Alterations in Central Control of Shoulder Muscles in Office Workers With Non-specific Chronic Neck Pain

NCT05000177 | Completed

• 1 other identifier: YM110059F
• Study Type: interventional
• Target: 51
• Locations: 1 country
• Sites: 1

Brief Summary

Non-specific chronic neck pain (NCNP) is commonly seen in office workers. Individuals with NCNP not only demonstrate impaired neck movement control and muscle activation, but also show abnormal scapular kinematics and muscle activation timing. Office workers with NCNP also show higher activity of upper trapezius during computer typing and have difficulty relaxing upper trapezius after typing. These changes related to scapula may increase strain over neck. In addition to the altered neuromuscular control, recent studies found neuroplasticity changes in the central nervous system on patients of chronic musculoskeletal disorders. Therefore, few studies found shifts and alterations of motor cortex representation of neck muscles in individuals with NCNP, which was correlated with delayed muscle activation of deep neck flexors muscle in functional activities. However, no studies have explored that whether this corticospinal adaptation also happens over scapular muscles, especially after a computer typing task. The objectives of this proposal are to investigate the differences in corticospinal and neuromuscular control of shoulder complex between office workers with and without NCNP. Thirty-five individuals with NCNP and 35 healthy controls will be recruited. Twenty young healthy subjects will be also recruited for a pilot study to test the reliability of all the measures. Scapular kinematics and muscle activation will be tested during arm elevation. Corticospinal parameters of trapezius and serratus anterior will be tested with transcranial magnetic stimulation (TMS), including active motor threshold, motor evoked potential, cortical silent period, short interval intracortical facilitation, short interval intracortical inhibition and cortical mapping. Corticospinal parameters, except cortical mapping, will be measured again after a 30-minute computer typing task. Scapular muscle activation will be also recorded during the typing task.

Conditions

Non-specific Chronic Neck Pain; Office Workers; Transcranial Magnetic Stimulation; Neuromuscular Control

Keywords

Non-specific chronic neck pain; Transcranial magnetic Stimulation; Corticospinal system; Scapular kinematics; Scapular muscles activation

Outcome Measures

Primary Outcomes (11)

• Neurophysiological measures - Active motor threshold

  Active motor threshold (AMT) will be described with the percentage (%) of maximum stimulator output (MSO).

  Change from baseline AMT after 30-minute computer typing task or 30-minute rest

• Neurophysiological measures - Motor evoked potential

  Motor evoked potential (MEP) will be described with millivolt (mV).

  Change from baseline MEP after 30-minute computer typing task or 30-minute rest

• Neurophysiological measures - Cortical silent period

  Cortical silent period (CSP) will be measured with millisecond (ms)

  Change from baseline CSP after 30-minute computer typing task or 30-minute rest

• Neurophysiological measures - Short interval cortical inhibition

  Short interval cortical inhibition (SICI) will be defined as percentage (%) of conditioning responses vs testing responses while the inter-stimulus interval is below 5 ms

  Change from baseline SICI after 30-minute computer typing task or 30-minute rest

• Neurophysiological measures - Short interval cortical facilitation

  Short interval cortical facilitation (SICF) will be defined as percentage (%) of conditioning responses vs testing responses while the inter-stimulus interval is above 5 ms

  Change from baseline SICF after 30-minute computer typing task or 30-minute rest

• Neurophysiological measures - Area of cortical mapping

  Area of cortical mapping will be described with square millimeter (mm2)

  Before 30-minute computer typing task

• Neurophysiological measures - Volume of cortical mapping

  Volume of cortical mapping will be calculated with multiplying summation of motor evoke potentials on the map (mV) by the area of the map (mm2) with the unit of mV\*mm2

  Before 30-minute computer typing task

• Neurophysiological measures - Center of gravity of cortical mapping

  Center of gravity of cortical mapping will be described in a x-y coordinate system (mm).

  Before 30-minute computer typing task

• Neurophysiological measures - Area of cortical mapping

  Area of cortical mapping will be described with square millimeter (mm2)

  Change from baseline area of cortical mapping after 30-minute rest (pilot subjects)

• Neurophysiological measures - Volume of cortical mapping

  Volume of cortical mapping will be calculated with multiplying summation of motor evoke potentials on the map (mV) by the area of the map (mm2) with the unit of mV\*mm2

  Change from baseline volume of cortical mapping after 30-minute rest (pilot subjects)

• Neurophysiological measures - Center of gravity of cortical mapping

  Center of gravity of cortical mapping will be described in a x-y coordinate system (mm).

