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Sex, head and neck posture, and cervical muscle preparation are contributing factors in the severity of head and neck injuries. However, it is unknown how these factors modulate the head kinematics. In this study, twenty-four (16 male and 8 female) participants experienced 50 impulsive forces to their heads with and without an acoustic warning. Female participants demonstrated a 71 ms faster (p = 0.002) muscle activation onset compared to males after warning. The magnitude of muscle activation was not significant between sexes. Females exhibited 21% (p < 0.008) greater peak angular velocity in all force directions and 18% (p < 0.04) greater peak angular acceleration in sagittal plane compared to males. Females exhibited 15% (p = 0.03) greater peak linear acceleration compared to males only in sagittal flexion. Preparation attenuated head kinematics significantly (p < 0.03) in 11 out of 18 investigated head kinematics for both sexes. A warning eliciting a startle response 420 ms prior to the impact resulted in significant attenuation of all measured head kinematics in sagittal extension (p < 0.037). In conclusion, both sex and warning type were significant factors in head kinematics. These data provide insight into the complex relationship of muscle activation and sex, and may help identify innovative strategies to reduce head and neck injury risk in sports.

We examined the weight distribution of skeletal muscles of the red jungle fowl, then compared these values with those of domesticated populations to determine how muscle distribution has changed by selecting breeding. Sonia, Fayoumi, and Rhode Island Red were selected for comparison from livestock breeds, while Japanese Shamo and Thai fighting cocks were selected from cockfighting groups. Principal component analysis was applied using body size-free data. The mass distribution of muscles clearly differed between the wild, livestock, and cockfighting groups, demonstrating that muscle distribution has changed after selecting breeding, coupled with functional demands of each group. The red jungle fowl, which has the ability to fly, could be clearly distinguished from the flightless domesticated populations due to differences in flight pectoral muscle size. The cervical muscles in the wild population were smaller than in the domesticated groups; these do not contribute to flight. The gluteal muscles were larger in the fighting cock group, functionally coupled to their traditionally preferred upright posture. Wild bird populations typically exhibit reduced weight of their hind limbs, associated with flight, but as the red jungle fowl displays largely terrestrial behavior, these muscles are similar in arrangement and relative size to those of the livestock groups. We showed that the mass distribution pattern of skeletal muscles expresses selecting breeding strategy and clearly reflects the specific traits for each group.

Cervical spine musculature still remains a less studied component of the cervical spine anatomical compartments, although it plays a significant role in the mobility of the head and the preservation of cervical spine alignment. The goal of this study was to extract any significant information from the literature regarding the role of cervical spine muscles morphology in the outcome of surgically treated patients for degenerative disc disease (DDD) based on preoperative magnetic resonance imaging (MRI) studies. Eleven clinical case series were found, from which four were prospective and seven were retrospective. Six studies were concentrated on anterior approaches and five studies on posterior approaches in the cervical spine. In posterior approaches aiming at the preservation of muscles attachments and overall less surgical manipulations, results on cervical lordosis, axial pain and patient’s functionality were found superior to traditional laminectomies. The study of cross-sectional areas (CSAs) of deep paraspinal muscles in the cervical spine could add significant information for the spine surgeon such as the prediction of adjacent level disease (ALD), fusion failure, axial pain persistence, postoperative cervical alignment and patient’s postoperative functionality. It seems that MRI studies focusing on muscle layers of the cervical spine could add significant information for the spinal surgeon regarding the final surgical outcome in terms of pain and function expression. Larger multicenter clinical studies are a necessity in defining the role of the muscle component of the cervical spine in the surgical treatment of DDD. J Clin Med Res. 2021;13(7):367-376 doi: https://doi.org/10.14740/jocmr4551

