Neck Pain w/ Movement Coordination Impairments

Question 1

What common symptoms are associated with neck pain w/ movement coordination impairments?

Answer 1

• mechanism of onset lined to trauma or whiplash
• associated (referred) shoulder girdle or upper extremity pain
• associated varied nonspecific concussive signs and symptoms
• dizziness/nausea
• headache, concentration, or memory difficulties

Question 2

What are the expected exam findings for neck pain w/ movement coordination impairments?

Answer 2

• positive cranial cervical flexion test
• positive neck flexor muscle endurance test
• positive pressure algometry
• strength and endurance deficits in neck muscles
• mid-range neck pain that worsens at end-range
• point tenderness may include myofascial trigger points
• sensorimotor impairment may include altered muscle activation patterns, proprioceptive deficit, postural balance or control
• neck and referred pain reproduced by provocation of the involved cervical segments

Question 3

What muscles are commonly affected by movement coordination impairments?

Answer 3

Anterior: Longus Colli, Longus Capitus

Posterior: Cervical multifidi, semispinalis cervicis/capitus, splenius cervicis/capitus

Question 4

Name the posterior neck muscles from deepest to most superficial.

Answer 4

1. Multifidus-rotators
2. semispinalis cervicis
3. semispinalis capitis
4. splenius cervicis and capitis
5. trapezius

Question 5

How do you perform the craniocervical flexion test?

Answer 5

1. inflate pressure unit to 20 mmHg
2. perform a “chin tuck” at 5 different pressures (22, 24, 26, 28, and 30)
3. hold for 10 sec. at each pressure w/ 30 sec rest inbetween
4. testing ends when patient can’t hold specific pressure level for 10 seconds

(looks for engagement of superficial muscles)

Question 6

How do you perform the deep neck flexor endurance test?

What are the norms for men and women?

Answer 6

1. patient supine in hook-lying position, hands on abdomen
2. “tuck and lift your chin”
3. maintained isometrically
4. head lifted 1 inch off table while keeping chin retracted
5. testing ends when skin separates ( for over 1 sec) or head falls to the table (on to hand)

Norms: male=39 sec. and female=29 sec.

Question 7

What is the main function of the deep neck flexor muscles?

Answer 7

they are endurance muscles and should be trained with endurance goals