå i halsryggen och riktning. Att graden av rörelsebegränsning uppvisade samband med självskattad funktion, symtom och hälsa styrker testets kliniska validitet. Ytterligare forskning behövs för att förstå orsakerna bakom de specifika nedsättningarna. Nackkoordinationsträningen som utvärderades kan inte rekommenderas för kvinnor med långvarig nacksmärta eftersom korttidsuppföljning och 6-månadersuppföljning visade att träningsformen inte var bättre än styrketräning eller massage, vare sig när det gällde att förbättra sensomotorisk funktion eller att minska smärta.
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Siivola, S. (Sari). "Neck and shoulder pain in a young population: prevalence and etiological factors." Doctoral thesis, University of Oulu, 2003. http://urn.fi/urn:isbn:9514271009.
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Abstract
This study comprised three parts: a cross-sectional survey of 826 high school students, a 7-year follow-up survey of the same sample, and a MRI study of a subgroup (n=31) of the follow-up study population. Firstly, the aims of the study were to determine the prevalence and incidence of neck and shoulder pain (NSP) in populations 15-18 and 22-25 years old, and to evaluate sociodemographic factors, body size measurements, psychological factors and leisure time activities as possible associated and predictive factors of NSP. Secondly, the aim was to find out whether structural changes of the cervical spine detected by magnetic resonance imaging (MRI) were associated with NSP in young adults.
The results showed the prevalence of self-reported weekly NSP in 15- to 18-year-old adolescents to be 17%, and in seven years, the prevalence of weekly NSP had increased to 28%. After seven years, the six-month incidence of occasional or weekly NSP was 59% among those asymptomatic at baseline. In the cross-sectional study, female gender, low physical activity, hobbies which statically load the upper extremities, low intensity of physical exercise, self-assessed moderate physical condition and psychosomatic symptoms and depressive mood were associated with a high prevalence of NSP, and sports which dynamically load the upper extremities were associated to a low prevalence of NSP.
Symptoms in adolescence were associated with a high prevalence of NSP seven years later. Activity in sports, which dynamically load the upper extremities in adolescence, was associated with a low prevalence of NSP in adulthood. Of all variables in the study, psychosomatic symptoms were most congruently associated with a high prevalence of NSP, and psychosomatic symptoms in adolescence also predicted NSP in adulthood. In the MRI study, disc degeneration and anular tears of the cervical spine were common in asymptomatic and symptomatic subjects. Disc herniations were the only abnormal finding that was significantly more common in symptomatic subjects.
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Ahmed, Hammad, and Mario Batinic. "Prevalence and Risk Factors of Neck Pain Among Dentists and Dental Hygienists." Thesis, Umeå universitet, Tandläkarutbildning, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-97846.
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During the past years it has been reported that musculoskeletal disorders (MSD) have increased in working life. The body region with the highest prevalence of reported pain is the neck region. Several studies show that MSD in the neck region varies between 20–68% among dentists and dental hygienists. The dental personnel work with a limited field of vision and space, which often results in an unnatural work posture. The aim of this study was to evaluate the prevalence of neck pain in dentists and dental hygienists working in the county of Västra Götaland, Sweden and to explore possible work-related and individual risk factors. The study was based on a questionnaire, which was sent out to all dentists and dental hygienists (n = 473) who worked at Folktandvården (response rate 60%). The overall prevalence of neck pain (neck pain every day the past month) was 23%. Female dentists and dental hygienists had an increased risk of neck pain compared to male dentists (OR 2.68, 95% CI 1.22 - 6.75). Dental personnel that experienced severe stress tended to have an increased risk of neck pain compared to those who perceived low stress (OR 2.08, 95% CI 0.94 - 4.53). We conclude that neck pain is a common problem among dental personnel in the county of Västra Götaland. Female dentists and female dental hygienists are at greater risk concerning the prevalence of neck pain.
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Alreni, Ahmad Salah Eldin. "Clinical management and measurement of upper limb disability in neck pain patients." Thesis, Sheffield Hallam University, 2018. http://shura.shu.ac.uk/24065/.
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There is a strong relationship between non-specific neck pain (NS-NP) and upper limb disability (ULD). Optimal management of NS-NP should incorporate upper limb (UL) rehabilitation and therefore include evaluation of ULD using suitable UL outcome measure (OM) in the assessment and during the management process. However, there is no clear guidance regarding the suitability of available measures alongside a lack of information on how physiotherapists in the United Kingdom (UK) measure and rehabilitate their patients with NS-NP. The purpose of this thesis was to explore the clinical measurement and management of ULD in patients with NS-NP. The quantitative research approach adopted by this thesis enabled the researcher to gain a deeper understanding of the clinical measurement and in turn rehabilitation of ULD in patients with NS-NP, and build on knowledge acquired throughout the period of study. In order to support this methodology, a positivist philosophical stance was adopted. A systematic review was completed to identify all available UL OMs that were used for patients with neck pain (NP) and to make recommendations about those that are suitable for use in clinical practice and research. A survey with a national sample of physiotherapists was completed to establish current physiotherapeutic management of NS-NP and ULD in the UK. This was followed by a validation study aimed at exploring the acceptability and feasibility of the Single Arm Military Press (SAMP) test. Subsequently, a second validation study was completed to explore the reliability and validity of the SAMP test in female patients with NS-NP and healthy subjects. The systematic review identified five measures but quality issues prevented a clear recommendation for any of the identified instruments. The survey highlighted substantial gaps in current evidence-based practice of UK physiotherapists regarding the measurement of patients with NS-NP and associated deficits in the measurement and management of ULD in this population. Subsequently, a validation study established the acceptability and feasibility of the SAMP test using a 1-kg hand weight in female patients with NS-NP. In the second validation study, the SAMP test was found to be a reliable and valid UL instrument for female patients with NS-NP. This thesis provided preliminary evidence that the SAMP test is an acceptable, feasible, valid and reliable measure of ULD for female patients with NS-NP and of its suitability for use in clinical practice and research. The SAMP test can be used by clinicians to improve their assessment of UL functional capacity and to suggest management strategies for patients with NS-NP. Further longitudinal studies are required to evaluate the further validity and reliability of the SAMP test in older and younger female patients, and male patients using additional examiners and additional populations. Further studies are required to establish the responsiveness of the SAMP test in patient populations with all types of NP.
