Schomacher Jochen, Erlenwein Joachim, Dieterich Angela, Petzke Frank, Falla Deborah
Alte Landstrasse 142, Küsnacht ZH, Switzerland.
Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany.
Man Ther. 2015 Oct;20(5):694-702. doi: 10.1016/j.math.2015.04.010. Epub 2015 Apr 17.
The deep cervical extensor, semispinalis cervicis, displays changes in behaviour and structure in people with chronic neck pain yet there is limited knowledge on how activation of this muscle can be emphasized during training. Using intramuscular electromyography (EMG), this study investigated the activity of the deep semispinalis cervicis and the superficial splenius capitis muscle at two spinal levels (C2 and C5) in ten healthy volunteers during a series of neck exercises: 1. Traction and compression, 2. Resistance applied in either flexion or extension at the occiput, at the level of the vertebral arch of C1 and of C4, and 3. Maintaining the neck in neutral while inclined on the elbows, with and without resistance at C4. The ratio between semispinalis cervicis and the splenius capitis EMG amplitude was quantified as an indication of whether the exercise could emphasize the activation of the semispinalis cervicis muscle relative to the splenius capitis. Manual resistance applied in extension over the vertebral arch emphasized the activation of the semispinalis cervicis relative to the splenius capitis at the spinal level directly caudal to the site of resistance (ratio: 2.0 ± 1.1 measured at C5 with resistance at C4 and 2.1 ± 1.2 measured at C2 with resistance at C1). This study confirmed the possibility of emphasizing the activation of the semispinalis cervicis relative to the splenius capitis which may be relevant for targeted exercise interventions for this deep extensor muscle. Further studies are required to investigate the clinical efficacy of these exercises for people with neck pain.
颈深部伸肌即颈半棘肌，在慢性颈痛患者中表现出行为和结构的变化，但对于如何在训练中增强该肌肉的激活，目前了解有限。本研究采用肌内肌电图（EMG），对10名健康志愿者在一系列颈部练习过程中，颈半棘肌深部和头夹肌浅部在两个脊柱节段（C2和C5）的活动进行了研究：1. 牵引和按压；2. 在枕部、C1椎弓水平和C4椎弓水平施加屈伸阻力；3. 双肘支撑时颈部保持中立位，C4水平有无阻力。通过量化颈半棘肌与头夹肌EMG振幅的比值，来判断该练习是否能增强颈半棘肌相对于头夹肌的激活。在椎弓上施加伸展方向的手动阻力时，在阻力部位直接尾侧的脊柱节段，颈半棘肌相对于头夹肌的激活增强（比值：C4施加阻力时，C5处测量值为2.0±1.1；C1施加阻力时，C2处测量值为2.1±1.2）。本研究证实了增强颈半棘肌相对于头夹肌激活的可能性，这可能与针对该深部伸肌的针对性运动干预有关。还需要进一步研究来探讨这些练习对颈痛患者的临床疗效。