Neck pain caused by functional impairment of the cervical spine is manageable with the appropriate intervention. This study aimed to prove that the addition of Abdominal Control Feedback to the conventional protocol, that included only Scapular Stabilization Exercises, would assist with pain minimization, increased available range of movement at the cervical spine, elevation in the endurance time of the deep flexor and extensor group of cervical muscles, better proprioception and an overall decrease in the disability caused due to the pain. A total of 40 participants with chronic mechanical neck pain in the age group of 18-40 years and a pain scale rating of less than 7 on the Visual Analog Scale were chosen and randomized into 2 groups. Group 1 (n=20) received Scapular stabilization exercises without Abdominal control feedback for 6 weeks whereas Group 2 (n=20) received Scapular stabilization exercises along with Abdominal control feedback for 6 weeks. Pain, range of motion, endurance, proprioception and disability were assessed before and after the interventions. There were significant intra group differences in pain, range, endurance, proprioception and disability in both the groups 1 and 2. There were significant inter group differences in pain and endurance siding with group 2. No significant inter group differences were observed in range of motion, proprioception and disability. This verified that the addition of Abdominal control feedback to Scapular stabilization exercises aided in reducing neck pain and increasing endurance time in individuals with chronic mechanical neck pain. Key words: Neck pain, Abdominal control feedback, Scapular stabilization.

Sports-related acute cervical trauma and spinal cord injury (SCI) represent a rare but devastating potential complication of collision sport injuries. Currently, there is debate on appropriate management protocols and return-to-play guidelines in professional collision athletes following cervical trauma. While cervical muscle strains and sprains are among the most common injuries sustained by collision athletes, the life-changing effects of severe neurological sequelae (ie, quadriplegia and paraplegia) from fractures and SCIs require increased attention and care. Appropriate on-field management and subsequent transfer/workup at an experienced trauma/SCI center is necessary for optimal patient care, prevention of injury exacerbation, and improvement in outcomes. This review discusses the epidemiology, pathophysiology, clinical presentation, immediate/long-term management, and current return-to-play recommendations of athletes who suffer cervical trauma and SCI.

Chronic neck pain may affect sensorimotor integration, which is critical for postural control. Accordingly, this study investigated whether individuals with chronic neck pain display altered muscle activation and postural control compared with those of healthy adults while performing functional reach tasks. Three-dimensional kinematic analyses and electromyographic analyses were performed. 20 individuals with chronic neck pain and twenty healthy adults were recruited. The reach distance, anterior displacements of the centers of mass and pressure, and activity of the cervical muscles were recorded during functional reach tasks. Compared with the healthy adults, the individuals with chronic neck pain showed significantly smaller anterior displacements of the centers of mass and pressure and reduced muscle activity of the upper trapezius muscle. However, no difference in the reach distance was observed between the two groups. It is speculated that a functional reach task may not be sensitive enough to detect changes in the postural control of individuals with chronic neck pain. For individuals with chronic neck pain, a combination of clinical measures and quantitative assessments of the centers of mass and pressure is suggested to facilitate the early detection of changes in postural control.

The col-cap concept encouraged neurologists to inject a large group of muscles in the treatment of cervical dystonia. This includes deep muscles such as the obliquus capitis inferior or the semispinalis capitis, and muscles close to vascular or neurological structures such as scalene muscles. Our aim was to determine the accuracy of injections in cervical muscles using ultrasonography (US) or palpation of anatomical landmarks. A mix of paint, gelatin and iodized contrast agent was injected in nine pairs of cervical muscles of human cadavers, according to two injection techniques: US-guided and non-guided. The dye was localized on 1 cm-thick, frozen slices. A total of 102 muscles was injected in the US-guided group (n = 8). The global accuracy was 88.2%. The lowest accuracy was in the OCI (41.7%); trying to avoid the vertebral artery, injections were too medial. A total of 54 muscles was injected in the non-guided group (n = 3). The global accuracy was 48.0%; moreover, some dye was found in four blood vessels. The embalming process produced texture changes, making difficult the palpation of bony landmarks. Our results indicate that US-guided injections are more accurate than non-guided injections in most cervical muscles.

Objective: This study investigated the deep upper cervical muscles echogenicity in cervicogenic headache (CGH) patients.Methods: The echogenicity of longus capitis (LCAP), rectus capitis posterior ...

