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Journal articles on the topic 'Deep cervical flexors'

Author: Grafiati

Published: 4 June 2021

Last updated: 2 February 2022

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1

Jull, G., C. Barrett, R. Magee, and P. Ho. "Further Clinical Clarification of the Muscle Dysfunction in Cervical Headache." Cephalalgia 19, no. 3 (April 1999): 179–85. http://dx.doi.org/10.1046/j.1468-2982.1999.1903179.x.

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The Headache Classification Committee of the International Headache Society listed impairments in cervical muscle function as criteria for headaches of cervical spine origin. Fifteen subjects with cervical headache and 15 controls were tested for the frequency of abnormal responses to passive stretching and abnormal muscle contraction. A new test of cranio-cervical flexion was used to assess the contraction of the deep neck flexors. Results indicated a trend towards a higher frequency of abnormal response to passive stretching of the muscles examined in the cervical headache group but only the upper trapezius proved significantly different to the control group. Deep neck flexor muscle contraction was significantly inferior in the cervical headache group. From the perspective of physical characterization of cervical headache, it appears mat response from passive stretch of muscle may not be a strong criterion for cervical headache but deep neck flexor performance may have potential to identify musculoskeletal involvement in headache. The finding may also provide positive directions for conservative treatment of cervical headache.

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2

Moon, Hyun-Ju, Bong-Oh Goo, Hae-Yeon Kwon, and Jun-Hyeok Jang. "The effects of eye coordination during deep cervical flexor training on the thickness of the cervical flexors." Journal of Physical Therapy Science 27, no. 12 (2015): 3799–801. http://dx.doi.org/10.1589/jpts.27.3799.

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3

Thakar, Sumit, Avinash Kurudi Siddappa, Saritha Aryan, Dilip Mohan, Narayanam Anantha Sai Kiran, and Alangar S. Hegde. "Does the mesodermal derangement in Chiari Type I malformation extend to the cervical spine? Evidence from an analytical morphometric study on cervical paraspinal muscles." Journal of Neurosurgery: Spine 27, no. 4 (October 2017): 421–27. http://dx.doi.org/10.3171/2016.12.spine16914.

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OBJECTIVEThe mesodermal derangement in Chiari Type I malformation (CMI) has been postulated to encompass the cervical spine. The objectives of this study were to assess the cross-sectional areas (CSAs) of cervical paraspinal muscles (PSMs) in patients with CMI without syringomyelia, compare them with those in non-CMI subjects, and evaluate their correlations with various factors.METHODSIn this retrospective study, the CSAs of cervical PSMs in 25 patients were calculated on T2-weighted axial MR images and computed as ratios with respect to the corresponding vertebral body areas. These values and the cervical taper ratios were then compared with those of age- and sex-matched non-CMI subjects and analyzed with respect to demographic data and clinicoradiological factors.RESULTSCompared with the non-CMI group, the mean CSA values for the rectus capitis minor and all of the subaxial PSMs were lower in the study group, and those of the deep extensors were significantly lower (p = 0.004). The cervical taper ratio was found to be significantly higher in the study cohort (p = 0.0003). A longer duration of symptoms and a steeper cervical taper ratio were independently associated with lower CSA values for the deep extensors (p = 0.04 and p = 0.03, respectively). The presence of neck pain was associated with a lower CSA value for the deep flexors (p = 0.03).CONCLUSIONSPatients with CMI demonstrate alterations in their cervical paraspinal musculature even in the absence of coexistent syringomyelia. Their deep extensor muscles undergo significant atrophic changes that worsen with the duration of their symptoms. This could be related to a significantly steeper cervical taper ratio that their cervical cords are exposed to. Neck pain in these patients is related to atrophy of their deep flexor muscles. A steeper cervical taper ratio and alterations in the PSMs could be additional indicators for surgery in patients with CMI without syringomyelia.

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Cagnie, Barbara, Nele Dickx, Ian Peeters, Jan Tuytens, Eric Achten, Dirk Cambier, and Lieven Danneels. "The use of functional MRI to evaluate cervical flexor activity during different cervical flexion exercises." Journal of Applied Physiology 104, no. 1 (January 2008): 230–35. http://dx.doi.org/10.1152/japplphysiol.00918.2007.

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The purpose of this study was to investigate the recruitment pattern of deep and superficial neck flexors evoked by three different cervical flexion exercises using muscle functional MRI. In 19 healthy participants, transverse relaxation time (T2) values were calculated for the longus colli (Lco), longus capitis (Lca), and sternocleidomastoid (SCM) at rest and following three exercises: conventional cervical flexion (CF), craniocervical flexion (CCF), and a combined craniocervical flexion and cervical flexion (CCF-CF). CCF-CF gave the highest T2 increase for all muscles. CCF displayed a significantly higher T2 increase for the Lca compared with the Lco and the SCM. When comparing the CCF and CF, no significant difference was found for the Lca, whereas the Lco and SCM displayed a higher T2 increase during CF compared with CCF. This study shows that muscle functional MRI can be used to characterize the specific activation levels and recruitment patterns of the superficial and deep neck flexors during different cervical flexion exercises. During CCF-CF, all synergists are maximally recruited, which makes this exercise useful for high-load training. CCF may provide a more specific method to assess and retrain Lca muscle performance compared with CF and CCF-CF. This study highlights the need to differentiate between the Lco and Lca when evaluating their function, since these results demonstrate a clear difference in activation of both muscles.

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5

Chung, Sin Ho, Jin Gang Her, Taesung Ko, Young Youl You, and Ju Sang Lee. "Effects of Exercise on Deep Cervical Flexors in Patients with Chronic Neck Pain." Journal of Physical Therapy Science 24, no. 7 (2012): 629–32. http://dx.doi.org/10.1589/jpts.24.629.

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6

Lee, Hae-Jung, Doo Heon Song, and Kwang Baek Kim. "Effective Computer-Assisted Automatic Cervical Vertebrae Extraction with Rehabilitative Ultrasound Imaging by using K-means Clustering." International Journal of Electrical and Computer Engineering (IJECE) 6, no. 6 (December 1, 2016): 2810. http://dx.doi.org/10.11591/ijece.v6i6.13268.

