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1.
Medicina (Kaunas) ; 58(7)2022 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-35888636

RESUMO

Background and objectives: Chronic tension-type headache (TTH) is the type of headache with the highest prevalence. The involvement of musculoskeletal structures in TTH is supported by evidence in the scientific literature. Among these, deep cervical muscle strength appears to be related to the function of the cervical spine and the clinical characteristics of TTH. This study aimed to correlate anatomical, functional, and psychological variables in patients with TTH. Materials and methods: An observational descriptive study was carried out with 22 participants diagnosed with TTH for at least six months. The characteristics of headaches, including ultrasound-based deep neck flexor and extensor muscle thickness, range of motion (ROM), and pressure pain threshold (PPT), were recorded. We also conducted the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Craniocervical Flexion Test (CCFT). Results: Moderate-large negative correlations were found between the PVAQ and the muscle thickness of right deep flexors contracted (r = -0.52; p = 0.01), left multifidus contracted (r = -0.44; p = 0.04), right multifidus at rest (r = -0.48; p = 0.02), and right multifidus contracted (r = -0.45; p = 0.04). Moderate-large positive correlations were found between the CCFT score and the left cervical rotation ROM (r = 0.53; p = 0.01), right cervical rotation ROM (r = 0.48; p = 0.03), muscle thickness of left multifidus contracted (r = 0.50; p = 0.02), and muscle thickness of right multifidus at rest (r = 0.51; p = 0.02). The muscle thickness of the contracted right deep cervical flexors showed a moderate negative correlation with headache intensity (r = -0.464; p = 0.03). No correlations were found between PPT and the rest of the variables analyzed. Conclusions: In patients with TTH, a higher thickness of deep cervical muscles was associated with higher ROM and higher scores in the CCFT. In turn, the thickness of deep cervical muscles showed negative correlations with pain hypervigilance and headache intensity. These results contribute to a better understanding of the physical and psychosocial factors contributing to the development of TTH, which is useful for implementing appropriate prevention and treatment measures.


Assuntos
Cefaleia do Tipo Tensional , Vértebras Cervicais , Cefaleia , Humanos , Músculos do Pescoço/fisiologia , Amplitude de Movimento Articular/fisiologia
2.
Surg Radiol Anat ; 44(7): 987-990, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35838777

RESUMO

PURPOSE: To report a previously undocumented variant of sternalis. METHODS: An unusual muscle was observed during routine dissection. RESULTS: The sternalis muscle located in the right thoracic region originated from the superior portion of the rectus abdominis sheath and 5-6th costal cartilages, crossed the midline and attached at the sternum. The muscle fibers then ascended with the left sternocleidomastoid muscle as an additional fasciculus, of which the superior ends were finally terminated at the left mastoid process. The sternalis muscle of the thoracic region was innervated by the anterior cutaneous branches of right intercostal nerve, while the additional fasciculus ascended with the left sternocleidomastoid muscle was innervated by the branches of left accessory nerve. CONCLUSIONS: This study presents a unilateral sternalis muscle with the contralateral sternocleidomastoid variation. It will enhance the exhaustive classification of sternalis, and provide significant information to radiologists, angiologists and surgeons for better interpretation of images and safer interventions.


Assuntos
Parede Torácica , Cadáver , Humanos , Músculo Esquelético/inervação , Músculos do Pescoço/diagnóstico por imagem , Esterno/diagnóstico por imagem
3.
Surg Radiol Anat ; 44(6): 877-882, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35715572

RESUMO

PURPOSE: Few reports have been published regarding the microanatomy of the dura mater located at the craniovertebral junction (CVJ). In clinic, the precise microanatomy of the CVJ dura mater would be taken into account, for reducing surgical complications and ineffective surgical outcomes. The main objective of the present investigation was to further elucidate the fiber composition and sources of the cervical spinal dura mater. METHODS: The formalin-fixed adult head and neck specimens (n = 21) were obtained and P45 plastinated section method was utilized for the present study. The fibers of the upper cervical spinal dura mater (SDM) were examined in the P45 sagittal sections in the CVJ area. All photographic documentation was performed via a Canon EOS 7D Mark camera. RESULTS: The posterior wall of the SDM sac at CVJ was found to be composed of stratified fibers, which are derived from three sources: the cerebral dura mater, the occipital periosteum, and the myodural bridge (MDB). The proper layer of the cerebral dura mater passes over the brim of the foramen magnum and enters the vertebral canal to form the inner layer of the SDM, and the fibers originating from the periosteum of the brim of the foramen magnum form the middle layer. The fibers of the MDB are inserted into the SDM and form its outer layer. It was found that the total number of fibers from each origin varied in humans. CONCLUSION: At the CVJ, the posterior wall of the SDM is a multi-layered structure composed of three different originated fibers. The cerebral dura mater, the periosteum located at the brim of the foramen magnum, and MDB contribute to the formation of the SDM. The present study would be beneficial to the choice of surgical approach at the CVJ and the protection of the SDB.


