Kronik Mekanik Boyun Ağrılı Bireylerde Kapalı Kinetik Halka Üst Ekstremite Stabilite Testi ile Ağrı Şiddeti Arasındaki İlişkinin İncelenmesi: Karşılaştırmalı Bir Çalışma

Öz

Amaç: Bu çalışmada birincil amacımız kronik mekanik boyun ağrılı (KMBA) erkek bireylerde kapalı kinetik halka üst ekstremite stabilite testi ile ağrı şiddeti arasındaki ilişkinin incelenmesi ve ikincil amacımızda boyun ağrısı olmayan erkek bireylerle karşılaştırılmasıdır. Gereç ve Yöntem: Çalışmaya 20-40 yaş aralığında en az 3 aydır mekanik boyun ağrısı olan 15 erkek (KMBA grubu) ve 15 boyun ağrısı olmayan erkek katılımcı (kontrol grubu) dahil edildi. Ağrı şiddetini ölçmek için Görsel Ağrı Skalası (GAS), üst ekstremite stabilite seviyesini belirlemek için Kapalı Kinetik Halka Üst Ekstremite Stabilite Testi (KKHÜEST) ve el kavrama kuvvetini ölçmek için ise el dinamometresi kullanıldı. Bulgular: KMBA grubunun ağrı şiddeti ortalaması istirahatte 3,81±2,63 cm; aktivitede 4,76±2,48 cm ve uykuda 1,70±1,55 cm’dir. Ortalama ağrı süresi 22,13±16,58 aydı. KMBA grubunun KKHÜEST ortalaması 16,73±3,04 tekrar; sağ el kavrama kuvveti 41,81±5,97 kg ve sol el kavrama kuvveti 39,65±5,00 kg olarak bulundu. Kontrol grubunda ise KKHÜEST ortalaması 17,81±2,70 tekrar; sağ el kavrama kuvveti 40,95±7,59 kg ve sol el kavrama kuvveti 41,41±6,81 kg’dı. KMBA grubu ve kontrol grubu arasında KKHÜEST sonucu açısından (p=0,312), sağ el kavrama kuvveti (p=0,732) ve sol el kavrama kuvveti açısından (p=0,432) istatistiksel olarak anlamlı farklılık bulunmadı. KMBA grubunda ağrı süresi, ağrı şiddeti, sağ el kavrama kuvveti, sol el kavrama kuvveti ve KKHÜEST arasında istatiksel olarak anlamlı korelasyon tespit edilmedi. Sonuç: Mekanik kronik boyun ağrısının şiddetli olmadığı erkeklerde üst ekstremite stabilitesi ve kavrama kuvveti korunmaktadır. Kronik mekanik boyun ağrısının, üst ekstremite stabilitesi ve kavrama kuvveti üzerinde bir etkisi bulunmamaktadır.

Anahtar Kelimeler

• Boyun ağrısı
• üst ekstremite
• el kuvveti
• ağrı değerlendirmesi

Investigation of the Relationship Between Closed Kinetic Chain Upper Extremity Stability Test and Pain Intensity in Male Individuals with Chronic Mechanical Neck Pain: A Comparative Study

Öz

Objective: The primary aim of this study was to investigate of the relationship between closed kinetic chain upper extremity stability test and pain intensity in male individuals with chronic mechanical neck pain (CMNP) and secondary purpose was to compare them to individuals without neck pain. Material and Method: Fifteen males between the ages of 20-40 who had mechanical neck pain for at least 3 months and (CMNP group) and 15 males without neck pain (control group) were included in the study. Visual Analog Scale (VAS) to measure pain intensity, Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) to determine upper extremity stability level and hand dynamometer to measure hand grip strength was used. Results: Mean pain intensity of the CMNP group was 3.81±2.63 cm at rest, 4.76±2.48 cm at activity and 1.70±1.55 cm at sleep. Mean of pain duration was 22.13±16.58 months for chronic mechanical neck pain. Mean CKCUEST scores was 16.73±3.04 repetition, right hand grip force was 41.81±5.97 kg and left-hand grip force was 39.65±5.00 kg in CMNP group. Mean CKCUEST scores was 17.81±2.70 repetition, right hand grip force was 40.95±7.59 kg and left and grip force was 41.41±6.81 kg in control group. There was no significant difference between two groups regarding CKCUEST (p=0.312), right hand grip force (p=0.732) and left-hand grip force (p=0.432). There was not found a statistically significant correlation between the pain intensity, pain duration, right hand grip force, left hand grip force and CKCUEST in CMNP group. Conclusion: Upper extremity stability and grip strength are preserved in male without severe mechanical chronic neck pain. The result of this study indicate that chronic mechanical neck pain does not affect upper limb stability strength and grip strength.

