Investigation of Lateral Trunk Flexor Muscle Performance in Individuals with Chronic Neck Pain: A Case-Control Study
Year 2025,
Volume: 9 Issue: 2, 361 - 367, 31.05.2025
Gamze Yalçınkaya Çolak
,
Müge Kırmızı
,
Ahmet Öztürk
,
Orhan Kalemci
,
Yeşim Salık Şengül
References
-
Shin DW, Shin J Il, Koyanagi A, Jacob L, Smith L, Lee H, et al. Global, regional, and national neck pain burden in the general population, 1990–2019: An analysis of the global burden of disease study 2019. Front Neuro 20221;13.
-
Peng Q, Zhang Y, Yang S, Meng B, Chen H, Liu X, et al. Morphologic Changes of Cervical Musculature in Relation to Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis. World Neurosurg 2022;168:79–88.
-
Dere T, Alemdaroğlu-Gürbüz İ. Muscular endurance and its association with neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain. Somatosens Mot Res 2024;41(3):134–41.
-
Yalcinkaya G, Ozyurek S, Kalemci O, Salik Sengul Y. Comparison of ultrasonographic characteristics of deep abdominal muscles in women with and without chronic neck pain: a case-control study. J Musculoskelet Neuronal Interact 2022;22(1):52–61.
-
Moseley GL. Impaired trunk muscle function in sub-acute neck pain: etiologic in the subsequent development of low back pain? Man Ther 2004;9(3):157–63.
-
Treleaven J, Takasaki H, Grip H. Altered trunk head co-ordination in those with persistent neck pain. Musculoskelet Sci Pract 2019;39:45–50.
-
Schweigart G, Heimbrand S, Mergner T, Becker W. Perception of horizontal head and trunk rotation: modification of neck input following loss of vestibular function. Exp Brain Res 1993;95(3).
-
Falla D, Gizzi L, Parsa H, Dieterich A, Petzke F. People With Chronic Neck Pain Walk With a Stiffer Spine. Journal of Orthopaedic & Sports Physical Therapy 2017;47(4):268–77.
-
Christensen SW, Hirata RP, Graven‐Nielsen T. Altered pain sensitivity and axioscapular muscle activity in neck pain patients compared with healthy controls. European Journal of Pain 2017;21(10):1763–71.
-
Sueki DG, Cleland JA, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. Journal of Manual & Manipulative Therapy 2013;21(2):90–102.
-
Ghamkhar L, Arab AM, Nourbakhsh MR, Kahlaee AH, Zolfaghari R. Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions. Pain Medicine 2019;21(2):e182-e190.
-
Castellini G, Pillastrini P, Vanti C, Bargeri S, Giagio S, Bordignon E, et al. Some conservative interventions are more effective than others for people with chronic non-specific neck pain: a systematic review and network meta-analysis. J Physiother 2022;68(4):244–54.
-
Cohen J. Statistical power analysis. In: Current directions in psychological science. 1992. p. 98–101.
-
MacDowall A, Skeppholm M, Robinson Y, Olerud C. Validation of the visual analog scale in the cervical spine. J Neurosurg Spine 2018;28(3):227–35.
-
Aslan E, Karaduman A, Yakut Y, Aras B, Simsek İE, Yaglý N. The Cultural Adaptation, Reliability and Validity of Neck Disability Index in Patients With Neck Pain. Spine (Phila Pa 1976) 2008;33(11):E362–5.
-
Waldhelm A, Li L. Endurance tests are the most reliable core stability related measurements. J Sport Health Sci 2012;1(2):121–8.
-
Newman BL, Pollock CL, Hunt MA. Reliability of Measurement of Maximal Isometric Lateral Trunk-Flexion Strength in Athletes Using Handheld Dynamometry. J Sport Rehabil 2012;21(4):10.1123/jsr.2012.TR6.
-
Iveson BD, McLaughlin SL, Todd RH, Gerber JP. Reliability and exploration of the side-lying thoraco-lumbar rotation measurement (strm). N Am J Sports Phys Ther 2010;5(4):201–7.
-
Briani RV, Waiteman MC, de Albuquerque CE, Gasoto E., Segatti G, Oliveira CB, de Oliveira Silva D. Lower trunk muscle thickness is associated with pain in women with patellofemoral pain. J Ultrasound Med 2019; 38(10):2685-2693.