Assuntos
Músculos do Pescoço , Plastinação , Vértebras Cervicais/anatomia & histologia , Dura-Máter/anatomia & histologia , Humanos , Pescoço/anatomia & histologia , Músculos do Pescoço/anatomia & histologia
4.
Medicina (Kaunas) ; 58(6)2022 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-35743991

RESUMO

Background and Objectives: The purpose of this study was to investigate the activity of bilateral cervical extensors and flexors on the sagittal, frontal, and horizontal planes of healthy adults during motions of the neck in a sitting position, which has not been satisfactorily investigated by surface electromyogram (sEMG). Materialand Methods: We recruited 35 healthy participants (mean ± standard deviation of age, 20.3 ± 2.4). sEMG recordings of the cervical extensors and flexors were performed for a total of nine seconds in three phases: Phase I involved the motion of the neck from the neutral position to the maximum range of motion; Phase II involved maintaining the neck at the maximum range of motion; and Phase III involved the motion of the neck from the maximum range of motion to the neutral position during neck flexion, extension, right and left lateral flexion, right and left rotation, and maintaining the neck in the neutral position. Muscle activities in each motion were normalized as a percentage of maximal voluntary contraction (%MVC) so that the muscles could be compared. Results: The %MVC of the extensors was significantly larger than that of the flexors in the neutral position (p < 0.001). In addition, the %MVCs of the following were significantly larger than the %MVC in the neutral position: the extensors in flexion (p = 0.014) and extension (p = 0.020), the ipsilateral extensors (p = 0.006) and flexors (p < 0.001) in lateral flexion in Phase I; the flexors in flexion (p < 0.001), the extensors in extension (p = 0.010), and the ipsilateral extensors and flexors in lateral flexion (p < 0.001) in Phase II; the extensors and flexors in flexion (p < 0.001), the flexors in extension (p < 0.001), the ipsilateral flexors (p < 0.001), the contralateral flexors (p = 0.004) and the contralateral extensors (p = 0.018) in lateral flexion in Phase III; and the bilateral extensors and contralateral flexors during rotation in all three phases (p < 0.001). Conclusion: The typical sEMG activities of the extensors and flexors during motion of the neck in healthy adults were identified in this study; this information can be used to understand the pathophysiology of non-specific neck pain and to provide an index for evaluating the effect of treatment.


Assuntos
Contração Muscular , Músculos do Pescoço , Adolescente , Adulto , Estudos Transversais , Eletromiografia , Humanos , Contração Muscular/fisiologia , Pescoço , Músculos do Pescoço/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto Jovem
5.
J Bodyw Mov Ther ; 31: 90-96, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710228

RESUMO

PURPOSE: To investigate and compare the effects of therapeutic exercise, therapeutic ultrasound and photobiomodulation on pain, functionality and recruitment pattern of motor units, after a rehabilitation protocol for seamstresses with neck pain. MATERIALS AND METHODS: All 36 female, randomly divided into three groups; i)exercise control group, ii)exercise and photobiomodulation group, iii)exercise and ultrasound group. The groups were composed of sewing machine operators with complaints neck pain. Clinical evaluations: Visual analog pain scale, questionnaires Nordic Musculoskeletal Questionnaire and the International Physical Activity Questionnaire, and electromyographic evaluations of the sternocleidomastoid and upper trapezius muscles. All variables were compared before and after the protocol. For statistical analysis, the values of mean, standard deviation and standard error of the mean were used. The values obtained were compared using the One-Way ANOVA with post-hoc Tukey, and Cohen's-d, with a significance coefficient of p < 0.05. RESULTS: In the Ultrasound and laser groups there was a greater tendency to improve pain (p < 0.0001) and size of the effect on pain reduction (ultrasound = d:1.99; photobiomodulation = d:1.81). Between groups, there was a significant difference in post-treatment for the onset of right trapezius (p = 0.024) in the exercise and photobiomodulation groups (p = 0.0347). The photobiomodulation group showed pre and post-intervention differences in the left trapezius maximum onset (p = 0.010). CONCLUSION: Interventions with photobiomodulation, ultrasound, and exercise assist to pain, function, and muscular activation in seamstresses with neck pain.


