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Virkni sternocleidomastoid vöðva í tveimur þungaberandi stöðum

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Authors
Gísli Sigurðsson
Issue Date
2008-03-01

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Sjúkraþjálfarinn 2008, 35(1):13-17
Abstract
Work-related neck and upper limb disorders (WRUNLD) are a negative factor of increased computer use. Neck pain has been associated with neck and head posture but according to the literature the outcome is conflicting. The purpose of this study was to investigate the muscular activity in the sternocleidomastoid (SCM) muscles during sitting in two different cranio-cervical postures (CCP’s) in a standard computer environment using electromyography (EMG). The muscular activity was measured during 5 minutes period, twice with the head held in a resting posture (RHP) and once after being placed, by the author, in a neutral head posture (NHP) as defined by Kendall et al. (2005). Linear excursion measurement device (LEMD) was used to determine the differences between the resting and neutral head postures. Twenty-four students from the University of Birmingham (aged 19-31) responded to an e-mail request for volunteers and fulfilled the inclusion criteria. The study was single-blinded, two-tailed, using the same subject design with A-A-B repeated measurements where A- represents the resting and B- the neutral head posture. The participants attended a laboratory room for measurements where the total procedure time was approximately 30 minutes. Root-mean-square (RMS) values over one minute of the EMG signals were calculated for data analysis. The paired t-test was used for statistical analysis using SPSS (version 15). The results showed no significant difference (P=0.08) in muscular activity in the sternocleidomastoid muscles when sitting with the head in resting or neutral head postures. The LEMD outcome showed that the participants’ resting head postures deviated significantly (P<0.001) from the neutral head posture. The findings suggest increased activity in the SCM muscles in the neutral head posture compared with the resting one. It also shows that neutral head posture is unfamiliar among young individuals working on computers.
Óþægindi frá stoðkerfinu eru algeng hjá einstaklingum sem vinna við tölvur. 24,48,49,55,56 Rannsóknir hafa sýnt fram á að bæði vinnustellingar og vinnuumhverfi geta verið undirliggjandi þættir í þróun einkenna fyrir háls- og herðasvæði.1,7,24,25,28,40,48,49,50,56 Aðferðir til að mæla virkni hálsvöðva eru ólíkar54 sem og aðferðir við mælingar á höfuð-hálsstöðu (cranio-cervical posture) þannig að samanburður er oft erfiður á milli rannsókna.29,41 Sú aðferð sem mest hefur verið notuð til mælingar á virkni beygjuvöðva háls er „höfuð-háls beygju prófið” (cranio-cervical flexion test) með aðstoð vöðvarafrits (EMG).4,16,17,31,33,34,42,52,57 „Höfuð-háls beygju prófið“ mælir hins vegar ekki virkni hálsvöðva í þungaberandi stöðu við starfræna færni. Sama má segja um mælingar á höfuð-háls stöðu sem enn hafa ekki verið staðlaðar fyrir þungaberandi stöðu. Fáar rannsóknir hafa mælt virkni beygjuvöðva háls í þungaberandi stöðu og engin „randomized controlled trials“ (RTC) (slembuð samanburðarrannsókn) hefur verið birt. Enn hefur ekki verið fundin sönnun fyrir sambandi milli höfuð-hálsstöðu og hreyfistjórnunarkerfisins (motor control).49 Rannsóknir hafa sýnt mismunandi niðurstöður varðandi hlutverk höfuð-hálsstöðu við verkjavandamál í hálsi og herðum.29,41 M. sternocleidomastoid hefur lítið verið rannsakaður í mismunandi höfuð-hálsstöðum í þungaberandi stöðu. Hlutverk m. sternocleidomastoid er tvíþætt, réttir (neck extensor) í atlanto-occipital lið en beygir (neck flexor) í neðri hluta hálsins.8,18,26 Tilgangur rannsóknarinnar var að mæla virkni í m. sternocleidomastoid hjá þátttakendum í sitjandi stöðu með höfuð í hvíldarstöðu (resting head posture) og í miðstöðu (neutral head posture).
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