Cervical myomas are benign tumors originating from cervical muscle tissue with a very rare incidence of only about 8% of all myomas. The surgical approach depends on the position of cervical myoma. This case report discusses a 44-year-old woman who complained of a lump discharge from her birth canal 6 months ago, and currently discharging from her vagina. We performed vaginal myomectomy, and the cervical myoma measuring 8 × 8 × 6 cm with solid consistency was removed. We continued with total vaginal hysterectomy. Post-operative recovery was progressing well. The histopathology report was consistent with leiomyoma. Large prolapsed cervical myoma can be disturbing and discomforting for many patients. It is relatively rare and can be successfully removed vaginally with minimal morbidity. J Med Cases. 2021;12(7):288-290 doi: https://doi.org/10.14740/jmc3698

Background: Forward head posture (FHP) is common postural malalignment. FHP is described relatively extension to upper cervical and lower cervical is relatively flexion. Although several researchers mentioned the lower cervical flexion posture in FHP, most of the studies related to FHP is focused on the deep cervical flexor function. Objects: The purposes of present study is to compare the cervical strength (upper cervical extension [UCE], lower cervical extension [LCE], upper cervical flexion [UCF], lower cervical flexion [LCF]) between individuals with and without FHP. Methods: Fifty-one participants are recruited. Participants who have the craniovertebral angle (CVA) less than 48 degree were classified to the FHP group (n = 24) and the others were included in without FHP group (n = 27). The cervical strength (UCE, LCE, UCF, LCF) were measured using Smart KEMA strength sensor and the strength data was normalized by body weight. All strength measurement conducted at head and neck neutral position in sitting. Independent t-test was used to compare the cervical strength between individuals with and without FHP. Results: The mean value of CVA was greater in without FHP group than with FHP group (p < 0.000). The strength value of UCF (p < 0.002) and LCE (p < 0.001) was significant less in FHP group than without FHP group. But no significant differences were seen in the LCF and UCE strength between two groups. Conclusion: UCF and LCE weakness in FHP group should be considered to evaluate and manage the individuals with FHP.

Objective Whether Kinesio taping® (KT) might change the endurance of the cervical deep flexor muscles.Methods: Healthy university students were assessed at baseline, immediately after the KT application over the posterior cervical muscles, and at a 24-h follow-up. The clinical assessment of the endurance of the deep cervical flexor muscles using the craniocervical flexion test (CCFT) was performed.Results: Sixty-two students (32 women) with a mean age of 20.4 ± 1.3 years completed the study protocol. Statistically significant pre- to post-taping differences in performance of the craniocervical flexion movement were found between baseline-immediate and baseline-24-h follow-up (p˂0.001). A statistically significant difference in the endurance of the cervical deepflexor muscles was found between baseline-immediate (for stage 2 result and cumulative endurance score), baseline-24-h follow-up (for stage 2result and cumulative endurance score), and immediate-24-h follow-up (for stage 2 result, for cumulative endurance score) p˂0.01.Conclusion: Cervical KT increased endurance for the short term.

[Purpose] Cervical vertigo as a common complaint is associated with some musculoskeletal disorders. However, to date, ultrasonographical parameters of cervical muscles in patients with cervical vertigo have not been investigated. This study was conducted to investigate size of cervical muscles in patients with cervical vertigo compared to healthy controls. [Participants and Methods] Thicknesses of cervical flexor and extensor muscles were evaluated through ultrasonography and results were compared between the patients and healthy controls by Independent Samples t-test or Mann-Whitney U nonparametric test. [Results] Results showed that, thickness of Longus Colli muscle was significantly different between the patients and healthy controls. [Conclusion] According to findings of the study, size of Longus Colli muscle is likely to be associated with etiology of cervical vertigo.

The aims of the present work was to describe primitive whisker movements in neonatal Wistar rats (postnatal days 4–7) in the states of sleep and waking and to study correlations between whisker movements and body movements. Whisker movements were recorded by high-speed video recording and the animals’ behavioral state was determined by recording electromyographic activity of the cervical muscles and simultaneous recording of limb movements using piezo elements. During active sleep, movements consisted mostly of short-term whisker movements, and a significant proportion of these movements arose simultaneously with short-term bursts of activity in the cervical muscles and transient myoclonic twitches of the animal’s body. During periods of waking, movements were mostly complex long-lasting whisker movements, which were accompanied by long-term increases in cervical muscle tone and complex body and limb movements. Both types of whisker movement occurred mainly in the rostral and caudal directions, and the amplitude of movements during waking was only slightly greater than the amplitude of whisker movements during sleep. The data obtained here provide evidence that the temporal organization of whisker movement activity in neonatal rats is significantly different in the states of sleep and waking and that whisker movements in both behavioral states showed strong correlations with the animal’s body movements. It is suggested that generalized primitive whisker and body movements in neonatal rats are due to the activity of a single central pattern generator both in the state of active sleep and in the state of waking.

