Ultrasonographic assessment of cross-sectional area of deep neck flexor muscles during a five-stage cranio-cervical flexion test in individuals with chronic neck pain and healthy controls

Abstract

Aims: The objective of this study was to investigate and compare the cross-sectional area (CSA) of deep neck flexor muscles (DNFs) in individuals with chronic non-specific neck pain (CNNP) and healthy controls while performing a five-stage cranio-cervical flexion (CCF) test.

Methods: Twenty individuals with CNNP and 20 healthy controls voluntarily participated in this case–control study. Cross-sectional area of DNFs was measured using ultrasonography while the participants lay in supine position to perform the CCF test. The five stages of the CCF test were determined by a pressure biofeedback tool. Neck disability index and pain were also assessed. Repeated measures analysis of variance was used to interpret the yielded data.

Results: A significant difference was observed in the CSA of DNFs between individuals with CNNP and healthy controls at the pressure of 24 mm (p = .009) of the CCF test. The CSA of DNFs significantly changed through increasing the CCF test pressure. No significant differences were observed on the right and left-side DNFs, neither in healthy controls, nor in individuals with CNNP.

Conclusions: The CSA changes in individuals with CNNP and healthy controls significantly varied during the CCF test, which may be a reasonable explanation to the muscle weakness and atrophy in individuals sustaining CNNP.

Keywords:

• Ultrasonography
• cross-sectional area
• deep neck flexors
• neck pain
• cranio-cervical flexion test

Acknowledgements

The study authors express their sincere thanks to the study participants.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

University of Social Welfare and Rehabilitation Sciences, Deputy of Research Affairs