Neck Pain Assessment Overview

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Questions and Answers

What is the relationship between excessive scapular protraction and reproducibility according to Lemeunier 2018?

It has no effect on reproducibility.

It improves reproducibility. (correct)

It complicates reproducibility.

It leads to poorer reproducibility.

Which device showed inconsistent evidence in distinguishing differences in Forward Head Posture?

Ultrasound

MRI

CROM device (correct)

Radiography

What was found to be associated with increased perceived disability in patients with neck pain?

Larger Craniovertebral angle (correct)

Reduced range of motion

Higher Schmerzen's scale score

Stronger muscle strength

What did the manual palpation studies show regarding segmental examination at C2-7?

Low consistency in identifying pain. Signup and view all the answers

Which muscle was NOT mentioned as associated with muscular tenderness in patients with neck pain?

Pectoralis major Signup and view all the answers

Joint motion palpation has been noted to have what value regarding mobility?

Very low value. Signup and view all the answers

According to the findings, what improves the validity of assessments regarding neck pain?

Combining joint and muscular palpation. Signup and view all the answers

What is the significance of psychosocial factors (PSFs) in relation to neck pain?

They correlate with the presence of muscular tenderness. Signup and view all the answers

What is the primary outcome measure used to evaluate neck extension strength?

Dynamometer (MVIC) Signup and view all the answers

What are the normative values for neck extension strength in women?

20 kg Signup and view all the answers

Which factor is NOT associated with reduced pain in chronic neck pain patients?

Substantial Passive Treatments Signup and view all the answers

Which pain assessment tool is considered most frequently used for patients with neck pain?

Pressure Pain Threshold (PPT) Signup and view all the answers

What is a significant finding in individuals with Acute Non-Specific Neck Pain?

Impaired Conditioned Pain Modulation (CPM) Signup and view all the answers

What defines the factor for evaluating strength reliability in dynamometer assessments?

Intra-rater reliability (ICC = 0.96) Signup and view all the answers

Which of the following considerations affects the strength of evidence in therapeutic approaches for neck pain?

Variability in inclusion/exclusion criteria Signup and view all the answers

Which statement regarding chronic neck pain is true?

Lower PPT is associated with moderate to severe pain. Signup and view all the answers

Which approach is recommended for treating patients with chronic neck pain?

Enhanced patient involvement and decision-making Signup and view all the answers

What is a common symptom in individuals experiencing mechanical hyperalgesia in chronic neck pain?

Localized tenderness Signup and view all the answers

What is the highest frequency age range for new cases observed?

40 to 69 years old Signup and view all the answers

Which psychological factor has a bidirectional association with the onset and severity of pain?

General Anxiety Disorders Signup and view all the answers

What factor is listed as a mediator between pain and disability?

Depression Signup and view all the answers

Which demographic is less likely to experience higher frequencies of new cases of cervical spine issues?

Younger adults Signup and view all the answers

What physical changes can contribute to the onset of cervical spine issues?

Changes in cervical spine mobility and anatomy Signup and view all the answers

What social factor is linked to an increased risk of new problems in the cervical spine?

Low social support Signup and view all the answers

Which group has the highest comorbidities associated with psychological factors?

Individuals with General Anxiety Disorders and PTSD Signup and view all the answers

What characteristic is a known risk factor for new cervical spine issues?

High job demands Signup and view all the answers

Which cognitive factor is associated with increased pain and disability?

Fear Avoidance Beliefs Signup and view all the answers

What is the relationship between sleep quality and pain perception?

Poor sleep quality may increase risk of developing neuropathic pain Signup and view all the answers

Which behavior is linked to a longer duration of neck pain?

Avoidance oriented behavior Signup and view all the answers

Which cognitive variable can lead to altered central pain processing?

Impaired cognitive variables Signup and view all the answers

How does social support influence neck complaints?

It alleviates neck complaints Signup and view all the answers

What is the primary immediate effect of dry needling (DN)?

Immediate effect on pain and PPT Signup and view all the answers

How do dry needling and manual techniques compare in the short term?

