Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / Neck pain is a common complaint and a common source of disability in the general population with a point prevalence of nearly 13%. Reports indicate that industry related neck disorders (lifetime incidence of nearly 50%) account for as many days of absenteeism as low back pain; one could compare the two clinical conditions in terms of these trends on a global scale. To investigate whether similar trends do exist, 200 participants with neck pain and 200 asymptomatic participants (stratified sampling according to age and gender) that consented to the research were clinically assessed. These participants also completed a questionnaire addressing the factors that have been identified as related to neck pain at the consultation where they were assessed. This research did not involve the treatment of the participants, although a free treatment was given for patients that opted for one or to those that required it post participation in the study. If treatment was outside the scope of the chiropractic clinic, the participants were referred to the appropriate health care provider. The aim of the study was to investigate factors associated with neck pain in the indigenous African population in the greater Durban area. Data was analysed according to the following: Descriptive statistics were interpreted by means of frequency tables, pie charts, bar graphs and / or in a tabular format in order to describe the sample characteristics of the population under study. Inferential statistics included regression analysis in order to determine any relationships between the patient‟s neck complaint characteristics and factors associated with the complaint. SPSS version 11.5 was used for data analysis (SPSS Inc, Chicago, Ill, USA). A p value of <0.05 was considered as statistically significant. Descriptive analysis involved presenting or graphing categorical variables as counts and percentages, and quantitative variables as medians and interquartile ranges due to the skewness of the data. Associations between factors and neck pain were examined bivariately using Pearson‟s chi square or Fisher‟s exact tests as appropriate for categorical factors, or Mann-Whitney tests in the case of quantitative non-parametric data. Finally in order to examine the adjusted independent effects of all factors which were found to be individually significant in the bivariate analysis, multivariate binary logistic regression analysis was done. A backwards elimination modelling technique was used, based on likelihood ratios, with entry and exit probabilities set to 0.05 and 0.010 respectively. Results were reported as odds ratios, 95% confidence intervals and p values. Chi squared analyses was utilised to assess the strength of the relationship and the degree of significance of the relationship. All statistics were analyzed at a confidence interval of 95% and a level of significance where α ≤0.05 (pvalue). The symptomatic participants seemed to be less well educated than the controls. The cases seemed to be less in full time employment, less unemployed, and more self employed than the controls. Income was unevenly distributed among cases and controls. The cases who were working seemed to earn less than the controls who were working. The duration of having neck pain was mainly 1 month. The majority of cases classified their pain as mild. Most participants felt that their pain was worst in the afternoons or related to activities, while they felt their pain was least in the mornings. Frequency of neck pain was mainly constant (36.5%), followed by frequent (32.5%) and seldom (25%). Symptomatic participants mostly reported that their pain began without injury, gradually in 67.5% and abruptly in 13.5%. Fewer symptomatic participants reported pain beginning after an injury (n=22 gradually and n=7 abruptly). The majority reported their neck pain to be stable (38%), while 34% felt it was getting worse and only 19% getting better. More than half of the cases reported difficulty with work due to neck pain. Fewer reported difficulties with daily activities such as washing (30%), sleeping (26%), and lifting (24%). Almost half of the cases rated their disability as none (48%). Only 16% reported severe disability. Thirty-three percent (n=66) reported having been absent from work due to neck pain. The duration of absence in those who were absent was mainly 0-1 week (89.4%). 