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Andersson, Eva-Karin, and Jali Collins. "The influence of Neck Pain on Jaw Motor Function: A Systematic Review." Thesis, Umeå universitet, Institutionen för odontologi, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-154244.
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ABSTRACT Background: Neck pain may influence jaw motor function. If so it would add to a growing body of evidence indicating the need for a more multidisciplinary care of affected patients. The aim of this systematic review was to review the current literature on this subject. Methods: A systematic literature search of the PubMed, Cochrane and Web of Science databases was carried out on September 20th, 2017. Included were studies with jaw motor function measurements, human participants ≥ 16 years old, with unspecified or experimental neck pain and without temporomandibular disorder (TMD) or tooth pain. Results: Of the 1701 initially identified articles, 32 were assessed in full text by two reviewers. Out of seven eligible articles, six were included after a risk of bias assessment. Two studies were contradictory on the effect of neck pain on maximal mouth opening. For maximal voluntary jaw clenching by individuals with/without neck pain, two studies showed no significant difference in force produced, and one study no significant difference in masseter muscle activity. One study showed a facilitated masseter stretch reflex in patients with neck pain. Conclusion: This systematic review shows how unexplored this field of research still is with a limited number of studies available. No firm conclusions could be drawn. Based on the included studies, neck pain seems to affect the jaw stretch reflex, but not the ability of the jaw muscles to produce force. Further research is warranted in the field of how neck pain may influence jaw motor function.
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Tampin, Brigitte. "Clinical and somatosensory characteristics of patients with nerve-related neck-arm pain." Thesis, Curtin University, 2011. http://hdl.handle.net/20.500.11937/106.
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Clinical and somatosensory characteristics of patients with nerve-related neck-arm pain were investigated. This research demonstrated that clinical classification systems are useful in differentiating presentations of nerve-related neck-arm pain and in identifying neuropathic pain components in these cohorts. Distinct clinical and somatosensory profiles were documented for patients with cervical radiculopathy and patients with non-specific neck-arm pain, suggesting differences in the underlying pain types and pain mechanisms. Findings may assist clinicians in better targeting patient management.
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Skillgate, Eva. "Back and neck pain : epidemiological studies on some risk factors and treatments, including naprapathic manual therapy /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-405-1/.
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Kivioja, Jouko. "Patient-related aspects on WAD /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-956-0/.
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Woo, Chuen-hau Alexander. "Association of physical activity during leisure time and pain at the lower back and neck." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31971374.
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Gonçalo, Camila da Silva 1975. "Aplicações da acupuntura e auriculoterapia no cenario odontologico e na atenção primaria em saude." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290244.
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Orientador: Antonio Carlos PereiraDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Considerada atualmente como uma importante tecnologia de saúde especialmente nos casos em que a terapêutica convencional não proporciona resultados satisfatórios, a acupuntura tem demonstrado efetiva redução da dor no tratamento das desordens oromiofaciais, cefaléias e cervicalgias. Neste contexto, três capítulos compuseram o presente estudo. No primeiro capítulo foi conduzida uma revisão de literatura para a compilação sistemática de pontos acupunturais localizados em áreas do corpo humano passíveis de punção durante o atendimento clínico do paciente na cadeira odontológica. Foram encontrados 142 acupontos diretamente relacionados com as principais afecções ligadas à prática da odontologia, além dos pontos auriculares mais freqüentemente empregados neste contexto. No segundo capítulo, foram apresentadas observações clínicas sobre a eficácia do uso da acupuntura e auriculoterapia como recurso terapêutico aplicado à odontologia. Nesta segunda revisão da literatura, 09 tipos de acomentimentos bucofaciais tratados por meio das terapias supracitadas foram encontrados e organizados sistematicamente de acordo com: o tipo de afecção, tratamento acupuntural empregado e resultados obtidos. No terceiro capítulo, foi realizado um estudo clínico sobre o uso da acupuntura e auriculopressão no tratamento de pacientes adultos com cervicalgia crônica, atendidos em um serviço público de atenção primária à saúde, localizado no sul da Espanha. Foi constatada a redução significante da intensidade da dor, do consumo de analgésicos, da incapacidade e das desordens do sono causadas por dor (p< 0, 0001).
Abstract: Currently considered an important technology in health, especially in cases where conventional therapy does not provide satisfactory results, acupuncture has demonstrated effective reduction of pain in the treatment of oromyofaciais disorders, headaches and neck pain. In this context three chapters were included in this study. In the first chapter it was conducted a review of the literature for the systematic compilation of acupuncture points located in the human body áreas that could be punctured on the dental chair during the clinical care of patients. It was found 142 acupoints directly related to the main diseases linked to the practice of dentistry, and ear points most frequently used in this context. In the second chapter, were presented clinical observations about efficacy of acupuncture use and auriculotherapy as a treatment applied to dentistry. In this second review of the literature, 09 types of involvement bucomaxilofacial treated with the therapies cited above were systematically organized according to: the type of disease, acupunctural treatment employed and outcomes. In the third chapter, we present a study on the clinical use of acupuncture and auriculopressure in the treatment of adult patients with chronic neck pain attended in a public primary health care service located in southern Spain. A significant reduction was found in the pain intensity, analgesic consumption, disability and sleep disorders caused by pain (p<0.0001).
Mestrado
Saude Coletiva
Mestre em Odontologia
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Davidsen, Roar Oskar. "Daytime stress, shoulder/neck-pain, and the relation to nocturnal heart rate variability." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for bevegelsesvitenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-13155.
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Stress and musculoskeletal pain (MSP) may affect the regulation of the autonomic nervous system. Earlier studies have revealed that subjects with MSP show reduced heart rate variability (HRV) during sleep indicating an increased sympathetic drive at rest. However, it is unclear whether daytime exposures, such as work stress, stress in leisure, and daytime MSP, affect nocturnal HRV. The aim of this study was therefore to investigate the possible association between daytime stress, shoulder/neck pain (SNP), and nocturnal HRV. Twenty-five female subjects working in health care service participated in the study. Subjective scores of stress and pain were obtained on an hourly basis throughout the workday and subsequent evening. An index for long-term pain was also calculated. Electrocardiography (ECG) was monitored at the end of the workday and until 1 hour after awakening the morning after. Both time and frequency HRV parameters were extracted for further analyses. High stress in leisure time was associated with higher nocturnal HRV (p< .05). In contrast, long-term pain tended to be associated with reduced HRV. Pain or stress during the workday had no effect on nocturnal HRV. The differences between groups were all found for the time domain variable pNN50. No difference was present for the frequency domain parameter. The results of this study both agree with, and are in contrast to earlier studies of MSP and the association with nocturnal HRV. The contrasting results make it difficult to draw a conclusive remark and further studies are needed to elucidate the association between stress, shoulder/neck pain, and nocturnal HRV.
