Evaluation of Cervical Endurance by Craniocervical Flexion Test in Patients with Subacromial Impingement Syndrome: A Preliminary Study

Year 2022, Volume: 4 Issue: 3, 479 - 482, 22.09.2022

Tuba Zoroglu , Selda Başar

https://doi.org/10.37990/medr.1141626

Abstract

Aim: The aim of the study is to evaluate deep cervical flexor endurance in patients with subacromial impingement syndrome (SIS) and compare it with norm values proven in the literature in asymptomatic individuals.
Materials and Methods: The patients’ age, weight, height, duration of complaints and dominant side information were recorded. 35 patients (25 female, 10 male) diagnosed with SIS by physicians participated in the study. Pain intensity was evaluated by numerical rating scale at rest, during elevation and at night. Craniocervical flexion test (CFT) is used for evaluating cervical endurance. “Stabilizer Pressure Biofeedback” device is used for this test. Two types of points are obtained as a result of this test. One is the CFT activation score, which expresses the activation level of the deep cervical muscles, and the other is the CFT performance index, which expresses the endurance of the deep cervical muscles.
Results: Both the activation score (3.9±1.9) and the performance index (31.4±14.2) of CFT were significantly different in patients with SIS when compared with those of asymptomatic individuals.
Conclusion: Cervical endurance is reduced in patients with SIS. Treatments including cervical stabilization should be planned in these patients.

Keywords

Cervical Endurance, Craniocervical Flexion Test, Subacromial Impingement Syndrome, Subacromial Pain, Cervical Stabilization

Subakromiyal Sıkışma Sendromlu Hastalarda Servikal Dayanıklılığın Kranioservikal Fleksiyon Testi ile Değerlendirilmesi: Ön Çalışma

Abstract

Amaç: Çalışmanın amacı, subakromiyal sıkışma sendromu (SSS) olan hastalarda derin servikal fleksör dayanıklılığı değerlendirmek ve literatürde asemptomatik bireylerde kanıtlanmış norm değerlerle karşılaştırmaktır.
Materyal ve Metot: Hastaların yaşı, kilosu, boyu, şikayet süresi ve dominant taraf bilgileri kaydedildi. Çalışmaya hekimler tarafından SSS tanısı konulan 35 hasta (25 kadın, 10 erkek) katıldı. İstirahatte, gece ve elevasyon sırasındaki ağrı yoğunluğu sayısal derecelendirme ölçeği ile değerlendirildi. Servikal dayanıklılığı değerlendirmek için kranioservikal fleksiyon testi (KFT) kullanılır. Bu test için “Stabilizer Basınç Biofeedback” cihazı kullanılmaktadır. Bu test sonucunda iki tür puan elde edilir. Biri derin servikal kasların aktivasyon seviyesini ifade eden KFT aktivasyon skoru, diğeri ise derin servikal kasların dayanıklılığını ifade eden KFT performans indeksidir.
Bulgular: SSS’li hastalarda KFT’nin hem aktivasyon skoru (3,9±1,9) hem de performans indeksi (31,4±14,2) asemptomatik bireylerinki ile karşılaştırıldığında anlamlı olarak farklıydı.
Sonuç: SSS’li hastalarda servikal endurans azalır. Bu hastalarda servikal stabilizasyonu içeren tedaviler planlanmalıdır.
araştırılmalı, FM’nin kardiyovasküler riske katkısını azaltmak için farmakolojik ve nonfarmakolojik tedavi yöntemleri uygulanmalıdır.

Keywords

Servikal endurans, kranioservikal fleksiyon testi, subakromiyal sıkışma sendromu, subakromiyal ağrı, servikal stabilizasyon

References

• 1. Greenfield, B. (2012). Impingement syndrome and impingement-related instability. D. RA içinde, Physical Therapy of the Shoulder (s. 185-206). United States of America: Elsevier
• 2. Lewis JS, Green A, Wright C. Subacromial impingement syndrome: The role of posture and muscle imbalance. J Shoulder Elbow Surg. 2005;14: 385-392.
• 3. Akman S, Küçükkaya M. Subacromial impingement syndrome: pathogenesis, clinical features and examination methods. Acta Orthop Traumatol Turc. 2003; 37 (1): 27–34
• 4. Gray JC, Grimsby O. Interrelationship of the Spine, Rib Cage, and Shoulder. In: Donatelli RA, eds, Physical Therapy of the Shoulder. 5th edition. United States of America: Elsevier. 2012; 87-130
• 5. Boyd-Clark L, Briggs C, Galea M. Muscle spindle distribution, morphology,and density in longus colli and multifidus muscles of the cervical spine. Spine. 2002;27(7):694-701.
• 6. O’Leary S, Hoogma C, Solberg ØM, et al. Comparative strength and endurance parameters of the craniocervical and cervicothoracic extensors and flexors in females with and without idiopathic neck pain. J Appl Biomech. 2019;35(3):209-15.
• 7. Nitayarak H, Charntaraviroj P. Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial. J Back Musculoskelet Rehabil. 2021;34(6):1031-1040.
• 8. Fatima A, Veqar Z, Zaidi S, Tanwar T. Effects of scapular stabilization and upper limb proprioception as an adjunct to cervical stabilization in chronic neck pain patients: A randomized controlled trial. J Bodyw Mov Ther. 2022 Jan;29:291-301.
• 9. Seo YG, Park WH, Lee CS, et al. Is Scapular Stabilization Exercise Effective for Managing Nonspecific Chronic Neck Pain?: A Systematic Review. Asian Spine J. 2020 Feb;14(1):122-129.
• 10. Hartrick CT, Kovan JP and Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract. 2003; 3:310-316.
• 11. Jull GA, Ashaun PO and Falla DL. Clinical Assessment of The Deep Cervical Flexor Muscles: The Craniocervical Flexion Test. J Manipulative Physiol Ther. 2008; 31(7): 525-531.
• 12. Fernandez-de-las-Peñas C, Pérez-de-Heredia M, Molero-Sánchez and Miangolarra-Page JC. Performance of The Craniocervical Flexion Test, Forward Head Posture, and Headache Clinical Parameters in Patients with Chronic Tension-Type Headache: A Pilot Study. J Orthop Sports Phys Ther. 2007; 37(2): 33-39.
• 13. George D and Mallery M. SPSS for Windows step by step: A simple guide and reference 11. 4th edition. 2001
• 14. Chiu T, Law E and Chiu T. Performance of the craniocervical flexion test in subjects with and without chronic neck pain.J Orthop Sports Phys Ther 2005; 35:567-71.
• 15. Faul F, Erdfelder E, Lang A and Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods, 2007; 39(2): 175–191.
• 16. Pheasant S. Cervical Contribution to Functional Shoulder Impingement: Two Case Reports. Int J Sports Phys Ther. 2016 Dec;11(6):980-991.
• 17. Zedan AME, Abd Al-Majeed SF, Sarhan MAM and Khater AH. Efficacy of cervical stability exercises in treating shoulder impingement syndrome. International Journal of Recent Advances in Multidisciplinary Research. 2018; 5(2): 3551-3558.
• 18. Lee S, Park J and Lee D. The effects of cervical stabilization exercises on the electromyographic activity of shoulder stabilizers. J Phys Ther Sci. 2013 25(12):1557-1560.