Background Botulinum toxin injections are effective in relieving focal spasticity resulting from upper motor neuron injuries. Doses approved in the United States for onabotulinumtoxinA and incobotulinumtoxinA are up to 400 units, yet higher doses are often used. Objective To determine differences in risk of adverse events when using higher (>600 units) as compared to lower doses within clinically applicable categories; the difference in adverse events between types of botulinum toxin-A, and any association of the injection of cervical muscles with increased risk for adverse events. Design and setting Retrospective analysis of injections performed over a 3-year period at a freestanding rehabilitation hospital network. Participants Persons with spasticity or dystonia undergoing ona- and/or incobotulinumtoxinA injections. Interventions Not applicable. Main outcome measures Adverse events for injections were divided into the three dose ranges (≤400 units, 401-600 units, or > 600 units). Results 889 injections in 342 patients met inclusion criteria with 65% ≤400 units, 21% 401-600 units, and 14% >600 units. Adverse events were not significantly increased in doses of 401-600 units relative to ≤400 units (OR 0.97, 95% CI 0.31, 2.98). Doses of toxin over 600 units were associated with significantly increased relative risk of adverse events (OR 2.98, 95% CI 1.12, 8.13). There were no significant differences between adverse event rates for onabotulinumtoxinA or incobotulinumtoxinA (P >.99). Inclusion of cervical muscles in isolation did significantly increase the risk of adverse events (OR 4.21, 95% CI 1.15, 15.46). Conclusion Risk for adverse events were not significantly increased in doses of ona- and/or incobotulinumtoxinA up to 600 units, suggesting that the current 400 units upper bound of approved dose may need to be reexamined. Doses above 600 units were found to increase the rate of adverse effects and clinical benefit versus risk should be taken into account. Level of evidence III.

Objective This study aimed to determine the correlation between gadget usage and the tension of cervical muscles in the gamers community. Methods This study is an analytical study using a cross-sectional approach. This research was conducted at the Game Play Unknown Battleground (PUBG) Community in Makassar. Forty people (n = 40) were included in the present study. Data including age, gender, and intensity (duration) of gadget usage, were collected using a questionnaire. Cervical muscle tension was assessed by palpation test and using goniometer. Results The relationship between the intensity of gadget usage in-game players and cervical muscle tension were found statistically significant (p Conclusion The intensity of gadget usage and age have a positive correlation with the development of cervical muscle tension in-game players.

Patients with various and indefinite symptoms in the whole body occasionally have coincident with stiffness or tenderness of the cervical muscles. This prospective case series examined the effect of local modulation of the cervical muscles in patients with cervical disorders reporting indefinite whole-body symptoms. A total of 1863 hospitalized patients with cervical disorders accompanying three or more indefinite whole-body symptoms, who were resistant to outpatient care, were enrolled in this study for 12 years. All patients underwent daily physical therapies to the cervical muscles during hospitalization. Self-rated records on the medical interview sheets documenting 30 representative symptoms including cervical/shoulder pain or stiffness and 28 representative indefinite whole-body symptoms at admission and discharge were compared across the population. The number of symptoms decreased significantly with the local modulation of the cervical muscles during hospitalization. All of the 28 indefinite whole-body symptoms at admission showed recovery rates greater than 50% at discharge. The mean number of symptoms decreased significantly from 17.8 at admission to 7.4 at discharge (p

Cervicogenic somatic tinnitus is a subtype of subjective tinnitus and is defined as tinnitus in which forceful contractions of jaw and neck muscles modulate its psychoacoustic attributes. Various physical therapies have been proposed for the treatment of somatosensory tinnitus although there is no definitive cure for it. This report describes the use of acupuncture in the treatment of a 71-year-old woman with chronic neck pain who suffered from a left-sided tinnitus for 2 years as well. The tinnitus and neck pain severity was rated as 7 and 6, respectively, on a numeric rating scale of 10. On examination, she had restricted cervical range of motion and several myofascial trigger points in cervical muscles. Audiometric tests of the patient were normal. She received trigger point acupuncture of cervical muscles twice per week for 10 sessions. Her tinnitus completely disappeared after the third session and did not return during the 5-year follow-up. Her neck pain intensity also decreased to 1 on the numeric rating scale after 10 sessions. Based on the results of this study, direct trigger point acupuncture of cervical muscles may be beneficial in the treatment of somatic tinnitus with a long-duration effect. Keywords: acupuncture, cervical trigger point, neck pain, somatosensory tinnitus

