Physiological mechanisms of efficacy of cervical flexor muscle retraining

颈部疼痛是社会中的一个重要问题，其频率开始与背部疼痛的比例相匹配，这可能反映了我们越来越久坐的生活方式。在患有颈部疼痛的人的肌肉系统中已经确定了几个问题。治疗性运动被发现对预防和缓解疼痛以及改善颈部功能有益处。目前有几种完全不同的锻炼方法，关于治疗性锻炼如何起作用存在争议。有人认为，肌肉力量、耐力、关节位置感或肌肉协调等参数的变化可能是临床疗效的原因。很难理清运动策略的有效成分，从而规定最有效的运动策略。这一系列的实验将评估生理因素的变化与一个特定的运动干预，并比较不同的运动方式，以确定最有效的手段来诱导这些变化。颈部肌肉训练，使用一种经过验证的运动干预策略治疗慢性颈部疼痛和头痛，已被选为研究这些问题的模型。选择这种锻炼策略不仅是因为它被证明是有效的，而且还因为它不符合当代力量或耐力训练的理论。因此，虽然有效缓解疼痛，但不太可能产生这些参数的变化。因此，其他机制可能是临床变化的原因。本研究通过确定不同运动方法的有效成分，并研究特定运动的疼痛缓解效果，为运动治疗学做出了重大贡献。这些知识将导致建立一个基于研究的颈痛患者运动计划，而不是目前的情况下，往往任意选择运动。

Neck pain is a significant problem in society and its frequency is beginning to match the proportions of back pain, probably reflecting our increasingly sedentary lifestyles. Several problems have been identified in the muscle system in persons who suffer from neck pain. Therapeutic exercise has been found to have benefit in preventing and relieving pain and improving the neck function. Currently there are several, quite different methods of exercise and there is controversy regarding how therapeutic exercise works. It has been argued that parameters such as changes in muscle strength, endurance, joint position sense or muscle coordination may be responsible for the clinical efficacy. It is difficult to disentangle the effective component of exercise strategies and thus prescribe the most effective exercise strategies. This series of experiments will evaluate the physiological factors that change with a specific exercise intervention and to compare different exercise modalities in order to identify the most effective means to induce these changes. Cervical muscle training, using a proven exercise intervention strategy for chronic neck pain and headache, has been chosen as the model to investigate these questions. This exercise strategy has been chosen not only because it has been shown to be effective, but also because it does not conform to contemporary rationales for strength or endurance training. Thus while effective in relieving pain, it is unlikely to produce changes in these parameters. Thus other mechanisms are likely to be responsible for the clinical change. This research stands to make a significant contribution to exercise therapeutics by identifying the effective components of different exercise methods and investigating the pain relieving effects of the specific exercise. This knowledge will lead to the construction of a research based exercise program for neck pain patients, rather than have the current situation of often arbitrary choice of exercise.