Is the disappearance of the cervical flexion-relaxation phenomenon associated with cervical degeneration in healthy people?

Purpose This study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to identify whether the disappearance of cervical FRP is related to cervical degeneration. Methods According to the flexion relaxation...

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Published inEuropean spine journal Vol. 33; no. 8; pp. 2997 - 3007
Main Authors He, Peifeng, Yang, Yunbo, Wang, Minglang, Li, Dan, Yuan, Hao, Wang, Jianxiong, He, Qiang, Feng, Daxiong, Liu, Xuanwen
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2024
Springer Nature B.V
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Abstract Purpose This study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to identify whether the disappearance of cervical FRP is related to cervical degeneration. Methods According to the flexion relaxation ratio (FRR), healthy subjects were divided into the normal FRP group and the abnormal FRP group. Besides, MRI was used to evaluate the degeneration of the passive subsystem (vertebral body, intervertebral disc, cervical sagittal balance, etc.) and the active subsystem (deep flexors [DEs], deep extensors [DFs], and superficial extensors [SEs]). In addition, the correlation of the FRR with the cervical degeneration score, C2-7Cobb, Borden method, relative total cross-sectional area (rTCSA), relative functional cross-sectional area (rFCSA), and fatty infiltration ratio (FIR) was analyzed. Results A total of 128 healthy subjects were divided into the normal FRP group ( n =52, 40.63%) and the abnormal FRP group ( n =76, 59.38%). There were significant differences between the normal FRP group and the abnormal FRP group in the cervical degeneration score (z=-6.819, P <0.001), C2-7Cobb (t=2.994, P =0.004), Borden method (t=2.811, P =0.006), and FIR of DEs (t=-4.322, P <0.001). The FRR was significantly correlated with the cervical degeneration score ( r =-0.457, P <0.001), C2-7Cobb ( r =0.228, P =0.010), Borden method ( r =0.197, P =0.026), and FIR of DEs ( r =-0.253, P =0.004). Conclusion The disappearance of cervical FRP is related to cervical degeneration. A new hypothesis mechanism for FRP is proposed. The cervical FRP test is an effective and noninvasive examination for the differential diagnosis of healthy people, people with potential NSNP, and patients with NSNP.
AbstractList This study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to identify whether the disappearance of cervical FRP is related to cervical degeneration. According to the flexion relaxation ratio (FRR), healthy subjects were divided into the normal FRP group and the abnormal FRP group. Besides, MRI was used to evaluate the degeneration of the passive subsystem (vertebral body, intervertebral disc, cervical sagittal balance, etc.) and the active subsystem (deep flexors [DEs], deep extensors [DFs], and superficial extensors [SEs]). In addition, the correlation of the FRR with the cervical degeneration score, C2-7Cobb, Borden method, relative total cross-sectional area (rTCSA), relative functional cross-sectional area (rFCSA), and fatty infiltration ratio (FIR) was analyzed. A total of 128 healthy subjects were divided into the normal FRP group (n=52, 40.63%) and the abnormal FRP group (n=76, 59.38%). There were significant differences between the normal FRP group and the abnormal FRP group in the cervical degeneration score (z=-6.819, P<0.001), C2-7Cobb (t=2.994, P=0.004), Borden method (t=2.811, P=0.006), and FIR of DEs (t=-4.322, P<0.001). The FRR was significantly correlated with the cervical degeneration score (r=-0.457, P<0.001), C2-7Cobb (r=0.228, P=0.010), Borden method (r=0.197, P=0.026), and FIR of DEs (r=-0.253, P=0.004). The disappearance of cervical FRP is related to cervical degeneration. A new hypothesis mechanism for FRP is proposed. The cervical FRP test is an effective and noninvasive examination for the differential diagnosis of healthy people, people with potential NSNP, and patients with NSNP.