Active muscle response is a key factor in the motion and injury of the human head and neck. Due to the limitations of experimentation and the shortcomings of previous finite element models, the influence of material parameters of cervical muscle on motions of the head and neck during a car crash have not been comprehensively investigated. In the present work, a model of the cervical muscle in a 50th-percentile adult male was constructed. The muscles were modelled using solid finite elements, with a nonlinear-elastic and viscoelastic material and a Hill material modelling the passive and active parts of each muscle, respectively. The head dynamic responses of the model were validated using results obtained from volunteer sled tests. The influence of the material parameters of a muscle on head and neck motions were determined. Our key finding was that the greater the stiffness and the contraction strength of the neck muscles, the smaller the rotation angle of the head and the neck, and, hence, the lower the risk of head and neck injury to occupants in a car crash.

Objective: The goal of this study is to detect the efficacy of Pilates mat exercise and conventional therapy on cervical flexor and extensor myoelectric amplitude in subjects with chronic mechanical neck pain. Methods: This trial included 91 participants from both genders (42 males and 49 females) who were diagnosed by an orthopedist with chronic mechanical neck pain and referred to the physiotherapy clinic. The participants were randomly assigned to two groups: Group A, which is an experimental group, included those receiving Pilates mat exercise in conjunction with conventional therapy, and Group B, which is a control group, included those receiving only conventional therapy. The intervention was delivered to both groups three times a week for 12 weeks. In this study, the variables pain, function, and muscle activity were measured using the visual analog scale, Arabic neck disability index, and Electromyography respectively. All variables were assessed before and after the 12 weeks. Results: To detect the impact of treatment and time on all measured variables, MANOVA was used and showed a statistically significant effect (p < 0.05) in both groups in treatment and time with favor to Pilate's group. Conclusion: Pilates mat exercise combined with conventional therapy and conventional therapy alone are effective techniques for refining neck pain, function, and muscle amplitude in subjects with chronic mechanical neck pain, with further advantages shown in the experimental group that received the Pilates mat exercise treatment.

Introduction: World health organization recommends protective mask as a primary preventive measure to offbeat the Covid-19 pandemic There are many commercially available protective masks, in that N-99, N-95, and 3 layer surgical masks are com-monly used among peoples Prolonged usage of this protective mask can cause forward neck posture and weakness of cervical flexors muscles Objective: The objective of this study is to find out the influence of the protective mask on cervical spine dysfunction Methods: An observational study was conducted by screening 237 participants;in that 110 participants were enrolled for the study based on the inclusion and exclusion criteria All these participants were categorized based on the type of protective mask and underwent forward neck posture assessment by using the Cranio-vertebral angle through Kinovean software and cervical flexor muscle endurance test Results: The mean value of the Cranio-vertebral angle is 42 64 and cervical flexor endurance is 8 5 for the participants using N-99 protective mask, the mean value of the Cranio-vertebral angle is 65 866 and cervical flexor endurance is 19 911 for the participants using N-95 protective mask and the mean value of the Cranio-vertebral angle is 72 193 and cervical flexor endurance is 27 49 for the participants using 3-layer surgical mask Conclusion: The analyzed results prove that patients using N99 type of protective mask reported decreased cervical muscle endurance and Cranio-vertebral angle when compared to N95 and 3 layers protective mask Copyright@IJCRR

