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Cervical Muscle Strength and Muscle Coactivation During Isometric Contractions in Patients With Migraine: A Cross‐Sectional Study
Author(s) -
Florencio Lidiane Lima,
de Oliveira Anamaria Siriani,
Carvalho Gabriela Ferreira,
Tolentino Gabriella de Almeida,
Dach Fabiola,
Bigal Marcelo Eduardo,
FernándezdelasPeñas César,
Bevilaqua Grossi Débora
Publication year - 2015
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12644
Subject(s) - isometric exercise , coactivation , migraine , medicine , electromyography , neck pain , cervicogenic headache , physical therapy , anesthesia , physical medicine and rehabilitation , alternative medicine , pathology
Objectives This cross‐sectional study investigated potential differences in cervical musculature in groups of migraine headaches vs. non‐headache controls. Differences in cervical muscle strength and antagonist coactivation during maximal isometric voluntary contraction (MIVC) were analyzed between individuals with migraine and non‐headache subjects and relationships between force with migraine and neck pain clinical aspects. Method A customized hand‐held dynamometer was used to assess cervical flexion, extension, and bilateral lateral flexion strength in subjects with episodic migraine ( n =31), chronic migraine ( n = 21) and healthy controls ( n = 31). Surface electromyography (EMG) from sternocleidomastoid, anterior scalene, and splenius capitis muscles were recorded during MIVC to evaluate antagonist coactivation. Comparison of main outcomes among groups was conducted with one‐way analysis of covariance with the presence of neck pain as covariable. Correlations between peak force and clinical variables were demonstrated by Spearman's coefficient. Results Chronic migraine subjects exhibited lower cervical extension force (mean diff. from controls: 4.4 N/kg; mean diff from episodic migraine: 3.7 N/kg; P = .006) and spent significantly more time to generate peak force during cervical flexion (mean diff. from controls: 0.5 seconds; P = .025) and left lateral‐flexion (mean diff. from controls: 0.4 seconds; mean diff. from episodic migraine: 0.5 seconds; P = .007). Both migraine groups showed significantly higher antagonist muscle coactivity of the splenius capitis muscle (mean diff. from controls: 20%MIVC, P = .03) during cervical flexion relative to healthy controls. Cervical extension peak force was moderately associated with the migraine frequency ( r s : −0.30, P = .034), neck pain frequency ( r s :−0.26, P = .020), and neck pain intensity ( r s :−0.27, P = .012). Conclusion Patients with chronic migraine exhibit altered muscle performance, took longer to reach peak of force during some cervical movements, and had higher coactivation of the splenius capitis during maximal isometric cervical flexion contraction. Finally, patients with migraine reported the presence of neck and head pain complaints during maximal isometric voluntary cervical contractions.