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<p>Neck pain is one of most common musculoskeletal condition resulting in significant clinical, social and economic costs. Muscles around cervical spine including deep neck flexors play a key role to support and control its stability, thus monitoring such muscles near cervical vertebrae is important. In this paper, we propose a fully automated computer assisted method to detect cervical vertebrae with K-means pixel clustering from ultrasonography. The method also applies a series of image processing algorithms to remove unnecessary organs and noises in the process. The experiment verifies that our approach is consistent with human medical experts’ decision to locate key measuring point for muscle analysis and successful in detecting cervical vertebrae accurately – successful in 48 out of 50 test cases (96%).</p>

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Lee, Hae-Jung, Doo Heon Song, and Kwang Baek Kim. "Effective Computer-Assisted Automatic Cervical Vertebrae Extraction with Rehabilitative Ultrasound Imaging by using K-means Clustering." International Journal of Electrical and Computer Engineering (IJECE) 6, no. 6 (December 1, 2016): 2810. http://dx.doi.org/10.11591/ijece.v6i6.pp2810-2817.

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<p>Neck pain is one of most common musculoskeletal condition resulting in significant clinical, social and economic costs. Muscles around cervical spine including deep neck flexors play a key role to support and control its stability, thus monitoring such muscles near cervical vertebrae is important. In this paper, we propose a fully automated computer assisted method to detect cervical vertebrae with K-means pixel clustering from ultrasonography. The method also applies a series of image processing algorithms to remove unnecessary organs and noises in the process. The experiment verifies that our approach is consistent with human medical experts’ decision to locate key measuring point for muscle analysis and successful in detecting cervical vertebrae accurately – successful in 48 out of 50 test cases (96%).</p>

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8

Davidson, Debbie. "Effectiveness of cervical stabilisation training and correction of muscle imbalance, following reduction of atlanto-axial rotatory subluxation: A single case study." South African Journal of Physiotherapy 54, no. 3 (August 31, 1998): 4–7. http://dx.doi.org/10.4102/sajp.v54i3.587.

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Atlanto-axial rotatory subluxation is a rare, controversial and frequently misdiagnosed condition occurring primarily in children. A single case study design was used to evaluate the effectiveness of cervical stabilisation training and correction of muscle imbalance, following reduction of this condition, in a nine-year-old boy. The study was conducted over a six-week period during which the subject maintained a daily diary to record his symptoms. The programme consisted of various muscle relaxation and lengthening techniques, endurance training of the deep cervical flexors and lower scapular stabilisers, as well as postural re-education. No treatment was directed at the articular component. The patients signs and symptoms were greatly reduced during the study period. This study supports the importance of correcting the muscle dysfunction component in cervicogenic pain sufferers.

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Patrao, Ashmita Iora Davania, Stephanie M. Correa, Prachi Prakash Kerkar, and Kavitha Vishal. "Craniocervical flexion performance in computer users: An observational study." Biomedical Human Kinetics 13, no. 1 (January 1, 2021): 139–46. http://dx.doi.org/10.2478/bhk-2021-0017.

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Abstract Study aim: To compare the performance of deep cervical flexors (DCF) among computer users (CU) and non-users using the craniocervical flexion test (CCFT). Material and methods: Eighty nine computer users and 100 non-users were recruited for evaluation of their craniocervical muscle performance. The activation score and performance index were assessed using the CCFT. Comparison of craniocervical flexor performance between the two groups was evaluated using the Mann Whitney test. A Chi-Square test was used to test the association between age, years of work and craniocervical flexion. Significance was set at p ≤ 0.05. Results: The median activation score was lower among computer users (median pressure-24 mmHg as compared to non-users (median pressure-28 mmHg) (p < 0.01). The performance index among computer users was lower when compared to non-users. Also, age (p < 0.001) and the years of work experience (p = 0.006) were associated with the DCF performance. Conclusion: CU have lower activation and endurance of the DCF compared to non-users. The endurance of the DCF was associated with the age and years of computer usage.

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10

Jun, Ilsub, Jaehong Lee, Hansoo Kim, and KyungHan Yang. "The effects of mouth opening on changes in the thickness of deep cervical flexors in normal adults." Journal of Physical Therapy Science 27, no. 1 (2015): 239–41. http://dx.doi.org/10.1589/jpts.27.239.

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Saleh, Marwa Shafiek Mustafa, Nagwa Ibrahim Rehab, and Moussa Abdel Fattah Sharaf. "Effect of deep cervical flexors training on neck proprioception, pain, muscle strength and dizziness in patients with cervical spondylosis: A randomized controlled trial." Physical Therapy and Rehabilitation 5, no. 1 (2018): 14. http://dx.doi.org/10.7243/2055-2386-5-14.

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12

Ferreira, Michele P., César B. Waisberg, Paulo César R. Conti, and Débora Bevilaqua‐Grossi. "Mobility of the upper cervical spine and muscle performance of the deep flexors in women with temporomandibular disorders." Journal of Oral Rehabilitation 46, no. 12 (August 2019): 1177–84. http://dx.doi.org/10.1111/joor.12858.

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13

Arora, D., and Z. Veqar. "Correlation between endurance of deep cervical flexors and lower scapular stabilisers in computer users with chronic neck pain." British Journal of Sports Medicine 44, Suppl_1 (September 1, 2010): i11. http://dx.doi.org/10.1136/bjsm.2010.078725.33.

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14

Raju, Addala Suvarna, Patchava Apparao, Ganapathi Swamy, P. Chaturvadi, and R. Geetha Mounika. "A Comparative Study on Deep Cervical Flexors Training and Neck Stabilization Exercises in Subjects with Chronic Neck Pain." Indian Journal of Physiotherapy and Occupational Therapy - An International Journal 13, no. 2 (2019): 1. http://dx.doi.org/10.5958/0973-5674.2019.00035.2.