59 (29%) reported being bed-ridden with neck pain. The most frequent duration was also 0-1 week (81.4%). Ninety three point five percent reported no change in occupational status, while 6 (3%) were demoted, 5 (2.5%) boarded, and 2 (1%) fired. With respect to associated signs and symptoms, 156 (78%) reported to suffer from headaches. In addition, symptomatic participants were asked if they associated their neck pain with any other activities. The most commonly reported factor was stress (22%), followed by bad posture (17%). The other reported factors were reported infrequently. Participants who worked in occupations that involved driving, turning neck, answering the telephone, working in an air-conditioned room, and bending over a desk were significantly more at risk of being cases than controls. Non-occupational factors which were associated with neck pain were worrying a lot, motor vehicle accident, not enough bed support, not using arms to support a book, sitting without back or arm support, not watching TV a lot, and exercising. The results of the study suggest that neck pain within the indigenous African population is associated with the level of education, income, stress levels, bad posture, repetitive movements of the neck, and motor vehicle accidents. It was also found that most of neck pain patients do suffer from headaches. The findings show that neck pain is mostly classified as mild in nature with 1 month duration. Although neck pain was reported to be responsible for at least 7 days of absenteeism from work, causing difficulty with daily activities, most patients reported no disability as a result of neck pain.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Neck pain is a condition that is becoming more common throughout the world and most people can expect to experience some degree of neck pain sometime during their life. There is a need for early diagnosis and follow-up of neck pain to assess a patient’s level of self-rated disability due to the escalating disability burden and compensation costs associated with neck pain. For this reason, disability questionnaires are increasingly used for clinical assessment and as an outcome measurement for the treatment of neck pain. Translation and cross-cultural adaptation of disability questionnaires have thus become increasingly necessary when dealing with different cultural groups. Methods: This is a quantitative validity and reliability assessment study comparing the English versions of the Neck Disability Index (NDI) and the Quadruple Visual Analogue Scale (QVAS) to their translated Afrikaans counterparts. The first step was to translate the questionnaires into Afrikaans. The translated questionnaires were then scrutinised and critiqued by an Expert group, who are fluent in both the Afrikaans and English languages, and back translated to English in order or establish their face validity. A small pilot study was conducted with the original and translated versions of the questionnaires to establish their content validity. The translated and original versions of the NDI and QVAS were given to a study group to complete with a suitable time delay between the completions of the questionnaires. The results from the study group were statistically analysed to establish concurrent validity and reliability. Results: There were 50 participants each completing one English NDI and QVAS and one Afrikaans NDI and QVAS. The results indicate high reliability for both the Afrikaans NDI (α = 0.900) and QVAS (α = 0.883). The Afrikaans NDI and QVAS are deemed reliable compared to their English counterparts. The results indicated a significant level of concurrent validity for both the NDI and the QVAS. Both the Afrikaans versions of the NDI and QVAS were deemed reliable and concurrent validity was established. The NDI and QVAS were successfully translated and the Afrikaans versions can now be used in the Afrikaans population as viable alternatives to the English NDI and QVAS. / M

A dissertation completed in partial compliance with the requirements for a Master's Degree in Technology Chiropractic, Durban Institute of Technology, 2006. / Neck pain is a common problem, globally, as well as in South Africa. Zulu is the first language of a very large proportion of the South African population, and as such, addressing the needs of this population group with respect to neck pain is a priority. Many reliable pain indexes exist in English to record the degree of disability with regards to neck pain. These are invaluable tools in aiding the health practitioner to assess the progress of treatment and the severity of the patient's disability. Two of the most credible and frequently used indexes are the Canadian Memorial Chiropractic College Neck Disability Index (CMCC NDl) and the Short Form McGill Pain Questionnaire (SFMPQ). However, no such scale exists in Zulu. The purpose of this pilot investigation was, firstly, to analyze and critique the Zulu translations of the CMCC NDl and the SFMPQ in order to establish their face validity. Secondly, to establish their concurrent validity ensuring that the translated questionnaires are specific and sensitive enough to use as tools in data collection when compared to their English counterparts. Thirdly, to make recommendations for further improvement in terms of the Zulu questionnaires and lastly, to make recommendations for further studies for improvement in terms of the use of these questionnaires as research tools amongst the Zulu speaking population of South Africa. Firstly, the CMCC NDl and the SFMP questionnaires were translated into Zulu by means of a focus group. These versions were then assessed by means of a focus (or discussion) group, to assess their face validity. Changes were made to the original translations according to