-
Colak GY, Kirmizi M, Sengul YS, Kalemci O, Angin S. Comparison of trunk muscle endurance between women with and without chronic neck pain. Pain Management Nursing 2024;26(1):e82-e87.
-
Elgueta‐Cancino E, Marinovic W, Jull G, Hodges PW. Motor cortex representation of deep and superficial neck flexor muscles in individuals with and without neck pain. Hum Brain Mapp 2019;40(9):2759–70.
-
Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 1999;4(2):74–86.
-
Heneghan NR, Webb K, Mahoney T, Rushton A. Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: A systematic review. Transl Sports Med 2019;2(6):301–15.
-
Borghuis J, Hof AL, Lemmink KAPM. The Importance of Sensory-Motor Control in Providing Core Stability. Sports Medicine 2008;38(11):893–916.
-
Moghaddas D, Edwards S, Snodgrass SJ. Comparisons of cervical and thoracic spine kinematic joint and body segment angles, timing, and velocity between individuals with and without chronic idiopathic neck pain during functional tasks. Gait Posture 2022;92:394–400.
-
Joshi S, Balthillaya G, Neelapala YVR. Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature. Asian Spine J 2019;13(5):849–60.
-
van den Hoorn W, Bruijn SM, Meijer OG, Hodges PW, van Dieën JH. Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain. J Biomech 2012;45(2):342–7.
Investigation of Lateral Trunk Flexor Muscle Performance in Individuals with Chronic Neck Pain: A Case-Control Study
Year 2025,
Volume: 9 Issue: 2, 361 - 367, 31.05.2025
Gamze Yalçınkaya Çolak
,
Müge Kırmızı
,
Ahmet Öztürk
,
Orhan Kalemci
,
Yeşim Salık Şengül
Abstract
Purpose: To investigate lateral trunk flexor muscle performance and thoracolumbar mobility in individuals with chronic neck pain (CNP) compared to asymptomatic controls.
Material and Methods: This case-control study included 20 participants with CNP and 20 asymptomatic controls. Pain and disability variables of the CNP group were assessed via visual analogue scale (VAS) and neck disability index. Lateral trunk flexor muscle performance was evaluated on endurance, strength, and thoracolumbar rotation range basis using the side-bridge lateral trunk flexor endurance test, hand-held dynamometer, and bubble inclinometer, respectively. Group differences were analyzed using the independent Sample’s t-test.
Results: The individuals with CNP reported pain intensity scores of 6.32 at rest and 6.63 during activity, on the VAS. Additionally, their neck disability index value was found to be 45.6%, indicating a moderate disability level. Compared to the asymptomatic controls, the CNP group demonstrated significantly lower lateral trunk flexor endurance, strength, and thoracolumbar rotation, with large effect sizes (p<0.05, Cohen’s d>0.71).
Conclusion: Individuals with CNP exhibit reduced lateral trunk flexor muscle performance and thoracolumbar mobility compared to asymptomatic individuals. These observations suggest that interventions focused on improving trunk muscle strength and mobility may be advantageous in managing CNP.
Ethical Statement
This study was approved by Dokuz Eylul University Non-invasive Research Ethics Committee (Number: 2023/04-01, Date: 15.02.2023)
References
-
Shin DW, Shin J Il, Koyanagi A, Jacob L, Smith L, Lee H, et al. Global, regional, and national neck pain burden in the general population, 1990–2019: An analysis of the global burden of disease study 2019. Front Neuro 20221;13.
-
Peng Q, Zhang Y, Yang S, Meng B, Chen H, Liu X, et al. Morphologic Changes of Cervical Musculature in Relation to Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis. World Neurosurg 2022;168:79–88.
-
Dere T, Alemdaroğlu-Gürbüz İ. Muscular endurance and its association with neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain. Somatosens Mot Res 2024;41(3):134–41.
-
Yalcinkaya G, Ozyurek S, Kalemci O, Salik Sengul Y. Comparison of ultrasonographic characteristics of deep abdominal muscles in women with and without chronic neck pain: a case-control study. J Musculoskelet Neuronal Interact 2022;22(1):52–61.
-
Moseley GL. Impaired trunk muscle function in sub-acute neck pain: etiologic in the subsequent development of low back pain? Man Ther 2004;9(3):157–63.
