Effect of Proprioceptive Exercises along with Ergonomic Intervention on Middle Deltoid and Serratus Anterior Fatigue in Dentists with Non-Specific Chronic Neck Pain
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Abstract
There are several risk factors in dentistry that among them repetitive movements, being in a position for a long time due to muscle imbalances, and work-related musculoskeletal disorders which can cause problems such as limited mobility, fatigue, job loss or even changing jobs. Muscle imbalance between the stabilizers and mobilizers of the neck and shoulders in dentists leads to increased work-related disorders, superficial muscle fatigue, and deep muscle atrophy, which in turn, leads to many health problems such as neck pain and disability. To prevent such disorders, a high endurance of the cervical stabilizer muscles is essential for repetitive movements in the distal and shoulder region. In this study, the exercise program, including postural exercises, simultaneous training of shoulder-neck, scapular movements, and co-contraction were designed for 48 dentists. The statistical analysis showed that there was a significant decrease in the median frequency slope of the middle deltoid muscle (p = 0.004) and for the group who received the proprioception training along with posture correction exercises and exercise therapy (p = 0.004). Neck pain increased in the control group who received no exercises, after six weeks (p = 0.165). Six weeks of corrective exercises with ergonomic intervention balance muscles activity and can be used to decrease musculoskeletal disorders and muscle fatigue in person with Non-Specific Chronic Neck Pain.
1 . Gupta BD, Aggarwal S, Gupta B, Gupta M, Gupta N. Effect of deep cervical flexor training vs. conventional isometric training on forward head posture, pain, neck disability index in dentists suffering from chronic neck pain. J Clin Diagn Res: JCDR. 2013; 7(10): 2261-2264.
2 . O'leary S, Jull G, Kim M, Vicenzino B. Specificity in retraining craniocervical flexor muscle performance. J Orthop Sports Phys Ther. 2007; 37(1): 3-9.
3 . Côté P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004; 112(3): 267-273.
4 . Grooten WJA, Mulder M, Wiktorin C. The effect of ergonomic intervention on neck/shoulder and low back pain. Work. 2007;28(4): 313-323.
5 . Askaripoor T, Kermani A, Jandaghi J, Farivar F. Survey of musculoskeletal disorders and ergonomic risk factors among dentists and providing control measures in Semnan. J Health. 2013; 4(3): 241-248.
6 . Valachi B, Valachi K. Preventing musculoskeletal disorders in clinical dentistry: strategies to address the mechanisms leading to musculoskeletal disorders. J Am Dent Assoc. 2003; 134(12): 1604-1612.
7 . Patroncini M, Hannig S, Meichtry A, Luomajoki H. Reliability of movement control tests on the cervical spine. BMC Muscoskel Disord. 2014; 15(1): 402.
8 . Janda V. Muscles and motor control in cervicogenic disorders: assessment and management. In: Grant R. (Ed.) Physical therapy of the cervical and thoracic spine. Churchill Livingstone, New York; 1994.
9 . Ferrari S, Monticone M. Efficacy of a multimodal rehabilitation program in a dental hygienist with upper quadrant disorders. Description of a case report with one-year follow-up. G Ital Med Lav Erg. 2009; 31(4): 407-413.
10. Minning S, Eliot CA, Uhl TL, Malone TR. EMG analysis of shoulder muscle fatigue during resisted isometric shoulder elevation. J Electromyogr Kinesiol. 2007; 17(2): 153-159.
11. Rojhani Shirazi Z, Ebrahimi Takamjani E, Maroofi N, Kazemnejad A, Sanjari M. Comparison of Electromyographic Responses of Superficial Neck Muscles in Patients with Chronic Neck Pain and Healthy Subjects During Posterior-Anterior Perturbation. ZUMS J. 2008; 16(63) :49-58.
12. Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003; 13(4): 361-370.
13. Rojhani-Shirazi Z, Ebrahimi E, Ma'roufi N, Kazem-Nezhad A. Comparison of Muscle Fatigue Effects on Electromyographic Onset Latency of Trapezius Muscle in Posterior-Anterior Perturbation between Patients with Chronic Neck Pain and Healthy Persons. Arch Rehabil. 2008; 9(2): 47-51.
14. Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 2004; 29(19): 2108-2114.
15. Kallenberg LA, Hermens HJ, Vollenbroek-Hutten MM. Distinction between computer workers with and without work-related neck–shoulder complaints based on multiple surface EMG parameters. Int J Ind Ergon. 2006; 36(10): 921-929.
