Physiological mechanisms of efficacy of cervical flexor muscle retraining

颈部疼痛是社会上的一个重大问题，其频率正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不动的生活方式。在患有颈部疼痛的人中，已经发现了肌肉系统的几个问题。治疗性运动已被发现在预防和缓解疼痛以及改善颈部功能方面有好处。目前有几种非常不同的锻炼方法，关于治疗性锻炼是如何起作用的，也存在争议。有人认为，肌肉力量、耐力、关节位置感或肌肉协调性的变化等参数可能与临床疗效有关。很难理清锻炼策略的有效组成部分，从而制定出最有效的锻炼策略。这一系列实验将评估在特定运动干预下发生变化的生理因素，并比较不同的运动方式，以确定诱导这些变化的最有效手段。颈部肌肉训练，使用一种经过验证的运动干预策略来治疗慢性颈部疼痛和头痛，已被选为研究这些问题的模式。之所以选择这种锻炼策略，不仅是因为它被证明是有效的，还因为它不符合当代力量或耐力训练的原理。因此，虽然它在缓解疼痛方面有效，但不太可能导致这些参数的变化。因此，其他机制可能是导致临床变化的原因。本研究将通过确定不同运动方法的有效成分，并研究特定运动的止痛效果，为运动疗法做出重大贡献。这些知识将导致为颈部疼痛患者构建基于研究的锻炼计划，而不是出现经常随意选择锻炼的现状。

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.