The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain
Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with incre...
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doaj-2ead01c84b29456abab87d9fb970a98d2020-11-25T04:08:39ZengMDPI AGHealthcare2227-90322020-11-01844944910.3390/healthcare8040449The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck PainByoung-Kwon Lee0Dong-Kwon Seo1Department of Physical Therapy, Konyang University, Daejeon 35365, KoreaDepartment of Physical Therapy, Konyang University, Daejeon 35365, KoreaChronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing gaze direction. We aimed to investigate how DNF and SCM activation varies according to gaze direction in the CCFT, and to prescribe the appropriate gaze direction for CNP. Twenty-eight CNP subjects had their maximum strength pressure level determined by CCFT for strength (20–~30 mmHg) and at each of the measured pressures, DNF and SCM thickness in each of four gaze directions (0°, 20°, 40°, and 60°) was measured by ultrasound imaging. The DNF to SCM ratio varied significantly according to gaze direction (<i>p</i> < 0.05), with gaze directions of 20° and 0° being significantly different from 40° (<i>p</i> < 0.05). Although there was no significant difference in DNF activation according to gaze direction, there was in SCM activation (<i>p</i> < 0.05), with SCM 60° significantly different from SCM 20° and SCM 40° (<i>p</i> < 0.05). In order to increase DNF activation efficiency during the CCFT, SCM activation should be controlled, and a gaze direction below 20° is the most efficient. This can inform DNF training of CNP patients in a clinical environment.https://www.mdpi.com/2227-9032/8/4/449deep neck flexorsternocleidomastoidcranio-cervical flexion testgaze directionchronic neck pain |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Byoung-Kwon Lee Dong-Kwon Seo |
spellingShingle |
Byoung-Kwon Lee Dong-Kwon Seo The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain Healthcare deep neck flexor sternocleidomastoid cranio-cervical flexion test gaze direction chronic neck pain |
author_facet |
Byoung-Kwon Lee Dong-Kwon Seo |
author_sort |
Byoung-Kwon Lee |
title |
The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain |
title_short |
The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain |
title_full |
The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain |
title_fullStr |
The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain |
title_full_unstemmed |
The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain |
title_sort |
importance of optimal gaze direction on deep neck flexor activation in chronic neck pain |
publisher |
MDPI AG |
series |
Healthcare |
issn |
2227-9032 |
publishDate |
2020-11-01 |
description |
Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing gaze direction. We aimed to investigate how DNF and SCM activation varies according to gaze direction in the CCFT, and to prescribe the appropriate gaze direction for CNP. Twenty-eight CNP subjects had their maximum strength pressure level determined by CCFT for strength (20–~30 mmHg) and at each of the measured pressures, DNF and SCM thickness in each of four gaze directions (0°, 20°, 40°, and 60°) was measured by ultrasound imaging. The DNF to SCM ratio varied significantly according to gaze direction (<i>p</i> < 0.05), with gaze directions of 20° and 0° being significantly different from 40° (<i>p</i> < 0.05). Although there was no significant difference in DNF activation according to gaze direction, there was in SCM activation (<i>p</i> < 0.05), with SCM 60° significantly different from SCM 20° and SCM 40° (<i>p</i> < 0.05). In order to increase DNF activation efficiency during the CCFT, SCM activation should be controlled, and a gaze direction below 20° is the most efficient. This can inform DNF training of CNP patients in a clinical environment. |
topic |
deep neck flexor sternocleidomastoid cranio-cervical flexion test gaze direction chronic neck pain |
url |
https://www.mdpi.com/2227-9032/8/4/449 |
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