16. Punjabi NM, O'hearn DJ, Neubauer DN, Nieto FJ, Schwartz AR, Smith PL, Bandeen-Roche K. Modeling hypersomnolence in sleep-disordered breathing: a novel approach using survival analysis. Am J Respir Crit Care Med. 1999; 159(6): 1703-1709.
17. Izquierdo TG, Pecos-Martin D, Girbés EL, Plaza-Manzano G, Caldentey RR, Melús RM, Mariscal DB, Falla D. Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: A randomized controlled clinical trial. J Rehabil Med. 2016; 48(1): 48-55.
18. Ylinen J, Kautiainen H, Wirén K, Häkkinen A. Stretching exercises vs manual therapy in
treatment of chronic neck pain: a randomized, controlled cross-over trial. J Rehabil Med. 2007; 39(2): 126-132.
19. Michaleff ZA, Maher CG, Lin C-WC, Rebbeck T, Jull G, Latimer J, Connelly L, Sterling M. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial. Lancet. 2014; 384(9938): 133-141.
20. Beneka A, Malliou P, Gioftsidou A. Neck pain and office workers: An Exercise Program for the Workplace. ACSMs Health Fit J. 2014; 18(3): 18-24.
21. Bertozzi L, Gardenghi I, Turoni F, Villafañe JH, Capra F, Guccione AA, et al. Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials. Phys Ther. 2013; 93(8): 1026-1036.
22. Airaksinen MK, Kankaanpää M, Aranko O, Leinonen V, Arokoski JP, Airaksinen O. Wireless on-line electromyography in recording neck muscle function: a pilot study. Pathophysiology. 2005; 12(4): 303-306.
23. Murphy BA, Marshall PW, Taylor HH. The cervical flexion-relaxation ratio: reproducibility and comparison between chronic neck pain patients and controls. Spine. 2010; 35(24): 2103-2108.
24. Gupta BD, Aggarwal S, Gupta B, Gupta M, Gupta N. Effect of Deep Cervical Flexor Training vs. Conventional Isometric Training on Forward Head Posture, Pain, Neck Disability Index In Dentists Suffering from Chronic Neck Pain. J Clin Diagn Res: JCDR. 2013;7(10): 2261-2264.
25. Borisut S, Vongsirinavarat M, Vachalathiti R, Sakulsriprasert P. Effects of strength and endurance training of superficial and deep neck muscles on muscle activities and pain levels of females with chronic neck pain. J Phys Ther Sci. 2013; 25(9): 1157-1162.
26. Akbari A, Ghiasi F, Barahoie M, Arab-Kangan M. The comparison of effectiveness of muscles specific stabilization training and dynamic exercises on the chronic neck pain and disability. J Gorgan Univ Med Sci. 2010; 11(4-32):29-38.
27. Rezasoltani A, Khaleghifar M, Tavakoli A, Ahmadi A, Minoonejad H. The effect of a proprioceptive neuromuscular facilitation program to increase neck muscle strength in patients with chronic non-specific neck pain. World J Sport Sci. 2010; 3(1): 59-63.
28. Jull G, Sterling M, Falla D, Treleaven J, O'Leary S. Whiplash, headache, and neck pain: research-based directions for physical therapies. Churchil Levingstone, Elsevier Health Sciences, 2008.
29. Iqbal ZA, Rajan R, Khan SA, Alghadir AH. Effect of deep cervical flexor muscles training using pressure biofeedback on pain and disability of school teachers with neck pain. J Phys Ther Sci. 2013; 25(6): 657-661.
30. Janda V. Muscles and motor control in cervicogenic disorders: assessment and management. Physical therapy of the cervical and thoracic spine New York: Churchill Livingstone. 1994; pp 195-216.
31. Ylinen J, Salo P, Nykänen M, Kautiainen H, Häkkinen A. Decreased isometric neck strength in women with chronic neck pain and the repeatability of neck strength measurements. Arch Phys Med Rehabil. 2004;85(8): 1303-1308.
32. Johnston V, Jull G, Darnell R, Jimmieson N, Souvlis T. Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain. Eur J Appl Physiol. 2008; 103(3): 253-264.
33. Griffiths C DK, Waterfield J, Sim J. Effectiveness of specific neck stabilization exercises or a general neck exercise program for chronic neck disorders: a randomized controlled trial. J Rheumatol. 2009;36: 390-397.
34. Revel M, Minguet M, Gregoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil. 1994; 75(8): 895-899.
35. Falla D, Jull G, Rainoldi A, Merletti R. Neck flexor muscle fatigue is side specific in patients with unilateral neck pain. Eur J Pain. 2004;8(1): 71-77.