the recommendations of this group. These versions were then assessed with regards to their concurrent validity with the original English versions. Fifty volunteers, who were literate in both English and Zulu and who have suffered with neck pain, filled in both the Zulu and English versions of both questionnaires. / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Neck pain is a condition that is becoming more common throughout the world and most people can expect to experience some degree of neck pain sometime during their life. There is a need for early diagnosis and follow-up of neck pain to assess a patient’s level of self-rated disability due to the escalating disability burden and compensation costs associated with neck pain. For this reason, disability questionnaires are increasingly used for clinical assessment and as an outcome measurement for the treatment of neck pain. Translation and cross-cultural adaptation of disability questionnaires have thus become increasingly necessary when dealing with different cultural groups. Methods: This is a quantitative validity and reliability assessment study comparing the English versions of the Neck Disability Index (NDI) and the Quadruple Visual Analogue Scale (QVAS) to their translated Afrikaans counterparts. The first step was to translate the questionnaires into Afrikaans. The translated questionnaires were then scrutinised and critiqued by an Expert group, who are fluent in both the Afrikaans and English languages, and back translated to English in order or establish their face validity. A small pilot study was conducted with the original and translated versions of the questionnaires to establish their content validity. The translated and original versions of the NDI and QVAS were given to a study group to complete with a suitable time delay between the completions of the questionnaires. The results from the study group were statistically analysed to establish concurrent validity and reliability. Results: There were 50 participants each completing one English NDI and QVAS and one Afrikaans NDI and QVAS. The results indicate high reliability for both the Afrikaans NDI (α = 0.900) and QVAS (α = 0.883). The Afrikaans NDI and QVAS are deemed reliable compared to their English counterparts. The results indicated a significant level of concurrent validity for both the NDI and the QVAS. Both the Afrikaans versions of the NDI and QVAS were deemed reliable and concurrent validity was established. The NDI and QVAS were successfully translated and the Afrikaans versions can now be used in the Afrikaans population as viable alternatives to the English NDI and QVAS. / M

M.Tech. (Chiropractic) / Purpose: The effectiveness of cervical spine adjustments for improving spinal function and relieving pain has been well established. However, the mechanisms responsible for these changes after spinal adjustments are still being researched. Further scientific evidence regarding the neurological and physiological effects following spinal adjustments is warranted. Evidence suggesting that spinal dysfunction has an effect on central neural processing is growing. A number of palpation from the first to the sixth visit. The seventh visit consisted of gathering data only. Results: Clinical and statistical improvements in the entire group were shown over the course of the treatment with regards to cervical spine range of motion, touch pressure threshold and neck pain and disability. Conclusion: The results show that lower cervical spine adjustments do have an effect on touch pressure threshold, cervical spine range of motion and neck pain and disability in patients with chronic cervical facet syndrome. Touch pressure threshold returned to optimal function, cervical spine range of motion increased and neck pain and disability decreased in all participants over time. authors have suggested that spinal dysfunction may lead to altered sensory input to the central nervous system (Murphy and Taylor, 2008). Aim: The aim of this study was to determine the effect of C6, C7 and T1 spinal adjustment therapy on those individuals with posterior neck pain due to chronic cervical facet syndrome and its influence on touch pressure threshold, neck pain and disability as well as cervical spine range of motion. Method: This study consisted of a single group of thirty participants between the ages of eighteen and fourty-five. The potential participants were examined and accepted according to the inclusion and exclusion criteria. The only method of treatment administered to each participant was cervical spine adjustments delivered to restricted C6, C7 and Tl segments in the lower cervical spine. Subjective and objective findings followed. Procedure: Treatment consisted of seven visits. Subjective and objective data was taken at the first, fourth and seventh visit. Objective data consisted of cervical spine range of motion readings taken using a Cervical Range of Motion measuring instrument (CROM), and touch pressure threshold results obtained via the Semmes Weinstein monofilaments. Subjective data was taken in the form of a Vernon Mior Neck Pain and Disability Index. Cervical spine adjustments were applied to restricted segments in the lower cervical spine (C6, C7, Tl), identified through motion

