Muscular endurance and its association with neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain

BackgroundRecent studies revealed the connection between the endurance of neck muscles and pain, neck awareness, and fear of movement in patients with chronic neck pain in literature.ObjectivesTo investigate the association between cervical, scapular, trunk, and upper extremity muscles' endurance and neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain.DesignCross-sectional, observational study.MethodsThirty-six patients with chronic neck pain (aged 18-65 years) were included in the study. Endurance tests were performed for 9 muscles/muscle groups in the cervical and scapular region, upper limb, and trunk. Pain severity, neck disability, neck awareness, and fear of movement were measured by Visual Analog Scale (VAS), Neck Disability Index (NDI), Fremantle Neck Awareness Questionnaire (FreNAQ), and Tampa Scale of Kinesiophobia (TSK), respectively.ResultsNegative, weak-to-moderate relations were found between VAS (at rest and during activity) and the endurance of muscles evaluated in the cervical and scapular regions, upper extremity, and trunk as well as between NDI and endurance of the same muscles, similar to the relations between FreNAQ scores and the endurance of the cervical flexor, anterior trunk flexor, and upper extremity muscles (p < 0.05). No relation was found between the endurance of the muscles and TSK (p > 0.05).ConclusionsSince the decrease in upper extremity, scapular region, and trunk muscles' endurance may contribute to neck pain and disability, and decrease neck awareness in patients with chronic neck pain; the evaluation of muscular endurance of upper body and trunk should also be considered.