Anahtar Kelimeler

• Neck pain
• upper extremity
• hand strength
• pain assessment

Kaynakça

1. Haldeman S, Carroll L, Cassidy JD. Findings from the bone and joint decade 2000 to 2010 task force on neck pain and its associated disorders. J Occup Environ Med. 2010 Apr;52(4):424-7.
2. Süt, N. Boyun ağrısının epidemiyolojisi. Turkiye Klinikleri J Neurosurg-Special Topics. 2011;4(2):1-4.
3. Safiri S, Kolahi AA, Hoy D, Buchbinder R, Mansournia MA, Bettampadi D, et al. Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ. 2020 Mar 26;368:m791.
4. Malchaire JB, Roquelaure Y, Cock N, Piette A, Vergracht S, Chiron H. Musculoskeletal complaints, functional capacity, personality and psychosocial factors. Int Arch Occup Environ Health. 2001 Oct;74(8):549- 57.
5. Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011 Apr;25(2):173-83.
6. Ahn NU, Ahn UM, Ipsen B, An HS. Mechanical neck pain and cervicogenic headache. Neurosurgery. 2007 Jan;60(1 Supp1 1): S21-7.
7. Abichandani D, Parkar B. Comparison of upper limb proprioception in chronic mechanical neck pain patients with age-sex matched healhty normals. IInt J Sci Res. 2017;6(3):1423-8.
8. Elliott J, Jull G, Noteboom JT, Darnell R, Galloway G, Gibbon WW. Fatty infiltration in the cervical extensor muscles in persistent whiplashassociated disorders: a magnetic resonance imaging analysis. Spine (Phila Pa 1976). 2006 Oct 15;31(22): E 847-55.

9. Schomacher J, Falla D. Function and structure of the deep cervical extensor muscles in patients with neck pain. Man Ther. 2013 Oct;18(5):360-6.
10. Kristjansson E. Reliability of ultrasonography for the cervical multifidus muscle in asymptomatic and symptomatic subjects. Man Ther. 2004 May;9(2):83-8.
11. Behrsin JF, Maguire K. Levator scapulae action during shoulder movement: a possible mechanism for shoulder pain of cervical origin. Aust J Physiother. 1986;32(2):101-6.
12. Jull G, Sterling M, Falla D, Treleaven J, O’Leary S. Jull G, Sterling M, Falla D, Treleaven J, O’Leary, S, editors. Whiplash, headache, and neck pain. Edinburgh: Churchill Livingstone; 2008. p.21-39.
13. Petersen SM, Wyatt SN. Lower trapezius muscle strength in individuals with unilateral neck pain. J Orthop Sports Phys Ther. 2011 Apr;41(4):260-5.
14. Ghaderi F, Javanshir K, Jafarabadi MA, Moghadam AN, Arab AM. Chronic neck pain and muscle activation characteristics of the shoulder complex. J Bodyw Mov Ther. 2019 Oct;23(4):913-17.
15. Osborn W, Jull G. Patients with non-specific neck disorders commonly report upper limb disability. Man Ther. 2013 Dec;18(6):492-7.
16. Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010 Jun;9(2):49-59.
17. El-Sais WM, Mohammad WS., Influence of different testing positions on hand grip strength.Eur Sci J 2014; 10 (36): 290-301.
18. Lee DR, Kim LJ. Reliability and validity of the closed kinetic chain upper extremity stability test. J Phys Ther Sci. 2015 Apr;27(4):1071-3.
19. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91.
20. Sümbüloğlu K, Sümbüloğlu V. Biyoistatistik (12. basım). Hatiboğlu Yayınları. 2007. p. 264-66.
21. Wegner S, Jull G, O’Leary S, Johnston V. The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. Man Ther. 2010 Dec;15(6):562-6.
22. Gorski JM, Schwartz LH. Shoulder impingement presenting as neck pain. J Bone Joint Surg Am. 2003 Apr;85(4):635-8.
23. McLean SM, Moffett JK, Sharp DM, Gardiner E. An investigation to determine the association between neck pain and upper limb disability for patients with non-specific neck pain: a secondary analysis. Man Ther. 2011 Oct;16(5):434-9.
24. Altuğ F, Büker N, Kavlak E, Kitiş A, Cavlak U. Relationship between disability, pain ıntensity and quality of life in patients with chronic neck pain. Rom. J. Physical Ther. 2013;19(31), 69-73.
25. Demirbüken İ, Aydoğdu O, Sarı Z, Özgül B, Acar G, Polat M, Yurdalan U. Kronik boyun ağrılı bireylerde akupunktur transkutanöz elektriksel sinir stimulasyonunun ağrı ve üst ekstremite reaksiyon zamanı üzerine etkisi. Journal of Exercise Therapy and Rehabilitation. 2016; 1(2): 55-61.
26. Christensen SW, Hirata RP, Graven-Nielsen T. Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity. Eur J Pain. 2017 Apr;21(4):681-691.
27. Ylinen J, Salo P, Nykänen M, Kautiainen H, Häkkinen A. Decreased isometric neck strength in women with chronic neck pain and the repeatability of neck strength measurements. Arch Phys Med Rehabil. 2004 Aug;85(8):1303-8.
28. da Silva RM, Bezerra MA, Santos-de-Araújo AD, de Paula Gomes CAF, da Silva Souza C, de Souza Matias PHVA, et al . Inactive individuals with chronic neck pain have changes in range of motion and functional performance of the shoulder. Physiother Res Int. 2018 Oct;23(4):e1739.
29. Brandt M, Sundstrup E, Jakobsen MD, Jay K, Colado JC, Wang Y, et al. Association between neck/shoulder pain and trapezius muscle tenderness in office workers. Pain Res Treat. 2014; 2014:352735.
30. Yalcinkaya H, Ucok K, Ulasli AM, Coban NF, Aydin S, Kaya I, et al. Do male and female patients with chronic neck pain really have different health-related physical fitness, depression, anxiety and quality of life parameters? Int J Rheum Dis. 2017 Sep;20(9):1079-1087.