Accessory Inspiratory Muscles in Chronic Neck Pain

N/ARecruitingNCT07782099

Kocaeli Sağlık ve Teknoloji Üniversitesi10 enrolled

Overview

This cross-sectional case-control study aims to investigate the ultrasonographic structural and functional characteristics of accessory inspiratory muscles in individuals with chronic non-specific neck pain and compare them with healthy controls. In addition, the relationships between accessory inspiratory muscle characteristics, diaphragm function, respiratory muscle strength, and pulmonary function parameters will be examined. The findings may improve understanding of the respiratory involvement associated with chronic neck pain and contribute to more comprehensive assessment strategies.

Chronic non-specific neck pain is a prevalent musculoskeletal disorder associated with pain, disability, and reduced quality of life. Emerging evidence suggests that its effects may extend beyond the cervical region and involve respiratory dysfunction. Previous studies have reported reductions in respiratory muscle strength, pulmonary function, and diaphragm function in individuals with chronic neck pain. The diaphragm plays an important role not only in respiration but also in postural control and spinal stabilization. Ultrasonographic studies have demonstrated alterations in diaphragm thickness and mobility in individuals with chronic neck pain. However, little is known about potential compensatory adaptations occurring in accessory inspiratory muscles, including the sternocleidomastoid, anterior scalene, and upper trapezius muscles. The purpose of this observational case-control study is to investigate the ultrasonographic characteristics of accessory inspiratory muscles in individuals with chronic non-specific neck pain and to compare these characteristics with those of healthy controls. Additionally, the relationships between accessory inspiratory muscle characteristics, diaphragm function, respiratory muscle strength, and pulmonary function will be examined. Participants with chronic non-specific neck pain and age-matched healthy controls will undergo ultrasonographic assessment of the diaphragm and accessory inspiratory muscles, pulmonary function testing, and respiratory muscle strength evaluation. Associations among ultrasonographic, respiratory, and functional variables will be analyzed to improve understanding of respiratory involvement in chronic neck pain and to identify potential clinical assessment targets.

Study Type

OBSERVATIONAL

Enrollment

Interventions

Diaphragm UltrasonographyDIAGNOSTIC_TEST

Diaphragm thickness was assessed by ultrasonography while the participant was in a standardized position. Measurements were obtained at the end of expiration and during maximal inspiration.

Anterior Scalene Muscle UltrasonographyDIAGNOSTIC_TEST

Anterior scalene muscle thickness was assessed by ultrasonography while the participant was in a standardized position. Measurements were obtained at rest and during maximal inspiratory effort.

Upper Trapezius Muscle UltrasonographyDIAGNOSTIC_TEST

Upper trapezius muscle thickness was assessed by ultrasonography while the participant was in a standardized position. Measurements were obtained at rest and during maximal inspiratory effort.

Maximal Inspiratory Pressure MeasurementDEVICE

Maximal inspiratory pressure was measured using a respiratory pressure measurement device. The participant performed a maximal inspiratory effort against an occluded airway after complete expiration. Repeated measurements were performed with appropriate rest intervals.

Maximal Expiratory Pressure MeasurementDEVICE

Maximal expiratory pressure was measured using a respiratory pressure measurement device. The participant performed a maximal expiratory effort against an occluded airway after maximal inspiration. Repeated measurements were performed with appropriate rest intervals.

Pulmonary Function TestingDEVICE

Pulmonary function testing was performed using spirometry while the participant was in a standardized seated position. The participant completed maximal forced expiratory maneuvers following standardized instructions, and technically acceptable measurements were recorded.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria Chronic Non-Specific Neck Pain Group: * Age between 18 and 65 years * Presence of chronic non-specific neck pain for at least 3 months * Non-traumatic origin of neck pain * Pain intensity ≥ 3 on the Numeric Pain Rating Scale (NPRS) or Visual Analog Scale (VAS) * Neck Disability Index (NDI) score ≥ 15 * Willingness to participate and provide informed consent Healthy Control Group: * Age between 18 and 65 years * No neck pain during the previous 3 months * Not receiving any treatment related to the cervical region * Willingness to participate and provide informed consent Exclusion Criteria (Both Groups): * History of whiplash injury or cervical trauma * Previous cervical spine surgery * Cervical radiculopathy or neurological deficits * Chronic respiratory diseases (e.g., COPD, asthma) * Active respiratory tract infection * Thoracic or abdominal surgery within the previous 6 months * Rheumatologic, neuromuscular, or systemic inflammatory disorders * Pregnancy * Physiotherapy treatment for neck pain within the previous 3 months * Regular respiratory muscle training or breathing exercises within the previous 3 months * Inability to comply with study procedures or assessments

Outcomes

Primary Outcomes

Diaphragm Thickening Ratio

Diaphragm thickening ratio measured using ultrasonography.

Time frame: Baseline

Sternocleidomastoid Muscle Thickness

Sternocleidomastoid muscle thickness measured using ultrasonography.

Time frame: Baseline

Secondary Outcomes

Anterior Scalene Muscle Thickness

Anterior scalene muscle thickness measured using ultrasonography.

Time frame: Baseline

Upper Trapezius Muscle Thickness

Upper trapezius muscle thickness measured using ultrasonography.

Time frame: Baseline

Maximal Inspiratory Pressure (MIP)

Maximal inspiratory pressure will be measured using a respiratory pressure measurement device. Participants will perform a maximal inspiratory effort against an occluded airway after complete expiration. The highest technically acceptable value will be recorded in cmH₂O. Higher values indicate greater inspiratory muscle strength.

Time frame: Baseline

Forced Vital Capacity (L)

Forced vital capacity will be measured using spirometry during a maximal forced expiratory maneuver performed after maximal inspiration.

Time frame: Baseline

Maximal Expiratory Pressure (MEP)

Maximal expiratory pressure will be measured using a respiratory pressure measurement device. Participants will perform a maximal expiratory effort against an occluded airway after maximal inspiration. The highest technically acceptable value will be recorded in cmH₂O. Higher values indicate greater expiratory muscle strength.

Time frame: Baseline

Forced Expiratory Volume in 1 Second (L)

Forced expiratory volume in the first second will be measured using spirometry during a maximal forced expiratory maneuver performed after maximal inspiration.

Time frame: Baseline

FEV1/FVC Ratio (%)

The ratio of forced expiratory volume in the first second to forced vital capacity will be determined from spirometry measurements.

Time frame: Baseline

Peak Expiratory Flow (L/sn)

Peak expiratory flow will be measured using spirometry during a maximal forced expiratory maneuver performed after maximal inspiration.

Time frame: Baseline

Forced Expiratory Flow at 25-75%

Forced expiratory flow during the middle 50% of the forced vital capacity maneuver will be measured using spirometry.

Time frame: Baseline

Accessory Inspiratory Muscles in Chronic Neck Pain

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts