Associations Between Active Myofascial Trigger Points, Electromyographic Activity and Kinesiophobia in Chronic...

Introduction: Chronic non-specific neck pain (CNSNP) is a prevalent condition where active myofascial trigger points (A-MTrPs) are commonly detected in cervical muscles and may be associated with altered electromyographic activity (EMGact). However, their association with EMGact during functional tasks remains unclear. Objectives: This study aimed to explore this relationship, hypothesizing that A-MTrPs in cervical muscles would be associated with altered EMGact. Methods: An analytical cross-sectional exploratory study was conducted in 52 patients with CNSNP. Surface EMGact of the sternocleidomastoid (SCM), anterior scalene (AS), and upper trapezius (UT) muscles was recorded during the craniocervical flexion test (CCFT) and an isometric shoulder abduction task (ABD-90). Linear mixed-effects models were constructed to identify factors associated with EMGact. Age, pain intensity, pain duration, analgesic dose, anti-inflammatory dose, and kinesiophobia score were included as covariates, while gender, physical activity level, and the presence or absence of A-MTrPs were included as categorical factors. Results: At the 22 mmHg CCFT level, analgesic consumption was positively associated with peak EMGact and average AS activation (B = 0.791 and B = 0.223, respectively) and with SCM peak EMG act (B = 0.510). At the same level, kinesiophobia was associated with average SCM EMGact (B = 0.231). At the 26 mmHg CCFT level, average AS activation remained positively associated with analgesic consumption (B = 0.148) and SCM without A-MTrPs was associated with lower EMGact compared to SCM with A-MTrPs. At the 30 mmHg CCFT level, kinesiophobia was negatively associated with average EMGact of AS. In the UT muscle, during ABD-90, kinesiophobia was negatively associated with both peak (B = -0.378) and average EMGact (B = -0.132). Conclusions: The presence of A-MTrPs may be related to SCM EMGact during CCFT in individuals with CNSNP, while analgesic consumption and kinesiophobia also could be associated with cervical muscles EMGact during functional tasks.