M.Tech.

Head and neck injuries are common in contact sports. Proper function of the cervical spine sensorimotor system is important in limiting these injuries. Repetitive stress incurred during contact sport participation may negatively affect this system and increase injury risk. Currently, there is a paucity of research examining contact sport exposure and cervical spine sensorimotor function. The purpose of this study was to examine the effect of contact sport participation on cervical sensorimotor function. The independent variables were group (rugby, non-contact), sex (male, female), and time (pre-season, post-season). The primary dependent variable was neck position sense error as measured by total neck reposition (TNRE) error and maximum neck reposition error (MaxNRE). Secondary dependent variables included neck disability index, signs and symptom (S/S) number, symptom severity, concussion history, cervical range of motion, and isometric neck strength. This prospective observational study included forty-nine participants (15 male rugby, 11 female rugby, 11 non-contact male control, 12 non-contact female control) from Temple University campus recreation club sport teams. Athletes participated in two testing sessions, one prior to the season (i.e., pre-season) and one following the season. Data were analyzed using descriptive and inferential statistics. Independent-sample t-tests with Bonferroni corrections were used to assess statistically significant differences in dependent variables at pre-season between groups (Aim 1) and sex (Aim 2). Independent-samples t-tests with Bonferroni correction were also used to explore statistically significant differences in dependent variables change scores from pre-season to post-season between groups (Aim 1). Pearson correlations (r > .60) were used to assess potential covariates but none were identified. Pearson correlations were also used to evaluate the relationship between pre-season maximum and total neck reposition sense error and the following dependent variables: years of contact sport participation, concussion S/S number and severity score, global cervical range of motion and global cervical isometric strength (Aim 3). For Aim 1, between group differences were identified for global cervical isometric strength, t (1, 45) = 2.98, p = .005, and total joint reposition error t (1, 45) = 2.78, p = .008, only. There were no significant change score differences between groups across time. For Aim 2, sex differences were identified in years of contact sport exposure (p = .004), height (p < .001) and global isometric strength (p <.001), only. For Aim 3, preseason concussion S/S number and severity scores were significantly correlated (p < .05) with total joint reposition error (r = .352) and maximum joint reposition error (r = .476). The present study findings indicate a difference in cervical spine sensorimotor function between collegiate club rugby athletes and controls. Specifically, rugby athletes exhibited significantly greater neck reposition sense error than controls. Additionally, concussion S/S scores were related to reposition sense error. Differences in position sense error were not identified between males and females, however females did exhibit less neck strength mirroring previous reports. These findings suggest that exposure to contact sport-related impacts may lead to changes in cervical spine sensorimotor function. These changes are important as they could represent an increased risk of injury and can be modified proactively. A comprehensive cervical spine pre-season examination including concussion S/S and position sense assessments could identify individuals needing preventative intervention. Future research should explore the risk associated with these proprioceptive deficits and the benefits of proactive therapeutic intervention designed to mitigate sensorimotor deficits in contact sport athletes. / Kinesiology

Title Cervicogenic headache Objectives The aim of this master thesis is to present a comprehensive overview of the topic of cervicogenic headache. It focuses on the prevalence of this disease in the general population and on the cervical spine segment where the dysfunction in patients with cervical headache occurs the most frequently. It also focuses on the link between suboccipital muscles, cervical dura mater spinalis and headache on the effectiveness of different therapies for this diagnosis. Method The thesis is conceived as a scientific literature research. In order to obtain sources professional database such as Pubmed, PEDro, Medline, HighWire, Science direct were used. The thesis is divided into a theoretical and an analytical part. There have been 4 questions and 4 hypotheses set for the purposes of work the thesis. Results Based on the analysis of available studies, the thesis confirmed that the incidence of cervicogenic headache in the general population is not negligible. It has also been proved that the diagnosis is quite frequent in patients suffering from headache, which may represent up to 35 % of patients. The results of available studies indicate that the dysfunction of the cervical spine causes 15-20 % of cervicogenic headaches. In most of the cases, it is the influence of the...

Title Cervicogenic headache Objectives It focuses on the prevalence of this disease in the general population and on the cervical spine segment where the dysfunction in patients with cervical headache occurs the most frequently. It also focuses on the effectiveness of manipulative therapies for this diagnosis. Method The thesis is conceived as a scientific literature research. In order to obtain sources professio- nal database such as Pubmed, PEDro, Medline, HighWire, Science direct were used. The thesis is divided into a theoretical and an analytical part. There have been 3 research questions set for the purposes of the thesis. Results Based on the analysis of available studies, the thesis confirmed that the incidence of cervico- genic headache in the general population is not negligible. It has been proved that the diagno- sis is quite frequent in patients suffering from headache, which may represent up to 35 % of patients. The results of available studies indicate that the dysfunction of the cervical spine causes 15-20 % of cervicogenic headaches. In most of the cases, it is the influence of the C1- C2, which is in more than 60 % of the cases. On the other hand, the influence of the AO joint is not very frequent. It only occurs in approximately 7 % of the cases. Due to the fact that the...