-
Treleaven J, Takasaki H, Grip H. Altered trunk head co-ordination in those with persistent neck pain. Musculoskelet Sci Pract 2019;39:45–50.
-
Schweigart G, Heimbrand S, Mergner T, Becker W. Perception of horizontal head and trunk rotation: modification of neck input following loss of vestibular function. Exp Brain Res 1993;95(3).
-
Falla D, Gizzi L, Parsa H, Dieterich A, Petzke F. People With Chronic Neck Pain Walk With a Stiffer Spine. Journal of Orthopaedic & Sports Physical Therapy 2017;47(4):268–77.
-
Christensen SW, Hirata RP, Graven‐Nielsen T. Altered pain sensitivity and axioscapular muscle activity in neck pain patients compared with healthy controls. European Journal of Pain 2017;21(10):1763–71.
-
Sueki DG, Cleland JA, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. Journal of Manual & Manipulative Therapy 2013;21(2):90–102.
-
Ghamkhar L, Arab AM, Nourbakhsh MR, Kahlaee AH, Zolfaghari R. Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions. Pain Medicine 2019;21(2):e182-e190.
-
Castellini G, Pillastrini P, Vanti C, Bargeri S, Giagio S, Bordignon E, et al. Some conservative interventions are more effective than others for people with chronic non-specific neck pain: a systematic review and network meta-analysis. J Physiother 2022;68(4):244–54.
-
Cohen J. Statistical power analysis. In: Current directions in psychological science. 1992. p. 98–101.
-
MacDowall A, Skeppholm M, Robinson Y, Olerud C. Validation of the visual analog scale in the cervical spine. J Neurosurg Spine 2018;28(3):227–35.
-
Aslan E, Karaduman A, Yakut Y, Aras B, Simsek İE, Yaglý N. The Cultural Adaptation, Reliability and Validity of Neck Disability Index in Patients With Neck Pain. Spine (Phila Pa 1976) 2008;33(11):E362–5.
-
Waldhelm A, Li L. Endurance tests are the most reliable core stability related measurements. J Sport Health Sci 2012;1(2):121–8.
-
Newman BL, Pollock CL, Hunt MA. Reliability of Measurement of Maximal Isometric Lateral Trunk-Flexion Strength in Athletes Using Handheld Dynamometry. J Sport Rehabil 2012;21(4):10.1123/jsr.2012.TR6.
-
Iveson BD, McLaughlin SL, Todd RH, Gerber JP. Reliability and exploration of the side-lying thoraco-lumbar rotation measurement (strm). N Am J Sports Phys Ther 2010;5(4):201–7.
-
Briani RV, Waiteman MC, de Albuquerque CE, Gasoto E., Segatti G, Oliveira CB, de Oliveira Silva D. Lower trunk muscle thickness is associated with pain in women with patellofemoral pain. J Ultrasound Med 2019; 38(10):2685-2693.
-
Colak GY, Kirmizi M, Sengul YS, Kalemci O, Angin S. Comparison of trunk muscle endurance between women with and without chronic neck pain. Pain Management Nursing 2024;26(1):e82-e87.
-
Elgueta‐Cancino E, Marinovic W, Jull G, Hodges PW. Motor cortex representation of deep and superficial neck flexor muscles in individuals with and without neck pain. Hum Brain Mapp 2019;40(9):2759–70.
-
Hodges PW. Is there a role for transversus abdominis in lumbo-pelvic stability? Man Ther 1999;4(2):74–86.
-
Heneghan NR, Webb K, Mahoney T, Rushton A. Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: A systematic review. Transl Sports Med 2019;2(6):301–15.
-
Borghuis J, Hof AL, Lemmink KAPM. The Importance of Sensory-Motor Control in Providing Core Stability. Sports Medicine 2008;38(11):893–916.
-
Moghaddas D, Edwards S, Snodgrass SJ. Comparisons of cervical and thoracic spine kinematic joint and body segment angles, timing, and velocity between individuals with and without chronic idiopathic neck pain during functional tasks. Gait Posture 2022;92:394–400.
-
Joshi S, Balthillaya G, Neelapala YVR. Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature. Asian Spine J 2019;13(5):849–60.
-
van den Hoorn W, Bruijn SM, Meijer OG, Hodges PW, van Dieën JH. Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain. J Biomech 2012;45(2):342–7.