Manual techniques are more effective than dry needling. Signup and view all the answers

What does aerobic exercise training (AET) improve according to the provided content?

Pain, function, and level of disability Signup and view all the answers

What is a significant issue with the studies analyzed regarding aerobic exercise training?

Heterogeneous sample of patients Signup and view all the answers

How frequently is aerobic exercise suggested for patients?

2/3 times a week for 30-45 minutes per session Signup and view all the answers

What common belief about patients who could benefit from AET is indicated in the content?

No clear indications about which patients could benefit. Signup and view all the answers

What does DN stand for in the content?

Dry needling Signup and view all the answers

What is a noted effect of dry needling at the intermediate term?

Reversal of initial improvements Signup and view all the answers

Which method is stated as not being more effective than manual therapy for pain management?

Dry needling Signup and view all the answers

What type of exercise is included under aerobic exercise training?

Swimming and jogging Signup and view all the answers

Which exercise method is primarily used for Scapular Resistance Training?

Open Kinetic Chain Signup and view all the answers

What is a crucial aspect to consider when using Scapular Training exercises?

Assessment of posture and movement patterns Signup and view all the answers

What is the key benefit of neck extensor strengthening in managing Chronic Neck Pain?

It provides better balance between flexor and extensor muscles Signup and view all the answers

Which of the following outcomes is NOT an objective of Deep Flexor Cervical Strengthening?

Reduction of forward head posture Signup and view all the answers

What is the primary mechanism through which MWM Self-Mobilization is thought to be effective?

Reducing inflammation markers Signup and view all the answers

Pain Neurophysiology Education (PNE) should primarily target which two outcomes?

Pain and kinesiophobia Signup and view all the answers

Cognitive Functional Therapy (CFT) primarily addresses which aspects of rehabilitation?

Bio-psycho-social factors Signup and view all the answers

Which exercise intervention is shown to reduce the risk of developing neck pain in office workers?

Strength/resistance training 3 times/week Signup and view all the answers

What approach is emphasized for treatment in chronic neck pain based on the summary?

Multifactorial treatment strategies Signup and view all the answers

Virtual Reality (VR) implementation aims to enhance which aspect in patients with chronic neck pain?

Specific kinematic functions Signup and view all the answers

What is one potential benefit of deep flexor muscles compared to conventional exercises for neck pain?

Improved pain and disability outcomes Signup and view all the answers

Which component is crucial for achieving positive outcomes in Pain Neurophysiology Education?

Emotional delivery of information Signup and view all the answers

What is the primary goal of Scapular Resistance Training exercises?

Strengthening the shoulder girdle muscles Signup and view all the answers

Which vertebra is key for activating deep extensor muscles according to effective neck management strategies?