PurposeThis study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to identify whether the disappearance of cervical FRP is related to cervical degeneration.MethodsAccording to the flexion relaxation ratio (FRR), healthy subjects were divided into the normal FRP group and the abnormal FRP group. Besides, MRI was used to evaluate the degeneration of the passive subsystem (vertebral body, intervertebral disc, cervical sagittal balance, etc.) and the active subsystem (deep flexors [DEs], deep extensors [DFs], and superficial extensors [SEs]). In addition, the correlation of the FRR with the cervical degeneration score, C2-7Cobb, Borden method, relative total cross-sectional area (rTCSA), relative functional cross-sectional area (rFCSA), and fatty infiltration ratio (FIR) was analyzed.ResultsA total of 128 healthy subjects were divided into the normal FRP group (n=52, 40.63%) and the abnormal FRP group (n=76, 59.38%). There were significant differences between the normal FRP group and the abnormal FRP group in the cervical degeneration score (z=-6.819, P<0.001), C2-7Cobb (t=2.994, P=0.004), Borden method (t=2.811, P=0.006), and FIR of DEs (t=-4.322, P<0.001). The FRR was significantly correlated with the cervical degeneration score (r=-0.457, P<0.001), C2-7Cobb (r=0.228, P=0.010), Borden method (r=0.197, P=0.026), and FIR of DEs (r=-0.253, P=0.004).ConclusionThe disappearance of cervical FRP is related to cervical degeneration. A new hypothesis mechanism for FRP is proposed. The cervical FRP test is an effective and noninvasive examination for the differential diagnosis of healthy people, people with potential NSNP, and patients with NSNP.
This study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to identify whether the disappearance of cervical FRP is related to cervical degeneration.PURPOSEThis study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to identify whether the disappearance of cervical FRP is related to cervical degeneration.According to the flexion relaxation ratio (FRR), healthy subjects were divided into the normal FRP group and the abnormal FRP group. Besides, MRI was used to evaluate the degeneration of the passive subsystem (vertebral body, intervertebral disc, cervical sagittal balance, etc.) and the active subsystem (deep flexors [DEs], deep extensors [DFs], and superficial extensors [SEs]). In addition, the correlation of the FRR with the cervical degeneration score, C2-7Cobb, Borden method, relative total cross-sectional area (rTCSA), relative functional cross-sectional area (rFCSA), and fatty infiltration ratio (FIR) was analyzed.METHODSAccording to the flexion relaxation ratio (FRR), healthy subjects were divided into the normal FRP group and the abnormal FRP group. Besides, MRI was used to evaluate the degeneration of the passive subsystem (vertebral body, intervertebral disc, cervical sagittal balance, etc.) and the active subsystem (deep flexors [DEs], deep extensors [DFs], and superficial extensors [SEs]). In addition, the correlation of the FRR with the cervical degeneration score, C2-7Cobb, Borden method, relative total cross-sectional area (rTCSA), relative functional cross-sectional area (rFCSA), and fatty infiltration ratio (FIR) was analyzed.A total of 128 healthy subjects were divided into the normal FRP group (n=52, 40.63%) and the abnormal FRP group (n=76, 59.38%). There were significant differences between the normal FRP group and the abnormal FRP group in the cervical degeneration score (z=-6.819, P<0.001), C2-7Cobb (t=2.994, P=0.004), Borden method (t=2.811, P=0.006), and FIR of DEs (t=-4.322, P<0.001). The FRR was significantly correlated with the cervical degeneration score (r=-0.457, P<0.001), C2-7Cobb (r=0.228, P=0.010), Borden method (r=0.197, P=0.026), and FIR of DEs (r=-0.253, P=0.004).RESULTSA total of 128 healthy subjects were divided into the normal FRP group (n=52, 40.63%) and the abnormal FRP group (n=76, 59.38%). There were significant differences between the normal FRP group and the abnormal FRP group in the cervical degeneration score (z=-6.819, P<0.001), C2-7Cobb (t=2.994, P=0.004), Borden method (t=2.811, P=0.006), and FIR of DEs (t=-4.322, P<0.001). The FRR was significantly correlated with the cervical degeneration score (r=-0.457, P<0.001), C2-7Cobb (r=0.228, P=0.010), Borden method (r=0.197, P=0.026), and FIR of DEs (r=-0.253, P=0.004).The disappearance of cervical FRP is related to cervical degeneration. A new hypothesis mechanism for FRP is proposed. The cervical FRP test is an effective and noninvasive examination for the differential diagnosis of healthy people, people with potential NSNP, and patients with NSNP.CONCLUSIONThe disappearance of cervical FRP is related to cervical degeneration. A new hypothesis mechanism for FRP is proposed. The cervical FRP test is an effective and noninvasive examination for the differential diagnosis of healthy people, people with potential NSNP, and patients with NSNP.
