Week 3: Neck Pain Motor Control Training

Question 1

Common symptoms for neck pain w/ movement coordination impairments (WAD)

Answer 1

• MOI linked to trauma or whiplash
• Referred shoulder girdle or UE pain
• Dizziness/nausea
• Headache, concentration, or memory difficulty
• Hypersensitivity to stimulus

Question 2

Expected exam findings for neck pain w/ movement coordination impairments (WAD)

Answer 2

• • CCFT
• • neck flexor muscle endurance test
• • pressure algometry
• Strength and endurance deficits of neck
• Pain in mid-range
• Pain reproduced by provocation of the involved cervical segments

Question 3

What patients may benefit from treatment from this classification?

Answer 3

• Those suffering from WAD
• Post-concussive symptoms
• Persistent neck pain
• Vestibular/dizziness

Question 4

What anterior muscles are implicated in this classification?

Answer 4

• Longus colli

- Longus capitus

Question 5

What posterior muscles are implicated in this classification?

Answer 5

• Cervical multifidi
• Semispinaliis cervicis/capitus
• Splenius cervicis/capitus

Question 6

What is the overall function of these muscles?

Answer 6

• Control
• Stability
• Support of cervical curvature
• Unable to be replicated by superficial muscles

Question 7

What impairments are in place that make treating these patients so important?

Answer 7

• Cranial muscles are also sensory systems and orient the head
• Fatty infiltrate can be found
• Increased activation of superficial muscles
• Poor endurance and coordination

Question 8

What tests are used for neck pain w/ movement coordination impairments?

Answer 8

• Craniocervical flexion test
• Deep neck flexor endurance test
• Joint position error (JPE)

Question 9

Procedure for craniocervical flexion test (CCFT)

Answer 9

• Start: Inflate pressure unit to 20 mmHg
• Perform “chin tuck” at 5 different pressures (22, 24, 26, 28 and 30 mmHg)
• Hold for 10 seconds at each pressure, 30 sec. rest in between
• Testing ends: patient can’t hold specific pressure level for 10 seconds
• Looking for engagement of superficial muscles

Question 10

Procedure for deep neck flexor endurance test

Answer 10

• Start: Patient supine in hook-lying position, hands on abdomen
• “Tuck and lift your chin” (Maintained isometrically)
• Head lifted 1 inch (2.5 cm) off table while keeping chin retracted
• Testing ends: Skin separates (> 1 sec.), head falls to table (on to hand)

Question 11

Norms for males in the deep neck flexor endurance test

Answer 11

39 seconds

Question 12

Norms for females in the deep neck flexor endurance test

Answer 12

29 seconds

Question 13

Procedure for joint position error test

Answer 13

• Use laser attached to head to establish baseline

- Look away with eyes closed, and return to see if they can get to the same spot

Question 14

Scoring for joint position error test

Answer 14

• 1-3 inches from baseline = green
• 3-4.5 inches = yellow
• 4.5-6 inches = red

Question 15

Guidelines for training muscles for neck pain w/ movement coordination impairments

Answer 15

• Focus on functional deficits
• Train endurance
• Incorporate axioscapular muscles

Question 16

Role of education for those w/ neck pain w/ movement coordination impairments

Answer 16

• Decrease use of collar
• Stay active/act as usual
• Perform mobilizing exercises