M.Tech. / Purpose: The cervical facet joints have attracted relatively little attention as possible sources of neck pain and referred pain. Multiple authors have described the management of cervical facet joint pain but not the cause (Manchikanti et al., 2002). Method: This study consisted of one group of 100 participants. The participants were between the ages of 18 and 40 years. Potential participants were examined and accepted based on the inclusion and exclusion criteria. All the participants received a cervical spine adjustment. Objective and subjective readings were taken. Procedure: The participants were seen only once. The Visual Analogue Scale was completed by each participant before treatment. Algometer readings were taken over the most restricted cervical spine facet joint and cervical spine range of motion (CROM) machine readings were taken measuring the ranges of motion of the cervical spine. The participants received an adjustment to the most restricted cervical spine facet joint as determined by motion palpation. The CROM machine and algometer readings were taken again immediately after the adjustment and the algometer readings were taken again 10 minutes later. Results: In terms of subjective measurements based on the Visual Analogue Scale, all participants experienced clinically significant pain before starting the trial.In terms of objective measurements based on algometer readings, a clinically significant difference was found as the pressure pain threshold increases over a period of time. In terms of the CROM machine readings there was a clinical improvement from the pretreatment ranges of motion to the post-treatment ranges of motion. The algometer and CROM readings were statistically incomparable to begin with. Conclusion: The results proved that there was a statistical significant noted immediately after the adjustment and 10 minutes later, however, this does not mean much as thegroups were not comparable to begin with. A statistically significant difference was noted for all ranges of cervical spine motion (flexion, extension, right and left lateral flexion and rotation), thus showing that the cervical spine adjustment was successfully delivered to the restricted segments.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Aim: This study aimed to compare the effectiveness of the Impulse iQ® Adjusting Instrument and ischaemic compression on trigger points in pain relief and quality of life in adults presenting with non-specific neck pain. Methodology: This study was a randomised single-blinded clinical trial which consisted of 40 participants residing in the eThekwini municipality, divided into two groups of 20 each. The participants were randomly assigned using concealed allocation to one of two treatment groups of 20 viz. Impulse iQ® Adjusting Instrument (IAI) trigger point therapy group and ischaemic compression (IC) group. Neck pain level was determined using a numerical pain rating scale (NRS). Degree of lateral flexion (LF) was determined by a cervical range of motion (CROM) goniometer. Pain pressure thresholds (PPT) were measured with a pain pressure algometer. The effect of neck pain on participants’ activities of daily living was assessed using the Canadian Memorial Chiropractic College (CMCC) Neck Disability Index (NDI). The participants’ overall perception of improvement since the initiation of treatment was assessed using the Patients Global Impression of Change (PGIC). The participants received three treatments over a two and half week period with the fourth consultation being used for the final subjective and objective measurements. Results: Repeated measures ANOVA testing was used to examine the intra-group effect of time and the inter-group effect of treatment on the outcomes of NRS, algometer readings and CROM goniometer measurements. Profile plots were used to assess the direction and trends of the effects. An intra-group analysis revealed that, objectively and subjectively, all groups responded positively to treatment over time, with no significant time-group interaction. It was noted that there was a higher rate of improvement in IAI Group with respect to algometer readings over time; however, this difference was not statistically significant. Conclusion: This study concluded that neither IAI nor IC is more effective than the other with respect to participants’ pain perception and CROM. However, the IAI was more effective on pain pressure threshold. Based on the results collected from this study, both therapies can used in the treatment protocols of neck pain associated with MFTPs. / M