Purpose This study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to identify whether the disappearance of cervical FRP is related to cervical degeneration. Methods According to the flexion relaxation ratio (FRR), healthy subjects were divided into the normal FRP group and the abnormal FRP group. Besides, MRI was used to evaluate the degeneration of the passive subsystem (vertebral body, intervertebral disc, cervical sagittal balance, etc.) and the active subsystem (deep flexors [DEs], deep extensors [DFs], and superficial extensors [SEs]). In addition, the correlation of the FRR with the cervical degeneration score, C2-7Cobb, Borden method, relative total cross-sectional area (rTCSA), relative functional cross-sectional area (rFCSA), and fatty infiltration ratio (FIR) was analyzed. Results A total of 128 healthy subjects were divided into the normal FRP group ( n =52, 40.63%) and the abnormal FRP group ( n =76, 59.38%). There were significant differences between the normal FRP group and the abnormal FRP group in the cervical degeneration score (z=-6.819, P <0.001), C2-7Cobb (t=2.994, P =0.004), Borden method (t=2.811, P =0.006), and FIR of DEs (t=-4.322, P <0.001). The FRR was significantly correlated with the cervical degeneration score ( r =-0.457, P <0.001), C2-7Cobb ( r =0.228, P =0.010), Borden method ( r =0.197, P =0.026), and FIR of DEs ( r =-0.253, P =0.004). Conclusion The disappearance of cervical FRP is related to cervical degeneration. A new hypothesis mechanism for FRP is proposed. The cervical FRP test is an effective and noninvasive examination for the differential diagnosis of healthy people, people with potential NSNP, and patients with NSNP.
Author Feng, Daxiong
Li, Dan
He, Peifeng
Liu, Xuanwen
Yuan, Hao
He, Qiang
Yang, Yunbo
Wang, Jianxiong
Wang, Minglang
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  organization: Department of Orthopaedic Surgery, Chengdu 363 Hospital of Southwest Medical University
BackLink https://www.ncbi.nlm.nih.gov/pubmed/38869650$$D View this record in MEDLINE/PubMed
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Sat Aug 23 14:56:46 EDT 2025
Wed Feb 19 02:04:41 EST 2025
Tue Jul 01 02:58:24 EDT 2025
Fri Feb 21 02:38:08 EST 2025
IsPeerReviewed true
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Issue 8
Keywords Nonspecific neck pain (NSNP)
Cervical flexion-relaxation phenomenon (FRP)
Cervical degeneration
Language English
License 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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PublicationTitle European spine journal
PublicationTitleAbbrev Eur Spine J
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References Eijiro OkadaMMatsumotoDIchiharaKTakeshi TakahataAging of the cervical spine in healthy volunteers: a 10-year longitudinal magnetic resonance imaging studySpine (Phila Pa 1976)200934770671210.1097/BRS.0b013e31819c200319333104
BernadetteAMurphyPWMarshallHeidi Haavik TaylorThe cervical flexion-relaxation ratio: reproducibility and comparison between chronic neck pain patients and controlsSpine (Phila Pa 1976)201035242103210810.1097/BRS.0b013e3181cbc7d8
YoganandanNKumaresanSPintarFABiomechanics of the cervical spine part 2. Cervical spine soft tissue responses and biomechanical modelingClin Biomech (Bristol Avon)20011611271:STN:280:DC%2BD3M7ktVOmuw%3D%3D10.1016/s0268-0033(00)00074-711114440
Ruka Nobe H, Yajima M, Takayama N Takakura (2022) Characteristics of Surface Electromyograph Activity of Cervical extensors and flexors in nonspecific Neck Pain patients: a cross-sectional study. Med (Kaunas) 58(12). https://doi.org/10.3390/medicina58121770