We aimed to compare movement parameters and muscle activity during active cervical spine movements between women with episodic or chronic migraine and asymptomatic control. We also assessed the correlations between cervical movement measures with neck-related disability and kinesiophobia. Women with episodic (n = 27, EM) or chronic (n = 27, CM) migraine and headache-free controls (n = 27, CG) performed active cervical movements. Cervical range of motion, angular velocity, and percentage of muscular activation were calculated in a blinded fashion. Compared to CG, the EM and CM groups presented a reduced total range of motion (p &lt, 0.05). Reduced mean angular velocity of cervical movement was also observed in both EM and CM compared to CG (p &lt, 0.05). Total cervical range of motion and mean angular velocity showed weak correlations with disability (r = −0.25 and −0.30, respectively, p &lt, 0.05) and weak-to-moderate correlations with kinesiophobia (r = −0.30 and −0.40, respectively, 0.05). No significant correlation was observed between headache features and total cervical range of motion or mean angular velocity (p &gt, 0.05). No differences in the percentage of activation of both flexors and extensors cervical muscles during active neck movements were seen (p &gt, 0.05). In conclusion, episodic and chronic migraines were associated with less mobility and less velocity of neck movements, without differences within muscle activity. Neck disability and kinesiophobia are negative and weakly associated with cervical movement.

Simple Summary As sarcopenia has been shown to be associated with a variety of functional impairments and increased mortality, it has become increasingly important to evaluate sarcopenia comorbidity in oral squamous cell carcinoma (OSCC). We assessed sarcopenia in patients with OSCC in a way that is feasible in daily practice and retrospectively evaluated its impact on prognosis. Patients with both low quality and low quantity of cervical muscles had a significantly worse prognosis. Assessing sarcopenia by evaluating both the quality and quantity of preoperative cervical skeletal muscle mass may be useful in optimizing the treatment of patients with OSCC without requiring additional imaging or patient burden. Abstract Accumulating evidence has shown that sarcopenia in patients with oral squamous cell carcinoma (OSCC) is at a risk of poor prognosis. There is no universal consensus on how to assess sarcopenia in patients with OSCC in daily practice. It is important to validate the usefulness of sarcopenia assessment from cervical muscles, which are frequently used in routine clinical practice in patients with OSCC. In this study, we investigated whether preoperative lumbar (L3) skeletal muscle mass and adiposity in OSCC patients were associated with cervical (C3) skeletal muscle mass and adiposity from CT measurements. We also investigated whether skeletal muscle mass and adiposity in the C3 muscles were associated with survival rates in patients with OSCC. We demonstrated that both the quality and quantity of muscle between the C3 and L3 levels were positively correlated with each other. We also demonstrated that the survival rates in patients with low sternocleidomastoid muscle mass index, high processus spinosus muscle-intramuscular adipose tissue content, and the combination of both were significantly lower than those in the controls. These results suggest that the assessment of sarcopenia from multiple neck muscles by preoperative CT measurements may be useful in predicting the prognosis of patients with OSCC.

This study aimed to verify if migraine frequency or migraine-associated neck pain were associated with a reduction of normalized force and altered electromyographic activity during maximal cervical muscle isometric contractions. Additionally, it aimed to assess the correlation of normalized isometric force with years with migraine, headache frequency, headache intensity, migraine-related disability, and severity of cutaneous allodynia. The sample comprises 71 women with migraine (40/31 episodic/chronic, 42/18 with/without neck pain) and 32 women without headache. Cervical muscle isometric force in flexion, extension, and lateral flexion was assessed synchronized with the acquisition of superficial electromyography from the cervical muscles. Women with episodic migraine presented lower normalized isometric force in extension, flexion, and right and left lateral flexions than controls (P P

Objective To examine the effects of dry needling against trigger point (TrP) injections (wet needling) applied to TrPs associated with neck pain. Methods Electronic databases were searched for randomized clinical trials in which dry needling was compared with TrP injections (wet needling) applied to neck muscles and in which outcomes on pain or pain-related disability were collected. Secondary outcomes consisted of pressure pain thresholds, cervical mobility, and psychological factors. The Cochrane Risk of Bias tool, the Physiotherapy Evidence Database score, and the Grading of Recommendations Assessment, Development, and Evaluation approach were used. Results Six trials were included. TrP injection reduced pain intensity (mean difference [MD ] –2.13, 95% confidence interval [CI] –3.22 to –1.03) with a large effect size (standardized mean difference [SMD] –1.46, 95% CI –2.27 to –0.65) as compared with dry needling. No differences between TrP injection and dry needling were found for pain-related disability (MD 0.9, 95% CI –3.09 to 4.89), pressure pain thresholds (MD 25.78 kPa, 95% CI –6.43 to 57.99 kPa), cervical lateral-flexion (MD 2.02°, 95% CI –0.19° to 4.24°), or depression (SMD –0.22, 95% CI –0.85 to 0.41). The risk of bias was low, but the heterogenicity and imprecision of results downgraded the evidence level. Conclusion Low evidence suggests a superior effect of TrP injection (wet needling) for decreasing pain of cervical muscle TrPs in the short term as compared with dry needling. No significant effects on other outcomes (very low-quality evidence) were observed. Level of Evidence Therapy, level 1a.