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15

Cagnie, Barbara, Roseline D'Hooge, Eric Achten, Dirk Cambier, and Lieven Danneels. "A Magnetic Resonance Imaging Investigation Into the Function of the Deep Cervical Flexors During the Performance of Craniocervical Flexion." Journal of Manipulative and Physiological Therapeutics 33, no. 4 (May 2010): 286–91. http://dx.doi.org/10.1016/j.jmpt.2010.03.010.

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16

Aquaroli, Rafael Souza, Elder Soares Camacho, Luis Marchi, and Luiz Pimenta. "Manual therapy and segmental stabilization in the treatment of cervical radiculopathy." Fisioterapia em Movimento 29, no. 1 (March 2016): 45–52. http://dx.doi.org/10.1590/0103-5150.029.001.ao04.

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Abstract Introduction: Cervical radiculopathy (CR) is one of the diseases that most affect the cervical spine, causing radicular symptoms in the ipsilateral limb. Conservative treatment aim recover of both mechanical and physiological functions through neural mobilization techniques, along with the activation of the deep neck flexors with cervical segmental stabilization, combining techniques of joint mobilization and manipulation, which seeks mobility improvement of crucial areas of the cervical spine. The objective of this study was to evaluate a multimodal treatment to enhance the outcomes of conservative care in patients diagnosed with CR. Methods: The sample consisted of 11 patients with CR, between 21 and 59 years old, 3 female and 8 male. It was recorded the Visual Analogue Scale (VAS) for pain, the Functional Development of the Neck Pain and Disability Scale (NPDS) and the goniometry during shoulder abduction. The intervention plan was composed by neural mobilization, intermittent cervical traction, pompages, stretching, myofascial inhibition techniques, manipulative techniques and cervical segmental stabilization exercises. After 12 weeks of treatment, subjects underwent a new evaluation process. Results: Before the treatment, subjects reported an average pain of 7 (± 1.48) in VAS, whose dropped to average 1.18 (± 1.99) (p < 0.01). Functional disability evaluated in NPDS was 36 (± 10.95) before treatment decreasing to 11.45 (± 9.8) (p < 0.01) after the treatment. Range of motion of the ipsilateral upper limb was restores by increasing from 9.2° (± 8.2) to 137° (± 24.4) (p < 0.01). Conclusion: The proposed treatment approach was effective, significantly improving the results of analgesia and functional disability a series of cases of patients diagnosed with cervical radiculopathy. {#}

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Cho, Juchul, Eunsang Lee, and Seungwon Lee. "Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness." Journal of Back and Musculoskeletal Rehabilitation 32, no. 4 (July 23, 2019): 595–602. http://dx.doi.org/10.3233/bmr-181228.

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18

Jeong, Seung-Young, Jong-Pil Eun, and Young-Min Oh. "Magnetic Resonance Imaging Analysis of Deep Cervical Flexors in Patients with Ossification of the Posterior Longitudinal Ligament and Clinical Implication." American Journal of Physical Medicine & Rehabilitation 94, no. 11 (November 2015): 967–74. http://dx.doi.org/10.1097/phm.0000000000000288.

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19

Lee, Byoung-Kwon, and Dong-Kwon Seo. "The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain." Healthcare 8, no. 4 (November 1, 2020): 449. http://dx.doi.org/10.3390/healthcare8040449.

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Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing gaze direction. We aimed to investigate how DNF and SCM activation varies according to gaze direction in the CCFT, and to prescribe the appropriate gaze direction for CNP. Twenty-eight CNP subjects had their maximum strength pressure level determined by CCFT for strength (20–~30 mmHg) and at each of the measured pressures, DNF and SCM thickness in each of four gaze directions (0°, 20°, 40°, and 60°) was measured by ultrasound imaging. The DNF to SCM ratio varied significantly according to gaze direction (p < 0.05), with gaze directions of 20° and 0° being significantly different from 40° (p < 0.05). Although there was no significant difference in DNF activation according to gaze direction, there was in SCM activation (p < 0.05), with SCM 60° significantly different from SCM 20° and SCM 40° (p < 0.05). In order to increase DNF activation efficiency during the CCFT, SCM activation should be controlled, and a gaze direction below 20° is the most efficient. This can inform DNF training of CNP patients in a clinical environment.

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20

Falla, Deborah, Shaun OʼLeary, Dario Farina, and Gwendolen Jull. "Association Between Intensity of Pain and Impairment in Onset and Activation of the Deep Cervical Flexors in Patients With Persistent Neck Pain." Clinical Journal of Pain 27, no. 4 (May 2011): 309–14. http://dx.doi.org/10.1097/ajp.0b013e31820212cf.

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Cagnie, Barbara, Mieke Dolphens, Ian Peeters, Eric Achten, Dirk Cambier, and Lieven Danneels. "Use of Muscle Functional Magnetic Resonance Imaging to Compare Cervical Flexor Activity Between Patients With Whiplash-Associated Disorders and People Who Are Healthy." Physical Therapy 90, no. 8 (August 1, 2010): 1157–64. http://dx.doi.org/10.2522/ptj.20090351.

