| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 97 === Introduction: Neck pain is a common musculoskeletal disorder which causes economic burden of medical service and patients. Recently, the importance of neuromuscular control in subjects with neck pain has been highlighted. Previous studies showed different characteristics of the proprioception, muscle activation and posture control in subjects with and without chronic neck pain; and exercise could successively improve the proprioception and cranio-cervical posture control and reduce superficial muscle activities in patients with chronic neck pain. The effect of exercise training on these neuromuscular control characteristics during functional activities were nevertheless unknown. Therefore, we designed this study to investigate the effect of the motor control exercise on head and scapular posture control, muscle performance and cervical proprioception during bilateral arm elevation and a 30-minute computer task in individuals with chronic neck pain.
Methods: Thirty subjects with chronic neck pain were randomly assigned to the motor control group (n=15) or to the regular hospital care group (n=15). Regular hospital care group received routine hospital management for chronic neck pain, and motor control group received motor control exercise in addition to the routine hospital care. The intervention period lasted 4-6 weeks. Outcome measures consisted of cervical ROM and muscle strength, head and scapular kinematics, EMG activity of the upper trapezius and scernocleidomastoid muscles, cervical proprioception, and pain and dysfunction of the neck.
Statistical Analysis: Independent t test and chi-square test were used to compare differences of basic data between two groups. Repeated measures ANCOVA was used to examine the exercise effect between two groups. Post hoc t tests were used for subsequent analyses. The significant level was set at 0.05.
Results: After exercise training, the motor control group had greater improvement in right rotation range of motion (ROM) (p=0.03) than the regular hospital care group. During the 30 minutes of computer task, subjects receiving motor control training showed increased head flexion (p=0.02-0.05) and left scapular downward rotation (p=0.01). Besides, subjects in the motor control group experienced more pain reduction compared to subjects of the regular hospital care group (p=0.04).
Conclusions: Compared to the routine hospital management, motor control exercise training could effectively reduce neck pain, improve ROM as well as posture control during functional activities. This type of exercise should be used in conjunction with other pain management methods when treating patients with chronic neck pain problems.
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