BACKGROUND:
67% of people will suffer neck pain at some point in their lives. Abnormal muscle recruitment patterns may lead to a cycle of impaired movement patterns, which result in neck pain becomig chronic. Spinal manipu- lation combined with exercise has been shown to decrease pain and disability in patients with chronic low back pain and this improvement can be partially attributed to improved neuromuscular activation patterns. The purpose of this pilot study was to apply this model from the back to the neck and also to determine whether similar changes in neuromuscular activation occurred in chronic neck pain patients.
DESIGN:
This pilot study was a randomized controlled trial comparing chiropractic care combined with exercise versus exercise only for participants with chronic neck pain. Group 1 received 4 weeks of chiropractic care, and Group 2 waited 4 weeks before both groups participated in an 8-week exercise intervention. The following outcome measures were assessed in week 1 (baseline), week 4 and at week 12: Neck Disability Index (NDI); Visual Analogue Scale; Neck flexion-relaxation (FR) response and feed forward activation times.
OBJECTIVES:
1) To determine whether a 4-week period of chiropractic care improves the ability of patients to respond to an 8-week period of exercise rehabilitation on indices of disability, and neuromuscular function.
2) To determine effect sizes for any changes in neuromuscular activation patterns.
RESULTS:
There was a significant reduction observed in functional disability and pain levels in both groups. There were medium effect size changes in feed forward activation for both groups and for the FR response in the exercise group.
CONCLUSIONS:
Chiropractic care combined with exercise and exercise alone are both effective at reducing functional disability and pain in chronic non-specific neck pain patients, which may be related to improved neuromuscular measures.
Grant Value: $36,030.82
Chief Investigator: Dr Bernadette Murphy – University of Auckland
Status: Complete
Publications:
- Journal of Manipulative and Physiological Therapeutics, Volume 33, Issue 3, March 2010, Pages 168 – 177
Murphy, B.A., Haavik Taylor, H., Marshall, P.W., (2010) The effect of spinal manipulation on the efficacy of a rehabilitation protocol for patients with chronic neck pain: a pilot study. - Spine, Volume 35, Issue 24, November 2010
Murphy, Bernadette A. DC, PhD*; Marshall, Paul W. PhD†; Taylor, Heidi Haavik BSc (Chiro), PhD‡. The Cervical Flexion-Relaxation Ratio: Reproducibility and Comparison Between Chronic Neck Pain Patients and Controls. Spine 35(24):p 2103-2108, November 15, 2010. | DOI: 10.1097/BRS.0b013e3181cbc7d8
Posters:
- Proceedings of the 12th World Federation of Chiropractic Biennial Congress April 2013, Durban, South Africa Page 107
Barker, I., Yielder, P., Haavik, H, Murphy, B. The Effect of 12 Weeks of Manipulative Care on the Cervical Flexion Relaxation Response: A Pilot Study.
Presentation:
- International Society of Electromyography and Kinesiology (ISEK) Biannual Meeting July 2012. Brisbane, QLD, Australia. Page 244
Barker, I., Yielder, P., Murphy, B. “The effects of neck muscle fatigue on the cervical flexion relaxation response and on cervical joint position sense”. - Proceedings of the 9th World Federation of Chiropractic Biennial Congress May 2007. Vilamoura, Portugal.
Murphy B, Marshall P, Haavik Taylor H, Govorko D, Palmer S (2007). The cervical flexion-relaxation ratio: Reproducibility and Comparison between Chronic neck pain patients and controls. World Federation of Chiropractic’s 9th Biennial Congress in Vilamoura, Portugal May 17-19, - ACC Research Agenda Conference March 2009. Las Vegas, USA
Murphy B.A., Marshall, P.W. and Haavik Taylor H. The effect of spinal manipulation on exercise rehabilitation neuromuscular outcome measures for patients with chronic neck pain: a pilot study. JCA 23(1):p83