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BackgroundChronic whiplash-associated disorders (WAD) have been shown to be associated with motor dysfunction. Increased electromyographic (EMG) activity in neck and shoulder girdle muscles has been demonstrated during different tasks in participants with persistent WAD. Muscle functional magnetic resonance imaging (mfMRI) is an innovative technique to evaluate muscle activity and differential recruitment of deep and superficial muscles following exercise.ObjectiveThe purpose of this study was to compare the recruitment pattern of deep and superficial neck flexors between patients with WAD and controls using mfMRI.DesignA cross-sectional design was used.MethodThe study was conducted in a physical and rehabilitation medicine department. The participants were 19 controls who were healthy (10 men, 9 women; mean [±SD] age=22.2±0.6 years) and 16 patients with WAD (5 men, 11 women; mean [±SD] age=32.9±12.7 years). The T2 values were calculated for the longus colli (Lco), longus capitis (Lca), and sternocleidomastoid (SCM) muscles at rest and following cranio-cervical flexion (CCF).ResultsIn the overall statistical model for T2 shift, there was a significant main effect for muscle (F=3.906, P=.033) but not for group (F=2.855, P=.101). The muscle × group interaction effect was significant (F=3.618, P=.041). Although not significant, there was a strong trend for lesser Lco (P=.061) and Lca (P=.060) activity for the WAD group compared with the control group. Although the SCM showed higher T2 shifts, this difference was not significant (P=.291).LimitationsAlthough mfMRI is an innovative and useful technique for the evaluation of deep cervical muscles, consideration is required, as this method encompasses a postexercise evaluation and is limited to resistance types of exercises.ConclusionsMuscle functional magnetic resonance imaging demonstrated a difference in muscle recruitment between the Lco, Lca, and SCM during CCF in the control group, but failed to demonstrate a changed activity pattern in the WAD group compared with the control group. The mild symptoms in the WAD group and the wide variability in T2 values may explain the lack of significance.

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Michiels, Sarah, Paul Van de Heyning, Steven Truijen, and Willem De Hertogh. "Diagnostic Value of Clinical Cervical Spine Tests in Patients With Cervicogenic Somatic Tinnitus." Physical Therapy 95, no. 11 (November 1, 2015): 1529–35. http://dx.doi.org/10.2522/ptj.20140457.

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Background Tinnitus can be related to many different etiologies, such as hearing loss or a noise trauma, but it also can be related to the somatosensory system of the cervical spine. The diagnosis of cervicogenic somatic tinnitus (CST) is made when the predominant feature is the temporal coincidence of appearance or increase of both neck pain and tinnitus. Objective The aim of this study was to assess the diagnostic value of clinical cervical spine tests in people with CST. Design A cross-sectional study was conducted. Setting The study was conducted at a tertiary referral center. Patients Consecutive adult patients with chronic subjective nonpulsatile tinnitus were included. Exclusion criteria were vertigo, Ménière disease, middle ear pathology, intracranial pathology, cervical spine surgery, whiplash trauma, and temporomandibular dysfunction. Measurements A full ear, nose, and throat examination was conducted to classify patients into CST and non-CST groups. The physical therapist examination included completion of the Neck Bournemouth Questionnaire (NBQ) and the following clinical cervical spine tests: manual rotation test, adapted Spurling test (AST), trigger point tests, and tests for strength and endurance of the deep neck flexors. Results Eighty-seven patients with tinnitus were included, of whom 37 (43%) were diagnosed with CST. The diagnosis of CST becomes less likely with NBQ scores of <14 points (sensitivity of 80%, likelihood ratio [LR] of 0.3, and posttest probability of 19%). Absence of trigger points corresponded to an LR of 0.3, a sensitivity of 82%, and a posttest probability of 22%. A positive manual rotation test and AST indicate a higher probability of CST (LR of 5, specificity of 90%, and posttest probability of 78%). Limitations A limited number of clinical cervical spine tests were used in this study. Although tests with good validity and reliability were included, additional tests could provide more information on cervical spine dysfunction in patients with CST. Conclusions Clinical cervical spine tests can support the diagnostic process for CST. An NBQ score of <14 points and the absence of trigger points can help to exclude CST. In contrast, a positive manual rotation test and AST can help to include CST. In future studies, these tests should be included in a multidisciplinary assessment of patients with suspected CST.

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Bobos, P., T. Papanikolaou, C. Koutsojannis, J. MacDermid, and E. Billis. "Is deep cervical neck flexors' training more effective than general neck exercises or advice in patients with chronic neck pain? A prospective randomized controlled trial." Manual Therapy 25 (September 2016): e145-e146. http://dx.doi.org/10.1016/j.math.2016.05.280.

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Thoomes-de Graaf, Marloes, and Maarten A. Schmitt. "The Effect of Training the Deep Cervical Flexors on Neck Pain, Neck Mobility, and Dizziness in a Patient With Chronic Nonspecific Neck Pain After Prolonged Bed Rest: A Case Report." Journal of Orthopaedic & Sports Physical Therapy 42, no. 10 (October 2012): 853–60. http://dx.doi.org/10.2519/jospt.2012.4056.

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25

Kindl, Radek P., Krunal Patel, and Rikin A. Trivedi. "Supraclavicular Brachial Plexus Approach for Excision of C8 Nerve Root Schwannoma: 3-Dimensional Operative Video." Operative Neurosurgery 16, no. 5 (August 8, 2018): 634–35. http://dx.doi.org/10.1093/ons/opy209.

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Abstract Brachial plexus tumors are uncommon lesions in young adults. The majority of these are benign peripheral sheath tumors. In this 3-dimensional video, we present a case of a 19-yr-old female who presented to the neurosurgical outpatients with an anterior neck lump. It has been present for months, causing occasional numbness and paraesthesia in the distribution of the left ring finger. There was no objective weakness in finger flexion with normal long flexors reflexes. The cervical spine and supraclavicular brachial plexus were investigated with a magnetic resonance imaging (Gadolinium) scan (Figure 1). It demonstrated 30 × 20 × 20 mm lesion adjacent to the C8 nerve arising from the neural foramen, however, mostly occupying the space lateral to it. The patient was consented for resection of the tumor. This was done via the supraclavicular brachial plexus approach. The brachial plexus nerves were macroscopically demonstrated lateral to the anterior scalene muscle. The intraoperative electrophysiology was used to directly stimulate the nerves, which aided in accurate tracking during the dissection. The tumor was exposed after tracing the C8 nerve deep and medial to the anterior scalene muscle. It was resected down to the foramen, reaching the level of the epidural venous plexus, while C8 was spared. The patient recovered with no neurological deficit. The histopathology confirmed grade 1 schwannoma. Subsequently, there was no radiological follow-up performed. This case demonstrates the surgical dissection of supraclavicular brachial plexus in 3-dimensions while describing the unusual dissection medial to scalenus anterior muscle.