YipCHTChiuTTWAnthony Tung Kuen PoonThe relationship between head posture and severity and disability of patients with neck painMan Ther200813214815410.1016/j.math.2006.11.00217368075
R F McLainMechanoreceptor endings in human cervical facet jointsSpine (Phila Pa 1976)199419549550110.1097/00007632-199403000-00001
Emiliano CèSLongoELimontaGFabio EspositoPeripheral fatigue: new mechanistic insights from recent technologiesEur J Appl Physiol20201201173910.1007/s00421-019-04264-w31745629
Yasutsugu YukawaFKatoKSudaMTakayoshi UetaAge-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from over 1,200 asymptomatic subjectsEur Spine J20122181492149810.1007/s00586-012-2167-5223108833535253
PetraMKlingeAMcElroy, OwenPLearyJEDonahueZiyaLGNot just an Anchor: the human Filum Terminale contains Stretch sensitive and nociceptive nerve endings and responds to Electrical Stimulation with Paraspinal muscle activationNeurosurgery202291461862410.1227/neu.0000000000002081
AnderssonEAOddssonLIEGrundströmHNilssonJThorstenssonAEMG activities of the quadratus lumborum and erector spinae muscles during flexion-relaxation and other motor tasksClin Biomech (Bristol Avon)19961173924001:STN:280:DC%2BC2sbks1eqtQ%3D%3D10.1016/0268-0033(96)00033-211415651
PialasseJ-PDuboisJ-DPilon ChoquetteM-HLafondDM DescarreauxKinematic and electromyographic parameters of the cervical flexion-relaxation phenomenon: the effect of trunk positioningAnn Phys Rehabil Med2009521495810.1016/j.rehab.2008.10.00219419658
JosephNFMakYHu, AldousCSChengHYKwokKeithDKLukFlexion-relaxation ratio in sitting: application in low back pain rehabilitationSpine (Phila Pa 1976)201035161532153810.1097/BRS.0b013e3181ba021e
Marine Gueugneau Cécile, Coudy-Gandilhon Laëtitia Théron, Bruno Meunier, &Daniel Béchet (2015) skeletal muscle lipid content and oxidative activity in relation to muscle fiber type in aging and metabolic syndrome. J Gerontol Biol Sci Med Sci 70(5):566–576. https://doi.org/10.1093/gerona/glu086
Eijiro OkadaMMatsumotoDIchiharaKChibaTakeshi TakahataDoes the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteersEur Spine J200918111644165110.1007/s00586-009-1095-5196097842899405
OlsonMSolomonowMFlexion-relaxation response to gravityJ Biomech200639142545255410.1016/j.jbiomech.2005.09.00916256121
PialasseJ-PLafondDCantinVDescarreauxMLoad and speed effects on the cervical flexion relaxation phenomenonBMC Musculoskelet Disord2010114610.1186/1471-2474-11-46202191312850324
Hidalgo B, Hall T, Bossert J Axel Dugeny, &Laurent Pitance (2017) the efficacy of manual therapy and exercise for treating non-specific neck pain: a systematic review. J Back Musculoskelet Rehabil 30(6):1149–1169. https://doi.org/10.3233/BMR-169615
ChristopherJColloca, RichardNHinrichsThe biomechanical and clinical significance of the lumbar erector spinae flexion-relaxation phenomenon: a review of literatureJ Manipulative Physiol Ther200528862363110.1016/j.jmpt.2005.08.005
Mahboobeh ZabihhosseinianMWRHolmesBFergusonBNeck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patientsClin Biomech (Bristol Avon)201530539740410.1016/j.clinbiomech.2015.03.02025843481
Hasan ShamsiKKhademi-KalantariAAkbarzadeh-BaghbanNIzadiFarshad OkhovatianCervical flexion relaxation phenomenon in patients with and without non-specific chronic neck painJ Back Musculoskelet Rehabil202134346146810.3233/BMR-20013733492275
AshishDNimbarte, MajedMZreiqatSKCervical flexion-relaxation response to neck muscle fatigue in males and femalesJ Electromyogr Kinesiol201424696597110.1016/j.jelekin.2014.09.002
Herman Mun Cheung LauChiuTTWLamT-HThe effectiveness of thoracic manipulation on patients with chronic mechanical neck pain - a randomized controlled trialMan Ther201116214114710.1016/j.math.2010.08.00320813577
AshishDNimbarteMZreiqatXImpact of shoulder position and fatigue on the flexion-relaxation response in cervical spineClin Biomech (Bristol Avon)201429327728210.1016/j.clinbiomech.2013.12.003
Kuan WangLWangZDengCJiangMing ZhangInfluence of passive elements on prediction of intradiscal pressure and muscle activation in lumbar musculoskeletal modelsComput Methods Programs Biomed2019177394610.1016/j.cmpb.2019.05.01831319959
VincentKMaigneJ-YFischhoffCLanloOSimon DagenaisSystematic review of manual therapies for nonspecific neck painJoint Bone Spine201380550851510.1016/j.jbspin.2012.10.00623165183
DerekPZwambag, StephenHMBrownExperimental validation of a novel spine model demonstrates the large contribution of passive muscle to the flexion relaxation phenomenonJ Biomech202010210943110.1016/j.jbiomech.2019.109431
Sumit ThakarNRajagopalPAlleSAlangar HegdeCervical flexor-extensor muscle disparity in Monomelic Amyotrophy (Hirayama Disease): evidence from a comprehensive morphometric evaluation of Subaxial Paraspinal musculatureAsian J Neurosurg2022171686710.1055/s-0042-1749111358738549298585
RedaelliAStephanSRRiewKDIs neck pain treatable with surgery? European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European section of the cervicalSpine Res Soc20243331137114710.1007/s00586-023-08053-0
Arpalak PaksaicholCLawsiriratPJanwantanakulContribution of biopsychosocial risk factors to nonspecific neck pain in office workers: a path analysis modelJ Occup Health201557210010910.1539/joh.14-0124-OA25476863
KevinJNetto, AngusFBurnettReliability of normalisation methods for EMG analysis of neck musclesWork2006262123130
Jirasin ThongtonSSribureeMSremakaewSPain-side related difference in cross-sectional area of the longus colli muscle and its relationship with standing balance in persons with non-specific neck painMusculoskelet Sci Pract20226210263810.1016/j.msksp.2022.10263835939918
RubanaHChowdhury, MamunBIReazMABMAli, AshrifAABakarT G ChangSurface electromyography signal processing and classification techniquesSens (Basel)2013139124311246610.3390/s130912431
MeyerJJBerkRJAndersonAVRecruitment patterns in the cervical paraspinal muscles during cervical forward flexion: evidence of cervical flexion-relaxationElectromyogr Clin Neurophysiol19933342172231:STN:280:DyaK3szmsFCiug%3D%3D8359127
Akira OharaKMiyamotoTNaganawaKMatsumotoKatsuji ShimizuReliabilities of and correlations among five standard methods of assessing the sagittal alignment of the cervical spineSpine (Phila Pa 1976)200631222585259110.1097/01.brs.0000240656.79060.1817047548discussion 2592
Choi K-H, Cho M-U, Park C-W, Kim S-Y, Yong-Ku K (2020) A comparison study of posture and fatigue of Neck according to monitor types (moving and fixed monitor) by using Flexion Relaxation Phenomenon (FRP) and Craniovertebral Angle (CVA). Int J Environ Res Public Health 17(17). https://doi.org/10.3390/ijerph17176345
PetersRSchmittMAVerhagenAPPool-GoudzwaardALMutsaersJAMKoesBWComparing the range of musculoskeletal therapies applied by physical therapists with postgraduate qualifications in manual therapy in patients with non-specific neck pain with international guidelines and recommendations: an observational studyMusculoskelet Sci Pract2020461020691:STN:280:DC%2BB38%2Fltlajsw%3D%3D10.1016/j.msksp.2019.10206931989963
