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Re: Deep Neck Flexor Endurance
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Re: Deep Neck Flexor Endurance - June 22, 2005 3:25:00 AM
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Jon Newman
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From: Amherst, WI
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Hi Nari,
I'll start by admitting that what I know about DNF exercises I learned by reading the posts in this thread. In the first post the methods section of the abstract posted states:
[QUOTE] Subjects were positioned in supine and instructed in maintenance of a test position involving two components; 1) chin tuck (craniovertebral flexion) and 2) lower cervical flexion (maintaining the occiput approximately one inch above the table). [/QUOTE]Since the picture in the book is not accompanied by a detailed account of how much flexion is required to produce some neural movement (plus it is a cadaver), I'm admittedly speculating. But this is often when I learn the most.
I making a presumption that increased strength and endurance is secondary to a decrease in pain rather than the converse. Thus the decrease in pain, for those who experience such a thing (and we cannot know for sure who these people are until they try it) needs to be accounted for and I thought the effect of the movement on the neurodynamics seemed plausible.
jon
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Re: Deep Neck Flexor Endurance - June 22, 2005 4:42:00 AM
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JLS_PT_OCS
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Joined: January 30, 2005
From: USA
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Jon-
I think that's a very plausible line of thinking, and I think it addresses really nicely the whole concept of how layered any individual exercise is in terms of it's tissue effects. Nari brought up above the CNS and motor learning part of it (thanks Nari) which is I think a big part of this exercise progression as well.
Sarah-
We use that exercise version you discussed also. Thanks, though! Hope the sheets are helpful for everyone...
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Deep Neck Flexor Endurance - June 23, 2005 2:06:00 AM
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nari
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Joined: November 14, 2003
From: Australia
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jon
I did notice that the abstract involved 2 stages:
and thinking on it further, after your post, the added flexion component does make sense. McKenzie, in the 80s, stipulated no flexion, but I am probably out of date on that, now. It is just that I find, teaching it to patients, if they maintain neutral position the SCMs etc stay very relaxed, but if flexion is added (and they inevitably flex forward when trying to do the action for the first few times) the SCMs seem to become activated, or less able to be deactivated.
Interesting discussion...
Nari
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Re: Deep Neck Flexor Endurance - June 23, 2005 5:23:00 PM
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srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
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Nari,
I don't usually add flexion either because I don't want the patient to activate SCMs, as they are usually overly active already.
Jason, what is your rationale for having the patient lift the head off the table and how early in the process are you intiating this.
Sarah?
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Re: Deep Neck Flexor Endurance - June 23, 2005 5:32:00 PM
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srcase
Posts: 551
Joined: November 30, 2004
From: Michigan
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Nevermind Jason, you answered this much earlier in the thread.
Do any of you incorporate eye movements to facilitate the deep cervical flexors?
Going back to one of the initial questions about why use a cuff to train these muscles, I think it is simply a good way to give the patient biofeedback for motor learning, and it also mandates that the patient use the eye movements that are neurologically tied in with deep neck flexor activation (because they are looking at the readout). Don't ask me exactly what the connection is because I don't know, but I'm sure Jull and Richardson's work explains this. Any thoughts?
Sarah
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Re: Deep Neck Flexor Endurance - June 23, 2005 5:40:00 PM
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Synergy
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Joined: March 11, 2004
From: Texas
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Sarah,
A few of us discussed very briefly the use of eye movements on the following thread:
[URL=http://www.rehabedge.com/cgi-bin/ultimatebb.cgi?/ubb/get_topic/f/25/t/001653.html]Acute spinal muscle spasm treatments?[/URL]
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Chris Adams, PT, MPT
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