Assessing Upper Trapezius Elasticity In Healthy Population And Subjects With Chronic Neck Pain By Shear Wave Elastography

Objective1.To determine the intra-and interoperator reliabilities of evaluating upper trapezius by shear wave elastography(SWE)and to quantify the alterations of upper trapezius elastic modulus in healthy subjects during the cervical flexion at 0°and 50°.2.To certify the immediate effect of kinesio taping on upper trapezius elastic modulus during shoulder elevation in healthy population.3.To investigate the difference between the upper trapezius elastic modulus in painful and non-painful side in patients with chronic neck pain(CNP)and the relationship between muscle elastic modulus in painful side and pain intensity,and the neck functional disability.Methods1.From May to October,2018,20 healthy male subjects were recruited from the Henan Provincial Orthopedic Hospital(Luoyang Orthopedic-Traumatological Hospital of Henan Province).Upper trapezius was evaluated by SWE during the cervical flexion at 0°and at 50°.For reliability test,two experienced operators A and B assessed upper trapezius respectively for all subjects.the evaluator A repeated the measurement procedure after 5 days.2.From November 2018 to April 2019,40 healthy subjects were recruited from Henan Provincial Orthopedic Hospital(Luoyang Orthopedic-Traumatological Hospital of Henan Province).All subjects were divided into kinesio taping group and control group using a blind method.Upper trapezius in kinesio taping group and control group were quantified by SWE at 0°and 90°of shoulder flexion.3.From May to October,2019,30 patients with chronic neck pain were recruited from Henan Provincial Orthopedic Hospital(Luoyang Orthopedic-Traumatological Hospital of Henan Province).Before the experiment,all subjects were required to assess self-perceived pain via visual analogue scale(VAS)and neck neck functional disability by neck disability index(NDI).Upper trapezius in painful and non-painful side were evaluated by SWE and the correlations of muscle elastic modulus in painful side with VAS and NDI were investigated.Results1.The intra-and interoperator reliabilities of evaluating upper trapezius by SWE indicated both good and excellent.When the cervical flexion at 0°,the intraopertor reliability was good(intraclass correlation coefficient,ICC=0.86)and interoperator reliability was excellent(ICC=0.98).When the cervical flexion at 50°,the intraopertor reliability was good(ICC=0.85)and interoperator reliability was excellent(ICC=0.94).In addition,the elastic modulus of upper trapezius increased during the cervical flexion angle increased(P<0.05).2.With the increase of shoulder flexion angle,upper trapezius elastic modulus increased(P<0.05).For kinesio taping group,the muscle elastic modulus was showed a significant difference after kinesio taping intervention.Compared with control group,the muscle elastic modulus was decreased significantly in kinesio taping group(P<0.05).3.There is a significant difference in the upper trapezius elastic modulus in patients with CNP between painful and non-painful side(P<0.05).There was a significant positive correlation between muscle elastic modulus and VAS(r=0.652,P=0.000).Similarly,it was also shown a significant positive correlation between the muscle elasticity and NDI(r=0.494,P=0.006).Conclusion1.There were high reliabilities of assessing upper trapezius elastic modulus by SWE at different cervical flexion angles in healthy participants.And SWE can quantify accurately the modulations in upper trapezius elasticity during cervical flexion.It can be seen that SWE is an advanced tool for evaluating muscle with a high reliability.In addition,upper trapezius elastic modulus increased during the cervical flexion,which it indicated that the increase of cervical flexion angle may increase risk of neck and shoulder discomforts.2.The intervention of kinesio taping can reduce upper trapezius elastic modulus immediately.It was therefore that kinesio taping could replace upper trapezius to take a certain percentage of loading during the shoulder elevation and it might be used as an effective intervention to relieve musculoskeletal discomforts.3.For patients with chronic neck pain,upper trapezius elastic modulus in the painful side was significantly increased compared to the non-painful side.In addition,the muscle elastic modulus in painful side is positively correlated with VAS and NDI scores.Therefore,the findings about modulations of upper trapezius in pathological conditions can help the physicians to explore the pathogenesis of neck and shoulder discomforts.Additionally,relying on accurate rehabilitation assessment technology combined with assessment scales can help physicians to investigate more objectively and comprehensively the patients’ muscle condition,and provide a scientific reference for further establishing a rehabilitation treatment plan.