DayerAT-FRArmandStéphaneFlexion-relaxation phenomenon in children and adolescents with and without nonspecific chronic low back Pain: an Electromyographic and Kinematic cross-sectional comparative studySpine (Phila Pa 1976)201843191322133010.1097/BRS.000000000000262129509654
Nikolaos StrimpakosGGeorgiosKEleniKOldham JacquelineIssues in relation to the repeatability of and correlation between EMG and Borg scale assessments of neck muscle fatigueJ Electromyogr Kinesiol200515545246510.1016/j.jelekin.2005.01.00715935957
Jonathan PriceARushtonITyros, NicolaRHeneghanEffectiveness and optimal dosage of resistance training for chronic non-specific neck pain: a protocol for a systematic review with a qualitative synthesis and meta-analysisBMJ Open201992e02515810.1136/bmjopen-2018-025158307829266398773
WiechertKWangJCChapmanJRGetting rid of non-specific low back PainGlobal Spine J202414236310.1177/219256822312173433824500610802527
LeeH-DJeonC-HChungN-SComparative analysis of three imaging modalities for evaluation of cervical sagittal alignment parameters: a validity and reliability studySpine (Phila Pa 1976)201742241901190710.1097/BRS.000000000000225628574884
Maryse Fortin, MicheleCBattiéQuantitative paraspinal muscle measurements: inter-software reliability and agreement using OsiriX and ImageJPhys Ther201292685386410.2522/ptj.20110380
MollLTKindtMWStapelfeldtCMTue Secher JensenDegenerative findings on MRI of the cervical spine: an inter- and intra-rater reliability studyChiropr Man Th2018264310.1186/s12998-018-0210-2
Nader MaroufiAAhmadiSeyedeh Roghayeh Mousavi KhatirA comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjectsEur Spine J201322116216810.1007/s00586-012-2517-323053754
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References_xml – reference: Nader MaroufiAAhmadiSeyedeh Roghayeh Mousavi KhatirA comparative investigation of flexion relaxation phenomenon in healthy and chronic neck pain subjectsEur Spine J201322116216810.1007/s00586-012-2517-323053754
– reference: ChristopherJColloca, RichardNHinrichsThe biomechanical and clinical significance of the lumbar erector spinae flexion-relaxation phenomenon: a review of literatureJ Manipulative Physiol Ther200528862363110.1016/j.jmpt.2005.08.005
– reference: DerekPZwambag, StephenHMBrownExperimental validation of a novel spine model demonstrates the large contribution of passive muscle to the flexion relaxation phenomenonJ Biomech202010210943110.1016/j.jbiomech.2019.109431
– reference: Hiroyoshi Yajima R, Nobe M, Takayama N Takakura (2022) The Mode of activity of cervical extensors and flexors in healthy adults: a cross-sectional study. Med (Kaunas) 58(6). https://doi.org/10.3390/medicina58060728
– reference: Herman Mun Cheung LauChiuTTWLamT-HThe effectiveness of thoracic manipulation on patients with chronic mechanical neck pain - a randomized controlled trialMan Ther201116214114710.1016/j.math.2010.08.00320813577
– reference: MollLTKindtMWStapelfeldtCMTue Secher JensenDegenerative findings on MRI of the cervical spine: an inter- and intra-rater reliability studyChiropr Man Th2018264310.1186/s12998-018-0210-2
– reference: Hasan ShamsiKKhademi-KalantariAAkbarzadeh-BaghbanNIzadiFarshad OkhovatianCervical flexion relaxation phenomenon in patients with and without non-specific chronic neck painJ Back Musculoskelet Rehabil202134346146810.3233/BMR-20013733492275
