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A magnetic resonance imaging investigation into the function of the deep cervical flexors during the performance of craniocervical flexion

Barbara Cagnie (UGent) , Roseline D'hooge (UGent) , Eric Achten (UGent) , Dirk Cambier (UGent) and Lieven Danneels (UGent)
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Organization
Abstract
Objective: Evidence suggests that the deep cervical flexors (DCFs) are important for the control of the cervical spine. The craniocervical flexion (CCF) test is a clinical test developed for patients with neck pain disorders based on the action of the DCFs. Because these muscles are deeply situated, it is difficult to reach the DCFs with surface electromyography. Magnetic resonance imaging (MRI) can be used to measure these muscles in cross section. The objective of this study was (1) to determine the reliability of MRI for measuring cross-sectional area (CSA) of the longus colli (Lco) and longus capitis (Lea) and (2) to evaluate the changes in CSA during contraction. Methods: Thirty healthy subjects aged 29 +/- 9.3 years were imaged using MRI. The CSA of the Lco and Lca was evaluated at 4 different levels (CO-C1, C2-C3, C4-C5, and C6-C7) at rest and during CCF. Results: The intraclass correlation coefficients for the CSA of the Leo and Lea showed good to excellent reliability (0.73-0.92), except at the C4-C5 level. There was a significant increase in CSA of both Leo (F = 6.79, P = .015) and Lea (F = 19.20, P <= .001) due to CCF, and this was at different levels. The highest increases in CSA occurred at the C0-C1 level for the Lea (11.1%) and at the C2-C3 level for the Leo (17.4%). Conclusions: This study demonstrated that the action of CCF resulted in a contraction of the Leo and Lea at different levels. The results indicate that MRI is a promising technique to evaluate changes in CSA during contraction.
Keywords
MORPHOMETRY, CONTRACTION, SPINE, PAIN, IMPAIRMENT, MRI, WHIPLASH, LONGUS-COLLI, TRANSVERSUS ABDOMINIS, HUMAN NECK MUSCLES, Neck Muscles, Magnetic Resonance Imaging, Muscle Contraction

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MLA
Cagnie, Barbara et al. “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 33.4 (2010): 286–291. Print.
APA
Cagnie, B., D’hooge, R., Achten, E., Cambier, D., & Danneels, L. (2010). 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(4), 286–291.
Chicago author-date
Cagnie, Barbara, Roseline D’hooge, Eric Achten, Dirk Cambier, and Lieven Danneels. 2010. “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 (4): 286–291.
Chicago author-date (all authors)
Cagnie, Barbara, Roseline D’hooge, Eric Achten, Dirk Cambier, and Lieven Danneels. 2010. “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 (4): 286–291.
Vancouver
1.
Cagnie B, D’hooge R, Achten E, Cambier D, Danneels L. 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. 2010;33(4):286–91.
IEEE
[1]
B. Cagnie, R. D’hooge, E. Achten, D. Cambier, and L. 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, vol. 33, no. 4, pp. 286–291, 2010.
@article{986970,
  abstract     = {Objective: Evidence suggests that the deep cervical flexors (DCFs) are important for the control of the cervical spine. The craniocervical flexion (CCF) test is a clinical test developed for patients with neck pain disorders based on the action of the DCFs. Because these muscles are deeply situated, it is difficult to reach the DCFs with surface electromyography. Magnetic resonance imaging (MRI) can be used to measure these muscles in cross section. The objective of this study was (1) to determine the reliability of MRI for measuring cross-sectional area (CSA) of the longus colli (Lco) and longus capitis (Lea) and (2) to evaluate the changes in CSA during contraction.
Methods: Thirty healthy subjects aged 29 +/- 9.3 years were imaged using MRI. The CSA of the Lco and Lca was evaluated at 4 different levels (CO-C1, C2-C3, C4-C5, and C6-C7) at rest and during CCF.
Results: The intraclass correlation coefficients for the CSA of the Leo and Lea showed good to excellent reliability (0.73-0.92), except at the C4-C5 level. There was a significant increase in CSA of both Leo (F = 6.79, P = .015) and Lea (F = 19.20, P <= .001) due to CCF, and this was at different levels. The highest increases in CSA occurred at the C0-C1 level for the Lea (11.1%) and at the C2-C3 level for the Leo (17.4%).
Conclusions: This study demonstrated that the action of CCF resulted in a contraction of the Leo and Lea at different levels. The results indicate that MRI is a promising technique to evaluate changes in CSA during contraction.},
  author       = {Cagnie, Barbara and D'hooge, Roseline and Achten, Eric and Cambier, Dirk and Danneels, Lieven},
  issn         = {0161-4754},
  journal      = {JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS},
  keywords     = {MORPHOMETRY,CONTRACTION,SPINE,PAIN,IMPAIRMENT,MRI,WHIPLASH,LONGUS-COLLI,TRANSVERSUS ABDOMINIS,HUMAN NECK MUSCLES,Neck Muscles,Magnetic Resonance Imaging,Muscle Contraction},
  language     = {eng},
  number       = {4},
  pages        = {286--291},
  title        = {A magnetic resonance imaging investigation into the function of the deep cervical flexors during the performance of craniocervical flexion},
  url          = {http://dx.doi.org/10.1016/j.jmpt.2010.03.010},
  volume       = {33},
  year         = {2010},
}

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