Direction-specific impairments in cervical range of motion in women with chronic neck pain: Influence of head posture and gravitationally induced torque
2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203Article in journal (Refereed) Accepted
Background: Cervical range of motion (ROM) is commonly assessed in clinical practice and research. In a previous study we decomposed active cervical sagittal ROM into contributions from lower and upper levels of the cervical spine and found level- and direction-specific impairments in women with chronic non-specific neck pain. The present study aimed to validate these results and investigate if the specific impairments can be explained by the neutral posture (defining zero flexion/extension) or a movement strategy to avoid large gravitationally induced torques on the cervical spine.
Methods: Kinematics of the head and thorax was assessed in sitting during maximal sagittal cervical flexion/extension (high torque condition) and maximal protraction (low torque condition) in 120 women with chronic non-specific neck pain and 40 controls. We derived the lower and upper cervical angles, and the head centre of mass (HCM), from a 3-segment kinematic model. Neutral head posture was assessed using a standardized procedure.
Findings: Previous findings of level- and direction-specific impairments in neck pain were confirmed. Neutral head posture was equal between groups and did not explain the direction-specific impairments. The relative magnitude of group difference in HCM migration did not differ between high and low torques conditions, lending no support for our hypothesis that impairments in sagittal ROM are due to torque avoidance behaviour.
Interpretation: The direction- and level-specific impairments in cervical sagittal ROM can be generalised to the population of women with non-specific neck pain. Further research is necessary to clarify if torque avoidance behaviour can explain the impairments.
Place, publisher, year, edition, pages
Neck Pain; Cervical Range of Motion; Kinematics; Musculoskeletal pain
IdentifiersURN: urn:nbn:se:hig:diva-23215OAI: oai:DiVA.org:hig-23215DiVA: diva2:1062295
FunderForte, Swedish Research Council for Health, Working Life and Welfare, 2009-1403AFA Insurance, 090288
Additional funding from Centre for Environmental Research in Umeå, Award Number 1152383 and University of Gävle2017-01-052017-01-052017-01-10Bibliographically approved