【論文摘要】Alterations in Corticomotor Excitability of Upper Trapezius in Office Workers With Non-Specific Chronic Neck Pain

【論文摘要】非特異性慢性頸部疼痛辦公室族群在上斜方肌之皮質運動興奮性的改變

高閔威(Min-Wei Kao) ； 林吟亮(Yin-Liang Lin)

《物理治療》 47卷4期 (2022/12) Pp. 280-281

https://doi.org/10.6215/FJPT.202212.O03

摘要

Background and Purpose: Non-specific chronic neck pain (NCNP) is commonly seen in office workers. Individuals with NCNP demonstrate both impaired neck and scapular neuromuscular control, especially during a computer typing task. Further, corticomotor adaptation of neck muscles, including shifts and alterations of motor cortex representation, were also seen in individuals with NCNP. To our knowledge, no study has explored whether this corticomotor adaptation would also happen over upper trapezius in office workers with NCNP, especially after a computer typing task. The purposes were to compare corticomotor excitability of upper trapezius between office workers with and without NCNP before and after a computer typing task. Methods: This was a cross-sectional exploratory study. Nineteen individuals with NCNP and 19 age- and gender-matched healthy controls have been recruited. Corticomotor parameters of upper trapezius were collected by transcranial magnetic stimulation, including active motor threshold (AMT), motor evoked potential, cortical silent period, and cortical motor map at baseline. These parameters, except cortical motor map, were tested again after the 30-minute computer typing task. Two-way ANOVA was used to compare the corticospinal excitability parameters between groups at baseline and after the computer task. An independent t test was used to determine the difference in the map parameters between groups. The significant level was set at 0.05. Results: Compared to the control group, decreased cortical motor map volume (Cohen's d = 0.87, p = 0.011), more lateral location of the center of gravity (d = 0.71, p = 0.035) and a fewer number of discrete peaks (d = 1.27, p ＜ 0.001) was found in the NCNP group. The NCNP group demonstrated a significant increase in corticospinal excitability (decreased AMT) following the computer task (d = 0.88, p = 0.001). Conclusions: Office workers with NCNP show decreased corticomotor excitability and reorganization in cortical motor map of the upper trapezius at baseline, but increased excitability following the computer task. These central changes may be associated with central sensitization or pain-induced protective mechanism. Clinical Relevance: Treatment protocols may be designed to reverse this central adaptation. Future work may investigate how the corticomotor excitability changes following treatment and determine whether altered corticomotor excitability is related to chronicity of neck pain.