Jull G A, Falla D, Vicenzino B, Hodges P W
Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
Man Ther. 2009 Dec;14(6):696-701. doi: 10.1016/j.math.2009.05.004. Epub 2009 Jul 25.
Deep cervical flexor muscle (DCF) activation is impaired with neck pain. This study investigated the effects of low load cranio-cervical flexion (C-CF) and neck flexor strengthening exercises on spatial and temporal characteristics of DCF activation during a neck movement task and a task challenging the neck's postural stability. Forty-six chronic neck pain subjects were randomly assigned to an exercise group and undertook a 6-week training program. Electromyographic (EMG) activity was recorded from the DCF, sternocleidomastoid (SCM) and anterior scalene (AS) muscles pre and post intervention during the cranio-cervical flexion test (CCFT) and during perturbations induced by rapid, unilateral shoulder flexion and extension. C-CF training increased DCF EMG amplitude and decreased SCM and AS EMG amplitude across all stages of the CCFT (all P<0.05). No change occurred in DCF EMG amplitude following strength training. There was no significant between group difference in pre-post intervention change in relative latency of DCF but a greater proportion of the C-CF group shortened the relative latency between the activation of the deltoid and the DCF during rapid arm movement compared to the strength group (P<0.05). Specific low load C-CF exercise changes spatial and temporal characteristics of DCF activation which may partially explain its efficacy in rehabilitation.
颈部深层屈肌（DCF）的激活在颈部疼痛时会受损。本研究调查了低负荷颅颈屈曲（C-CF）和颈部屈肌强化训练对颈部运动任务以及挑战颈部姿势稳定性任务期间DCF激活的空间和时间特征的影响。46名慢性颈部疼痛受试者被随机分配到运动组，并进行了为期6周的训练计划。在颅颈屈曲试验（CCFT）期间以及快速单侧肩部屈伸引起的扰动过程中，干预前后记录DCF、胸锁乳突肌（SCM）和前斜角肌（AS）的肌电图（EMG）活动。C-CF训练在CCFT的所有阶段均增加了DCF的EMG幅度，并降低了SCM和AS的EMG幅度（所有P<0.05）。力量训练后DCF的EMG幅度没有变化。DCF相对潜伏期的干预前后变化在组间无显著差异，但与力量训练组相比，C-CF组在快速手臂运动期间，三角肌和DCF激活之间的相对潜伏期缩短的比例更大（P<0.05）。特定的低负荷C-CF运动改变了DCF激活的空间和时间特征，这可能部分解释了其在康复中的疗效。