36. Falla D, Farina D. Neuromuscular adaptation in experimental and clinical neck pain. J Electromyogr Kinesiol. 2008;18(2): 255-261.
37. Jull G, Kristjansson E, Dall’Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004; 2: 89-94.
38. Conley MS, Meyer RA, Feeback DL, Dudley GA. Noninvasive analysis of human neck muscle function. Spine. 1995; 20(23): 2505-2512.
2 . O'leary S, Jull G, Kim M, Vicenzino B. Specificity in retraining craniocervical flexor muscle performance. J Orthop Sports Phys Ther. 2007; 37(1): 3-9.
3 . Côté P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004; 112(3): 267-273.
4 . Grooten WJA, Mulder M, Wiktorin C. The effect of ergonomic intervention on neck/shoulder and low back pain. Work. 2007;28(4): 313-323.
5 . Askaripoor T, Kermani A, Jandaghi J, Farivar F. Survey of musculoskeletal disorders and ergonomic risk factors among dentists and providing control measures in Semnan. J Health. 2013; 4(3): 241-248.
6 . Valachi B, Valachi K. Preventing musculoskeletal disorders in clinical dentistry: strategies to address the mechanisms leading to musculoskeletal disorders. J Am Dent Assoc. 2003; 134(12): 1604-1612.
7 . Patroncini M, Hannig S, Meichtry A, Luomajoki H. Reliability of movement control tests on the cervical spine. BMC Muscoskel Disord. 2014; 15(1): 402.
8 . Janda V. Muscles and motor control in cervicogenic disorders: assessment and management. In: Grant R. (Ed.) Physical therapy of the cervical and thoracic spine. Churchill Livingstone, New York; 1994.
9 . Ferrari S, Monticone M. Efficacy of a multimodal rehabilitation program in a dental hygienist with upper quadrant disorders. Description of a case report with one-year follow-up. G Ital Med Lav Erg. 2009; 31(4): 407-413.
10. Minning S, Eliot CA, Uhl TL, Malone TR. EMG analysis of shoulder muscle fatigue during resisted isometric shoulder elevation. J Electromyogr Kinesiol. 2007; 17(2): 153-159.
11. Rojhani Shirazi Z, Ebrahimi Takamjani E, Maroofi N, Kazemnejad A, Sanjari M. Comparison of Electromyographic Responses of Superficial Neck Muscles in Patients with Chronic Neck Pain and Healthy Subjects During Posterior-Anterior Perturbation. ZUMS J. 2008; 16(63) :49-58.
12. Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003; 13(4): 361-370.
13. Rojhani-Shirazi Z, Ebrahimi E, Ma'roufi N, Kazem-Nezhad A. Comparison of Muscle Fatigue Effects on Electromyographic Onset Latency of Trapezius Muscle in Posterior-Anterior Perturbation between Patients with Chronic Neck Pain and Healthy Persons. Arch Rehabil. 2008; 9(2): 47-51.
14. Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 2004; 29(19): 2108-2114.
15. Kallenberg LA, Hermens HJ, Vollenbroek-Hutten MM. Distinction between computer workers with and without work-related neck–shoulder complaints based on multiple surface EMG parameters. Int J Ind Ergon. 2006; 36(10): 921-929.
16. Punjabi NM, O'hearn DJ, Neubauer DN, Nieto FJ, Schwartz AR, Smith PL, Bandeen-Roche K. Modeling hypersomnolence in sleep-disordered breathing: a novel approach using survival analysis. Am J Respir Crit Care Med. 1999; 159(6): 1703-1709.
17. Izquierdo TG, Pecos-Martin D, Girbés EL, Plaza-Manzano G, Caldentey RR, Melús RM, Mariscal DB, Falla D. Comparison of cranio-cervical flexion training versus cervical proprioception training in patients with chronic neck pain: A randomized controlled clinical trial. J Rehabil Med. 2016; 48(1): 48-55.
18. Ylinen J, Kautiainen H, Wirén K, Häkkinen A. Stretching exercises vs manual therapy in
treatment of chronic neck pain: a randomized, controlled cross-over trial. J Rehabil Med. 2007; 39(2): 126-132.
19. Michaleff ZA, Maher CG, Lin C-WC, Rebbeck T, Jull G, Latimer J, Connelly L, Sterling M. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial. Lancet. 2014; 384(9938): 133-141.
20. Beneka A, Malliou P, Gioftsidou A. Neck pain and office workers: An Exercise Program for the Workplace. ACSMs Health Fit J. 2014; 18(3): 18-24.
