Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 390014049-900, Brazil.
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.
Eur Spine J. 2019 Oct;28(10):2311-2318. doi: 10.1007/s00586-019-06097-9. Epub 2019 Aug 9.
Neck pain is considered a common characteristic of migraine attacks. The relationship between neck pain and migraine can be explained by central sensitization of the trigeminocervical complex, where superior cervical afferents and the trigeminal nerve converge. However, few studies have evaluated motor control of cervical muscles in individuals with migraine. Thus, the purpose of the present study was to determine the extensor/flexor ratio of neck muscle strength and electromyographic activity during a test of maximal voluntary isometric contraction and craniocervical flexion in individuals with migraine and individuals without history of migraine or other headaches.
Fifty-two women with the disease and 52 women with neither a history of migraine nor neck pain, between 18 and 55 years old, were included in the study. The electromyographic activities of the sternocleidomastoid, anterior scalene, splenius capitis, and upper trapezius muscles were evaluated during a test of maximal voluntary isometric contraction and craniocervical flexion.
The migraine group presented lower flexor muscle strength and a higher extensor/flexor muscle strength ratio than the control group. In addition, the migraine group showed a reduced electromyographic extensor/flexor muscle ratio during maximal voluntary isometric contraction in flexion. The results demonstrated worse performance in the craniocervical flexion test of the migraine group and a lower electromyographic ratio of extensor/flexor neck muscles in the last stage of the test.
Altogether, the migraine group presented an imbalance in cervical muscles verified not only during force production, but also during muscle activity. These slides can be retrieved under Electronic Supplementary Material.
颈痛被认为是偏头痛发作的常见特征。颈痛与偏头痛之间的关系可以用三叉颈复合体的中枢敏化来解释,其中颈上神经的传入纤维和三叉神经会聚。然而,很少有研究评估偏头痛患者颈椎肌肉的运动控制。因此,本研究的目的是确定偏头痛患者和无偏头痛或其他头痛史的个体在最大自主等长收缩和颅颈屈曲测试中颈肌的伸肌/屈肌比值和肌电图活动。
本研究纳入了 52 名患有偏头痛的女性和 52 名既无偏头痛也无颈痛史的女性,年龄在 18 至 55 岁之间。在最大自主等长收缩和颅颈屈曲测试中,评估了胸锁乳突肌、前斜角肌、头夹肌和上斜方肌的肌电图活动。
偏头痛组的屈肌肌力较低,伸肌/屈肌肌力比值较高。此外,偏头痛组在屈曲时的最大自主等长收缩中表现出伸肌/屈肌肌电图比值降低。结果表明,偏头痛组在颅颈屈曲测试中的表现较差,在测试的最后阶段,颈伸肌/屈肌的肌电图比值较低。
总之,偏头痛组不仅在肌力产生时,而且在肌肉活动时,颈椎肌肉的平衡都受到了损害。这些幻灯片可以在电子补充材料中检索到。