Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Germany; Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology (BFNT) Göttingen, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Germany.
Eur J Pain. 2013 Nov;17(10):1517-28. doi: 10.1002/j.1532-2149.2013.00321.x. Epub 2013 May 6.
Although exercise can be effective for relief of neck pain, little is known about the effect of exercise on the neural control of neck muscles.
A randomized controlled trial was conducted on 46 women with chronic neck pain to investigate the immediate effectiveness of an 8-week exercise programme on pain and directional specificity of neck muscle activity. At baseline, the patients completed questionnaires including the neck disability index (NDI) and performed a circular contraction of their head in the horizontal plane at 15 N force, with continuous change in force direction in the range 0-360°. Electromyography (EMG) was recorded from the sternocleidomastoid (SCM) and splenius capitis (SCap) muscles. Tuning curves of the EMG amplitude were computed, which depicts muscle activity over a range of force directions. The mean point of the tuning curves defined a directional vector, which determined the specificity of muscle activity. Patients were randomly assigned either to a training or control group.
A significant between-group difference in the change in NDI was observed. A reduction in NDI was observed following training (pre: 18.2 ± 7.4; post: 14.1 ± 6.5; p < 0.01) but not for the control group (pre: 17.5 ± 6.3; post: 16.6 ± 7.4). The training group showed higher specificity of muscle activity post-intervention (pre: 18.6 ± 9.8%, post: 24.7 ± 14.3%; p < 0.05), whereas no change occurred for the control group (pre: 19.4 ± 11.9%, post: 18.2 ± 10.1%).
An exercise programme that aims to enhance motor control of the cervical spine improves the specificity of neck muscle activity and reduces pain and disability in patients with neck pain.
尽管运动对于缓解颈部疼痛可能有效，但对于运动对颈部肌肉神经控制的影响知之甚少。
对 46 名患有慢性颈部疼痛的女性进行了一项随机对照试验，以研究为期 8 周的运动方案对疼痛和颈部肌肉活动方向特异性的即时影响。在基线时，患者完成了包括颈部残疾指数（NDI）在内的问卷，并在 15N 力的情况下在水平面内进行头部的圆形收缩，力的方向在 0-360°范围内连续变化。记录胸锁乳突肌（SCM）和头夹肌（SCap）的肌电图（EMG）。计算了 EMG 幅度的调谐曲线，该曲线描绘了肌肉在一系列力方向上的活动。调谐曲线的平均点定义了一个方向向量，确定了肌肉活动的特异性。患者被随机分配到训练组或对照组。
在 NDI 的变化方面观察到组间有显著差异。训练组的 NDI 降低（前：18.2±7.4；后：14.1±6.5；p<0.01），但对照组没有（前：17.5±6.3；后：16.6±7.4）。训练组在干预后肌肉活动的特异性更高（前：18.6±9.8%，后：24.7±14.3%；p<0.05），而对照组没有变化（前：19.4±11.9%，后：18.2±10.1%）。
旨在增强颈椎运动控制的运动方案可提高颈部肌肉活动的特异性，并减轻颈部疼痛患者的疼痛和残疾。