21. Bertozzi L, Gardenghi I, Turoni F, Villafañe JH, Capra F, Guccione AA, et al. Effect of therapeutic exercise on pain and disability in the management of chronic nonspecific neck pain: systematic review and meta-analysis of randomized trials. Phys Ther. 2013; 93(8): 1026-1036.
22. Airaksinen MK, Kankaanpää M, Aranko O, Leinonen V, Arokoski JP, Airaksinen O. Wireless on-line electromyography in recording neck muscle function: a pilot study. Pathophysiology. 2005; 12(4): 303-306.
23. Murphy BA, Marshall PW, Taylor HH. The cervical flexion-relaxation ratio: reproducibility and comparison between chronic neck pain patients and controls. Spine. 2010; 35(24): 2103-2108.
24. Gupta BD, Aggarwal S, Gupta B, Gupta M, Gupta N. Effect of Deep Cervical Flexor Training vs. Conventional Isometric Training on Forward Head Posture, Pain, Neck Disability Index In Dentists Suffering from Chronic Neck Pain. J Clin Diagn Res: JCDR. 2013;7(10): 2261-2264.
25. Borisut S, Vongsirinavarat M, Vachalathiti R, Sakulsriprasert P. Effects of strength and endurance training of superficial and deep neck muscles on muscle activities and pain levels of females with chronic neck pain. J Phys Ther Sci. 2013; 25(9): 1157-1162.
26. Akbari A, Ghiasi F, Barahoie M, Arab-Kangan M. The comparison of effectiveness of muscles specific stabilization training and dynamic exercises on the chronic neck pain and disability. J Gorgan Univ Med Sci. 2010; 11(4-32):29-38.
27. Rezasoltani A, Khaleghifar M, Tavakoli A, Ahmadi A, Minoonejad H. The effect of a proprioceptive neuromuscular facilitation program to increase neck muscle strength in patients with chronic non-specific neck pain. World J Sport Sci. 2010; 3(1): 59-63.
28. Jull G, Sterling M, Falla D, Treleaven J, O'Leary S. Whiplash, headache, and neck pain: research-based directions for physical therapies. Churchil Levingstone, Elsevier Health Sciences, 2008.
29. Iqbal ZA, Rajan R, Khan SA, Alghadir AH. Effect of deep cervical flexor muscles training using pressure biofeedback on pain and disability of school teachers with neck pain. J Phys Ther Sci. 2013; 25(6): 657-661.
30. Janda V. Muscles and motor control in cervicogenic disorders: assessment and management. Physical therapy of the cervical and thoracic spine New York: Churchill Livingstone. 1994; pp 195-216.
31. Ylinen J, Salo P, Nykänen M, Kautiainen H, Häkkinen A. Decreased isometric neck strength in women with chronic neck pain and the repeatability of neck strength measurements. Arch Phys Med Rehabil. 2004;85(8): 1303-1308.
32. Johnston V, Jull G, Darnell R, Jimmieson N, Souvlis T. Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain. Eur J Appl Physiol. 2008; 103(3): 253-264.
33. Griffiths C DK, Waterfield J, Sim J. Effectiveness of specific neck stabilization exercises or a general neck exercise program for chronic neck disorders: a randomized controlled trial. J Rheumatol. 2009;36: 390-397.
34. Revel M, Minguet M, Gregoy P, Vaillant J, Manuel JL. Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil. 1994; 75(8): 895-899.
35. Falla D, Jull G, Rainoldi A, Merletti R. Neck flexor muscle fatigue is side specific in patients with unilateral neck pain. Eur J Pain. 2004;8(1): 71-77.
36. Falla D, Farina D. Neuromuscular adaptation in experimental and clinical neck pain. J Electromyogr Kinesiol. 2008;18(2): 255-261.
37. Jull G, Kristjansson E, Dall’Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther. 2004; 2: 89-94.
38. Conley MS, Meyer RA, Feeback DL, Dudley GA. Noninvasive analysis of human neck muscle function. Spine. 1995; 20(23): 2505-2512.
| Files | ||
| Issue | Vol 13 No 4 (2021) | |
| Section | Original Article(s) | |
| Published | 2021-12-30 | |
| DOI | https://doi.org/10.18502/ijoh.v13i4.8422 | |
| Keywords | ||
| Proprioceptive Exercises Serratus Anterior Fatigue Dentists | ||
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How to Cite
1.
Bolandian A, Alimohammadi I, Forough B. Effect of Proprioceptive Exercises along with Ergonomic Intervention on Middle Deltoid and Serratus Anterior Fatigue in Dentists with Non-Specific Chronic Neck Pain. Int J Occup Hyg. 2021;13(4):313-323.
