Article

Respiratory weakness in patients with chronic neck pain

Manchester Academic Health Sciences Centre, The University of Manchester, Oxford Road, Manchester M13 9PL, UK. Electronic address: .
Manual therapy (Impact Factor: 1.71). 11/2012; 18(3). DOI: 10.1016/j.math.2012.10.014
Source: PubMed

ABSTRACT

Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P < 0.05). Neck muscle strength (r > 0.5), kinesiophobia (r < -0.3) and catastrophizing (r < -0.3) were significantly associated with maximal mouth pressures (P < 0.05), whereas MEP was additionally negatively correlated with neck pain and disability (r < -0.3, P < 0.05). Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.

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    • "Four representative methods of assessing the FHP were used (Yoo et al., 2005). The first method included calculation of the CVA, which is the angle between the horizontal line and the line extending from C7 to the tragus of the ear (Dimitriadis et al., 2013). The second method included the calculation of the oculovertebral angle (OVA), which is the angle between the line connecting C7 to the mastoid process and the line connecting the tragus of the ear to the canthus of the eye. "
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    • "As a further limitation, isometric neck muscle strength was not assessed in this study. Such assessments should however be included in further studies because they have emerged as predictors for both Pi max and Pe max (Dimitriadis et al., 2013b). Future studies on respiratory dysfunction in patients with chronic neck pain should focus on those patients with a higher level of neck disability to detect more pronounced effects and should also exclude traumatic neck patients. "
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