The Effect of the PostureJac on Deep Cervical Flexor Endurance: Implications in the Management of Cervicogenic Headache and Mechanical Neck Pain

Abstract

The convergence of cervical and trigeminal afferents on second-order neurons in the trigeminocervical nucleus may refer pain from the upper cervical spine into the head and face. Furthermore, “bi-directional interactions” between trigeminal and upper cervical afferents may also explain neck symptoms of trigeminal origin (e.g., migraine). It is known that cervicogenic headache sufferers present with several musculoskeletal changes including poor endurance of the deep cervical flexor muscles. These intrinsic muscles of the neck contribute to stabilization and protection of the cervical spine and are critical for the control of both intervertebral motion and the cervical lordosis. The purpose of this study was to determine whether the use of the PostureJac (SomatoCentric Systems, Inc., Toronto, Ontario, Canada), a posture support and exercise jacket, was effective in enhancing deep cervical muscle endurance. Forty-five (45) female subjects, between the ages of 18 and 40 years, were randomly assigned to three groups consisting of the no-treatment control, the treatment-control (table stabilization), and the experimental (PostureJac) group. The outcome measure of deep cervical flexor muscle endurance was based on the Flexor Endurance Test and was recorded in seconds. The results indicated that the PostureJac group was superior to the no-treatment control (p=.001) and the treatmentcontrol (p=.004) groups in terms of increasing endurance of the deep cervical flexors. Consequently, the PostureJac may be a useful therapeutic tool in the management of cervicogenic headache and mechanical neck pain.

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Notes on contributors

Howard W. Makofsky

Dr. Howard Makofsky received his B.Sc. in human physiology from McGill University in 1977, a B.S. in physical therapy, and an M.S. in health sciences, both from Stony Brook University in 1979 and 1993, respectively. Dr. Makofsky received a doctorate in health sciences from the University of St. Augustine for Health Sciences in 1999. He is an associate professor in the Physical Therapy Department at the New York Institute of Technology, an adjunct professor at Touro College, School of Health Sciences, and a clinical assistant professor at Stony Brook University.

Peter Douris

Dr. Peter Douris received his B.S. degree in physical education from Hunter College in 1979, an M.S. in physical therapy from Columbia University in 1982, a Doctor of education in movement from Columbia University in 1989, and a Doctor of physical therapy from the New York Institute of Technology in 2007. Dr. Douris is an associate professor in the Physical Therapy Department at the New York Institute of Technology.

Leonard B. Goldstein

Dr. Leonard Goldstein received his D.D.S. degree from the Case-Western Reserve University School of Dentistry in 1967 and a Ph.D. in biomedical sciences from the City University in Los Angeles, California in 1996. Dr. Goldstein is currently the director of Clerkship Education and an associate professor of family medicine at the New York College of Osteopathic Medicine in Old Westbury, New York. He has lectured and published nationally and internationally on the subjects of forensics and pain management.

Adam Discepolo

Dr. Adam Discepolo received his B.S. in health science from Stony Brook University in 2006 and his Doctor of physical therapy degree from the New York Institute of Technology n 2009. Dr. Discepolo practices physical therapy at the Professional Orthopedic and Sports Performance Center in Mamaroneck, New York and is also an advanced strength and conditioning coach.

Kelly Grion

Dr. Kelly Grion earned a B.S. in biology from St. John’s University in 2006 and a Doctor of physical therapy degree in 2009 from the New York Institute of Technology in Old Westbury, New York. Dr. Grion practices physical therapy at the North Shore University Hospital in Manhasset, New York and at Bicounty Physical Therapy and Rehabilitation in Floral Park, New York.

Garry Kushnir

Dr. Garry Kushnir received his B.S. in biology/neurosciences in 2005 from Stony Brook University and his Doctor of physical therapy degree in 2009 from the New York Institute of Technology in Old Westbury, New York. Dr. Kushnir practices physical therapy at Metro Comprehensive Physical and Aquatic Therapy in Rocky Point, New York. Dr. Kushnir manages patients with orthopedic, neurologic, and vestibular impairments.

Stacie Malner

Dr. Stacie Malner received her Doctor of physical therapy degree in 2009 from the New York Institute of Technology in Old Westbury, New York. She is currently practicing as a pediatric physical therapist in New York. Dr. Malner specializes in the treatment of autism and Down syndrome.

Jasmine Singh

Dr. Jasmine Singh earned a B.S. in life science and a Doctor of physical therapy degree, both from the New York Institute of Technology in Old Westbury, New York. Dr. Singh is a member of the American Physical Therapy Association and currently practices at New York Physical Therapy and Wellness in East Meadow, New York.

Lisa Urgolites

Dr. Lisa Urgolites graduated from the New York Insitiute of Technology with a doctor of physical therapy degree in May 2009. She received a Master's degree in medical biology from CW Post Long Island University in 2005, and a Bachelors degree in toxicology from St. John's University in 2000. She is currently working full-time in a preschool in Queens as a pediatric physical therapist.

Frank Zic

Dr. Frank Zic earned a B.S. in biology and psychology from Syracuse University in 2004 and a Doctor of physical therapy degree from the New York Institute of Technology in 2009. Dr. Zic practices physical therapy at New York Physical Therapy and Wellness in Melville, New York, where he specializes in the treatment of sports and orthopedic injuries.

Jacqueline Oricchio

Dr. Jacqueline Oricchio received a B.S. in life science in 2006 and a Doctor of physical therapy degree in 2009, both from the New York Institute of Technology in Old Westbury, New York. Dr. Oricchio manages patients with orthopedic injuries, as well as specializing in pediatric physical therapy.