– reference: Zhengqi HuangZBaiJYanYZhangWei YeAssociation between Muscle Morphology Changes, cervical spine degeneration, and clinical features in patients with chronic nonspecific Neck Pain: a magnetic resonance imaging analysisWorld Neurosurg2022159e273e28410.1016/j.wneu.2021.12.04134929370
– reference: KevinJNetto, AngusFBurnettReliability of normalisation methods for EMG analysis of neck musclesWork2006262123130
– reference: BergmarkAStability of the lumbar spine. A study in mechanical engineeringActa Orthop Scand Suppl19892301541:STN:280:DyaL1M3mvFKjtw%3D%3D10.3109/174536789091541772658468
– reference: PialasseJ-PDuboisJ-DPilon ChoquetteM-HLafondDM DescarreauxKinematic and electromyographic parameters of the cervical flexion-relaxation phenomenon: the effect of trunk positioningAnn Phys Rehabil Med2009521495810.1016/j.rehab.2008.10.00219419658
– reference: BernadetteAMurphyPWMarshallHeidi Haavik TaylorThe cervical flexion-relaxation ratio: reproducibility and comparison between chronic neck pain patients and controlsSpine (Phila Pa 1976)201035242103210810.1097/BRS.0b013e3181cbc7d8
– reference: OlsonMSolomonowMFlexion-relaxation response to gravityJ Biomech200639142545255410.1016/j.jbiomech.2005.09.00916256121
– reference: Emiliano CèSLongoELimontaGFabio EspositoPeripheral fatigue: new mechanistic insights from recent technologiesEur J Appl Physiol20201201173910.1007/s00421-019-04264-w31745629
– reference: AshishDNimbarteMZreiqatXImpact of shoulder position and fatigue on the flexion-relaxation response in cervical spineClin Biomech (Bristol Avon)201429327728210.1016/j.clinbiomech.2013.12.003
– reference: MeyerJJBerkRJAndersonAVRecruitment patterns in the cervical paraspinal muscles during cervical forward flexion: evidence of cervical flexion-relaxationElectromyogr Clin Neurophysiol19933342172231:STN:280:DyaK3szmsFCiug%3D%3D8359127
– reference: TeoECNgHWEvaluation of the role of ligaments, facets and disc nucleus in lower cervical spine under compression and sagittal moments using finite element methodMed Eng Phys20012331551641:STN:280:DC%2BD3MzkslOntQ%3D%3D10.1016/S1350-4533(01)00036-411410380
– reference: Jonathan PriceARushtonITyros, NicolaRHeneghanEffectiveness and optimal dosage of resistance training for chronic non-specific neck pain: a protocol for a systematic review with a qualitative synthesis and meta-analysisBMJ Open201992e02515810.1136/bmjopen-2018-025158307829266398773
– reference: Mahboobeh ZabihhosseinianMWRHolmesBFergusonBNeck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patientsClin Biomech (Bristol Avon)201530539740410.1016/j.clinbiomech.2015.03.02025843481
– reference: Akira OharaKMiyamotoTNaganawaKMatsumotoKatsuji ShimizuReliabilities of and correlations among five standard methods of assessing the sagittal alignment of the cervical spineSpine (Phila Pa 1976)200631222585259110.1097/01.brs.0000240656.79060.1817047548discussion 2592
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– reference: Mozammil HussainRNNatarajanHSAn, GunnarBJAnderssonProgressive disc degeneration at C5-C6 segment affects the mechanics between disc heights and posterior facets above and below the degenerated segment: a flexion-extension investigation using a poroelastic C3-T1 finite element modelMed Eng Phys201234555255810.1016/j.medengphy.2011.08.01421925919
– reference: Sumit ThakarNRajagopalPAlleSAlangar HegdeCervical flexor-extensor muscle disparity in Monomelic Amyotrophy (Hirayama Disease): evidence from a comprehensive morphometric evaluation of Subaxial Paraspinal musculatureAsian J Neurosurg2022171686710.1055/s-0042-1749111358738549298585