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Ranđelović, Ivan, Bojan Jorgić, Vladimir Antić, and Miljan Hadžović. "Effects of exercise programs on upper crossed syndrome: A systematic review." Physical Education and Sport Through the Centuries 7, no. 2 (2020): 152–68. http://dx.doi.org/10.2478/spes-2020-0012.

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Keeping the head in a forward position can, in the long run, cause a postural disorder termed upper crossed syndrome - UCS. Upper crossed syndrome is defined as overactivity, or tightening, of the upper trapezius, major pectoralis and levator scapulae, combined with a weakened rhomboid, serratus anterior, middle and lower trapezius, as well as deep cervical flexors. This posture can result in neck pain, as well as upper back pain. The syndrome has been exacerbated with technological advancement, and the ever-increasing use of computers and smartphones. It affects school-age children, university students, as well as employees who work in an incorrect position or repeat the same actions throughout their working day. Physical exercise, namely, strength and stretching exercises, is one of the possible methods of correcting this postural disorder. Therefore, the objective of this study is to conduct a systematic review of studies to date in order to determine the effects of implementing different exercise programs on the treatment of upper crossed syndrome. The analyzed scientific papers were collected by searching online databases of electronic academic journals: Google Scholar, PubMed, Wolters Kluwer. The review focused on papers published between 2000 and 2019. Key words used for searching the databases included: upper crossed syndrome, effects, exercise program. Studies were included based on meeting the following criteria: examining the effects of different exercise programs on upper crossed syndrome, as well as on reducing neck and upper back pain, and improving functional ability. Based on the criteria set, a total of 15 studies were included in the final analysis. The final analysis established that upper crossed syndrome was affected most favorably by programs containing strength and stretching exercises, when these were administered over a 4-week period, with a minimum weekly frequency of 3 practice sessions

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Nezamuddin, Md, Shahnawaz Anwer, Sohrab Ahmad Khan, and Ameed Equebal. "EFFICACY OF PRESSURE-BIOFEEDBACK GUIDED DEEP CERVICAL FLEXOR TRAINING ON NECK PAIN AND MUSCLE PERFORMANCE IN VISUAL DISPLAY TERMINAL OPERATORS." Journal of Musculoskeletal Research 16, no. 03 (September 2013): 1350011. http://dx.doi.org/10.1142/s0218957713500115.

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Purpose: This randomized trial study compared the efficacy of pressure-biofeedback guided deep cervical flexor training as an adjunct with conventional exercise on pain and muscle performance in visually displayed terminal operators. Methods: A total of 50 (22 men and 28 women) patients with neck pain participated in the study. Patients were randomly placed into two groups: a biofeedback group (n = 25) and a control group (n = 25). The biofeedback group received pressure-biofeedback guided deep cervical flexor training program for 5 days a week for 6 weeks, whereas the control group received an exercise program only. Results: On intergroup comparisons, the deep cervical flexor performance in biofeedback group, at the end of 6th week was significantly higher than those of control group (p < 0.01). Pain intensity was also significantly reduced in biofeedback group when compared to control group at the end of trial (p < 0.004). Conclusion: The addition of pressure-biofeedback to a 6-week conventional program appeared to increase deep cervical flexor muscle performance, compared to the exercise program alone for people with reduced muscle performance.

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Jull, Gwendolen A. "Deep Cervical Flexor Muscle Dysfunction in Whiplash." Journal of Musculoskeletal Pain 8, no. 1-2 (January 2000): 143–54. http://dx.doi.org/10.1300/j094v08n01_12.

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Kılınç, Hasan Erkan, Gülcan Harput, Gül Baltacı, and Deniz İnal İnce. "Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain." Orthopaedic Journal of Sports Medicine 2, no. 11_suppl3 (November 1, 2014): 2325967114S0027. http://dx.doi.org/10.1177/2325967114s00277.

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Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were evaluated. Cyriax cervical mobilization for 10 minutes and scapular mobilization for 10 repetition 10 sets were performed to patients as treatment protocol. After treatment, 24 hours after and a week after evaluations of neck pain and deep cervical muscles endurance were repeated. Results: Before treatment Neck pain Visual Analog Scale scores was 5.78±1.43 point, 2.80±1.99 point after treatment, 24 hours later 3.36±2.12 point, one week later 3.91±2.24 point. This alteration was found significant statistically (p<0.01). Before treatment deep cervical flexor muscle endurance score was 27.25±17.74 sec, after treatment 39.46±25.20 sec, 24 hours later 38.67±28.43 and one week later 40.11±27.82 sec. This alteration was also found significant statistically (p=0.01). Conclusion: Initially neck pain scores in our subjects decreased quickly, after 24 hours these scores increased but last scores were below first neck pain level in a week follow-up. Deep neck cervical flexor muscles test scores also increased quickly, after 24 hours later this scores were stable along a week. Mobilization techniques are effective methods on neck pain and endurance in chronical mechanic neck pain patients.

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Sonia Pawaria and Sheetal Kalra. "Effect of Deep Cervical Flexor training on Respiratory Functions in Chronic Neck Pain patients with Forward Head Posture." International Journal of Research in Pharmaceutical Sciences 11, no. 4 (September 25, 2020): 5287–92. http://dx.doi.org/10.26452/ijrps.v11i4.3146.

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Protruded chin posture is one of the commonly seen postural problem associated with patients having chronic neck pain. It is also known by names Forward Head Posture (FHP) or anteriorly translated head posture. The FHP causes an alteration in mechanics of rib cage which leads to a reduction in mobility of thorax and abdomen, decreased movement of the diaphragm, reduced ventilatory effectiveness of diaphragm and reduced efficacy of abdominals and intercostals muscles during respiration. Therefore this study was executed to check the effectiveness of deep cervical flexor exercises on Craniovertebral angle and pulmonary functions. It was a comparative experimental study design. Based on the study's selection criteria, the total numbers of 100 subjects were taken and divided into Experimental and Control groups. In-depth Cervical flexor training with the conventional Physiotherapy was given to subjects of the experimental group. Control group subjects received only Conventional Physiotherapy for six weeks. The baseline measurement was taken on day one of the studies. The digital camera assessed the Forward head posture by measuring Craniovertebral Angle (CVA). Spirometry determined pulmonary functions (FEV1& FVC). All measurements were repeated at the end of the 6th week. The baseline measurement and measurement at the end of 6th week were compared by using the t-test. Considerable improvement in Craniovertebral angle and functional status of the lung, resulted in subjects who were given in-depth cervical flexor training along with the conventional Physiotherapy treatment (p< 0.05). Therefore it is suggested that deep cervical flexor exercises improve the head posture and also correct the biomechanics of respiratory muscles. Deep neck flexor training can be considered as an efficient technique in lessening protruded chin posture.