Assuntos
Cervicalgia , Músculos Superficiais do Dorso , Terapia por Exercício , Feminino , Humanos , Músculos do Pescoço , Cervicalgia/reabilitação , Medição da Dor , Método Simples-Cego
7.
J Manipulative Physiol Ther ; 45(1): 33-44, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35753874

RESUMO

OBJECTIVES: The purpose of this study was to investigate the extent of electromyographic responses associated with manual high-velocity, low-amplitude (HVLA) spinal manipulation systematically applied to the upper and lower cervical and upper thoracic spines in a cohort with mild neck disability. METHODS: The study was a descriptive observational investigation, with all participants receiving the same interventions. Nineteen participants with mild neck disability received 6 manual HVLA manipulations to the cervical and upper thoracic spine. Bipolar surface electromyography electrode pairs were used to measure responses of 16 neck, back, and limb outlet muscles bilaterally. The number of electromyographic responses was then calculated. RESULTS: Electromyographic responses associated with cervical and thoracic manipulation occurred in a median of 4 of the 16 (range: 1-14) recorded muscles. Cervical spinal manipulation was associated with the highest rates of electromyographic responses in neck muscles, whereas responses in back muscles were highest after upper thoracic manipulation. CONCLUSION: Cervical spinal manipulation was associated with the highest rate of electromyographic responses in muscles of the cervical spine (sternocleidomastoid and splenius cervicis), whereas responses in back muscles (upper and middle trapezius, latissimus dorsi, and longissimus thoracis) were highest after upper thoracic manipulations. This result suggests that electromyographic muscular responses associated with spinal manipulation primarily occur locally (close to the target segment) rather than distally.


Assuntos
Músculos do Dorso , Manipulação da Coluna , Vértebras Cervicais , Eletromiografia , Humanos , Músculos do Pescoço , Cervicalgia
8.
Sensors (Basel) ; 22(12)2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35746295

RESUMO

Swallowing is a complex sequence of highly regulated and coordinated skeletal and smooth muscle activity. Previous studies have attempted to determine the temporal relationship between the muscles to establish the activation sequence pattern, assessing functional muscle coordination with cross-correlation or coherence, which is seriously impaired by volume conduction. In the present work, we used conditional Granger causality from surface electromyography signals to analyse the directed functional coordination between different swallowing muscles in both healthy and dysphagic subjects ingesting saliva, water, and yoghurt boluses. In healthy individuals, both bilateral and ipsilateral muscles showed higher coupling strength than contralateral muscles. We also found a dominant downward direction in ipsilateral supra and infrahyoid muscles. In dysphagic subjects, we found a significantly higher right-to-left infrahyoid, right ipsilateral infra-to-suprahyoid, and left ipsilateral supra-to-infrahyoid interactions, in addition to significant differences in the left ipsilateral muscles between bolus types. Our results suggest that the functional coordination analysis of swallowing muscles contains relevant information on the swallowing process and possible dysfunctions associated with dysphagia, indicating that it could potentially be used to assess the progress of the disease or the effectiveness of rehabilitation therapies.


Assuntos
Transtornos de Deglutição , Deglutição , Deglutição/fisiologia , Eletromiografia/métodos , Humanos , Músculos do Pescoço/fisiologia
9.
BMC Anesthesiol ; 22(1): 181, 2022 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-35698062

RESUMO

BACKGROUND: Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization. METHODS: The study included 30 volunteers. The volunteer's head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6-14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides - heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis. RESULTS: There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles. CONCLUSION: The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent. TRAIL REGISTRATION: ChiCTR2000034233 , Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.


