| dc.description.abstract | Neck pain and injury are highly prevalent conditions that constitute a growing global healthcare burden. Females are at greater risk of neck injury from impact, are more likely to have persistent neck pain, and have poorer treatment outcomes than males. Neck muscular strength differs significantly between the sexes and is believed to be an important modifiable factor in injury prevention strategies and pain treatment protocols. Given the increased prevalence of mechanical neck pain and the lack of effective treatment, there is a need for investigation into the factors underlying neck strength. This information would help tailor preventative and therapeutic interventions to the individual, with sex-specificity as a much needed first step in personalization. This dissertation investigates the morphological, biomechanical, and neuromuscular factors of neck strength through the development and analysis of subject-specific neck biomechanical models. These three strength factors correspond to the three studies of the dissertation: (1) Sex and Posture Dependence of Neck Muscle Size-Strength Relationships, (2) Subject-Specific Neck Modeling Unveils Sex Differences in Muscle Moment Arm and Cervical Spine Load During Maximal Contractions, and (3) Subject-Specific Maximum Muscle Tension: An Index to Capture Neuromuscular Differences in Neck Strength. This three-part, stepwise approach integrates subjects’ medical imaging with biomechanical measurements taken during maximal neck exertions to achieve a novel degree of subject-specificity in neck biomechanical modeling, one that affords the unique opportunity to investigate individual differences in neck strength factors. The discovered sex differences in neck structure and function provide insight into how potential pathomechanisms of neck pain and injury as well as potential targets for preventative or therapeutic intervention may differ between the sexes. | |
