Abstract
Lindstroem R, Graven-Nielsen T, Falla D. Current pain and fear of pain contribute
to reduced maximum voluntary contraction of neck muscles in patients with chronic
neck pain.
Objective
To assess a range of physical and psychological factors and determine which factors
contribute the most to reduced strength in patients with neck pain.
Design
Regression.
Setting
Laboratory.
Participants
Women with chronic neck pain (n=34) and healthy controls (n=14).
Interventions
Not applicable.
Main Outcome Measures
Neck flexion, extension, and lateral flexion maximum voluntary contractions (MVC)
were measured in patients and healthy controls. Additional parameters were collected
for the patient group including: (1) questionnaires measuring general health (Medical
Outcomes Study 36-Item Short-Form Health Survey), pain intensity, disability (Neck
Disability Index [NDI]; Patient Specific Functional Scale), and fear of movement (Fear-Avoidance
Beliefs Questionnaire [FABQ]), (2) pressure pain thresholds, (3) cross-sectional area of selected neck muscles, and (4) surface electromyography
from selected neck muscles during a multidirectional isometric task. Univariate and
multivariate regression analyses were applied with the average MVC (average of flexion,
extension, and lateral flexion MVC) as the dependent variable.
Results
The average MVC was significantly lower in patients (mean ± SD, 130.0±6.0N) compared
with controls (166.9±11.7N; P<.01). Univariate regression of the average MVC with the FABQ, NDI, or pain experienced
during the MVC gave R2 values of 13.4%, 13.8%, and 21.1%, respectively. Collectively, the FABQ and pain
experienced during the MVCs resulted in an R2 of 26.6% and the FABQ, contraction pain, and NDI, an R2 of 28.2%.
Conclusions
The average maximum voluntary force produced in neck flexion, extension, and lateral
flexion is inversely and moderately correlated with the pain experienced during maximal
contraction, fear of movement, and aspects of neck disability in patients with chronic
neck pain.
Key Words
List of Abbreviations:
ARV (average rectified value), CSA (cross-sectional area), EMG (electromyogram), FABQ (Fear-Avoidance Beliefs Questionnaire), MVC (maximum voluntary contraction), NDI (Neck Disability Index), PPT (pain pressure threshold), PSFS (Patient-Specific Functional Scale), SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 30, 2012
Footnotes
Supported by Kiropraktorfonden and the Danish Medical Research Council.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on Jun 20, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