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Michaelson, Peter. "Sensorimotor characteristics in chronic neck pain : possible pathophysiological mechanisms and implications for rehabilitation." Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-368.
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Peterson, Gunnel. "Neck muscle function in individuals with persistent pain and disability after whiplash injury." Doctoral thesis, Linköpings universitet, Avdelningen för fysioterapi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-132420.
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Background: Neck pain and disability are common after whiplash injury. One year after the accident up to 50 % still have symptoms called whiplash associated disorders (WAD). Despite decades of research the cause of persistent pain and disability are largely unknown and effective treatment and diagnostic tools are lacking. Altered neck muscle function may cause pain and disability, and real-time non-invasive methods that investigate both superficial and deep neck muscle function need to be evaluated. Aim: The general aim of the work presented in this thesis was to investigate mechanical neck muscle function and evaluate effects of three different exercise interventions related to neck muscle function in individuals with persistent pain and disability after whiplash injury. Method: The thesis comprised two studies, reported in four papers. Study A was a prospective randomized controlled trail with 216 participants. The effects of three exercise interventions; neck-specific exercises, neck-specific exercises with behavioral approach and prescription of physical activity were evaluated. Neck muscle endurance, perceived pain following testing, kinesiophobia and satisfaction with treatment were compared between the three groups (paper I). Study B was an experimental case-control study with participants consecutively recruited from the randomized controlled trial. Deformation and deformation rates in the neck muscles were investigated with real-time ultrasound imaging during ten repetitive arm elevations (paper II-IV). To investigate ventral neck muscles, 26 individuals with WAD were compared with 26 healthy controls (paper II). The dorsal neck muscles were investigated in paper III, including 40 individuals with WAD and 40 controls. In total 46 individuals, 23 with WAD and 23 healthy controls were included in paper IV to develop ventral neck muscle interaction models. Results: Paper I: Participants in the two neck-specific exercise groups (with and without behavioral approach) showed increased dorsal neck muscle endurance (p = 0.003), decreased pain intensity following testing (p = 0.04) and were more satisfied with treatment (p < 0.001) than participants in the prescribed physical activity group. Kinesiophobia did not significantly differ between groups (p > 0.12). Paper II: Deformation and deformation rate showed linear positive relationship between ventral muscle pairs in healthy controls, especially between superficial and deep neck muscles. This relationship was weaker or absent in the WAD group. Paper III: The WAD group had higher deformation rates in the deepest dorsal neck muscles during the first and tenth (only women) arm elevations compared to the control group (p < 0.04). Women in the WAD group showed a weaker linear relationship between the two deepest dorsal neck muscles compared to women in the control group. Paper IV: The results revealed two different ventral neck muscle models in individuals with WAD and healthy controls (R2Y = 0.72, Q2Y = 0.59). The models were capable to detect different neck muscle interplay in people with WAD. Conclusion: Neck-specific exercise intervention with or without a behavioral approach appears to improve neck muscle endurance in individuals with persistent WAD. Decreased pain after the neck muscle endurance test also suggests improved tolerance of load in these two groups. Altered mechanical neck muscle function was revealed in individuals with WAD indicating decreased muscular support for maintain a stable cervical spine during repetitive arm elevations. The results show great promise for improved diagnosis of neck muscle function in WAD.The corrections in the errata list has been carried out in the electronic version.
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Chang, Chien-Hua, and 張倩華. "The Effects of Acupressure on Neck Pain and Neck Range of Motion for Patient with Sub-acute and Chronic Neck Pain." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/54723438486235526610.
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碩士輔英科技大學
護理系碩士班
95
The purpose of this study was to examine the effects of acupressure on improvement of pain and range of motion for patients with sub-acute and chronic neck pain. A quasi-experimental research design was used for this study. Fifty subjects, who work in bank, school administration office, and scientist technology company in Kaohsiung, were included in this study with neck pain for more than one week and score ≧41 on neck pain and disability scale. Subjects were randomly divided into experimental and the control group, each group consisted of 25 people. Forty-eight people completed this study. The acupressure points of experimental group were Feng chi GB 20、Jianjing GB 21、Jian waishu SI 14, for 3 minutes in each point, 3 to 4 times of each week, ten times acupressure treatment . The control group received the same process of treatment like experimental group, but the acupoints were in the sham points. Data were obtained before and after each treatment, and one week after the completion of the treatment for all groups. Visual analog scale (VAS) with pain , the neck pain and disability scale (NPDS), neck range of motion (neck forward flexion, neck backward extension, neck left and right lateral flexion, and neck left and right rotation), blood pressure, and heart rate were used for data collection. The results showed that the neck pain level (VAS pain score and NPDS score) was significantly improved after acupressure treatment. In addition, there was a significant difference of neck pain between experimental group and control group after the fifth times of acupressure treatment, and this effect was accumulated and continued for one week after treatment. This treatment significantly improved the range of neck motion after ten times of acupressure treatment, but the effects of each time treatment were not stable. Furthermore, the improvement in the neck forward flexion is more significant than the right rotation of neck. One week after the treatment completed, there were significant improvement in the forward flexion, the left lateral flexion, and the right rotation of neck (P=0.003，P=0.02，P=0.01). Comparing the data prior to the intervention, the length of neck forward flexion, neck lateral flexion, and neck rotation was reduced (P＜0.0001、P＜0.0001、p＜0.0001), whereas the length of neck backward extension was extended (P=0.001) after 10 times of intervention. In addition, the most significant improvement of the slope of neck range of motion was neck forward flexion (46%，P<0.0001), neck left and right rotation (13%、13%， P<0.0001、P<0.0001), neck left and right lateral flexion (11%、11%，P<0.0001、P<0.0001), and neck backward extension (5%，P<0.0001) respectively. Finally, acupressure has no significant effects on blood pressure and heart rate. The results of this study can provide information for nurses to improve their independent professional skills as well as increasing the quality of nursing care by reducing pain and increasing the range of neck motion for patients with sub-acute and chronic neck pain.
