• Florencio LL
• Ferracni GN
• Chaves TC
• Palacios-Cena M
• Ordás-Bandera C
• Speciali JG
• Grossi DB
• Fernández-de-las-Peñas C

• Affiliation / Hospital Rey Juan Carlos. Department of Neurology
• Affiliation / Universidad Rey Juan Carlos. Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation
• Affiliation / University of São Paulo. Ribeirão Preto Medical School. Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus
• Affiliation / University of São Paulo. Ribeirão Preto Medical School. Department of Neurosciences and Behavioral Sciences
• Affiliation(G) / Brazil / São Paulo / Ribeirão Preto
• Affiliation(G) / Spain / Alcorcón
• Affiliation(G) / Spain / Madrid / Móstoles
• Electromyography
• Female
• Head / physiology
• Migraine Disorders
• Neck Muscles / physiology
• Posture
• Task Performance and Analysis

OBJECTIVE: The purpose of this study was to investigate the correlation between head and neck posture and superficial neck flexor and extensor activity during performance of the craniocervical flexion test (CCFT) in women with migraine and healthy controls.

METHODS: Fifty-two women with episodic migraine, 16 with chronic migraine, and 23 healthy controls participated. Head and neck posture were determined by assessing the craniovertebral (CV) angle and cervical lordosis angle. Surface electromyography signals were recorded bilaterally from sternocleidomastoid, anterior scalene, splenius capitis, and upper trapezius muscles as participants performed the CCFT. Differences in electromyogram activity and posture among groups were compared with analyses of variance. Correlations between posture and electromyogram activity were analyzed with the Pearson correlation coefficient.

RESULTS: Both migraine groups had a significant increase in splenius capitis muscle activity, when acting as an antagonist, at the last stage of CCFT (F = 4.687; P = .012) compared with controls. No differences among groups were observed for head and neck posture. No significant correlation was found in the episodic migraine group. Moderate correlations between the CV angle and upper trapezius activity at the majority stages of the CCFT (-0.61 < r < -0.65, all P < .05) were observed within the chronic migraine group: the more extended the head posture, the higher the activity of the upper trapezius muscle. The CV angle also was correlated with upper trapezius muscle activity at the first stage of the CCFT and with splenius capitis muscle activity at the last stages (-0.42 < r < -0.52; P < .05).

CONCLUSION: An extended (forward) head posture was moderately correlated with an increased in electrical activity of superficial neck extensor muscles, particularly the upper trapezius, when acting as an antagonist, during the performance of the CCFT in women with chronic but not episodic migraine.

Author keywords: Migraine Disorders; Posture; Electromyography

Author affiliations:  LLF, DBG: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto-SP, Sao Paulo, Brazil; GNF, TCC, JGS: Department of Neurosciences and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto-SP, Sao Paulo, Brazil; MP-C, CF-d-L-P: Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain; CO-B: Department of Neurology, Hospital Rey Juan Carlos, Móstoles, Madrid, Spain

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