Attentional Focus Influence During Cranio-Cervical Flexion Test

Study Overview
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Brief Summary
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The purpose of this study is to termine if a different attentional focus would alter the motor control in cervical muscles during the cranio-cervical test.

Detailed Description
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Asymptomatic subjects will be recruited to this study. Superficial electromyography of the Sternocleidomastoid, Range of Motion (ROM) and Cranio-Cervical Flexion Test (CCFT) will be measured before, immediately after change in focus of attention, 2 days after training under a particular focus of attention, and 7 days after training the task under the same focus of attention. Subjects will be randomized into three groups: Internal focus of attention, external focus of attention and control group.

Official Title
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Attentional Focus Influence During Cranio-Cervical Flexion Test

Conditions
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Neck; Anomaly, Muscle Weakness, Muscle Weakness Condition

Intervention / Treatment
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* Other: Internal Focus of Attention
* Other: External Focus of Attention
* Other: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Asymptomatic subjects Exclusion Criteria: Cervical pain Historic of trauma/surgery to the cervical or thoracic spine or upper limbs Temporomandibular pain Neurological or systemic disorder

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Internal Focus of Attention<br>30 subjects will be randomized to this arm. Only internal focus of attention feedback instructions will be given during the execution and training performing the Cranio-Cervical Flexion Test. The subjects allocated to this arm will not be allowed to use the visual feedback traditionally provided during the Cranio-cervical Flexion Test. | Other: Internal Focus of Attention<br>* Information already included in arm/group descriptions.<br>* Other names: Internal Focus;|
| Experimental: External Focus of Attention<br>30 subjects will be randomized to this arm. Only external focus of attention feedback instructions will be given during the execution and training performing the Cranio-Cervical Flexion Test. The subjects allocated to this arm will not be allowed to use the visual feedback traditionally provided during the Cranio-cervical Flexion Test. In addition, they will use just a laser point attached to the head to guide their cranio-cervical flexion. | Other: External Focus of Attention<br>* Information already included in arm/group descriptions.<br>* Other names: External Focus;|
| Active Comparator: Control<br>30 subjects will be randomized to this arm. The participants allocated to this arm will be instructed as traditionally during the Cranio-Cervical Flexion Test. They will be given visual feedback while have their attention guided to the inner neck movement. | Other: Control<br>* Information already included in arm/group descriptions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Electromyographic Activity of Sternocleidomastoid | The Electromyography (EMG) signal amplitude will be determined by the root mean square (RMS) value computed over intervals of 1 s during each 10-s contraction. RMS will be expressed as a percentage of the maximum RMS value during the reference voluntary contraction. | Baseline, Immediately after baseline, Post-Training (2 days after the baseline), Retention (7 days after finished training) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cranio-cervical Range of Motion | A neutral position and full range of active cranio-cervical flexion photograph will be taken using a digital camera. That camera will be positioned on a tripod horizontally parallel to the subject's head/neck region at a distance of 80 cm, anatomical markers positioned on the tragus of the ear, the mental protuberance of the mandible and the lateral aspect of the neck. Photos will be taken when the subject reached each level of the craniocervical flexion test. The Cranio-cervical Range of Motion will be expressed as relative percentage of degrees compared to the full range of motion. | Baseline, Immediately after baseline, Post-Training (2 days after the baseline), Retention (7 days after finished training) | 
| Cranio-Cervical Flexion Test Performance | Subjects will instructed to reach each one of the five stages (22-30 mmHg) of the test and hold the pressure as steady as possible for 10s. The stage will be mark as successful if the participant reaches the stage level and hold steady the pressure during the 10-s contrition. However, the individuals that reaches the stage-aimed pressure but are unable to maintain the pressure stable during the 10s contraction or use compensating strategies will be marked as unsuccessful. | Baseline, Immediately after baseline, Post-Training (2 days after the baseline), Retention (7 days after finished training) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cranio-cervical, Motor Control, Deep Flexor muscles