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Physiotherapy should investigate the processes involved 1)musculoskeletal system; 2)pain (sensory) system; and 3)psychological system. Neck afferents are vital for knowledge of head position in relation to the body, controlling posture, and eye-head coordination. The deep neck and girdle muscles are functionally more important to provide cervical joints support and control.
Physiotherapy should investigate the processes involved 1)musculoskeletal system; 2)pain (sensory) system; and 3)psychological system. Neck afferents are vital for knowledge of head position in relation to the body, controlling posture, and eye-head coordination. The deep neck and girdle muscles are functionally more important to provide cervical joints support and control.
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Physiotherapy should investigate the processes involved 1)musculoskeletal system; 2)pain (sensory) system; and 3)psychological system. Neck afferents are vital for knowledge of head position in relation to the body, controlling posture, and eye-head coordination. The deep neck and girdle muscles are functionally more important to provide cervical joints support and control.
Droits d'auteur :
Attribution Non-Commercial (BY-NC)
Formats disponibles
Téléchargez comme DOC, PDF, TXT ou lisez en ligne sur Scribd
The assessment of disorders of the cervical region
Previous protocols such as radiological imaging, classification systems are not helpful for diagnosis and management in patients with neck pain. The new models of diagnosis are to consider neck disorders as a pain syndrome. Physiotherapy should investigate the processes involved 1)musculoskeletal system; 2)pain (sensory) system; and 3)psychological system. 1) Impairments in the motor system Physiotherapists should investigate the following function; - Range of motion - Muscle function - Postural control system Measurable impairments: - Cranio-cervical flexion test - EMG 2) Impairments in the sensory system Sensory changes are like reflecting disturbances in central neurobiological processing of pain. Evidence is shown that patients with chronic whiplash had hyperalgesia which indicated the abnormal physiology in the way the nervous system processess pain signals. Quantitative sensory tests - Heat&cold tests - Pressure pain thresholds - Brachial plexus provocation test 3) Impairments in the postural control disturbances Neck afferents are vital for postural control. Cervical afferents are important for knowledge of head position in relation to the body, controlling posture, and eye-head coordination. Quantitative postural control tests - Cervical joint position error - Altered smooth pursuit eye movement with nock torsion(SPNT) - Dynamic standing balance
The management of disorders of the cervical region
There is a need for specificity when prescribing therapeutic exercise in the management of people with neck pain due to the general exercise (i.e.strengthening and stretching superficial neck muscles) showed no improvement in test performance. The deep neck and girdle muscles are functionally more important to provide cervical joints support and control. The specific therapeutic exercise programme should - Target and activate the deep neck and girdle muscles - Retraining tonic endurance capacity of deep neck and girdle muscles - Retrain the patterns of activation of deep and superficial neck and girdle muscles - Co-contraction exercise (deep flexors and extensors) - Re-educate the use of muscles in posture and functional tasks - Address strength and endurance for functional requirements - Designed to focus on the muscle control aspects and aims to improve control of the deep postural muscles - Low load exercise is used to train the co-ordination between the layers o the neck muscels - Based on biomechanical, physiological and clinical evidence of impairments in these muscles in neck pain patients.
There are several practice sessions on the use of neck
stabilizers on cranio-cervical flexion test, which is developed by the speaker (Professor Jull). The practical sessions are included the assessment of lumbar and shoulder girdle dysfunctions, therapeutic exercise for neck flexors and extensors, and balance control.