Altered transversus abdominis and internal oblique muscle activation during cervical motor control tasks in individuals with chronic neck pain: A surface EMG-based analysis.

Background: Chronic neck pain (CNP) is associated with disturbances in cervical motor control and altered postural strategies. However, little is known about how cervical motor demands influence the recruitment of deep abdominal stabilizers. This study examined the activation of the transversus abdo...

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Published in:Journal of Back & Musculoskeletal Rehabilitation Vol. 39; no. 4; pp. 1428 - 1438
Main Authors: Baydogan Tan, Banu Gokcen, Tan, Sefa, Karatas, Levent, Karaoglan, Belgin
Format: research tables/charts Journal Article
Published: Sage Publications Inc. Jul2026
Online Access:View this record in EBSCOhost
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      jtl: Journal of Back & Musculoskeletal Rehabilitation
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      dt: Jul2026
      vid: 39
      iid: 4
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/10538127261424302
        194801605
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        atl: Altered transversus abdominis and internal oblique muscle activation during cervical motor control tasks in individuals with chronic neck pain: A surface EMG-based analysis.
      aug:
        au:
          Baydogan Tan, Banu Gokcen
          Tan, Sefa
          Karatas, Levent
          Karaoglan, Belgin
        affil: Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Türkiye
      sug:
        subj:
          Neck Pain Physiopathology
          Chronic Pain Physiopathology
          Transversus Abdominis Physiology
          Abdominal Oblique Muscles Physiology
          Task Performance and Analysis
          Neck Muscles Physiology
          Motor Skills Evaluation
          Electromyography Methods
          Test-Retest Reliability
          Human
          Turkiye
          Male
          Female
          Adult
          Middle Age
          Cross Sectional Studies
          Academic Medical Centers
          Descriptive Statistics
          Data Analysis Software
          Spearman's Rank Correlation Coefficient
          Intraclass Correlation Coefficient
          Post Hoc Analysis
          Neurologic Examination
          Musculoskeletal System Pathology
          Visual Analog Scaling
          Therapeutic Exercise
          Exercise Test
          Isometric Contraction Evaluation
          Analysis of Variance
          Scales
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: Chronic neck pain (CNP) is associated with disturbances in cervical motor control and altered postural strategies. However, little is known about how cervical motor demands influence the recruitment of deep abdominal stabilizers. This study examined the activation of the transversus abdominis–internal oblique (TrA–IO) during isolated and combined cervical–trunk motor tasks in individuals with CNP. Objective: To compare TrA–IO activation during the abdominal drawing-in maneuver (ADIM) and ADIM combined with the craniocervical flexion test (CCFT) between individuals with CNP and healthy controls, and to evaluate the reliability of RMS-normalized surface EMG measurements. Methods: A total of 38 participants (19 individuals with chronic neck pain and 19 age- and sex-matched healthy controls) performed ADIM and ADIM + CCFT tasks while surface EMG recorded bilateral TrA–IO activity. EMG signals were processed using RMS and normalized to maximal voluntary isometric contraction (%MVIC). A 2 × 2 mixed-model ANOVA evaluated group and task effects. Reliability was assessed using ICC, SEM, and MDC. Results: Both groups showed increased TrA–IO activation during ADIM + CCFT compared to ADIM (p < 0.01). However, the CNP group demonstrated significantly lower activation during the combined task (left: p = 0.026; right: p < 0.001). No associations were found between EMG activation and pain, disability, or symptom duration. Reliability analyses showed excellent test–retest stability (ICC = 0.91–0.99). Conclusion: Individuals with CNP exhibit impaired ability to increase deep abdominal activation during cervical motor control tasks, indicating disrupted cervico-lumbopelvic synergy. Rehabilitation programs should integrate deep cervical flexor training with core stabilization strategies to address multi-segmental motor control deficits.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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