Abnormal performance of cervical stabilizer muscles in individuals with low back pain

ABSTRACT

Objectives: To compare the performance of cervical stabilizer muscles using the craniocervical flexion test (CCFT) among individuals with subacute, chronic, and asymptomatic low back pain (LBP) conditions.

Methods: Individuals with subacute (N = 23) and chronic LBP (N = 23) with their age- and gender-matched controls (N = 30) participated in this study. All recruited participants were required to perform the CCFT. The activation score (AS) and the performance index (PI) were recorded by an assessor who was blinded to the group of participants.

Results: Approximately, 74% of subacute LBP participants and 60–65% of chronic LBP participants obtained abnormal AS and PI. AS was significantly lower in participants with subacute (P = 0.0002) and chronic LBP (P = 0.0009) than the control group. Likewise, the PI was significantly lower in participants with subacute (P = 0.0002) and chronic LBP (P = 0.0036) than the control group. Participants in the subacute LBP group showed significantly greater percentages of abnormal responses on the AS (P < 0.0001) and the PI (P = 0.0001) than the control.

Discussion: Abnormal performance of cervical stabilizer muscles using the CCFT was demonstrated in a high proportion of participants with LBP. The findings highlight the plausible association in muscle control between cervical and lumbar stabilizers.

Level of Evidence: 2b.

KEYWORDS:

• Cervical spine
• Core stabilizer muscles
• craniocervical flexion test
• deep neck muscles
• low back pain
• lumbar spine
• motor control
• spinal stability

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the 90th Anniversary of Chulalongkorn University Fund (Ratchadaphiseksomphot Endowment Fund), Bangkok, Thailand under Grant [GCUGR1125594090M].

Notes on contributors

Chattrachoo Thongprasert

Chattrachoo Thongprasert is a physical therapist at Newton Em Physiotherapy Clinic Ratchadamri and she was a physical therapy student at time of study.

R. Kanlayanaphotporn

R. Kanlayanaphotporn is an assistant professor in the Undergraduate and Graduate Physical Therapy programs at Faculty of Allied Health Sciences, Chulalongkorn University. Her research interests are focused on patient outcomes, exercise therapy, and manual therapy techniques for treating musculoskeletal pathologies.