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Faizan, Khan M., Chorsiya Varsha, and Ahmad Shahnawaz. "Comparative Study of Pettibon’s Anterior Head Weighting System and Conventional Management for Deep Cervical Flexor Muscle Endurance in Forward Head Postured Young Adults." International Journal of Scientific Research 2, no. 9 (June 1, 2012): 319–20. http://dx.doi.org/10.15373/22778179/sep2013/109.

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Olson, Lee E., A. Lynn Millar, Jeremy Dunker, Jennifer Hicks, and Devin Glanz. "Reliability of a Clinical Test for Deep Cervical Flexor Endurance." Journal of Manipulative and Physiological Therapeutics 29, no. 2 (February 2006): 134–38. http://dx.doi.org/10.1016/j.jmpt.2005.12.009.

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Araujo, Francisco Xavier de, Giovanni Esteves Ferreira, Maurício Scholl Schell, Marcelo Peduzzi de Castro, Marcelo Faria Silva, and Daniel Cury Ribeiro. "Measurement properties of the craniocervical flexion test: a systematic review protocol." BMJ Open 8, no. 2 (February 2018): e019486. http://dx.doi.org/10.1136/bmjopen-2017-019486.

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IntroductionNeck pain is the leading cause of years lived with disability worldwide and it accounts for high economic and societal burden. Altered activation of the neck muscles is a common musculoskeletal impairment presented by patients with neck pain. The craniocervical flexion test with pressure biofeedback unit has been widely used in clinical practice to assess function of deep neck flexor muscles. This systematic review will assess the measurement properties of the craniocervical flexion test for assessing deep cervical flexor muscles.Methods and analysisThis is a protocol for a systematic review that will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. MEDLINE (via PubMed), EMBASE, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus and Science Direct will be systematically searched from inception. Studies of any design that have investigated and reported at least one measurement property of the craniocervical flexion test for assessing the deep cervical flexor muscles will be included. All measurement properties will be considered as outcomes. Two reviewers will independently rate the risk of bias of individual studies using the updated COnsensus-based Standards for the selection of health Measurement Instruments risk of bias checklist. A structured narrative synthesis will be used for data analysis. Quantitative findings for each measurement property will be summarised. The overall rating for a measurement property will be classified as ‘positive’, ‘indeterminate’ or ‘negative’. The overall rating will be accompanied with a level of evidence.Ethics and disseminationEthical approval and patient consent are not required since this is a systematic review based on published studies. Findings will be submitted to a peer-reviewed journal for publication.PROSPERO registration numberCRD42017062175.

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Moon, Hyun-Ju, Bong-Oh Goo, and Hae-Yeon Kwon. "Changes in the thickness of the cervical flexor depending on the contraction level of the masticatory muscle during deep cervical flexor training." Journal of Physical Therapy Science 27, no. 11 (2015): 3347–49. http://dx.doi.org/10.1589/jpts.27.3347.

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Jull, Gwendolen A., Shaun P. O'Leary, and Deborah L. Falla. "Clinical Assessment of the Deep Cervical Flexor Muscles: The Craniocervical Flexion Test." Journal of Manipulative and Physiological Therapeutics 31, no. 7 (September 2008): 525–33. http://dx.doi.org/10.1016/j.jmpt.2008.08.003.

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Amalina, Nurika, and Erna Setiawati. "Effectiveness of Deep Cervical Flexor (DCF) Exercise on Neck Functional Scores in Helicopter Crew with Mechanical Neck Pain." Surabaya Physical Medicine and Rehabilitation Journal 3, no. 2 (August 27, 2021): 71. http://dx.doi.org/10.20473/spmrj.v3i2.24272.

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Background: Mechanical neck pain is defined as neck pain due to biomechanical dysfunction in the neck or upper back. Exercise can reduce muscle tension and strengthen deep cervical flexor (DCF) muscles by helping to relieve pain. The prevalence of neck pain is considered high in helicopter crews compared to the general population. Aim: To investigate the effectiveness of DCF exercise on neck functional scores (study of helicopter crews with mechanical neck pain).Material and Methods: Experimental one pre and post-test group design. The samples were 14 squadron-31/serbu helicopter crew performing conventional DCF muscle exercise 12 times for 4 weeks with a frequency of 3 times each week. Neck function was assessed using the Neck Outcome Score (NOOS) which consists of domains of mobility, stiffness, symptoms, sleep disturbances, everyday activity and pain, participating in everyday life, and quality of life.Results: This study showed that the mean NOOS score before intervention was 30.64 (SD: 9.44) and the mean NOOS score after intervention was 8.57 (SD: 5.33). There was a significant difference in the NOOS score before and after deep cervical flexor exercise (p = 0.001).Conclusion: DCF exercises are effective for improving neck functionality in helicopter crew with mechanical neck pain.

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Aslıyüce, Yasemin Özel, and Özlem Ülger. "Efficacy of Suboccipital Release and Stabilization Exercise Training in Type 1 Chiari Malformation Patient Undergoing Surgical Treatment: A Case Report." International Journal of Sport, Exercise and Health Research 5, no. 1 (May 30, 2021): 30–33. http://dx.doi.org/10.31254/sportmed.5109.