Assuntos
Cateterismo Venoso Central , Veias Jugulares , Músculos do Pescoço , Cabeça , Humanos , Veias Jugulares/diagnóstico por imagem , Músculos , Músculos do Pescoço/anatomia & histologia , Ultrassonografia
10.
Aerosp Med Hum Perform ; 93(5): 458-466, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35551729

RESUMO

INTRODUCTION: Between 43 and 97% of helicopter pilots in the Canadian Armed Forces report neck pain. Potential contributing factors include the weight of their helmet, night vision goggles (NVG), and counterweight (CW) combined with deviated neck postures. Therefore, the purpose of this investigation was to quantify changes in neck loads associated with posture, helmet, NVG, and CW.METHODS: Eight male subjects volunteered. They undertook one of five deviated neck postures (flexion, extension, lateral bending, axial rotation) times four configurations (no helmet, helmet only, helmet and NVG, and helmet, NVG, and CW). 3D kinematics and EMG from 10 muscles (5 bilaterally) drove a 3D inverse dynamics, EMG-driven model of the cervical spine which calculated joint compression and shear at C5-C6.RESULTS: The compression in the neutral posture was 116.5 (5.7) N, which increased to 143.7 (11.4) N due to a 12.7 N helmet. NVGs, weighing 7.9 N, also generated this disproportionate increase, where the compression was 164.2 (3.7) N. In flexion or extension, the compression increased with increasing head-supported mass, with a maximum of 315.8 (67.5) N with the CW in flexion. Anteroposterior shear was highest in the lateral bending [34.0 (6.2) N] condition, but was generally low (< 30 N). Mediolateral shear was less than 5 N for all conditions.DISCUSSION: Repositioning the center of gravity of the helmet with either NVGs or CW resulted in posture-specific changes to loading. Posture demonstrated a greater potential to reposition the head segment's center of gravity compared to the helmet design. Therefore, helmet designs which consider repositioning the center of gravity may reduce loads in one posture, but likely exacerbate loading in other postures.Barrett JM, McKinnon CD, Dickerson CR, Laing AC, Callaghan JP. Posture and helmet configuration effects on joint reaction loads in the middle cervical spine. Aerosp Med Hum Perform. 2022; 93(5):458-466.


Assuntos
Dispositivos de Proteção da Cabeça , Músculos do Pescoço , Fenômenos Biomecânicos , Canadá , Vértebras Cervicais , Eletromiografia , Humanos , Masculino , Músculos do Pescoço/fisiologia , Postura/fisiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-35577432

RESUMO

BACKGROUND AND OBJECTIVES: Examine vestibular evoked myogenic potential (VEMP) responses recorded from surface electrodes over Splenius Capitis (SPC) in a seated position. SPECIFIC AIMS: (1) validate response characteristics of VEMP recordings from surface electrodes over Sternocleidomastoid (SCM) and over SCP and (2) assess age effects on responses in adolescents and young adults. MATERIALS AND METHODS: Simultaneous surface VEMP was recorded bilaterally from electrodes placed over the dorsal neck musculature at a location known from previous work to record from SPC in 15 healthy participants during trials with head rotation toward and away from the stimulated ear. VEMP was also recorded from electrodes over SCM, ipsilateral to the stimulus ear, in the same participants in a supine, head lift/turn position. RESULTS: Response amplitudes significantly increased with contraction strength and decreased with age. Participants were able to maintain sufficient contraction strength (amplitude) with head rotation to reliably measure over SPC. Normalized response amplitudes measured from electrodes over contralateral SPC were largest with head rotation contralateral to the stimulus ear. Normalized amplitudes and peak latencies were comparable to the same measures from SCM obtained in supine, head lift/turn position. CONCLUSIONS: Otolith generated myogenic responses can be recorded seated from electrodes over the dorsal neck with head rotation contralateral to the stimulus ear. In this position, contralateral recordings are consistent with responses known from previous work to arise from SPC; ipsilateral recordings may include crosstalk from activated muscles nearby, including ipsilateral SCM. Overall, techniques targeting contralateral SPC during contralateral head turn may provide additional methods of recording VEMPs.


Assuntos
Potenciais Evocados Miogênicos Vestibulares , Vestíbulo do Labirinto , Adolescente , Eletromiografia/métodos , Humanos , Músculos do Pescoço/fisiologia , Músculos Paraespinais/fisiologia , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Vestíbulo do Labirinto/fisiologia , Adulto Jovem
12.
Niger J Clin Pract ; 25(5): 563-568, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35593596