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Wang, Hsiao-Lan. "Shoulder Pain after Neck Dissection among Head and Neck Cancer Patients." Thesis, 2009. http://hdl.handle.net/1805/1995.
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Indiana University-Purdue University Indianapolis (IUPUI)Shoulder pain was constantly reported as a problematic symptom causing dysfunction and quality of life interference after neck dissection in head and neck cancer patients. Due to a lack of conceptual framework and inconsistency of instrument selection, a comparison among previous studies was almost impossible, making it difficult to understand the phenomenon. The current study applied the University of California, San Francisco School of Nursing Symptom Management Model. The purposes of the study were to (a) describe the symptom experience of shoulder pain at 1 month after neck dissection, (b) describe the relationships among symptom experience of shoulder pain, functional status, and quality of life, and (c) identify the contextual variables, concurrent symptoms, and/or adherence predicting symptom experience of shoulder pain, functional status, and/or quality of life. This was a descriptive study with a convenience sample of head and neck cancer patients. The data were collected via a medical record review, a self-administered survey, and a physical examination. The data from 29 patients were entered for descriptive statistics, Pearson correlations, and multiple regressions. At 1 month after surgery, 62% of patients reported they had shoulder pain at some point within a week. Their shoulder pain was from mild to moderate. Fifty-nine percent complained that shoulder pain bothered them about the moderated level. In the final model, symptom experience, shoulder pain, was significantly correlated with one outcome, active shoulder abduction, but not the other, total quality of life, generic quality of life, and head and neck quality of life. Active shoulder abduction was significantly correlated with three quality of life measures. Adding significant predictors of symptom experience and outcomes into the final model, there is a potential that the model would be useful to guide treatment strategies. Treatment for myofascial pain of the levator scapulae could relieve shoulder pain after neck dissection and improve head and neck quality of life. Those with level V dissection were high risk populations of developing shoulder pain. Risk factors of quality of life, which were depression, loss of sensation, and radiation would describe how an intervention could change or unchange the patient’s life.
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Chou, Yen-chun, and 周彥君. "The Additional Effect Of A Neck Class On Subjects With Neck Pain." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/02683485365706053347.
Full textAbstract:
碩士國立陽明大學
物理治療研究所
91
Background and purpose: Neck pain, like back pain, is a common compliant that may result in functional limitation, disability, and high medical costs. Back education programs have been shown effective in reducing symptoms and back pain recurrence. However, few studies investigated the effectiveness of education programs for treating neck pain. The purpose of the study was to examine the additional effect of a neck education program as an adjunctive treatment for neck pain. Methods: This was a randomized control design. Sixty physical therapy (PT) outpatients with neck pain were randomly assigned to a treatment group (individualized PT + neck class), or a control group (individualized PT only). The “neck class” contained four 45-minute classes of lectures and exercises. Outcome measurements included pain, function, head posture, knowledge, medical utilization, and satisfaction. They were taken before, immediately (posttest1) and 3 months after the intervention (posttest2). Pain was assessed by an 11-point numerical pain scale. Function was evaluated by the Neck Disability Index and Short Form 36-Item Health Survey. Head posture (forward head posture, FHP; resting head position, RHP; and total head excursion, THE) was assessed by the Digitalizing System for Head Posture Assessment. Knowledge was evaluated by a specially developed questionnaire. Medical utilization was counted by the PT treatments received in the 3-month period. Satisfaction was assessed by phone interview to reflect the subject’s overall satisfaction to the treatment for neck pain.. Two-factor (time and group) repeated measures analyses of variance (ANOVA) were used to analyze pain intensity, function and postural variables. An analysis of covariance was used to compare the group difference in medical utilization at posttest2, with the number of pre-intervention PT sessions as the covariate. The Mann-Whitney U test was used to compare the group difference in knowledge and patient satisfaction. The α-level was preset at 0.05. Results: At posttest1, the treatment group showed higher knowledge scores, but failed to demonstrate the time-group interaction in pain and postural variables. The treatment group showed more significant pain reduction than the control group at posttest2 (p<0.05). Both groups showed functional improvement, however, the time-group interaction was not significant. The treatment group improved more in the FHP at posttest2 (p<0.05), but RHP and THE showed no differences in time, group, or time- group interaction. We found significant group differences patient satisfaction, but not in medical utilization. Conclusion: Neck class combined with individualized PT was more effective in reducing pain, correcting forward head posture, improving knowledge, and satisfaction, as compared to individualized therapy alone. However, no additional effects in improving functional status and reducing medical utilization could be demonstrated.
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Chen, Chao-Hsun, and 陳昭勳. "Therapeutic Effects of Acupuncture on Neck Pain." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/26307657191730322786.
Full textAbstract:
碩士中國醫藥大學
針灸研究所碩士班
98
Background: Apply Cervical Range of Motion Instrument & Algometer to measure effects of neck pain after acupuncture therapy. Purpose: Our aim is observation on therapeutic therapeutic effects of acupuncture on neck pain. Methodology: The study was a single-blind randomized controlled trial. All the participants were neck pain of less than 6 months and ages between 20 to 65 years old. Thirty two outpatients were divided into 2 groups. Park Sham Device was adopted in the research. Participants were inserted needles unilateral acupoints between 2 to 6 acupoints on lesion side and retained 20 minutes. Participants received 1 times treatment totally. The measurement tools were contained VAS, Algometer and Cervical Range of Motion Instrument and measured at baseline, after treatment and 1 hour follow up. Outcomes: Compared with the therapeutic effects of internal group by repeated measurement ANOVA. VAS: Two groups had significant difference(p＜0.05). Algometer: Before treatment and 1 hour follow up had significant difference on intolerance pain of real acupuncture; Initial feeling and intolerance pain of sham acupuncture hardly had significant difference. CROM: Range of motion had significant difference of real acupuncture except flexion; On sham acupuncture lesion side rotation had significant difference only. The therapeutic effects of two groups compared with independent t test. It showed significant difference only on 1 hour follow up. Conclusion: It display pain feeling was decreasing, pain threshold and cervical range of motion was increasing after acupuncture.
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Hsu, Min-Yu, and 許名佑. "Mindfulness for Neck and Shoulder Pain Therapy." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/34212618645897445102.