– reference: Maryse Fortin, MicheleCBattiéQuantitative paraspinal muscle measurements: inter-software reliability and agreement using OsiriX and ImageJPhys Ther201292685386410.2522/ptj.20110380
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– reference: PetraMKlingeAMcElroy, OwenPLearyJEDonahueZiyaLGNot just an Anchor: the human Filum Terminale contains Stretch sensitive and nociceptive nerve endings and responds to Electrical Stimulation with Paraspinal muscle activationNeurosurgery202291461862410.1227/neu.0000000000002081
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– reference: Farra FD, Buffone F, Risio RG Andrea Gianmaria Tarantino, &Andrea Bergna (2022) effectiveness of osteopathic interventions in patients with non-specific neck pain: a systematic review and meta-analysis. Complement Ther Clin Pract 49:101655. https://doi.org/10.1016/j.ctcp.2022.101655
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– reference: JosephNFMakYHu, AldousCSChengHYKwokKeithDKLukFlexion-relaxation ratio in sitting: application in low back pain rehabilitationSpine (Phila Pa 1976)201035161532153810.1097/BRS.0b013e3181ba021e
– reference: RubanaHChowdhury, MamunBIReazMABMAli, AshrifAABakarT G ChangSurface electromyography signal processing and classification techniquesSens (Basel)2013139124311246610.3390/s130912431
– reference: Ruka Nobe H, Yajima M, Takayama N Takakura (2022) Characteristics of Surface Electromyograph Activity of Cervical extensors and flexors in nonspecific Neck Pain patients: a cross-sectional study. Med (Kaunas) 58(12). https://doi.org/10.3390/medicina58121770
– reference: Kuan WangLWangZDengCJiangMing ZhangInfluence of passive elements on prediction of intradiscal pressure and muscle activation in lumbar musculoskeletal modelsComput Methods Programs Biomed2019177394610.1016/j.cmpb.2019.05.01831319959
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– reference: VincentKMaigneJ-YFischhoffCLanloOSimon DagenaisSystematic review of manual therapies for nonspecific neck painJoint Bone Spine201380550851510.1016/j.jbspin.2012.10.00623165183
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Snippet Purpose This study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon...
This study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP) and to...
PurposeThis study aims to explore the differences in cervical degeneration between healthy people with and without cervical flexion-relaxation phenomenon (FRP)...
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StartPage 2997
SubjectTerms Adult
Aged
Back surgery
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - physiopathology
Degeneration
Differential diagnosis
Electromyography
Ethics
Female
Hospitals
Humans
Intervertebral Disc Degeneration - diagnostic imaging
Intervertebral Disc Degeneration - physiopathology
Intervertebral discs
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Methods
Middle Aged
Neck pain
Neurosurgery
Original Article
Orthopedics
Range of Motion, Articular - physiology
Surgical Orthopedics
Vertebrae
X-rays
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Title Is the disappearance of the cervical flexion-relaxation phenomenon associated with cervical degeneration in healthy people?
URI https://link.springer.com/article/10.1007/s00586-024-08355-x
https://www.ncbi.nlm.nih.gov/pubmed/38869650
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