Association of electromyographic activation patterns with pain and functional disability in people with chronic neck pain

Tsang, Sharon M. H.; Szeto, Grace P. Y.; Xie, Y. F.; Lee, Raymond Y. W.

doi:10.1007/s00421-018-3878-z

Original Article
Published: 05 May 2018

Association of electromyographic activation patterns with pain and functional disability in people with chronic neck pain

Sharon M. H. Tsang ORCID: orcid.org/0000-0002-2232-9814¹,
Grace P. Y. Szeto¹,
Y. F. Xie² &
Raymond Y. W. Lee³

European Journal of Applied Physiology volume 118, pages 1481–1492 (2018)Cite this article

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Abstract

Purpose

This study examined the activation patterns of the cervical and thoracic muscles in people with and without chronic neck pain during functional activities and their associations with pain intensity and functional disability.

Methods

Thirty-four adults with chronic neck pain and 34 asymptomatic adults were recruited. They were requested to perform active cervical movements and an upper limb lifting task. Electromyographic activation patterns (EMG) of bilateral upper trapezius, cervical erector spinae, sternocleidomastoid, and thoracic erector spinae were recorded during these tasks. Correlation and multiple regression analysis were used to examine the associations between EMG variables and severity of pain and functional disability.

Results

When performing the cervical movements, the neck pain group displayed lower EMG activity levels, especially in the cervical and thoracic extensors. In addition, significantly prolonged activation was observed in seven of the ten muscles during the upper limb lifting task. The changes in EMG amplitude and activation duration were found to be significantly correlated with severity of pain (R² = 0.716) and functional disability (R² = 0.623).

Conclusions

Significant differences in the activation patterns of multiple cervical and thoracic muscles were found in individuals with neck pain compared with those without neck pain. These were significantly associated with their degree of pain and functional limitation. The findings of this study highlight the importance of assessing and optimising the neuromuscular activation of these muscles in the rehabilitation of those suffering from chronic neck pain.

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Abbreviations

AS:: Asymptomatic
CES:: Cervical erector spinae
CMD:: Coefficient of multiple determination
Cx:: Cervical spine
EMG:: Electromyography
ICC:: Intraclass correlation coefficient
MCS:: Mental Component Score
MIVC:: Maximal isometric voluntary contraction
NDI:: Neck Disability Index
NP:: Neck pain
NPQ:: Northwick Park Disability Questionnaire
NPRS:: Numeric Pain Rating Scale
PCS:: Physical Component Score
SCM:: Sternocleidomastoid
SENIAM:: Surface electromyography for the non-invasive assessment of muscles
SF-12:: Short Form 12 health survey
SMIVC:: Sub-maximal isometric voluntary contraction
TES4:: Thoracic erector spinae at 4th thoracic spine level
TES9:: Thoracic erector spinae at 9th thoracic spine level
Tx:: Thoracic spine
UTr:: Upper trapezius

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Affiliations

Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hunghom, Hong Kong
Sharon M. H. Tsang & Grace P. Y. Szeto
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
Y. F. Xie
Faculty of Technology, University of Portsmouth, Portsmouth, UK
Raymond Y. W. Lee

Authors

Sharon M. H. Tsang
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Grace P. Y. Szeto
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Y. F. Xie
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Raymond Y. W. Lee
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Contributions

All authors contributed to the preparation and revision of the manuscript. All authors have reviewed and agreed on the revision made in the manuscript.

Corresponding author

Correspondence to Sharon M. H. Tsang.

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Communicated by Guido Ferretti.

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Tsang, S.M.H., Szeto, G.P.Y., Xie, Y.F. et al. Association of electromyographic activation patterns with pain and functional disability in people with chronic neck pain. Eur J Appl Physiol 118, 1481–1492 (2018). https://doi.org/10.1007/s00421-018-3878-z

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Received: 14 July 2017
Accepted: 26 April 2018
Published: 05 May 2018
Issue Date: July 2018
DOI: https://doi.org/10.1007/s00421-018-3878-z

Keywords

Chronic neck pain
Muscle activation
Pain intensity
Functional disability
Cervical movements
Upper limb lifting task