Full textAbstract:
碩士中臺科技大學
醫療暨健康產業管理系碩士班
101
Background and Purpose: Neck and shoulder pain are physical treatment of the common symptoms. Neck and shoulder pain are non-fatal disease, but the physical discomfort and emotional disturbance will seriously reduce the quality of life. Today 's mainstream medicine has improved the measures of neck and shoulder pain, but in recent years, studies have shown that , for some physical therapy services , integrated medicine compared with mainstream medicine has a shorter course of treatment effect . Due to the prevalence of neck and shoulder pain up to 55% , in this study would be like to compare integrated medicine and mainstream medicine are two ways to improve the effectiveness of the differences for neck and shoulder pain . Methods : This study used an experimental method , one is the control group physical therapy , another is the experimental group physical therapy with alternative therapies (Integrated Medicine). 20 people are expected to participate in the random sampling average packet . The experiment is lasted two weeks, five times a week , thirty minutes . The experimental process application visual pain and physical examination as a measurement tool . Results: The general conclusions, MBSR mindfulness body scan activities are consistent with the hypothesis, Can really reduce neck and back pain, and has the effect. MBSR mindfulness body scan activity in the experimental part of the experimental group before and after VAS, neck and back pain and neck disability assessment table has a significant difference in the effect of the experimental part. On clinical is difficult to distinguish causation is caused by neck and back pain due to poor posture, neck and shoulder pain, but facing the neck and back pain use of mindfulness body scan training to accelerate the effects of treatment. Conclusion: Mindfulness therapy affect the physiological mechanisms of pain, neck and back pain for the central sensory nerves to inhibit effective. Mindfulness body scan of interventions to reduce neck and back pain and shorten the course of treatment, not only effectively reduce medical costs, and provide health education of the public health advocacy.
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Shiang-HuaHua and 花湘樺. "Comparison of neck position sense, balance control, and forward reach performance between neck pain patients and pain-free controls." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/qhz943.
Full textAbstract:
碩士國立成功大學
物理治療學系
102
Background: The myofascial pain in the neck and shoulder regions are major cause of mechanical neck pain. Prolonged awkward posture or inappropriate ergonomics may lead to neck myofascial pain with taut bands in muscles. The neck proprioception is mainly controlled by the muscles with high density concentrations of muscle spindles. The proprioceptive information from cervical region links to the whole body via a proprioceptive chain, thus may have direct effect on balance or postural control. Besides, forward reach is composed of chin out and shoulder flexion, and thus requires greater activation of neck extensors. Therefore, the forward reach test may challenge the ability of dynamic balance control in the neck pain patients. The purpose of this study was to compare the neck tissue hardness, pressure pain threshold, neck position sense, electromyography of neck muscles, balance control, and forward reach performance between the patients with mechanical neck pain and the healthy controls. The other purpose is to discuss the relationship between neck position sense and balance control. Methods: Twenty subjects with chronic neck pain (24.1 ± 3.4years, 14F6M) and twenty age-matched healthy controls (23.7 ± 3.3years, 14F6M) participated in this study. The neck pain group received reproduced pain protocol by playing the tablet in sustained neck flexed posture. The tissue hardness and pressure pain threshold were measured in neck pain group before and after pain-induced and in the controls. Both groups were asked to perform the cervical kinesthetic sensibility test, forward reach test, and balance tasks. There were twelve subjects with chronic neck pain performing the tests before pain-induced. The neck proprioception test requires the subjects to relocate the neutral head position after active neck flexion, extension, left and right rotation with eyes closed. The balance tasks were performed with eyes open and eyes closed conditions. Furthermore, the forward reach test was to measure the maximal distance by reaching forward without stepping forward or losing balance. Results: The neck pain group demonstrated harder tissue status and lower pressure pain threshold before and after pain-induced than control group in bilateral suboccipital (p〈.01), upper trapezius (p〈.01) and levator scapulae (p〈.01) muscles. In the cervical kinesthetic sensibility test, there were significant differences between the three conditions (neck pain group before pain-induced vs neck pain group after pain-induced vs control) on absolute error of flexion to neutral in the frontal plane (F=3.718, p=0.031), extension to neutral in the sagittal plane (F=3.384, p=0.042), right rotation to neutral in the frontal plane (F=5.475, p〈0.01), and left rotation to neutral in the sagittal plane (F=5.95, p〈0.01). Besides, there were significant differences on variable error of right rotation to neutral in the transverse plane (F=3.323, p=0.044), and root mean square error of flexion to neutral in the frontal plane (F=3.698, p=0.032), right rotation to neutral in the frontal plane (F=4.522, p=0.016), left rotation to neutral on sagittal plane (F=5.405, p〈0.01), and left rotation to neutral in the transverse plane (F=3.261, p=0.047). In the balance tasks, the COP sway area for neck pain group were greater than those in control group in Romberg stance with eyes-open (p=0.04) and Tandem stance with eyes-open (p=0.004). In forward reach test, there were significant group effect (neck pain before pain-induced vs. neck pain after pain-induced vs. control) on COM forward displacement (F=5.89, p=0.004) and COP forward displacement (F=4.98, p=0.009). In addition, significant pain effect was also found on reach distance (F=4.96, p=0.028) and ACJ displacement (F=13.4, p〈.001). Conclusions: The muscle pain, muscle spasm, and joint dysfunction may influence the perception of neck position, and thus give rise to deficit in standing balance . In addition, patients with neck pain achieved lesser distance with the fixed arm strategy (less acromioclavicular joint displacement) during forward reach. Conversely, the control group had better capacity of moving the COM forward to achieve greater distance primarily by increasing the upper body movement.
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Cresswell, Clare. "The prevalence of fear avoidance and pain catastrophising in patients with chronic neck pain attending private physiotherapy in Johannesburg." Thesis, 2017. https://hdl.handle.net/10539/24224.