Title: Effect of proprioceptive neuromuscular facilitation on strengthening of deep neck flexors in patients with cervicogenic headache Objectives: The aim of this diploma thesis is to investigate the effectiveness of proprioceptive neuromuscular facilitation on relieving or reduction headaches in patients diagnosed with cervicogenic headache. Methods: This is a pilot study involving 10 patients diagnosed with cervicogenic headache in the age range of 23-41 years. Patients participated in proprioceptive neuromuscular head and neck therapy, which took place 3 times per week for 5 weeks. Patients on the first and last therapy completed the Neck Disability Index, the measurements were done twice a week. It was a measurement of performance index of deep neck flexors by means of a craniocervical flexion test and evaluation of pain on visual analogue scales. The statistical method - paired t-test was used to analyze the obtained data. Results: The results of this thesis show that proprioceptive neuromuscular facilitation therapy is effective in elimination or reduction of headaches in patients diagnosed with cervicogenic headache. Keywords: cervicogenic headache, proprioceptive neuromuscular facilitation, craniocervical flexion test, Neck Disability Index, physiotherapy

Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Forward head posture (FHP) is a common postural abnormality, often associated with myofascial trigger points which can result in head and neck pain. The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting C7 spinous process to the tragus of the ear. The smaller the angle the greater the FHP. Cervical musculoskeletal abnormalities have often been linked to headache types, most especially episodic tension-type headache (ETTH) and cervicogenic headaches (CGH). Objectives: To determine whether an association exists between FHP, distance of the external auditory meatus (EAM) from the plumbline and cervical range of motion and the presentation of ETTH and CGH. Method: This was a quantitative comparative study (n=60) comparing three equal groups, one with ETTH, CGH and healthy controls. The FHP of the Subjects FHP was assessed by measuring the CV angle. A lateral digital photograph was taken to assess the distance of the external auditory meatus from the plumbline. Lastly, cervical range of motion was measured. The two symptomatic groups also received a headache diary for a fourteen day period monitoring frequency, intensity and duration of their headaches. Result: The two symptomatic groups had a smaller CV angle and a greater distance from the plumbline (p<0.05) than the asymptomatic group. The asymptomatic group had a significantly greater flexion (p=0.009), extension (p=0.038) and left rotation (p=0.018) range of motion than the two symptomatic groups. The CGH group had a significant positive correlation between the distance of the EAM from the plumbline and the intensity of headaches. The ETTH group had a significant positive correlation between the right craniovertebral angle and the mean duration of headaches. Conclusion: Therefore, it can be concluded that patients presenting with ETTH and/or CGH may have associated postural abnormalities that may act as a trigger or a contributory factor to the presenting headache. / Durban University of Technology

Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Forward head posture (FHP) is a common postural abnormality, often associated with myofascial trigger points which can result in head and neck pain. The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting C7 spinous process to the tragus of the ear. The smaller the angle the greater the FHP. Cervical musculoskeletal abnormalities have often been linked to headache types, most especially episodic tension-type headache (ETTH) and cervicogenic headaches (CGH). Objectives: To determine whether an association exists between FHP, distance of the external auditory meatus (EAM) from the plumbline and cervical range of motion and the presentation of ETTH and CGH. Method: This was a quantitative comparative study (n=60) comparing three equal groups, one with ETTH, CGH and healthy controls. The FHP of the Subjects FHP was assessed by measuring the CV angle. A lateral digital photograph was taken to assess the distance of the external auditory meatus from the plumbline. Lastly, cervical range of motion was measured. The two symptomatic groups also received a headache diary for a fourteen day period monitoring frequency, intensity and duration of their headaches. Result: The two symptomatic groups had a smaller CV angle and a greater distance from the plumbline (p<0.05) than the asymptomatic group. The asymptomatic group had a significantly greater flexion (p=0.009), extension (p=0.038) and left rotation (p=0.018) range of motion than the two symptomatic groups. The CGH group had a significant positive correlation between the distance of the EAM from the plumbline and the intensity of headaches. The ETTH group had a significant positive correlation between the right craniovertebral angle and the mean duration of headaches. Conclusion: Therefore, it can be concluded that patients presenting with ETTH and/or CGH may have associated postural abnormalities that may act as a trigger or a contributory factor to the presenting headache. / Durban University of Technology / M