Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio-cervical flexion test.
When people with neck pain perform the cranio-cervical flexion test (CCFT), activation of the deep neck flexors reduces. This movement, as an exercise, lessens neck pain and better co-ordinates neck flexors.
This study compared the immediate effects of active cranio-cervical flexion for 3 minutes, assisted by a physiotherapist for the first minute (exercise group) versus passive mobilisation plus assisted cranio-cervical flexion (mobilisation group).
Eighteen participants with chronic, idiopathic neck pain and pain of 3/10 or greater were randomised into the 2 groups. Current level of pain, cervical ROM and pain perceived during movement, pressure pain threshold (PPT) and surface electromyography (EMG) during performance of the CCFT were measured before and immediately after the intervention.
A reduction in resting pain and PPT over cervical sites occurred immediately following intervention for both groups but was greater for the exercise group. Improved performance of CCFT occurred only after active exercise. The improved motor task was reflected in the superficial cervical flexors (anterior scalenes and sternocleidomastoid) showing reduced EMG activity immediately after the intervention. Active range of movement was not altered by either intervention.
So, active and passive interventions produce immediate pain relief but improved motor control relies on repetitive, active exercise therapy. > From: Lluch et al., Man Ther (2013) (Epub ahead of print). All rights reserved to Elsevier Ltd.
The Pubmed summary of the article can be found here.
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