ABSTRACT
Carpal tunnel syndrome (CTS) may be a consequence of increased forearm flexor activity secondary to muscle dysfunction in the neck. Eighteen CTS patients, with an average duration of symptoms of 10 months, were studied. Standardized nerve-conduction studies were administered before and after treatment. Surface-EMG techniques measured sternomastoid and cervical paraspinal muscle activity and flexor and extensor muscle activity during head movement. Both sets of neck muscles were found to be asymmetrical when compared side to side. Reduction of the sternomastoid asymmetry decreased forearm flexor EMG activity. Significant decreases in all nerve conduction measures were noted for every subject. Over half reported a loss of symptoms with post hoc analysis suggesting this may be related to the sternomastoid median frequency. It is suggested that increased flexor and/or extensor motor activity is an expression of dysfunctional sternomastoid activity. Possible mechanisms of dysfunction including the tonic neck reflex are discussed.
ABSTRACT
An educational program which emphasized the symmetrical use of back muscles was studied at a health care facility which had extremely high time lost injury rates due to back strains. Participants (N=180) were involved with half studying an educational program entitled "Back to Balance" with the remainder serving as controls. After 3 months, the controls studied the program. All subjects completed psychological tests, received cervical and lumbar paraspinal dynamic EMG evaluations four times (pre-and post-treatment, and after 3 and 12 months). Administrative indices (costs, incidence, and time lost injury rate) were obtained for the 3 years prior to the study and for the 1 year of the study. The 1-year results showed decreased pain, retained knowledge which was generalized to the home, and significantly improved symmetry of both sets of muscles. Administrative data revealed a 72% decrease in the time lost injury rate with reduced costs.