  Change from baseline center of gravity of cortical mapping of cortical mapping after 30-minute rest (pilot subjects)

Secondary Outcomes (9)

• Scapular kinematics during arm elevation

  Before 30-minute computer typing task

• Scapular kinematics during performing the computer task

  Change from baseline during the 30-minute computer typing task at 5, 10, 15, 20, 25, 30 minutes of the task

• Scapular muscles activation during arm elevation

  Before 30-minute computer typing task

• Scapular muscles activation during performing the computer task

  Change from baseline during the 30-minute computer typing task at 5, 10, 15, 20, 25, 30 minutes of the task

• Craniovertebral angle

  Before 30-minute computer typing task

Study Arms (3)

Experimental group: Non-specific chronic neck pain group

OTHER

Subjects with non-specific chronic neck pain will be included to perform 30-minute computer typing task and assess neurophysiological measurements of scapular muscles, scapular kinematics and muscle activation.

Other: 30-minute computer typing task

Control group: Healthy subjects group

OTHER

Healthy subjects will be included to compare the differences in neurophysiological measurements of scapular muscles, scapular kinematics and muscle activation between healthy subjects and subjects with non-specific chronic neck pain. Subjects in this group will received the same assessment as the NCNP group.

Other: 30-minute computer typing task

Pilot study: Healthy subjects group

OTHER

Healthy subjects will be included to test reliability of single-pulse and paired-pulse TMS, including its associated neurophysiological measurements, and also to test reliability of Liberty electromagnetic tracing system and surface electromyography. Subjects in this group will received the same assessment as the NCNP group.

Other: 30-minute rest

Interventions

30-minute computer typing task OTHER

The subject sits in front of a computer screen and perform computer typing tasks for 30 minutes. The same computer table and chair were used for all subjects. The height of the table and screen, and the distance of the keyboard from the subject were adjusted according to their familiar and comfortable position.

Control group: Healthy subjects group; Experimental group: Non-specific chronic neck pain group

30-minute rest OTHER

Rest for 30 minutes

Pilot study: Healthy subjects group

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Ages ranges from 20-40 years old
• Work with the computer at least 25 hours per week
• Neck pain of idiopathic origin ≥ 6 months during the past year
• Minimum of 3/10 on the numerical rating scale (NRS) in past 7 days
• No structural abnormalities which are confirmed by neck X-ray or negative results of all the following special tests
• Exclude nerve root compression: Cervical distraction test and Spurling's test
• Exclude cervical radiculopathy: Valsalva test
• Exclude cervical instability: Alar ligament test and Sharp-Purser test
• Specific head movements or maintaining the fixed posture for a long time reproduced neck pain
• Ages ranges from 20-40 years old
• Work with the computer at least 25 hours per week
• No history of neck and/or shoulder pain sustained over one week in the past one year
• Ages ranges from 20-40 years old
• No history of neck and/or shoulder pain sustained over one week in the past one year

You may not qualify if:

• Any known pathology or impairment in the shoulder joint, which is the origin of neck pain
• Current episode of neck pain related to a traumatic event (e.g., whiplash injury)
• Have a history of cervical and/or shoulder pathology (e.g., fracture, dislocation, trauma, surgery of spinal or shoulder joint, inflammatory disease, frequent headache or dizziness)
• Brain injury and neurological impairment (e.g., radiculopathy, myelopathy or stroke)
• Systematic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis), fibromyalgia, tumor
• Contraindications to the use of transcranial magnetic stimulation (TMS), assessed with a safety screening questionnaire, including pregnancy, history of seizure, epilepsy and syncope, having cochlear implant, having medal implant and taking anti-depressant medication
• Any kind of previous manual and/or movement therapy on upper extremity and neck during in recent 3 months

Sponsors & Collaborators

• National Yang Ming Chiao Tung University: lead

Study Sites (1)

National Yang-Ming University

Taipei, 112, Taiwan

Location

MeSH Terms

Interventions

RE1-silencing transcription factor

Study Officials

• Yin-Liang Lin, PhD

  National Yang Ming Chiao Tung University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: July 18, 2021
• First Posted: August 11, 2021
• Study Start: December 21, 2021
• Primary Completion: May 13, 2022
• Study Completion: May 13, 2022
• Last Updated: September 21, 2022

Record last verified: 2022-09

Locations

TW (1)