The relationship between neck pain and dysfunction, and breathing outcomes

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2020

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Stephen, Sarah

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Background Neck pain is common and has a high rate of chronicity. A relationship between neck pain and breathing exists and is influenced by biomechanical, biochemical and psychological factors. The aim of the study was to investigate this relationship, and how perceived stress and muscle activity of the scalene and sternocleidomastoid muscles during breathing influences it. Method This cross-sectional study consisted of 49 participants with neck pain and 49 matched controls. Both groups completed the Nijmegen Questionnaire (NQ), Self-Evaluation of Breathing Questionnaire (SEBQ) and Perceived Stress Scale (PSS). Deep neck flexor strength, respiratory rate, thoracic expansion, Breath Hold Time (BHT) and surface electromyography (sEMG) of the sternocleidomastoid and scalene muscles during breathing were also assessed. The numeric rating scale (NRS) and neck disability index (NDI) assessed pain intensity and neck disability in the neck pain group only. Results Participants with neck pain reported mild pain and disability, and had reduced deep neck flexor strength, higher NQ and higher SEBQ scores than participants without neck pain. Respiratory rate, thoracic expansion, BHT, sEMG and PSS were similar between the groups. The NQ and SEBQ correlated moderately with NDI and PSS scores. The SEBQ correlated fairly with NRS. Respiratory rate correlated fairly with NDI. Muscle activity did not correlate to any other measure. Conclusion Self-reported symptoms of dysfunctional breathing, assessed using the NQ and SEBQ, were more present in participants experiencing neck pain than participants without neck pain. The NQ and SEBQ were associated with neck disability as well as with perceived stress.

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A dissertation submitted in fulfilment of the requirements for the degree Master of Science in Physiotherapy to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020

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