Muscle strength and electromyography ratio of the extensor and flexors cervical muscles in individuals with migraine: a cross-sectional study

Abstract

Although cervical dysfunction is more prevalent in patients with tension-type headache, it is also identified in migraineurs and neck pain is most common symptom. The migraineurs who reported neck pain have reduced cervical range, worsening of disability, changes in performance of cervical muscles and increased risk of chronicity of the disease. They also have reduced muscle strength and an increase of co-activation of cervical extensors. Patients with tension-type headache the ratio of muscle strength of the extensors / flexors of the cervical muscles is reduced. However, the ratio of muscle strength and of myoelectrical activity between flexors and extensors in migraineurs have not been investigated yet. Objectives: to verify the ratio for extensor and flexors cervical muscles strength and electromyographic activity in migraine patients and headache-free subjects. Methods: The sample will be composed by 52 women, aged between 18 and 55 years and diagnosis of migraine and 52 women without headache in the same age group for the control group. Both groups will respond to questionnaires about the disability caused by neck pain or migraine, such as Neck Disability Index, Migraine Disability Assessment and 12 item Allodynia Symptom Checklist. Cervical muscle strength will be assessed by a maximal isometric voluntary contraction (MIVC) using a customized hand held dynamometer (Lafayette Instrument Company®, model 2201163, Lafayette, IN, USA). Neck muscles activity will be acquired during MIVC and also during the performance of the craniocervical flexion test (CCFT) using surface electromyopgraphy (TrignoTM Wireless System, Delsys Inc. Boston, MA). Statistical analysis: Descriptive analysis of all variables will be conducted, and the data will be present as mean, standard deviation, confidence interval and frequency of observations. A statistical analysis will also be performed according to the nature and distribution of each variable studded in this project in order to verify if there will be changes in the ratio of cervical muscles in the parameters of muscle strength and electromyographic activity. Expected results: Knowledge of the ratio between flexors and extensor strength and electromyographic activity of may be a new parameter in the assessment of patients contributing to a better assessment of these patients. In addition, it would help to further clarification of motor control of the cervical muscles of patients with migraine and hence the relationship agonists and antagonists. (AU)