Introdução: Embora a migrânea seja considerada uma desordem primariamente da função cerebral, seu quadro é frequentemente acompanhado de dor e disfunções cervicais associadas, como diminuição da amplitude de movimento, pontos-gatilhos em cabeça e pescoço, diminuição do limiar de dor à pressão, bem como diminuição da força muscular e padrões alterados de atividade dos músculos da cervical. Um protocolo de fortalecimento para os flexores e extensores da cervical demonstra resultados positivos para a dor cervical crônica e melhora da atividade eletromiográfica, porém não está estabelecido se este mesmo protocolo teria efeitos em pacientes com migrânea. Objetivo: Investigar os efeitos de um protocolo de exercícios específicos para os músculos flexores e extensores da coluna cervical na força e atividade eletromiográfica em indivíduos com migrânea. Materiais e Métodos: 23 indivíduos do sexo feminino, entre 18 a 55 anos, com diagnóstico de migrânea passaram por um avaliação inicial contendo os questionários Neck Disability Index (NDI), 12 itemAllodynia Symptom Checklist (ASC-12), TAMPA questionário de Cinesiofobia e Migraine Disability Assesment (MIDAS). Após os questionários, foi avaliada a força da contração isométrica voluntária máxima (CIVM) dos flexores e extensores cervicais, tempo de pico necessário para atingir a contração, e concomitantemente, avaliada as variáveis eletromiográficas para os músculos esternocleidomastóideo, escaleno anterior, esplênio da cabeça e trapézio superior de frequência mediana e slope, além da coativação dos antagonistas. Os pacientes realizaram um protocolo de fortalecimento de oito semanas para os flexores e extensores cervicais e na nona semana, foram reavaliados.. Resultados: Não houve diferença na pontuação dos questionários NDI, ASC-12/Brasil e TAMPA pré e pós intervenção, porém houve diminuição da incapacidade gerada pela migrânea avaliado pelo questionário MIDAS (p=0,017). Foi observado aumento da força dos músculos extensores cervicais (p=0,001) e não houve diferença na força dos músculos flexores e no pico da força pré e pós intervenção. Em relação às variáveis eletromiográficas, os valores da frequência mediana foram diferentes apenas no músculo escaleno anterior pós intervenção na atividade de flexão(p=0,004). Não houve diferença para o slope em ambas as atividades de flexão e10 extensão, porém houve diminuição da coativação antagonista na tarefa de flexão (p=0,001). Conclusão: Um protocolo de fortalecimento dos flexores e extensores cervicais de oito semanas parece ter efeito na diminuição da incapacidade gerada pela migrânea, no ganho de força dos músculos extensores cervicais e na diminuição da coativação antagonista em flexão, resultando em menor atividade antagonista pós treinamento. / Introduction: Although migraine is considered a disorder primarily of brain function, its condition is often accompanied by pain and associated cervical dysfunctions, such as decreased range of motion, trigger points in the head and neck, decreased pressure pain threshold, and such as decreased muscle strength and altered patterns of cervical muscle activity. A strengthening protocol for cervical flexors and extensors demonstrates positive results for chronic neck pain and improved electromyographic activity, but it is not established whether this protocol would have effects in patients with migraine. Objective: To investigate the effects of a specific exercise protocol for the cervical spine flexor and extensor muscles on the force and electromyographic activity in individuals with migraine. Materials and methods: Twenty-three female subjects aged 18 to 55 years with a diagnosis of migraine underwent an initial evaluation containing the Neck Disability Index (NDI) questionnaire, 12 item-Allodynia Symptom Checklist (ASC-12), TAMPA questionnaire Kinesiophobia and Migraine Disability Assesment (MIDAS). After the questionnaires, the strength of the maximal voluntary isometric contraction (MVIC) of the cervical flexors and extensors, the peak time required to achieve the contraction, and the electromyographic variables for the sternocleidomastoid, anterior scalene, splenius and upper trapezoid of medium frequency and slope, besides the coactivation of the antagonists. The patients underwent an eight-week strengthening protocol for flexors and cervical extensors and in the ninth week, they were reevaluated. Results: There was no difference in the scores of the NDI, ASC-12/Brasil and TAMPA questionnaires before and after intervention, but there was a decrease in disability generated by the MIDAS questionnaire (p = 0.017). Increased cervical extensor muscle strength (p = 0.001) was observed and there was no difference in flexor muscle strength and peak pre and post intervention force. Regarding the electromyographic variables, the median frequency values were different only in the anterior scalene muscle post intervention in the flexion activity (p = 0.004). There was no difference for the slope in both flexion and extension activities, but there was decrease of the antagonistic coactivation in the flexion task (p = 0.001). Conclusion: An eight-week protocol for strengthening cervical flexors and12 extensors seems to have an effect on the decrease in the disability generated by migraine, on increase in strenght of the cervical extensor muscles and on the decrease of the antagonist coactivation in flexion, resulting in less antagonist activity post-intervention.

