Changes in Neck Mobility and Pressure Pain Threshold Levels Following a Cervical Myofascial Induction Technique in Pain-Free Healthy Subjects
Received 1 December 2008; received in revised form 7 January 2009; accepted 13 January 2009.
Abstract
Objective
The purpose of this study was to investigate if the application of a cervical myofascial induction technique targeted to the ligamentum nuchae resulted in changes in cervical range of motion and pressure pain thresholds (PPT) in asymptomatic subjects.
Methods
Thirty-five subjects, 8 men and 27 women (mean age, 21 ± 4 years), without a current history of neck, shoulder, or arm pain participated. Participants were randomly divided into 2 groups: the experimental group, which received a real cervical myofascial induction technique, and the control group, which received a sham-manual procedure. Bilateral PPT levels over C5-C6 zygapophyseal joints and tibialis anterior muscles and neck mobility were assessed preintervention and 5 minutes postintervention by an assessor blinded to the treatment allocation of the subject. Separate mixed-model analyses of variance were used to examined the effects of the treatment on neck mobility and PPT levels as the dependent variable, with group (experimental or control) as the between-subjects variable and time (pre-post test) or side (dominant, nondominant) as the within-subjects variable. The hypothesis of interest was the group × time interaction at an a priori α level equal to .05.
Results
The group × time interaction was statistically significant for cervical flexion (F = 5.4; P = .03), extension (F = 3.3; P = .045), and left lateral-flexion (F = 4.6; P = .04), but not for right lateral-flexion (F = 2.5; P = .1), right rotation (F = 0.5; P = .5), and left rotation (F = 0.09; P = .2). Subjects receiving the real cervical myofascial induction technique experienced greater improvement in cervical mobility when compared with the control group. The group × time interaction did not reveal any significance for PPT in the C5-C6 zygapophyseal joints (F = 0.5; P = .5) and in the tibialis anterior muscle (F = 0.2; P = .8).
Conclusions
The application of a cervical myofascial induction technique resulted in an increase in cervical flexion, extension, and left lateral-flexion, but not rotation motion in a cohort of healthy subjects. No changes in PPT in either C5-C6 zygapophyseal joint (local point) or tibialis anterior muscle (distant point) were found.
aProfessor, Department of Physical Therapy, Centro de Salud Parquesol, Spain
bProfessor, Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain
cClinical Researcher, Department of Physical Therapy, Hospital Clínico San Ceciclio, Granada, Spain
dProfessor, Director of School of Myofascial Therapy, San Lorenzo del Escorial, Madrid, Spain
eProfessor and Clinical Researcher, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
Submit requests for reprints to: César Fernández de las Peñas, PT, PhD, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid Spain
ABSTRACT