Clinical trial NCT05000177: Alterations in Central Control of Shoulder Muscles in Office Workers With Non-specific Chronic Neck Pain
Official title: Alterations in Corticospinal and Neuromuscular Control of Shoulder Complex in Office Workers With Non-specific Chronic Neck Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
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
Lead sponsor: National Yang Ming Chiao Tung University
Sponsor class: OTHER
First posted: 2021-08-11
Enrollment: 51
Sex: ALL
Minimum age (years): 20
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

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.


Eligibility criteria: Inclusion Criteria of Patients with Non-specific Chronic Neck Pain

1. Ages ranges from 20-40 years old
2. Work with the computer at least 25 hours per week
3. Neck pain of idiopathic origin ≥ 6 months during the past year
4. Minimum of 3/10 on the numerical rating scale (NRS) in past 7 days
5. 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
6. Specific head movements or maintaining the fixed posture for a long time reproduced neck pain

Inclusion Criteria of Healthy Subjects in the control group

1. Ages ranges from 20-40 years old
2. Work with the computer at least 25 hours per week
3. No history of neck and/or shoulder pain sustained over one week in the past one year

Inclusion Criteria of Healthy subjects in the Pilot Study

1. Ages ranges from 20-40 years old
2. No history of neck and/or shoulder pain sustained over one week in the past one year

Exclusion Criteria of Patients with Non-specific Chronic Neck Pain and All Healthy Subjects)

1. Any known pathology or impairment in the shoulder joint, which is the origin of neck pain
2. Current episode of neck pain related to a traumatic event (e.g., whiplash injury)
3. 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)
4. Brain injury and neurological impairment (e.g., radiculopathy, myelopathy or stroke)
5. Systematic diseases (e.g., rheumatoid arthritis, ankylosing spondylitis), fibromyalgia, tumor
6. 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
7. Any kind of previous manual and/or movement therapy on upper extremity and neck during in recent 3 months

Primary outcomes:
measure: Neurophysiological measures - Active motor threshold
timeFrame: Change from baseline AMT after 30-minute computer typing task or 30-minute rest
measure: Neurophysiological measures - Motor evoked potential
timeFrame: Change from baseline MEP after 30-minute computer typing task or 30-minute rest
measure: Neurophysiological measures - Cortical silent period
timeFrame: Change from baseline CSP after 30-minute computer typing task or 30-minute rest
measure: Neurophysiological measures - Short interval cortical inhibition
timeFrame: Change from baseline SICI after 30-minute computer typing task or 30-minute rest
measure: Neurophysiological measures - Short interval cortical facilitation
timeFrame: Change from baseline SICF after 30-minute computer typing task or 30-minute rest
measure: Neurophysiological measures - Area of cortical mapping
timeFrame: Before 30-minute computer typing task
measure: Neurophysiological measures - Volume of cortical mapping
timeFrame: Before 30-minute computer typing task
measure: Neurophysiological measures - Center of gravity of cortical mapping
timeFrame: Before 30-minute computer typing task
measure: Neurophysiological measures - Area of cortical mapping
timeFrame: Change from baseline area of cortical mapping after 30-minute rest (pilot subjects)
measure: Neurophysiological measures - Volume of cortical mapping
timeFrame: Change from baseline volume of cortical mapping after 30-minute rest (pilot subjects)
measure: Neurophysiological measures - Center of gravity of cortical mapping
timeFrame: Change from baseline center of gravity of cortical mapping of cortical mapping after 30-minute rest (pilot subjects)
Secondary outcomes:
measure: Scapular kinematics during arm elevation
timeFrame: Before 30-minute computer typing task
measure: Scapular kinematics during performing the computer task
timeFrame: Change from baseline during the 30-minute computer typing task at 5, 10, 15, 20, 25, 30 minutes of the task
measure: Scapular muscles activation during arm elevation
timeFrame: Before 30-minute computer typing task
measure: Scapular muscles activation during performing the computer task
timeFrame: Change from baseline during the 30-minute computer typing task at 5, 10, 15, 20, 25, 30 minutes of the task
measure: Craniovertebral angle
timeFrame: Before 30-minute computer typing task
measure: Craniovertebral angle
timeFrame: Change from baseline during the 30-minute computer typing task at 5, 10, 15, 20, 25, 30 minutes of the task
measure: Scapular kinematics during arm elevation
timeFrame: Change from baseline scapular kinematics after 30-minute rest (pilot subjects)
measure: Scapular muscles activation during arm elevation
timeFrame: Change from baseline scapular muscles activation after 30-minute rest (pilot subjects)
measure: Craniovertebral angle
timeFrame: Change from baseline craniovertebral angle after 30-minute rest (pilot subjects)
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: National Yang-Ming University
Study officials:
affiliation: National Yang Ming Chiao Tung University
name: Yin-Liang Lin, PhD
role: PRINCIPAL_INVESTIGATOR
References: