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Completed

NCT Number: NCT05000177

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

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.

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Key information

Conditions

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

Age range

20 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

National Yang-Ming University

Taipei, 112, Taiwan

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

of Patients with Non-specific Chronic Neck Pain

  • 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

Inclusion criteria

of Healthy Subjects in the control group

  • 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

Inclusion criteria

of Healthy subjects in the Pilot Study

  • Ages ranges from 20-40 years old
  • 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)

  • 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

Treatment and study plan

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.

30-minute rest

Other

Rest for 30 minutes

Primary outcomes

  1. Neurophysiological measures - Active motor threshold

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

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

  2. Neurophysiological measures - Motor evoked potential

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

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

  3. Neurophysiological measures - Cortical silent period

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

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

  4. Neurophysiological measures - Short interval cortical inhibition

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

    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

  5. Neurophysiological measures - Short interval cortical facilitation

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

    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

  6. Neurophysiological measures - Area of cortical mapping

    Time frame: Before 30-minute computer typing task

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

  7. Neurophysiological measures - Volume of cortical mapping

    Time frame: Before 30-minute computer typing task

    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

  8. Neurophysiological measures - Center of gravity of cortical mapping

    Time frame: Before 30-minute computer typing task

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

  9. Neurophysiological measures - Area of cortical mapping

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

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

  10. Neurophysiological measures - Volume of cortical mapping

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

    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

  11. Neurophysiological measures - Center of gravity of cortical mapping

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

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

Secondary outcomes

  1. Scapular kinematics during arm elevation

    Time frame: Before 30-minute computer typing task

    Scapular kinematics, including anterior/posterior tilt, upward/downward rotation, and internal/external rotation in scapula plane elevation at 30°, 60°, 90°, and 120°, and will be described with degree (°).

  2. Scapular kinematics during performing the computer task

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

    The average of scapular kinematics, including anterior/posterior tilt, upward/downward rotation, and internal/external rotation will be calculated with a window of 10 seconds and will be described with degree (°).

  3. Scapular muscles activation during arm elevation

    Time frame: Before 30-minute computer typing task

    The root mean square of electromyography (EMG) data of the upper trapezius, lower trapezius, and serratus anterior will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %) and calculated over three 30° increments of motion during arm elevation from 30° to 120°, including 30° - 60°, 60° - 90°, and 90° - 120°.

  4. Scapular muscles activation during performing the computer task

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

    The root mean square of electromyography (EMG) data of the upper trapezius, lower trapezius, and serratus anterior will be calculated with a window of 10 seconds and will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %).

  5. Craniovertebral angle

    Time frame: Before 30-minute computer typing task

    Craniovertebral angle will be measured as the included angle between the tragus, C7 spinous process and the horizontal line and will be described with degree (°)

  6. Craniovertebral angle

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

    Craniovertebral angle will be measured as the included angle between the tragus, C7 spinous process and the horizontal line and will be described with degree (°)

  7. Scapular kinematics during arm elevation

    Time frame: Change from baseline scapular kinematics after 30-minute rest (pilot subjects)

    Scapular kinematics, including anterior/posterior tilt, upward/downward rotation, and internal/external rotation in scapula plane elevation at 30°, 60°, 90°, and 120°, and will be described with degree (°).

  8. Scapular muscles activation during arm elevation

    Time frame: Change from baseline scapular muscles activation after 30-minute rest (pilot subjects)

    The root mean square of electromyography (EMG) data of the upper trapezius, lower trapezius, and serratus anterior will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %) and calculated over three 30° increments of motion during arm elevation from 30° to 120°, including 30° - 60°, 60° - 90°, and 90° - 120°.

  9. Craniovertebral angle

    Time frame: Change from baseline craniovertebral angle after 30-minute rest (pilot subjects)

    Craniovertebral angle will be measured as the included angle between the tragus, C7 spinous process and the horizontal line and will be described with degree (°)

Sponsors and collaborators

Lead sponsor

National Yang Ming Chiao Tung University

Other

Registry information

Official study title

Alterations in Corticospinal and Neuromuscular Control of Shoulder Complex in Office Workers With Non-specific Chronic Neck Pain

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Aug 11, 2021
Registry last updated
Sep 21, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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