Full textAbstract:
A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirement for the degree
of
Master of Science in Physiotherapy
Johannesburg, 2017Background: The cognitive elements of fear avoidance and pain catastrophising in individuals suffering from chronic pain, including chronic low back pain and chronic musculoskeletal conditions, have been found to be significant impediments to recovery. However, little is known about the influence of fear avoidance and pain catastrophising on chronic non-specific neck pain, especially in the context of a South African population. The purpose of this study was to determine the prevalence of fear avoidance and pain catastrophising in patients suffering from chronic neck pain of three or more months’ duration who were attending physiotherapy in private clinics in Johannesburg, South Africa. The objectives of this study were to establish the prevalence of fear avoidance, the prevalence of pain catastrophising, and to establish the association between demographic variables and fear avoidance and pain catastrophising respectively. Methods: In order to fulfil the objectives, a cross-sectional design was used on the basis of the validated Tampa Scale for Kinesiophobia-11 (TSK-11) and the Pain Catastrophising Scale (PCS) questionnaires to determine the prevalence of fear avoidance and pain catastrophising respectively in patients suffering with chronic neck pain. The patients were sampled sequentially from randomly selected private practices in Johannesburg, South Africa, with the particular focus being on musculoskeletal conditions. The demographic data included gender, age, pain intensity, marital status, highest level of education attained, employment status, duration of neck pain, and whether or not the participant had had to reduce his/her work load as a result of the pain experienced. These factors were tested in terms of their association between fear avoidance and pain catastrophising respectively, and of the association between fear avoidance and pain catastrophising itself. A total of 106 participants were interviewed. The data from the questionnaires and the demographic questionnaires were analysed using Statistica, version 12. The results were considered significant when p-values of 0.05 were attained. Results: A total of 106 participants with a mean age of 48.7 years (SD=14.8; range 20-80 years) were drawn sequentially from a randomly selected total of 25 private practices. Female participants constituted 81.1% (n=86) of the total participants and 76.4% had some form of tertiary education. The majority (76.4%) were working and most (79.2%) had not reduced their work load as a result of their pain. Many participants were in a relationship (67.9%) and the pain intensity showed a mean of 4.4 on the VAS (SD=2.2; range 0.3-8.7), with the median pain duration being 96 months (8 years) (IQR=30-180 months) (2.5-15 years); range 3-756 months (0.25-63 years)). The TSK-11–Total showed a mean score of 22.9 and 25.5% of the participants (n=106) presented with significant fear avoidance measured on theTSK-11-Total scale. The prevalence was based on a cut-off equivalent to the midpoint scale. The median score for the PCS-Total was 12. The prevalence of clinically relevant scores for the PCS-Total was 15.1% (n=106) of the population studied, based on a cut-off score of =30. There was a significant, positive correlation between the TSK-Total and the PCS-Total and its subscales; and between the TSK-SF and the PCS-Total and its subscales. Significant association was found between the highest level of education and the TSK-11-Total score. The mean TSK-11 score for those with secondary education (26.0 ± 3.4) was higher than that for patients with a tertiary education (21.9 ± 1.5), indicating that those with a secondary education were more likely to be fear avoidant than those with a tertiary education. There was a significant, positive correlation between pain intensity and the TSK-Total score, and a significant positive correlation between pain intensity and the PCS-Total score. No significant association was found for fear avoidance and pain catastrophising in respect of any of the other demographic variables. Conclusion: This prevalence study established that of the sample of adults attending physiotherapy for chronic non-specific neck pain, 25.5% suffer from fear avoidance and 15.1% suffer from pain catastrophising. An association was found between the total scores for fear avoidance and pain catastrophising. Furthermore, an association was also found between fear avoidance and its subscale, somatic focus, and between pain catastrophising and all its subscales, namely rumination, magnification and helplessness. Yet another positive association was found between secondary education and fear avoidance, and a positive correlation between pain intensity and both fear avoidance and pain catastrophising respectively.
MT2018
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Barker, Ian. "Alterations in neck muscle performance and proprioception with fatique, altered posture and recurrent neck pain." Thesis, 2011. http://hdl.handle.net/10155/189.
Full textAbstract:
Altered neuromuscular processing and motor output as both a risk and perpetuating factor for chronic neck pain is a relative new area of study. The cervical flexion relaxation response (FRR) is a reproducible and reliable marker of differences in neuromuscular function between neck pain patients and controls. Change in joint position sense (JPS) of upper limb joints has also been linked to chronic neck pain. Studies in this thesis sought to develop an experimental model in humans to investigate whether the FRR and JPS can be altered by fatigue and/or postural stress. Additionally a pilot study on the effect of three months of chiropractic treatment on the FRR was conducted. The studies revealed that muscular fatigue is a modulator of the FRR and may play a large role in spine stabilization. Minor postural alterations in the neck can impact joint position error at the elbow and 12 weeks of chiropractic care is a useful therapy to improve chronic and recurrent neck pain as well as improving the cervical FRR.UOIT
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LIN, CHIH-YUAN, and 林志遠. "The Acute Effects of Eye Circular Exercise and Neck Stabilization Exercise on Chronic Neck Pain." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/17019652652265078241.
Full textAbstract:
碩士國立體育大學
運動科學研究所
105
Impaired cervical proprioception is usually been found in neck pain patients and affect neck and head posture control ability, result in repeated pain and leads to chronic neck pain which causing a heavy burden on individual, social and whole country costs. In clinically, eye movement and neck stabilization exercise are used to treat chronic neck pain. Eye circular exercise is a new eye movement and there is no research to discuss the effect of it. Purpose: This study aimed to compare the acute treatment effect of eye circular exercise and neck stabilization exercise for chronic neck pain patients. Methods: Thirty-two subjects with chronic neck pain were recruited, sixteen randomized arranged to eye circular exercise group and sixteen to stabilization exercise group. All subjects were examined and received one time exercise course. Cervical range of motion（CROM）, pain（VAS）, head-to-neutral position error were measured before and after intervention. Result: After intervention, eye circular exercise show decreases of pain intensity（p=0.06） and head to neutral position error in generally（p=0.1）, the stabilization exercise group show a significant decrease of pain intensity（p<0.0001）. There is no significant change in CROM in both groups. No significant different was found between two groups on CROM, pain and head to neutral position error. Conclusion: There is an acute effect of neck stabilization exercise in this study on pain, but there is no significant difference between the acute effect of two groups on CROM, pain and head to neutral position error.
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Wen, Shao-Feng, and 溫紹豐. "The Effectiveness of Naprapathy for Neck and Shoulder Pain." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/89265853694921038143.
Full textAbstract:
碩士國立體育大學
休閒產業經營學系碩士班
101
This research is mainly about the effectiveness of naprapathy for neck and shoulder pain, the influences that neck and shoulder pain have on physical movements, the effectiveness of naprapathy for improving the quality of sleep and moods. In the experiment, the researcher has recruited eight experimental subjects suffering from neck and shoulder pain to receive naprapathy more than three times from June 2012 to June 2013. In the process, observations and recording are conducted. After receiving the therapy, all subjects were interviewed in detail and then, they filled out the questionnaires.From the comparison and the relevance of the questionnaires, the interviews and the reference materials, conclusions of the effectiveness of naprapathy for neck and shoulder pain were given as the following. The researcher found that first, in the experiment of practicing naprapathy, the overall shoulder pain scale was reduced by 76%. Second, in the experiment of practicing naprapathy, the overall neck pain scale was reduced by 68%. Third, when the length of time is controlled to be 30 minutes, neck and shoulder pain can be alleviated. Fourth, the experiment proves that practicing naprapathy helps reduce shoulder and neck pain, improving neck and shoulder movements. In addition, practicing naprapathy makes quality of sleep better. Fifth, subjects’ emotional ups and downs in everyday life are managed. Sixth, in the experiment, a lack of sleep and poor quality of sleep lead to a high possibility of recurrence of shoulder and neck pain. Also, when feeling physically tired, the experimental subjects are prone to getting neck and shoulder pain. Moreover, under the condition that the subjects’ immune systems are low, the possibility of getting neck and shoulder pain comes in the third place. However, the subjects say that when the weather is cold, the possibility to get shoulder and neck pain is the lowest.
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Huang, Jian-Ru, and 黃建儒. "Effects of Thoracic Exercise on Subjects with Neck Pain." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/06006296436435610690.
Full textAbstract:
碩士國立陽明大學
物理治療暨輔助科技學系
98
Background: Neck pain is a common musculoskeletal complaint and near half of the patients may develop persistent neck pain for one year. The relationships between neck pain and abnormal posture or abnormal thoracic mobility have been postulated in the literature. Recent evidences provided in several clinical studies support the use of thoracic thrust manipulation for subjects with neck pain. Therefore, thoracic approaches become a new direction for treating patients with neck pain. Although exercises for thoracic mobility have been used to treat subjects with spinal pain in clinical practice, no studies have investigated the effects of thoracic exercises on pain reduction and/or functional improvement for subjects with neck pain. Purpose of the study: This study was to investigate the additional effects of thoracic exercises compared with the regaular physical therapy treatment program on decreasing neck pain and disability, increasing cervical and thoracic mobility, and improving posture in patients with neck pain. Methods: A single blind randomized controlled trial has been conducted. Fifty-seven patients with neck pain were randomly assigned into either the thoracic exercise (TE) group (n=28) or regular treatment (RT) group (n=29). Both groups received their regular physical therapy treatment and cervical range of motion (ROM) exercises for 12 sessions within 4 to 6 weeks. Only the TE group received additional thoracic exercises. Outcome measures included the cervical ROM, upper thoracic and thoracic ROM, static posture measurement of the forward head angle and thoracic kyphotic angle in 3 different postures (habitual posture, self-corrected posture and verbally-corrected posture), intensity of pain, perceived improvement, function, and disability. Two-way repeated measures analyses of variance with group as the between-subject variable and time as the within-subject variable were used to analyze the effects of the interventions. In order to further understand if there were patients who demonstrated better treatment effects, subgroup analyses were conducted in this study. Three types of subgroups including cervical hypomobility group, thoracic hypomoblity group and cervical and thoracic hypomobility group were identified and analyzed. Results and Discussion: The whole group analysis showed that the TE group demonstrated more improvement in cervical rotation of the restricted side and upper thoracic side-bending of the restricted side. The subgroup analysis showed that in the cervical hypomobility group the TE group showed more increase of their cervical and upper thoracic mobility than the RT group. In upper thoracic hypomobility and thoracic hypomobility subgroups, compared to the RT group, TE group showed significantly better improvement in their cervical, upper thoracic as well as thoracic mobility. Furthermore, TE group also demonstrated significantly greater reduction in pain intensity and disability and more improvement in function than the RT group. However, posture and perceived improvement were found with no significant group by time interactions in all subgroups. In summary, results of this study demonstrated that both the regular treatment program and the thoracic exercise program were effective for patients with neck pain. Patients who had more restriction of their spinal mobility benefited more from the thoracic exercise program in increasing spinal mobility, decreasing disability as well as improving function. Improvement of the upper thoracic and thoracic range of motion can help redistribute cervical joint force, and therefore, decrease neck pain and increase neck mobility. Furthermore, thoracic exercise could increase thoracic extension and side-bending mobility, and thus, contribute to the improvement of disability and function in patients with neck pain. Clinical relevance: Thoracic exercises demonstrated additional effects on improving neck pain, function and disability in patients with neck pain especially in patients who had more restriction of their spinal mobility. Physical therapists should consider adding thoracic exercises into the treatment program for neck pain when appropriate.
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Camitsis, Aaryn. "The effect of craniocervical flexion exercise on cervical posture and cervical range of motion in asymptomatic participants." 2015. http://hdl.handle.net/10321/1210.