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In Chiari malformation, some symptoms are known to recur after decompression surgery. To our knowledge, this is the first case for symptomatic outcome after suboccipital release and stabilization exercises the patient with type 1 Chiari malformation who has experienced surgery. The present study aims to investigate the efficacy of suboccipital release and stabilization exercise training in a patient with Type 1 Chiari Malformation undergoing surgical treatment. A 47- year-old female patient with Chiari malformation received suboccipital release and stabilization exercise training for 10 weeks. Her symptomatic parameters were evaluated, such as pain, grip and pinch strength, deep cervical flexor strength, balance and gait. After the treatment, there were improvements in pain perception, the score of performance index of deep cervical muscles, grip force, static balance and gait parameters. Suboccipital oscillation and stabilization exercises are thought to be safe and effective in patients with Chiari malformation undergoing decompression surgery

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Senthil, P., S. Sudhakar, and R. Radhakrishnan. "Isolated Activation of Deep Cervical Flexor Muscles to Improve the Functional Outcome of Subjects with Cervical Dysfunction." Indian Journal of Physiotherapy and Occupational Therapy - An International Journal 10, no. 2 (2016): 121. http://dx.doi.org/10.5958/0973-5674.2016.00061.7.

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Farrell, Michael, Barbara I. Karp, Panagiotis Kassavetis, William Berrigan, Simge Yonter, Debra Ehrlich, and Katharine E. Alter. "Management of Anterocapitis and Anterocollis: A Novel Ultrasound Guided Approach Combined with Electromyography for Botulinum Toxin Injection of Longus Colli and Longus Capitis." Toxins 12, no. 10 (September 30, 2020): 626. http://dx.doi.org/10.3390/toxins12100626.

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Chemodenervation of cervical musculature using botulinum neurotoxin (BoNT) is established as the gold standard or treatment of choice for management of Cervical Dystonia (CD). The success of BoNT procedures is measured by improved symptomology while minimizing side effects and is dependent upon many factors including: clinical pattern recognition, identifying contributory muscles, BoNT dosage, and locating and safely injecting target muscles. In patients with CD, treatment of anterocollis (forward flexion of the neck) and anterocaput (anterocapitis) (forward flexion of the head) are inarguably challenging. The longus Colli (LoCol) and longus capitis (LoCap) muscles, two deep cervical spine and head flexor muscles, frequently contribute to these patterns. Localizing and safely injecting these muscles is particularly challenging owing to their deep location and the complex regional anatomy which includes critical neurovascular and other structures. Ultrasound (US) guidance provides direct visualization of the LoCol, LoCap, other cervical muscles and adjacent structures reducing the risks and side effects while improving the clinical outcome of BoNT for these conditions. The addition of electromyography (EMG) provides confirmation of muscle activity within the target muscle. Within this manuscript, we present a technical description of a novel US guided approach (combined with EMG) for BoNT injection into the LoCol and LoCap muscles for the management of anterocollis and anterocaput in patients with CD.

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Lira, Maria das Graças de Araújo, Raysa Vanessa de Medeiros Freitas, Wildna Sharon Martins da Costa, Henrique de Paula Bedaque, Maria Clara Silva de Melo, Lidiane Maria de Brito Macedo Ferreira, and Karyna Myrelly Oliveira Bezerra de Figueiredo Ribeiro. "Vestibular Physiotherapy and Yoga in Vasovagal Syndrome: case report." Research, Society and Development 10, no. 1 (January 25, 2021): e48210110633. http://dx.doi.org/10.33448/rsd-v10i1.10633.

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This study aimed to report the effects of vestibular physiotherapy (VP) associated with Yoga in a vasovagal syndrome (VVS) patient with dizziness and body imbalance complaints. We described a 22-year-old patient who underwent one year of VP with a frequency of one to two times per week (totaling 31 sessions). The treatment for the cervical region was performed using manual therapy and motor control training of the deep cervical flexor muscles. The patient started to practice Yoga three months after the beginning of the VP. After one year of treatment, a substantial improvement in the symptoms of dizziness and postural balance were observed. However, the cervical pain remained present and cervical mobility was slightly limited after two years. These findings lasted one year after the end of the VP program, a period in which the patient performed only Yoga. Despite the promising results, future studies with larger sample sizes and adequate methodological quality are necessary to confirm the effects of therapeutic exercises in individuals with VVS.

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Falla, Deborah, Gwendolen Jull, Paul Dall'Alba, Alberto Rainoldi, and Roberto Merletti. "An Electromyographic Analysis of the Deep Cervical Flexor Muscles in Performance of Craniocervical Flexion." Physical Therapy 83, no. 10 (October 1, 2003): 899–906. http://dx.doi.org/10.1093/ptj/83.10.899.

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Abstract Background and Purpose. This study evaluated an electromyographic technique for the measurement of muscle activity of the deep cervical flexor (DCF) muscles. Electromyographic signals were detected from the DCF, sternocleidomastoid (SCM), and anterior scalene (AS) muscles during performance of the craniocervical flexion (CCF) test, which involves performing 5 stages of increasing craniocervical flexion range of motion—the anatomical action of the DCF muscles. Subjects. Ten volunteers without known pathology or impairment participated in this study. Methods. Root-mean-square (RMS) values were calculated for the DCF, SCM, and AS muscles during performance of the CCF test. Myoelectric signals were recorded from the DCF muscles using bipolar electrodes placed over the posterior oropharyngeal wall. Reliability estimates of normalized RMS values were obtained by evaluating intraclass correlation coefficients and the normalized standard error of the mean (SEM). Results. A linear relationship was evident between the amplitude of DCF muscle activity and the incremental stages of the CCF test (F=239.04, df=36, P<.0001). Normalized SEMs in the range 6.7% to 10.3% were obtained for the normalized RMS values for the DCF muscles, providing evidence of reliability for these variables. Discussion and Conclusion. This approach for obtaining a direct measure of the DCF muscles, which differs from those previously used, may be useful for the examination of these muscles in future electromyographic applications.

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Kim, Jin Young, and Kwang Il Kwag. "Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain." Journal of Physical Therapy Science 28, no. 1 (2016): 269–73. http://dx.doi.org/10.1589/jpts.28.269.

