Document Detail

Stability of the upper neck during isometric neck exercises in rheumatoid arthritis patients with atlantoaxial disorders.
MedLine Citation:
PMID:  18609259     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To study the effect of isometric neck strength exercises on upper cervical stability in patients with rheumatoid arthritis (RA). METHODS: Twenty patients with a mean (SD) age of 58 (9) years and duration of RA of 27 (10) years volunteered for the study. Lateral radiographs of the cervical spine were taken to measure the current atlantoaxial distance (AAD) in flexion and extension. Maximal isometric neck flexion and extension strength values were measured by a dynamometer. Thereafter, AADs were measured from radiographs taken at 80-90% resistance of maximal strength. RESULTS: According to the full flexion radiographs at baseline, the patients were classified into three groups: eight patients without anterior atlantoaxial subluxation (aAAS) [AAD = 2.1 (2-3) mm], seven with unstable aAAS [AAD = 6.6 (5-8) mm], and five with stable aAAS [AAD = 5.5 (5-7) mm]. During resisted flexion the AAD decreased by 5 (3-7) mm (p<0.001) in the unstable aAAS group, while in the other two groups the changes were minor. During resisted extension the AAD increased by 3 (2-6) mm (p<0.001) in the cases with unstable aAAS only. CONCLUSION: Isometric exercising towards flexion decreases the AAD in cases with unstable aAAS. Submaximal loading of the neck extensors by pushing the back of the head against the resistance even in the neutral position of the cervical spine leads to a decrease in the width of the cervical spine canal and is not recommended in unstable aAAS.
A Hakkinen; H Makinen; J Ylinen; P Hannonen; T Sokka; M Neva; H Kautiainen; M Kauppi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of rheumatology     Volume:  37     ISSN:  1502-7732     ISO Abbreviation:  Scand. J. Rheumatol.     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-09-29     Completed Date:  2008-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0321213     Medline TA:  Scand J Rheumatol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  343-7     Citation Subset:  IM    
Department of Physical Medicine and Rehabilitation, Jyväskylä Central Hospital, Jyväskylä, Finland.
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MeSH Terms
Arthritis, Rheumatoid / physiopathology*,  radiography
Atlanto-Axial Joint / physiopathology*,  radiography
Cross-Sectional Studies
Exercise / physiology*
Exercise Therapy / adverse effects*
Joint Instability / physiopathology*
Middle Aged
Neck / physiopathology*,  radiography
Neck Muscles / physiopathology
Range of Motion, Articular / physiology

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