Servikojenik baş ağrısında postür, kas sertliği ve kan akışı arasındaki ilişki

Abstract

Bu çalışmanın amacı servikojenik baş ağrısında (KH) baş-boyun kas sertliği, baş-omuz postürü ve kan akışı arasındaki ilişkiyi araştırmaktır. Bu çalışmaya dahil edilme kriterlerini karşılayan toplam 37 hasta katılmıştır. Suboksipital, üst trapezius (UT) ve sternekleidomastoid (SCM) kas sertliği Myoton Pro cihazı ile, baş-omuz postürü PostureScreen uygulaması ile, internal karotis (ICA), vertebral arter (VA) kan akımı Doppler US ile değerlendirildi. Değişkenler arasındaki ilişki Spearman testi ile analiz edildi. Baş-omuz postür sapmaları sağ ve sol suboksipital kas sertliğinin artmasıyla arttı ve baş postürü sapmaları sol SCM kas sertliğinin artmasıyla arttı. UT kas sertliği arttıkça VA kan akışı, sol SCM kas sertliği arttıkça ICA-VA kan akışı azaldı. Baş postürü deviasyonu arttıkça ICA-VA kan akımı azaldı. Sonuç olarak KH'de kas sertliği ve baş-omuz postüründeki sapmalar kan akışını olumsuz etkilemektedir.

Keywords

• servikojenik baş ağrısı
• boyun
• sertlik
• postür
• kan akışı

The relationship between posture, muscle stiffness and blood flow in cervicogenic headache

Abstract

The aim of this study was to investigate the relationship between head-neck muscle stiffness, head-shoulder posture and blood flow in cervicogenic headache (CH). A total of 37 patients who met the inclusion criteria participated in this study. Suboccipital, upper trapezius(UT) and sternecleidomastoid (SCM) muscle stiffness were assessed with Myoton Pro device, head-shoulder posture with PostureScreen application, internal carotid (ICA), vertebral artery (VA) blood flow with Doppler US. The relationship between the variables was analysed by Spearman test. Head-shoulder posture deviations increased with increasing right and left suboccipital muscle stiffness and head posture deviations increased with increasing left SCM muscle stiffness. As the UT muscle stiffness increased, VA blood flow and as the left SCM muscle stiffness increased, ICA-VA blood flow decreased. As head posture deviation increased, ICA-VA blood flow decreased. In conclusion, muscle stiffness and head-shoulder posture deviations negatively affect blood flow in CH.

Keywords

• cervicogenic headache
• neck
• stiffness
• posture
• blood flow

References

1. 1. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38:1-211.
2. 2. Antonaci F, Inan LE. Headache and neck. Cephalalgia. 2021;41(4):438-442.
3. 3. Nilsson N. The prevalence of cervicogenic headache in a random population sample of 20-59 year olds. Spine (Phila Pa 1976). 1995;20(17):1884‑1888.
4. 4. Liang Z, Galea O, Thomas L, et al. Cervical musculoskeletal impairments in migraine and tension type headache: A systematic review and meta-analysis. Musculoskeletal Science & Practice. 2019;42:67-83. 5. Bogduk N. The neck and headaches. Neurologic Clinics. 2014;32:471-487.
5. 6. Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Manuel Therapy. 2006;11:118-129.
6. 7. Farmer PK, Snodgrass SJ, Buxton AJ, et al. An investigation of cervical spinal posture in cervicogenic headache. Physical Therapy Rehabilitation Journal. 2015;95:212-222.
7. 8. Olivier B, Pramod A, Maleka D. Trigger Point Sensitivity Is a Differentiating Factor between Cervicogenic and Non-Cervicogenic Headaches: A Cross-Sectional, Descriptive Study. Physiotherapy Canada. 2018;1–7.
8. 9. Hall T, Briffa K, Hopper D, Robinson K. Reliability of manual examination and frequency of symptomatic cervical motion segment dysfunction in cervicogenic headache. Manual Therapy. 2010;15(6):542–546.

9. 10. Yoon JH, An Convergence Analysis of Muscle Characteristics, Muscle Activity and Posture in Patients with Cervicogenic Headache. Journal of Digital Convergence. 2021;19(6):265-271.
10. 11. Abdullaiev RY, Kalashnikov VI, Voronzhev IA, et al. Dopplerographic Assessment of Blood Flow Parameters of Vertebral Arteries in Patients with Cervicogenic Headache Due to Arthrosis and Instability of Atlanto-Axial Junction, Trends in Technical & Scientific Research. 2018;1(5).
11. 12. Hopkins BB, Vehrs PR, Fellingham GW, et al. Validity and Reliability of Standing Posture Measurements Using a Mobile Application. Journal of Manipulative and Physiological Therapeutics. 2019;42(2):132-140.
12. 13. Pruyn EC, Watsford ML Murphy AJ. Validity and reliability of three methods of stiffness assessment. Journal of Sport and Health Science. 2016;5(4):476–483.
13. 14. Park SK, Yang DJ, Kim JH, et al. Analysis of mechanical properties of cervical muscles in patients with cervicogenic headache. Journal of Physical Therapy Science. 2017;29(2):332–335.
14. 15. Taş S, Yaşar Ü, Kaynak BA. Interrater and Intrarater Reliability of a Handheld Myotonometer in Measuring Mechanical Properties of the Neck and Orofacial Muscles. Journal of Manipulative and Physiological Therapeutics. 2021:44(1):42-48.
15. 16. Kocabey B, Coşkunsu DK, Güven K. Effects of Manual Versus Instrumental Spinal Manipulation on Blood Flow of the Vertebral and Internal Carotid Arteries in Participants with Chronic Nonspecific Neck Pain: A Single-Blind, Randomized Study. Journal of Chiropiractic Medicine. 2023;22(1):1–10.
16. 17. Farmer PK, Snodgrass SJ, Buxton AJ, et al. An Investigation of Cervical Spinal Posture in Cervicogenic Headache. Physical Therapy and Rehabilitation Journal. 2015;95(2):212-22.
17. 18. Moustafa IM, Shousha TM, Harrison DE. An investigation of 3D spinal alignment in cervicogenic headache. Musculoskeletal Science and Practice. 2021;51:102284.
18. 19. Núñez-Cabaleiro P, Leirós-Rodríguez R. Effectiveness of manual therapy in the treatment of cervicogenic headache: A systematic review. Headache. 2022;62(3):271–283.
19. 20. Kaur A, Rakesh N, Sujatha SR, et al. Association Between Vertebrobasilar Insufficiency and Cervicogenic Headache: Hypothetical Approach Towards Etiopathogenesis of Headache. Journal of Oral Medicine and Pain. 2020;45(4):97-109.
20. 21. Aikawa R, Kishino T, Shibasaki S, et al. Relationship between trapezius muscle hardness and transverse cervical artery flow in association with neck and upper-back stiffness. Clinical Physiology and Functional Imaging. 2020;40:385–389.
21. 22. Park KH, Kim HJ, Baek SY. Effect of Acupuncture on Blood Flow Velocity and Volume in Common Carotid and Vertebral Arteries in Migraine Patients. Medical Acupuncture. 2009;21(1):47-54.