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Ishida, Hiroshi, Tadanobu Suehiro, Chiharu Kurozumi, Koji Ono, Suguru Ando, and Susumu Watanabe. "Correlation between neck slope angle and deep cervical flexor muscle thickness in healthy participants." Journal of Bodywork and Movement Therapies 19, no. 4 (October 2015): 717–21. http://dx.doi.org/10.1016/j.jbmt.2015.04.001.

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Falla, D., G. Jull, S. O’Leary, and P. Dall’Alba. "Further evaluation of an EMG technique for assessment of the deep cervical flexor muscles." Journal of Electromyography and Kinesiology 16, no. 6 (December 2006): 621–28. http://dx.doi.org/10.1016/j.jelekin.2005.10.003.

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Hidayat, Nitaya Putri Nur, Dewa Putu Gede Purwa Samatra, S. Indra Lesmana, Nyoman Mangku Karmaya, Ni Wayan Tianing, and I. Putu Gede Adiatmika. "INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUE LEBIH MENURUNKAN NILAI DISABILITAS LEHER DARIPADA AKTIVASI DEEP CERVICAL FLEXOR MUSCLE PADA MYOFASCIAL PAIN SYNDROME OTOT UPPER TRAPEZIUS." Sport and Fitness Journal 8, no. 1 (January 9, 2020): 45. http://dx.doi.org/10.24843/spj.2020.v08.i01.p06.

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Pendahuluan: Perkembangan teknologi memudahkan seseorang untuk menyelesaikan tugas sehari-hari. Banyak orang menghabiskan sebagian besar waktunya untuk berada di depan gawai. Dampak negatif yang timbul pada penggunaan gawai yang berlebihan adalah buruknya postur tubuh, karena seseorang cenderung akan duduk dengan posisi leher yang membungkuk ke depan. Hal tersebut akan menyebabkan ketidakseimbangan kerja otot area leher, terjadi ketegangan terus menerus tanpa disertai relaksasi yang cukup pada otot upper trapezius akan menimbulkan myofascial pain syndrome pada otot tersebut. Tujuan Penelitian: Untuk menemukan intervensi fisioterapi yang efektif dan efisien guna menurunkan nilai disabilitas leher pada myofascial pain syndrome otot upper trapezius. Metode: Penelitian ini bersifat experimental, dengan pretest-posttest design dengan randomisasi sebagai desain penelitiannya. Intervensi dilakukan 3 kali seminggu selama 4 minggu. Sampel merupakan pasien di klinik Fitasoma, Colomadu, Karanganyar, yang terdiri dari 19 orang berusia 25 - 40 tahun, dibagi menjadi 2 kelompok yang terdiri dari Kelompok I dengan perlakuan intervensi integrated neuromuscular inhibition technique yang berjumlah 9 orang dan Kelompok II dengan perlakuan aktivasi deep cervical flexor muscle yang berjumlah 10 orang. Pengukuran nilai disabilitas menggunakan Neck Disability Index. Hasil: Terdapat penurunan nilai disabilitas leher yang bermakna pada ke dua kelompok. Pada Kelompok I didapat rerata dari 40,00 menjadi 21,67 dan pada Kelompok II di dapat rerata dari 39,10 menjadi 30,30. Uji beda setelah perlakuan pada masing-masing kelompok didapatkan nilai p=0,042 dan selisih rerata 18,33 pada Kelompok I dan 8,80 pada Kelompok II yang berarti Integrated Neuromuscular Inhibition Technique lebih baik daripada aktivasi deep cervical flexor muscle dalam menurunkan nilai disabilitas leher.

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Shin, Chang-Hun, In-Ho Lee, and Shin-Jung Yoon. "Effect of the Deep Neck Flexor Muscle Strength Training on Cervical Spine Alignment and Pain." Korea Journal of Sport 18, no. 4 (December 31, 2020): 395–406. http://dx.doi.org/10.46669/kss.2020.18.4.036.

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Falla, Deborah, Shaun O’Leary, Amy Fagan, and Gwendolen Jull. "Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting." Manual Therapy 12, no. 2 (May 2007): 139–43. http://dx.doi.org/10.1016/j.math.2006.06.003.

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Schwarz, J. "Recruitment of the Deep Cervical Flexor Muscles during a Postural-Correction Exercise Performed in Sitting." manuelletherapie 12, no. 02 (April 25, 2008): 76–77. http://dx.doi.org/10.1055/s-2008-1027472.

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Kim, Kwang Baek, Doo Heon Song, and Hyun Jun Park. "Computer Vision Based Automatic Extraction and Thickness Measurement of Deep Cervical Flexor from Ultrasonic Images." Computational and Mathematical Methods in Medicine 2016 (2016): 1–11. http://dx.doi.org/10.1155/2016/5892051.

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Deep Cervical Flexor (DCF) muscles are important in monitoring and controlling neck pain. While ultrasonographic analysis is useful in this area, it has intrinsic subjectivity problem. In this paper, we propose automatic DCF extractor/analyzer software based on computer vision. One of the major difficulties in developing such an automatic analyzer is to detect important organs and their boundaries under very low brightness contrast environment. Our fuzzy sigma binarization process is one of the answers for that problem. Another difficulty is to compensate information loss that happened during such image processing procedures. Many morphologically motivated image processing algorithms are applied for that purpose. The proposed method is verified as successful in extracting DCFs and measuring thicknesses in experiment using two hundred 800 × 600 DICOM ultrasonography images with 98.5% extraction rate. Also, the thickness of DCFs automatically measured by this software has small difference (less than 0.3 cm) for 89.8% of extracted DCFs.

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Shin, Chang-Hun, In-Ho Lee, and Shin-Jung Yoon. "Effect of the Deep Neck Flexor Muscle Strength Training on Cervical Spine Alignment and Pain." Korea Journal of Sport 18, no. 4 (December 31, 2020): 395–406. http://dx.doi.org/10.46669/kss.2020.18.4.036.

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