Full textAbstract:
Dissertation submitted in partial compliance with the requirements for the Master’s degree in technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2013.Background: Forward head posture (FHP) is a common postural abnormality that is commonly associated with weak deep cervical flexor muscles (DCF). The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting the C7 spinous process to the tragus of the ear. The smaller the angle, the greater the forward head posture. Weak DCF musculature and FHP has been linked to cervical dysfunction in the short and long term such as cervicogenic headache and premature development of cervical regional degenerative joint disease. Improving isometric endurance and neuromotor control of the DCF muscles using craniocervical flexion exercise (CCFE) has been shown to be efficient in patients experiencing cervical dysfunction such as headache, although the relevance of CCFE has not been established in the asymptomatic group. Deficiency in the activity of these muscles can be accurately measured using craniocervical flexion testing (CCFT). There is a paucity of information regarding the definitive relationship between weakness of the DCF and FHP in asymptomatic participants. This research will help establish an efficient and safe prophylactic treatment protocol preventing long term sequela associated with FHP. Objectives: To determine the effect of CCFE on cervical posture by assessment of the CV angle in asymptomatic participants as well as to determine the effect of CCFE on cervical range of motion by assessment of flexion, extension, bilateral rotation and lateral flexion movements in asymptomatic participants whilst measuring the effect of CCFE on isometric endurance and neuromotor control of the DCF muscles assessed by the CCFT in asymptomatic participants. Method: This is a quantitative pre/post intervention study comparing the results of one group of 45 asymptomatic participants before and after the CCFE protocol has been allocated to them over a period of 3-5 weeks. Participants FHP was assessed by measuring the CV angle. This was done by marking the C7 spinous process and extending a horizontal line toward the shoulder. Then marking the tragus of the ipsilateral ear and measuring the angle using the smart tool angle finder (MD products). iv CCFT measurements were taken and the CCFE protocol allocated to those who qualified to take part in the study. Lastly, cervical range of motion was measured. This group received a home exercise protocol of 3 sets of 10 supine chin tucks daily with each repetition being held for 10 seconds. The technique was first ensured by the researcher prior to leaving the consultation rooms and an exercise diary was given to the participant until the 5th and final consultation to record the progress and efficiency of the home programme as well as any complaints regarding this. Result: The asymptomatic group included in the study improved in both the seated and standing CV angle measurements in that the CV was greater at the conclusion of the pre/post intervention (p=0.00000002) and (p=0.000003) respectively . Cervical range of motion showed improvement in some but not all ranges. Flexion showed a reduction in range of motion (p=0.0086) which was significant. Extension showed an improvement in range of motion (p=0.0000002) which was significant. Rotation toward the left (p=0.00003) and right (p=0.00063) showed an improvement in range of motion which was significant. Lateral flexion showed improvement which was not significant in both, left (p=0.0145) and right (p= 0.24985) ranges of motion. Neuromotor control showed 100 percent improvement in that all 45 of the participants were able to perform CCFT correctly through all five stages at conclusion of the study. Conclusion: Therefore it can be concluded that asymptomatic participants will benefit from CCFEs In terms of CV angle improvement, cervical range of motion as well as neuromotor control of the DCF muscles.
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Peek, Nigel Richard. "An investigation into the contributing factors associated with work related musculoskeletal disorders of the neck and shoulders in non- secretarial computer users in a selected corporate banking environment." Thesis, 2005. http://hdl.handle.net/10321/179.
Full textAbstract:
Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005
xii, [137] leavesMusculoskeletal injuries in computer users are an increasing concern. The computer has become an essential working tool that is used throughout all levels of companies and organisations. Management and professional personnel are required to use computers, often without training in typing skills, this combined with higher stress and responsibility levels and lengthy work hours. Potentially this makes them a high-risk group for work related injury. Previous research has focused mainly on data entry and secretarial workers, who are often competent in typing and keyboard skills. There is an increasing body of literature that implicates a wide variety of factors responsible for computer and office related musculoskeletal injury, however there is still much conflict as to what factors play the most influential role in development of these disorders. Conflict largely remains over the role of individual and constitutional factors versus workplace factors such as ergonomic design and patterns of computer use. The aim of this study was therefore to determine the prevalence of and related risk factors associated with work related musculoskeletal injuries of the neck and shoulder in non-secretarial computer users within the South African context.
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Rinke, Marike. "The effect of manual cervical traction versus mechanical cervical traction in the treatment of chronic neck pain." Thesis, 2014. http://hdl.handle.net/10210/9970.
Full textAbstract:
M.Tech. (Chiropractic)Introduction: The most common chronic pain condition in modern society is neck pain (Jensen and Harms-Ringdahl, 2007). Chronic neck pain is a common complaint for many, from young patients to older patients with stressful work situations. According to Graham, Gross and Goldsmith (2006) neck disorders are common, disabling to various degrees and costly. Various structures in the cervical spine capable of transmitting pain include facet joints, intervertebral discs, nerve root dura, ligaments, and muscles (Manchikanti, Singh, Rivera and Pampati, 2002). According to Rochester (2009) chiropractors treat patients with chronic neck pain by using spinal manipulative therapy (SMT) to address a segmental joint hypomobility within the cervical spine as determined by joint motion palpation and endplay assessment. Traction is commonly used for the treatment of the spine by various physical therapists. It may be included as part of a chiropractic treatment protocol. According to Hooper (1996) traction involves the application of both manual and mechanical forces to draw adjacent body parts away from each other resulting in decompressed irritated tissues, realign parts, and relaxing tight structures. There are several types of cervical traction. The short and medium term improvement for chronic neck pain as well as the comparative effect of manual cervical traction versus mechanical cervical traction in combination with spinal manipulative therapy has not yet been established. Aim: This particular research study aimed to compare the short to medium term efficacy of manual cervical traction with mechanical cervical traction combined with spinal manipulative therapy with regards to decreased pain and improvement of cervical spine ranges of motion in patients with chronic neck pain. Methodology: Participants who met the inclusion and exclusion criteria were eligible to participate in this study. Advertisements were placed on notice boards around the campus of the University of Johannesburg and participants were recruited from the use of advertisements as well as word of mouth to partake in this research study. Thirty participants who suffered from chronic neck pain, volunteered for this comparative research study. This study was a randomized comparative study, where participants were randomly selected to be either in Group 1 or in Group 2. Group 1 received manual cervical traction whereas Group 2 received mechanical cervical traction. Both groups received spinal manipulative therapy to the restricted motion segments found in the cervical spine. Participants received seven trial sessions, with six treatments, over a period of two weeks. At the final 7th visit, one month after the sixth visit, no treatment was performed. Subjective and objective measurements were recorded at each visit. The subjective measurements of this particular study consisted of the Numerical Pain Rating Scale (NPRS) and the Vernon-Mior Neck Disability Index to evaluate the participants’ sensitivity to pain and disability. The objective measurements of this study included the Cervical Spine Range of Motion instrument to assess the participants’ cervical spine movement. Results: Both groups demonstrated a statistically significant improvement over time with regards to pain and disability, as well as increased range of motion to the cervical spine. The greatest percentage improvement with regards to range of motion was in lateral flexion and rotation of the cervical spine. Conclusion: According to the results of this study, it could be concluded that either manual cervical traction or mechanical cervical traction in combination with spinal manipulative therapy can be used effectively in the treatment of chronic neck pain as part of a chiropractic treatment protocol. Both groups proved to have a statistically significant improvement with regards to pain and disability as well as increased cervical spine range of motion...