Department of Health Science and Technology, SMI, Aalborg University, Denmark.
Center for Neuroplasticity and Pain (CNAP), SMI, Dept. Of Health Science and Technology, Aalborg University, Denmark.
Eur J Pain. 2017 Nov;21(10):1763-1771. doi: 10.1002/ejp.1088. Epub 2017 Aug 27.
Previous studies have indicated that neck pain patients feel increased symptoms following upper limb activities, and altered axioscapular muscle function has been proposed as a contributing factor.
Pain sensitivity and muscle activity, during arm movements, were assessed in neck pain patients and controls. Patients with ongoing insidious-onset neck pain (IONP, N = 16) and whiplash-associated disorders (WAD, N = 9) were included along with sex- and age-matched controls (N = 25). Six series of repeated arm abductions were performed during electromyographic (EMG) recordings from eight bilateral muscles. The first and last three series were separated by 8 min and 42 s, respectively. Each series consisted of three slow and three fast movements. Pressure pain thresholds (PPTs) were recorded bilaterally from neck, head and arm at baseline, after the third and sixth movement series. Pain intensity was recorded on an electronic visual analogue scale (VAS).
Larger pain areas and higher VAS scores were found in patients compared with controls (p < 0.001), and in patients, the VAS scores increased in the course of movements (p < 0.02). PPTs were lower in patients compared with controls at all sites (p < 0.03), and these decreased during arm movements in the IONP group (p < 0.03), while increasing at head and neck sites in controls (p < 0.04). During the slow movements, increasing serratus anterior EMG activity was found in the series with short breaks in-between for the WAD group compared with IONP and controls (p < 0.001).
Axioscapular movement caused different responses in pain sensitivity and muscle activity between neck pain patient groups compared with controls.
Neck pain patients report increased symptoms following upper limb activities. This study shows that repeated arm movements caused differentiated responses in pain sensitivity and muscle activity between subgroups of neck pain patient and asymptomatic controls. Such findings may be of great clinical significance when planning rehabilitation for this patient population.
先前的研究表明，颈部疼痛患者在上肢活动后会感到症状加重，并且已经提出了轴向肩带肌肉功能改变是一个促成因素。
评估颈部疼痛患者和对照组在手臂运动期间的疼痛敏感性和肌肉活动。纳入了患有隐匿性发作性颈痛（IONP，N=16）和挥鞭样损伤相关疾病（WAD，N=9）的患者以及性别和年龄匹配的对照组（N=25）。在肌电图（EMG）记录期间进行了六组重复手臂外展，记录了来自八个双侧肌肉的 EMG 记录。第一组和最后三组之间的间隔分别为 8 分钟和 42 秒。每组由三个慢动作和三个快动作组成。在基线时、第三组和第六组运动系列之后，双侧记录颈部、头部和手臂的压力疼痛阈值（PPT）。使用电子视觉模拟量表（VAS）记录疼痛强度。
与对照组相比，患者的疼痛区域更大，VAS 评分更高（p<0.001），并且在运动过程中，患者的 VAS 评分增加（p<0.02）。与对照组相比，患者在所有部位的 PPT 均较低（p<0.03），并且在 IONP 组中，在手臂运动期间这些 PPT 降低（p<0.03），而在对照组中，在头部和颈部部位增加（p<0.04）。在缓慢运动期间，与 IONP 和对照组相比，WAD 组在组间休息时间较短的情况下发现前锯肌的 EMG 活动增加（p<0.001）。
与对照组相比，轴向肩带运动在疼痛敏感性和肌肉活动方面引起了不同的反应。
颈部疼痛患者在上肢活动后会感到症状加重。本研究表明，在颈部疼痛患者亚组和无症状对照组之间，重复手臂运动引起了疼痛敏感性和肌肉活动的不同反应。当为该患者人群制定康复计划时，这些发现可能具有重要的临床意义。