Objectives Neck stiffness could lead to impaired ocular accommodation. We report two cases that visual function was improved by relieving neck stiffness. Case presentation (Case 1) A 34-year-old female complained of neck stiffness and visual problems after computer work. She was treated by parietal acupoint therapy (PAPT), which is a new scalp micro-acupuncture system. The evaluation of accommodative micro-fluctuations (the Fk-map) showed that increased bilateral ciliary muscle tension in the middle to near distance was relieved bilaterally, accompanied by relief of neck stiffness after treatment. (Case 2) A 43-year-old female complained of a visual problem with pressure pain on the bilateral posterior cervical muscles. Performing with PAPT improved impaired ciliary muscle tension noticeably with relief of neck stiffness after treatment. Conclusions This is the first report on the improvement of impaired ocular accommodation with treating neck stiffness by using PAPT.

A reduced capacity to generate and sustain cervical muscle force over a range of contraction intensities is a feature of some participants with neck pain. To date there have been no studies comparing the accuracy of force perception in participants with and without neck pain.Cross-sectional observational study.Participants with (n = 25) and without (n = 25) neck pain performed isometric muscle contractions at three progressive self-perceived (no feedback provided) intensities (10, 25, 50) % of their maximal voluntary contraction (MVC) in cervical: flexion, extension, right and left lateral flexion. Absolute error (AE), constant error (CE), and variable error (VE) between actual and targeted force values were calculated.The neck pain group had: (1) AE-combined direction -significantly higher at 10% and lower at 50% (p 0.05); (2) significantly lower CE in most measures (p 0.05); (3) higher mean VE in all measures, with 10, 25, and 50% combined direction and overall combined % extension significantly higher (p 0.05).Findings indicate higher variability in force generation perception across all directions and intensities in participants with neck pain compared to healthy controls. Potentially this greater variability might suggest impaired force sense, a construct of proprioception in participants with neck pain. Reduced force sense may have implications for participants with neck pain during functional activities requiring precision and may need to be trained. Further research is required.

ContextCervical muscle strains are an often-overlooked injury, with neck- and spine-related research typically focusing on spinal cord and vertebral injuries.ObjectiveTo examine the rates and distributions of cervical muscle strains in collegiate and high school football athletes.DesignDescriptive epidemiology study.SettingCollegiate and high school football teams.Patients or Other ParticipantsThe National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) collected data from collegiate football athletes. The High School National Athletic Treatment, Injury and Outcomes Network (HS NATION) and High School Reporting Information Online (HS RIO) collected data from high school football athletes. Data from the 2011–2012 through 2013–2014 academic years were used.Main Outcome Measure(s)Athletic trainers collected injury and exposure data for football players. Injury counts, injury rates per 10 000 athlete-exposures (AEs), and injury rate ratios with 95% confidence intervals (CIs) were calculated.ResultsThe NCAA-ISP reported 49 cervical muscle strains (rate = 0.96/10 000 AEs), of which 28 (57.1%) were TL (time loss; rate = 0.55/10 000 AEs). High School NATION reported 184 cervical muscle strains (rate = 1.66/10 000 AEs), of which 33 (17.9%) were TL injuries (rate = 0.30/10 000 AEs). The HS RIO, which collects only TL injuries, reported 120 TL cervical muscle strains (rate = 0.51/10 000 AEs). The overall injury rate was lower in the NCAA-ISP than in HS NATION (injury rate ratio = 0.58; 95% CI = 0.42, 0.79); when restricted to TL injuries, the overall injury rate was higher in the NCAA-ISP (injury rate ratio = 1.83; 95% CI = 1.11, 3.03). No differences were found when comparing TL injuries in HS RIO and the NCAA-ISP. Cervical muscle-strain rates were higher during competitions than during practices across all 3 surveillance systems for all injuries. Most cervical muscle strains were due to player contact (NCAA-ISP = 85.7%, HS NATION = 78.8%, HS RIO = 85.8%).ConclusionsThe incidence of cervical muscle strains in football players was low compared with other injuries. Nonetheless, identifying and implementing interventions, particularly those aimed at reducing unsafe player contact, are essential to further decrease the risk of injury and associated adverse outcomes.