Abstract Objective: This study has aimed to estimate the association between malocclusion and temporomandibular disorder with neck pain in patients seen in the area of odontology in an Odontology clinic. Materials and methods: A cross-sectional was performed in Lima, Peru. The population was composed of patients attending a dental clinic. During the last three months, assessment was made of self-reported neck pain, the temporomandibular disorder (TMD) with the index of Fonseca, types of malocclusion with dental assessment recorded in their medical history, oral habits and lack of teeth. The association was evaluated by estimating the established prevalence reasons (RPa). Results: The study included 215 people, whose mean age was 33.1±12.4 years old. Most of the subjects were women (69.3%). Prevalence of neck pain was 64.2%, 79.1% had some degree of TMD and 97.7% malocclusion. Having TMD was associated with neck pain, both moderate as severe (OR: 6.65, 95% CI: 3.17-3.95) and mild (OR: 4.88 95%, 95% CI: 2.29-10.41). No association between malocclusion and neck pain (95% CI: 0, 71-1, 13 OR 0.89) was found. Another associated factor was the absence of 3 or more teeth (OR: 1.25, 95% CI 1.01-1.56). Conclusions: Neck pain is associated with TMD but not with malocclusion. Therefore, a coordinated work between dentists and physiotherapists in the management of TMD and neck pain is recommended in order to comprehensively treat these patients. / Objetivo Estimar la asociación entre la maloclusión y el trastorno temporomandibular (TTM) con la cervicalgia en los pacientes que asistían al área odontológica de una clínica de Odontología. Materiales y métodos Se realizó un estudio de corte transversal en Lima, Perú. La población fue conformada por pacientes que asistían a una clínica odontológica, a quienes se evaluó el autorreporte de cervicalgia en los últimos 3 meses, el TTM con el índice de Fonseca, los tipos de maloclusión con la evaluación odontológica registrada en su historia clínica, así como hábitos orales y falta de piezas dentarias. Se evaluó la asociación calculando las razones de prevalencia ajustadas (RPa). Resultados Se incluyó a 215 personas, cuya edad media ± desviación estándar fue de 33,1±12,4 años y la mayoría fueron mujeres (69,3%). La prevalencia de cervicalgia fue del 64,2; el 79,1% tuvo algún grado de TTM y el 97,7% maloclusión. Tener TTM estuvo asociado a cervicalgia, tanto moderada como severa (RPa: 6,65; IC del 95%, 3,17-13,95), como leve (RPa: 4,88; IC del 95%, 2,29-10,41). No se halló asociación entre maloclusión y cervicalgia (RPa: 0,89; IC del 95%, 0,71-1,13). Otro factor asociado fue la ausencia de 3 o más dientes (RPa: 1,25; IC del 95%, 1,01-1,56). Conclusiones La cervicalgia está asociada al TTM pero no a la maloclusión, por lo que se recomienda un trabajo coordinado entre odontólogos y fisioterapeutas en el manejo de la TTM y cervicalgia para tratar integralmente a estos pacientes. / Revisión por pares

Introdução: Embora a migrânea seja considerada uma desordem primariamente da função cerebral, seu quadro é frequentemente acompanhado de dor e disfunções cervicais associadas, como diminuição da amplitude de movimento, pontos-gatilhos em cabeça e pescoço, diminuição do limiar de dor à pressão, bem como diminuição da força muscular e padrões alterados de atividade dos músculos da cervical. Um protocolo de fortalecimento para os flexores e extensores da cervical demonstra resultados positivos para a dor cervical crônica e melhora da atividade eletromiográfica, porém não está estabelecido se este mesmo protocolo teria efeitos em pacientes com migrânea. Objetivo: Investigar os efeitos de um protocolo de exercícios específicos para os músculos flexores e extensores da coluna cervical na força e atividade eletromiográfica em indivíduos com migrânea. Materiais e Métodos: 23 indivíduos do sexo feminino, entre 18 a 55 anos, com diagnóstico de migrânea passaram por um avaliação inicial contendo os questionários Neck Disability Index (NDI), 12 itemAllodynia Symptom Checklist (ASC-12), TAMPA questionário de Cinesiofobia e Migraine Disability Assesment (MIDAS). Após os questionários, foi avaliada a força da contração isométrica voluntária máxima (CIVM) dos flexores e extensores cervicais, tempo de pico necessário para atingir a contração, e concomitantemente, avaliada as variáveis eletromiográficas para os músculos esternocleidomastóideo, escaleno anterior, esplênio da cabeça e trapézio superior de frequência mediana e slope, além da coativação dos antagonistas. Os pacientes realizaram um protocolo de fortalecimento de oito semanas para os flexores e extensores cervicais e na nona semana, foram reavaliados.. Resultados: Não houve diferença na pontuação dos questionários NDI, ASC-12/Brasil e TAMPA pré e pós intervenção, porém houve diminuição da incapacidade gerada pela migrânea avaliado pelo questionário MIDAS (p=0,017). Foi observado aumento da força dos músculos extensores cervicais (p=0,001) e não houve diferença na força dos músculos flexores e no pico da força pré e pós intervenção. Em relação às variáveis eletromiográficas, os valores da frequência mediana foram diferentes apenas no músculo escaleno anterior pós intervenção na atividade de flexão(p=0,004). Não houve diferença para o slope em ambas as atividades de flexão e10 extensão, porém houve diminuição da coativação antagonista na tarefa de flexão (p=0,001). Conclusão: Um protocolo de fortalecimento dos flexores e extensores cervicais de oito semanas parece ter efeito na diminuição da incapacidade gerada pela migrânea, no ganho de força dos músculos extensores cervicais e na diminuição da coativação antagonista em flexão, resultando em menor atividade antagonista pós treinamento. / Introduction: Although migraine is considered a disorder primarily of brain function, its condition is often accompanied by pain and associated cervical dysfunctions, such as decreased range of motion, trigger points in the head and neck, decreased pressure pain threshold, and such as decreased muscle strength and altered patterns of cervical muscle activity. A strengthening protocol for cervical flexors and extensors demonstrates positive results for chronic neck pain and improved electromyographic activity, but it is not established whether this protocol would have effects in patients with migraine. Objective: To investigate the effects of a specific exercise protocol for the cervical spine flexor and extensor muscles on the force and electromyographic activity in individuals with migraine. Materials and methods: Twenty-three female subjects aged 18 to 55 years with a diagnosis of migraine underwent an initial evaluation containing the Neck Disability Index (NDI) questionnaire, 12 item-Allodynia Symptom Checklist (ASC-12), TAMPA questionnaire Kinesiophobia and Migraine Disability Assesment (MIDAS). After the questionnaires, the strength of the maximal voluntary isometric contraction (MVIC) of the cervical flexors and extensors, the peak time required to achieve the contraction, and the electromyographic variables for the sternocleidomastoid, anterior scalene, splenius and upper trapezoid of medium frequency and slope, besides the coactivation of the antagonists. The patients underwent an eight-week strengthening protocol for flexors and cervical extensors and in the ninth week, they were reevaluated. Results: There was no difference in the scores of the NDI, ASC-12/Brasil and TAMPA questionnaires before and after intervention, but there was a decrease in disability generated by the MIDAS questionnaire (p = 0.017). Increased cervical extensor muscle strength (p = 0.001) was observed and there was no difference in flexor muscle strength and peak pre and post intervention force. Regarding the electromyographic variables, the median frequency values were different only in the anterior scalene muscle post intervention in the flexion activity (p = 0.004). There was no difference for the slope in both flexion and extension activities, but there was decrease of the antagonistic coactivation in the flexion task (p = 0.001). Conclusion: An eight-week protocol for strengthening cervical flexors and12 extensors seems to have an effect on the decrease in the disability generated by migraine, on increase in strenght of the cervical extensor muscles and on the decrease of the antagonist coactivation in flexion, resulting in less antagonist activity post-intervention.