Changes in respiratory muscle strength and diaphragm thickness in chronic neck pain: A systematic review
Sima Hatamvand, Nahid Rahmani, Mohammad Ali Mohseni-Bandpei, Somayeh Amiri-Arimi, Mohammad SaatchiBACKGROUND:
Changes in the respiratory system are one of the problems associated with neck pain. The purpose of the present study was to systematically review the previously published studies that have focused on changes in the strength of the respiratory muscles and the diaphragm thickness in individuals with chronic neck pain (CNP).
MATERIALS AND METHODS:
This systematic review was conducted according to PRISMA guidelines. Articles were retrieved from PubMed, Scopus, Embase, Web of Science, and Google Scholar databases. The keywords used were: “neck pain”, “Respiratory Muscles”, “diaphragm”, “Muscle Strength”, and “ultrasonography”. Among the 160 articles identified, 15 articles were selected that investigated changes in respiratory muscles and diaphragm thickness in patients with chronic neck pain. Study quality was assessed using a validated tool. All studies had a cross-sectional and case-control design. There were some variations among the studies in terms of methodology, musculoskeletal conditions, respiratory parameters, and sample size.
RESULTS:
A significant difference was reported in maximum inspiratory pressure, maximum expiratory pressure, maximum voluntary ventilation, and diaphragm thickness and excursion in patients with chronic neck pain compared to asymptomatic subjects. Pain score, neck disability index, and neck muscle strength were significantly correlated with respiratory parameters.
CONCLUSION:
Chronic neck pain is linked to measurable changes in the respiratory system, such as decreased diaphragm thickness and reduced respiratory muscle strength. These changes may impact functional capacity and should be considered in clinical evaluation and rehabilitation planning. These findings support incorporating respiratory assessments into the comprehensive management of CNP.