Background Concussions have become a significant public health concern with rising incidence rates. Concussions have been shown to occur concurrently with neck injuries, such as whiplash-associated-disorder, therefore, understanding the role of the neck in concussions is important. Objectives To determine if there is a relationship between cervical muscle endurance and either concussion incidence, or concussion recovery in university athletes. Specifically, the primary aim was to investigate a relationship between pre-season deep neck flexor endurance test (DNFET) time in those who sustained an in-season injury versus those who did not. The secondary aim is to determine correlation in DNFET times and concussion recovery. Design Longitudinal observational study. Methods Pre-season DNFET was performed on university athletes. In the event of a concussion, cervical endurance and neuromuscular adaptation was re-assessed with the DNFET. Rehabilitative exercises were prescribed, as required, and DNFET was measured at subsequent treatments. Results There was no significant difference between pre-season DNFET times and concussion incidence (p = 0.55). However, there was a moderate correlation between DNFET times and concussion recovery (R = 0.47, p = 0.001) whereby DNFET times improved predictively throughout rehabilitation. Conclusions While no statistically significant relationship was found between DNFET and concussion incidence, a significant clinical relationship was present with recovery. The validity of the DNFET test as a means for assessing risk or measuring recovery requires additional research.

Background: Recently, attention has been given to use the manual therapy for thoracic spine to treat Mechanical Neck Pain (MNP).The Aim of Study: To investigate the effect of upper thoracic mobilization on Cervical Range of Motion (CROM), resting pain level and functional abilities of the neck in patients with chronic mechanical neck pain.Subjects and Method: Thirty patients with chronic me-chanical neck pain participated in this study. Subjects were divided into two groups, fifteen in each group. The first group was the treatment group (Group A) who received upper thoracic mobilization and traditional physical therapy program; and the second group was the control group (Group B) who received the traditional physical therapy program only. Before and after the treatment, the CROM was measured by baseline cervical inclinometer, the rest pain level was measured by a Visual Analog Scale (VAS) and neck disability was measured by Neck Disability Index (NDI). Patients in treatment group were treated with upper thoracic mobilization, infra-red, transcutaneous electrical nerve stimulation and cervical muscle stretching exercises. On the other hand, patients in control group were treated the same like treatment group without upper thoracic mobilization.Results: There is a statistical significant difference between both groups. There is a positive effect of upper thoracic mobilization on CROM and neck function when comparing with routine physical therapy, there was no a statistical significant effect of upper thoracic mobilization on resting pain level when compared with routine physical therapy.Conclusion: There is a positive effect of upper thoracic mobilization on all CROM and neck function, although there was no a significant effect on resting pain level.

In a crash situation, drivers typically make evasive maneuvers before an upcoming impact, which can affect the kinematics and injury during impact. The purpose of the current study was to investigate the response and effect of drivers’ cervical muscles in a frontal impact. A crash scenario was developed using a vehicle driving simulator, and 10 volunteers were employed to drive the simulator at 20 km/h, 50 km/h, 80 km/h and 100 km/h. Electromyography (EMG) was recorded from the sternocleidomastoideus (SCM), splenius cervicis (SPL) and trapezium (TRP) muscles using a data acquisition system, and the level of muscle activation was calculated. A numerical study was conducted using data collected in the experiment. The results revealed that the cervical muscles were activated during drivers’ protective action. EMG activity of cervical muscles before impact was greater than that during normal driving. EMG activity increased with driving speed, with the SCM and TRP exhibiting larger increases than the SPL. The kinematics and load of the driver were influenced by muscle activation. Before the collision, the head of an active model stretched backward, while the passive model kept the head upright. In low-speed impact, the torque and shear of the cervical muscle in the active model were much lower than those in the passive model, while the tension of the cervical muscle was higher in the active model compared with the passive model. The results indicated that the incidence of cervical injury in high-speed impact is complex.