RESUMO

Background: Breastfeeding-related Neck Pain (BFNP) is prevalent in nursing mothers and cuts across the utilization of different breastfeeding (BF) hold positions. Biomechanical considerations to highlight ergonomically safe BF positions for the prevention of BFNP have not been previously studied. Aim: This study was designed to compare the electrical activities of selected neck muscles across three breastfeeding hold positions [cradle (C1), cross-cradle (C2), and football (FB)]. Materials and Method: Surface electromyographic analyses of four neck muscles (right and left components of each trapezius and sternocleidomastoid) were performed respectively during three BF trials with different BF hold positions (C1, C2, and FB) in 22 nursing mothers. For all the trials, the mothers nursed from the left breast. Results: Across the three BF trials, the electrical activities of each of the neck muscles did not vary significantly (P > 0.05). Furthermore, the left muscular components showed predominantly higher activities, as compared to their right components. Conclusion: The breastfeeding hold position adopted during BF tasks may not be a determinant of BFNP in nursing mothers. Further studies to ascertain the biomechanical implications of the utilized BF holds are recommended.


Assuntos
Futebol Americano , Futebol , Aleitamento Materno , Feminino , Humanos , Mães , Músculos do Pescoço/fisiologia
13.
BMJ Case Rep ; 15(5)2022 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-35589260

RESUMO

Longus colli tendinitis (LCT) has been described in several case reports, and is likely underdiagnosed due to its non-specific symptoms and self-limiting nature. It usually presents as acute neck pain with retropharyngeal swelling seen on nasoendoscopy and imaging studies. This may lead to unnecessary invasive interventions if physicians are unaware of the disease course. We discuss a case of LCT in a young woman who was treated at our institution, with recommendations on how to identify and treat such cases accurately without overtreatment.


Assuntos
Dor Aguda , Calcinose , Tendinopatia , Dor Aguda/complicações , Calcinose/complicações , Dor no Peito , Edema/complicações , Edema/etiologia , Feminino , Humanos , Músculos do Pescoço/diagnóstico por imagem , Cervicalgia/diagnóstico por imagem , Cervicalgia/etiologia , Tendinopatia/diagnóstico , Tendinopatia/diagnóstico por imagem
14.
Neurosci Lett ; 781: 136677, 2022 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-35545152

RESUMO

We present an initial report using 5 subjects, of short and long latency collic evoked responses following a half cycle of 100 Hz vibration (5 ms) applied to the sternocleidomastoid (SCM) tendon. These were detected in EEG and extraocular and leg muscles and compared with vestibular-dependent responses from direct mastoid stimulation. The responses from the extraocular recording site are likely to be evoked myogenic potentials, thus "collic evoked myogenic potentials" (CEMPs). An n19/p24 presumed ocular CEMP (oCEMP) was followed by a P22/N28 response over the posterior fossa, referred to as a collic cerebellar evoked potential (CoCEP), with responses in leg muscles starting around 55 ms. In contrast to their vestibular analogues, the oCEMP and CoCEP were predominantly ipsilateral to the side of stimulation, consistent with a double-crossed projection. In addition, their thresholds were just above the threshold of vibrotactile sensation, implying a low threshold, oligo-synaptic projection of SCM afferents to both extraocular and cerebellar targets. Following these short latency responses, SCM tendon stimulation evoked prolonged EMG responses in postural muscles of the legs, consistent with a role in the afferent limb of a short latency, spino-bulbar-spinal postural response to sternal perturbations. These collic evoked responses are likely to be of value in understanding the functions of cervical muscle afferents and have clinical value, for example in monitoring compensation after vestibular loss.


Assuntos
Potenciais Evocados Miogênicos Vestibulares , Vestíbulo do Labirinto , Estimulação Acústica , Eletromiografia , Potenciais Evocados/fisiologia , Humanos , Músculos do Pescoço/fisiologia , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Vestíbulo do Labirinto/fisiologia , Vibração
15.
Pediatr Phys Ther ; 34(3): 335-341, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35616484

RESUMO

PURPOSE: To describe supplemental intervention (SI) frequency in infants with congenital muscular torticollis (CMT) and compare groups of infants who received first-choice intervention only to infants who received SI. METHODS: Data were retrospectively extracted from a registry. Baseline and treatment variables were collected and analyzed. RESULTS: The cohort included 907 infants with 85 receiving SI. Order of SI frequency was kinesiological tape, manual techniques, tubular orthosis for torticollis (TOT) collar, and the Benik system. Statistically significant differences were found in baseline age, passive cervical range of motion (ROM), muscle function, and treatment time between groups. A positive association was found for CMT presentation, classification grade, plagiocephaly type, and external referrals between groups. CONCLUSIONS: Nine percent of infants received SI, most frequently kinesiological tape. Infants who received SI had larger baseline passive ROM and muscle function differences and more visits over a longer duration but had similar CMT resolution. Education is needed when using SI.


