2009 APA Conference Week Abstracts - Australian Physiotherapy ...

Musculoskeletal Physiotherapy Australia
dorsi, teres major) and external rotators (infraspinatus,
supraspinatus, posterior deltoid) in 15 normal subjects
during maximal isometric rotation tests, using a combination
of surface and indwelling electrodes. Eight rotation test
positions were examined: external and internal rotation in
sitting with the arm pendant and at 90º abduction and in 90º
abduction in supine; the lift off (Gerber) test; and the belly
press test. EMG data was normalised to standard maximal
voluntary contractions (MVC). Mean EMG data for each
subject and group mean EMG data for each exercise were
then calculated. Repeated measures ANOVA with Tukey
post hoc analysis were used to compare the activity level in
all the muscles in all test positions. All test positions activated
the rotator cuff muscles to equally high levels. Only the lift
off position demonstrated significant differences between
subscapularis and other muscles, with significantly higher
activity in latissimus dorsi and teres major and significantly
less activity in pectoralis major. None of the test positions
examined recruited a rotator cuff muscles bat
significantly
higher levels than other shoulder rotators.
Endurance and fatigue characteristics during submaximal
neck muscle tests in patients with postural
neck pain
Edmondston SJ, 1 Bjornsdottir GB, 1 Palsson TS, 1 Solgard
H, 1 Ussing K, 1 Allison GT 1,2
1
Curtin University of Technology, WA, 2 Royal Perth Hospital, WA
The aim of this study was to evaluate neck muscle endurance
and fatigue characteristics in female subjects with postural
neck pain. Thirteen subjects with postural neck pain and
12 asymptomatic control subjects were recruited for the
study. Postural pain was defined as neck pain provoked by
sustained postures during work or recreational activities.
Subjects performed timed sub-maximal muscle endurance
tests for the neck flexor and extensor muscles. Muscle
fatigue, defined as the time-dependent decrease in median
frequency EMG was examined using surface EMG analysis
during the tests. The median extensor test holding time
was for the neck pain group was 165 seconds (IQR = 111
to 240), compared to 228 seconds (IQR = 190 to 240) for
the control group (p = 0.12). The median holding time for
the flexor test was 38 seconds (IQR = 14 to 83) for the neck
pain group and 36 seconds (IQR = 25 to 63) for the control
group (p = 0.74). The neck pain group was characterised
by greater variability in muscle endurance. For both tests,
the rate of decrease in median frequency EMG was highly
variable within and between groups with no significant
between group difference for the flexor (p = 0.29) or
extensor test (p = 0.23). Subjects with postural neck pain
did not have significant impairment of muscle endurance or
accelerated fatigue compared to control subjects. However,
greater variability in neck muscle endurance and fatigue
characteristics was evident in the postural neck pain subjects
compared to the control group.
Fatty infiltration in the cervical flexor muscles in
chronic whiplash
Elliott JM, 1,3 O’Leary SP, 1 Sterling MA, 1,3 Pedler AR, 3
Jull GA 1
1
The University of Queensland, CCRE-Spine, Brisbane, 2 The University
of Queensland, Centre for Magnetic Resonance, Brisbane, 3 The
University of Queensland, Centre of National Research on Disability
and Rehabilitation Medicine, Brisbane
The purpose of this study was to determine if subjects with
chronic WAD demonstrate significantly larger amounts
of fat in the cervical flexor muscles compared to controls.
It was hypothesised that subjects with chronic whiplash
would demonstrate higher fatty infiltrates in the cervical
flexors than controls. Subjects consisted of 78 females with
chronic whiplash (age: 29.8 ± 7.8) and 34 controls (age: 27.0
± 5.6) within the age range of 18–45 years. A previously
established MRI measure for fat infiltrate was performed on
all participants to determine differences by group, muscle
(longus capitis/colli and sternocleidomastoid) and spine
level. A repeated measures linear mixed model was used
to model the effects of cervical level by muscle by group.
Subjects with chronic whiplash had significantly higher
fatty infiltrate in the cervical flexors compared to controls
(p < 0.001). Significant group differences were found based
on muscle and level where the deeper longus capitis/colli
had larger amounts of fatty infiltrate when compared to the
SCM in the WAD group (p < 0.01), but this was reversed in
the control group (p < 0.001). There is significantly greater
fatty infiltration in the neck flexor muscles, especially in
the deeper muscles, in subjects with chronic WAD when
compared to controls. These changes are consistent with
those observed in the posterior muscles and are of potential
detriment to the optimal recovery of patients with chronic
whiplash. Studies are underway to better investigate the
mechanisms underlying these changes.
An investigation of the association between C2 spinal
alignment and cervicogenic headache
Farmer P, Rivett DA, Snodgrass SJ
The University of Newcastle, Newcastle
Abnormal habitual postures are proposed to contribute to
cervical spine and headache symptoms through altered
spinal alignment. Cervicogenic headaches are associated
with symptomatic palpation of the upper cervical spine,
suggesting this area should be a focus of investigations
into possible associations between spinal alignment and
cervicogenic headache. This study aims to determine if C2
spinal alignment is associated with cervicogenic headache,
and if physiotherapists can reliability assess C2 alignment.
A single blind comparative measurement design evaluated
C2 alignment in subjects with cervicogenic headache and
age and gender matched controls. Subjects with headache
had symptoms consistent with the Cervicogenic Headache
International Study Group diagnostic criteria, while
controls had no history of neck trauma or treatment for
neck/headache in the previous 12 months. Altered C2
alignment was defined as ≥ 3 mm of C2 spinous process
deviation from midline on anteroposterior radiograph,
and 2 titled musculoskeletal physiotherapists assessed C2
alignment using palpation. Preliminary analysis of the first
46 recruited subjects indicates that 11 of 26 subjects with
headache and 5 of 20 controls had altered C2 alignment (X2
= 1.49, p = 0.22). Inter-therapist reliability of C2 alignment
The e-AJP Vol 55: 4, Supplement 11