C2 Signup and view all the answers

Study Notes

Neck Pain with Mobility Deficits

Neck pain is described as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, beginning at the superior nuchal line and continuing down to the scapular spine.
22% to 70% of the population will experience neck pain at some point in their lives.
54% of individuals experienced neck pain within the last 6 months.
Neck pain increases with age and is most common in women (ages 40-69).
Neck pain ranks 19th overall in global cause of Disability Adjusted Life Year (DALY).
The highest frequency of new neck pain cases is between the ages of 40 and 69.
Risk factors for neck pain include: reduced physical activity, high work and household demands, changes in cervical spine mobility and anatomy, previous spinal disorders, being female, older age (up to 70), low social or work support, high job demands, and being an ex-smoker.
Psychological factors, such as mood disorders, distress, anxiety, and depression, are associated with neck pain and its severity. Pain catastrophizing and fear avoidance beliefs are linked to self-perceived poor health.
Lifestyle factors, like sleep quality and social support, are also correlated with the development and duration of neck pain. Avoidance-oriented behavior (with annoyance and anger reaction) leads to a longer duration of neck pain.
Individual factors, such as marital status, low income and economic stress, perception of muscular tension, and genetics/autoimmune disease/NMSK comorbidities, can also be contributing factors to neck pain.
Work factors, including a lack of coworker support, role-related conflicts, part-time employment, anxiety about economical status and income, effort-reward imbalance, poor sitting adjustments, work in sustained positions, are among other contributing factors.
Posture of the head is associated with the weight born by the cervical structure.
Spending over 4 hours a day on phones leads to an increase in neck pain and reduced cervical extensor muscle endurance. Spending more than 10 hours per week on phones increases the risk of neck pain.
F1 drivers experience 4-5g forces during specific circuits while Verstappen's crash in Silverstone was 51g.
Patients with neck pain generally report symptoms such as tightness, stiffness, blockage, difficulty during movements, headaches, migraines, vertigo, dizziness, different shapes and posture of neck and shoulder structure; difficulties in focusing attention in non-painful area, helplessness, frustration, fear of movement, impaired cognition. Patients wish to receive clear & concrete explanations, good therapeutic relationship, and preference for challenging treatments.
Workplace and social support are critical for the clinical course of neck pain.
Chronic or insidious neck pain often follows a recurrent or episodic course (50-85% recurrence rate within 5 years), with complete resolution being the exception rather than the rule (45%).
Neck pain is not just a matter of pain; 60% of patients presented with some disability and failed to achieve satisfactory improvements at 8 weeks; 47% of patients presented with some disability and failed to achieve satisfactory improvements at 12 weeks.
Biomechanical performance modifications, cognitive perceived modifications and activity of daily living are key factors in neck pain cases.

Specific Worker Risks

White-collar workers (office workers/PC) are more at risk due to high mental demands and prolonged use of computers.
Blue-collar workers face high working demands and low job control/social support.
Healthcare professionals are prone to repetitive movements, heavy lifting, and fixed positions (awkward neck position).

Other Factors

Confounding factors for neck pain development include time, age, and psychosocial factors.
Evaluations for neck pain should consider the static posture, dynamics, and standing vs. sitting postures.
65% of sonographers with neck pain have low/resolving disability and 35% have moderate/fluctuating disability.
High levels of disability are associated with depression, anxiety, widespread pain, and nociceplastic features at baseline.
710 college students after a first episode of neck pain: 334 experienced persistent pain while 370 recovered, emphasizing the importance of assessing negative prognostic factors including a higher number of painful body sites, higher scores in CSI, being female, depression/anxiety, and catastrophizing.
Psychological awareness of symptoms and clinical courses among patients with neck pain is not fully developed.
The treatment of acute neck pain with mobility deficits should include general education, general exercise, mobilization/manipulation of neck/thoracic, and specific exercise or CFT approaches (depending on PSF/physical impairments).
Thoracic manipulation is not indicated for the treatment of acute neck pain but may be beneficial in chronic cases, with techniques like A-P-manipulation, supine distraction and thoracic screw manipulation.
Cervical manipulation has been considered a promising approach for patients with mechanical neck pain, showing positive outcomes such as reduced pain, improved ROM, and increased PPT in the suboccipital region.
Articulatory treatment is a frequently used approach for the management of neck pain as it has no difference from Mulligan treatments and exercise and thermal therapies. Articular treatments are also more effective than oral medications. Soft tissue techniques are proven to be highly effective in short-term pain relief. Manual treatment and dry needling are effective for acute pain, but improvements can be reversed in the middle term.
Different exercises, including those targeting flexor/extensor muscles, scapular resistance training, and aerobic exercise, are recommended for neck pain. Active breaks and postural shifts may also be effective in preventing ongoing episodes.
Education on pain neurophysiology and cognitive functional therapy (CFT) is deemed useful in helping patients to self-manage and reduce kinesiophobia and catastrophizing.

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Description

Explore the key concepts and findings related to neck pain assessment as discussed in Lemeunier 2018. This quiz covers topics such as scapular protraction, forward head posture, and the impact of psychosocial factors on neck pain. Test your knowledge on the primary outcomes, assessment tools, and normative values for neck extension strength.

Neck Pain Assessment Overview - Lemeunier 2018

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