Assuntos
Doenças Musculares , Torcicolo , Humanos , Lactente , Músculos do Pescoço , Modalidades de Fisioterapia , Estudos Retrospectivos , Torcicolo/congênito
16.
Phys Ther ; 102(7)2022 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-35554598

RESUMO

OBJECTIVE: Among the tests designed to evaluate neck neuromuscular function, the craniocervical flexion test (CCFT) assesses the function of the deep cervical flexor muscles (DCFs). The purpose of this study was to conduct a review and meta-analysis of published articles about all measurement properties of the different CCFT versions (CCFT Activation Score [CCFT-AS], CCFT Performance Index [CCFT-PI], CCFT Cumulative Performance Index [CCFT-CPI], and CCFT alternative procedures for measuring activation level (CCFT1) or endurance (CCFT2) in people who were asymptomatic and people with nonspecific neck pain. METHODS: PubMed Central, MEDLINE, CINAHL, Scopus, Web of Science, and Google Scholar were searched from inception to June 30, 2020. Studies were selected if they reported data on reliability, validity, and/or responsiveness of the CCFT in adults who were asymptomatic or who had nonspecific neck pain. Two reviewers independently selected the studies, conducted quality assessment, and extracted the results. All meta-analyses used a random-effects model. RESULTS: Twenty-one studies met the inclusion criteria. The rating of interrater reliability (assessed for CCFT-AS and CCFT-CPI) was positive only for using the test at a group level. The same rating was ascribed to the intrarater reliability of CCFT-AS, CCFT1, and CCFT2, whereas CCFT-PI and CCFT-CPI showed positive intrarater reliability for assessment of individuals as well. CCFT validity was rated as positive for expressly assessing DCF action when measuring DCF activation through electromyography-not through ultrasonography-or craniocervical flexion motion as well as for differentiating patients who were asymptomatic and patients who had nonspecific neck pain (only the AS version). CCFT validity was rated as negative for investigating the CCFT performance correlation with the severity of nonspecific neck pain. CCFT responsiveness was rated as negative. CONCLUSIONS: The CCFT is a potentially useful tool for detecting impairment in DCF control and identifying patients who have nonspecific neck pain and who would benefit from a targeted intervention. However, the limited reliability affects its suitability for that purpose. Further research on the reliability of different CCFT versions in which the raters are thoroughly trained is strongly recommended. IMPACT: The CCFT might help to detect impairment in DCF control and identify patients who have nonspecific neck pain and who would benefit from a targeted intervention. However, the poor reliability of most versions of the test greatly limits its application in clinical practice. Only CCFT-PI and CCFT-CPI seem reliable enough to help in clinical decision-making at the individual level.


Assuntos
Músculos do Pescoço , Cervicalgia , Adulto , Dor no Peito , Humanos , Pescoço , Cervicalgia/diagnóstico , Exame Físico/métodos , Reprodutibilidade dos Testes
17.
Front Endocrinol (Lausanne) ; 13: 865621, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35547002

RESUMO

Background: This study aimed to evaluate the association between clinicopathologic variables and metastasis of the lymph node (LN) between the sternocleidomastoid and sternohyoid muscles (LNSS) to clarify the necessity of LNSS dissection in papillary thyroid carcinomas (PTCs). Methods: A total of 219 patients undergoing unilateral or bilateral neck dissection for PTCs were prospectively enrolled. The associations between clinicopathologic variables and LNSS metastasis were evaluated by univariate and multivariate analyses. Results: LNSS was present in 108 (40.1%) neck dissection samples and in 76 (34.7%) patients. Positive LNSS occurred in 40/269 (14.9%) neck dissection samples and in 20/219 (9.1%) patients. Univariate analysis showed that tumor stage, number of positive nodes in level III, and number of positive nodes in level IV were related to LNSS metastasis. Multivariate analysis confirmed that T3/4 stage tumors and >2 positive LNs in level IV independently increased the risk of LNSS metastasis. Conclusions: The low rate of LNSS metastasis would deem routine dissection unnecessary; however, LNSS would require excision if advanced stage tumors or level IV LN metastasis were present.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Humanos , Metástase Linfática/patologia , Esvaziamento Cervical , Músculos do Pescoço/patologia , Músculos do Pescoço/cirurgia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia
18.
BMC Neurol ; 22(1): 126, 2022 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-35366822

RESUMO

BACKGROUND: Migraine patients have musculoskeletal disorders and pain in the cervical. And, despite the pathophysiology demonstrating the relationship between migraine and the cervical spine, the effectiveness of craniocervical exercises in these patients has not been verified. So, the aimed of this study was verify the effectiveness of craniocervical muscle-strengthening exercise (CMSE) in reducing the frequency and intensity of headache in migraine patients.  METHODS: A two-armed, parallel-group randomized controlled trial with a 3-month follow-up was performed. For eight weeks, the volunteers in the intervention group (n = 21) performed a protocol of CMSE, while those in the sham ultrasound group (n = 21) received the application of disconnected therapeutic ultrasound in the upper trapezius and guideline for home-stretching. The primary outcomes were the frequency and intensity of the headache. The secondary outcomes were questionnaires about migraine and neck disability, and satisfaction with the treatment, cervical range of motion, the pressure pain threshold, craniocervical flexion test (CCFT), cervical muscle strength and endurance test, and the cervical muscle activity during the physical tests. RESULTS: No differences were observed for the changes observed in primary outcomes after eight weeks and at the 3-months follow up (p > 0.05). For the secondary outcomes, craniocervical exercises improved the sensitivity of the frontal muscle (p = 0.040) and promoted a reduced amplitude of muscle activity of the anterior scalene and upper trapezius in the last stages of CCFT (p ≤ 0.010). There was also reduced muscle activity of the anterior scalene and splenius capitis in the endurance test (p ≤ 0.045), as evaluated by surface electromyography. CONCLUSION: CMSE were insufficient in reducing the frequency and intensity of headache, improving the performance of the cervical muscles, or reducing migraine and neck pain-related disabilities. This was found despite a decreased electromyographic activity of the cervical muscles during the last stages of CCFT and increased median frequency during the endurance test. TRIAL REGISTRATION: Accession code RBR-8gfv5j , registered 28/11/2016 in the Registro Brasileiro de Ensaios Clínicos (ReBEC).


Assuntos
Transtornos de Enxaqueca , Músculos do Pescoço , Humanos , Transtornos de Enxaqueca/diagnóstico por imagem , Transtornos de Enxaqueca/terapia , Força Muscular/fisiologia , Músculos do Pescoço/diagnóstico por imagem , Cervicalgia/diagnóstico por imagem , Cervicalgia/terapia , Ultrassonografia
19.
Artigo em Chinês | MEDLINE | ID: mdl-35439860

RESUMO

Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.


Assuntos
Vértebras Cervicais , Força Muscular/fisiologia , Músculos do Pescoço/fisiologia , Cervicalgia/etiologia , Doenças Profissionais/etiologia , Espondilose/etiologia , Humanos , Cervicalgia/epidemiologia , Cervicalgia/fisiopatologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Espondilose/epidemiologia , Espondilose/fisiopatologia
20.
Ann Anat ; 243: 151938, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35367623

RESUMO

Pain over the superior angle of the scapula is a common musculoskeletal symptom. It is often accompanied by radiating pain to the neck, head, and shoulder. The aetiologies can be varied but may also be idiopathic in nature. To explore the fascial connections of this region, we studied 26 unembalmed, -two Thiel and one alcohol body-donors of science, by dissection, histological probes, and plastinations. When removing the descending and transverse fibres of the trapezius, a large prominent triangular area of white connectives is revealed, varying in mass. A subdivision of these connectives can be further dissected to prove that the rhomboid minor and levator scapulae muscles are interconnected and enclosed by connectives. Between these two muscles a bridge of connective tissue, containing fat, is observed. These connectives end cranially at the surface of the splenius capitis, and at the midline, containing vessels and nerves, as supported by histology and plastinations. This unification is separate from the rhomboid major muscle but overlaps with the latter dorsally. It connects to the superior angle of scapula and its upper medial borders, respectively, and cranially to the root of the spine of the scapula. Beneath the united levator scapulae and rhomboid minor, described here, the serratus posterior superior and possibly serratus anterior form a hypomochlion or fulcrum at the superior angle of the scapula. Any tension on this unified entity can unbalance this fulcrum. Investigating the connections between these two unified muscles may help explain the often idiopathic nature of superior scapular pain, and the success or failure of surgery, and other treatments.


Assuntos
Músculos Superficiais do Dorso , Humanos , Músculos do Pescoço , Dor , Escápula , Ombro
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