Coppieters Michel W, Stappaerts Karel H, Wouters Leo L, Janssens Koen
Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, University of Leuven, Leuven, Belgium.
J Orthop Sports Phys Ther. 2003 Jul;33(7):369-78. doi: 10.2519/jospt.2003.33.7.369.
Randomized clinical trial.
To analyze the immediate treatment effects of cervical mobilization and therapeutic ultrasound in patients with neurogenic cervicobrachial pain.
Different treatment modalities have been described for patients with neurogenic cervicobrachial pain. Although it has been suggested that a more specific approach, like cervical mobilization, would be more effective, effect studies are scarce.
Twenty patients with subacute peripheral neurogenic cervicobrachial pain were assessed. Besides other criteria, patients were included if a cervical segmental motion restriction was present which could be regarded as a possible cause of the neurogenic disorder. Patients were randomly assigned to a mobilization or ultrasound group. Mobilization consisted of a contralateral lateral glide technique. The range of elbow extension, symptom distribution, and pain intensity during the neural tissue provocation test for the median nerve were used as outcome measures. Results were analyzed using a 2-way mixed-design ANOVA.
Significant differences in treatment effects between the 2 groups could be observed for all outcome measures (P < or = .0306). For the mobilization group, the increase in elbow extension from 137.3 degrees to 156.7 degrees, the 43.4% decrease in area of symptom distribution, and the decreased pain intensity from 7.3 to 5.8 were significant (P < or = .0003). For the ultrasound group, there were no significant improvements (P > or = .0521).
When a cervical dysfunction can be regarded as a cause of the neurogenic disorder or as a contributing factor that impedes natural recovery, a cervical lateral glide mobilization has positive immediate effects in patients with subacute peripheral neurogenic cervicobrachial pain. This movement-based approach seems preferable to ultrasound.
随机临床试验。
分析颈椎松动术和治疗性超声对神经源性颈臂痛患者的即时治疗效果。
对于神经源性颈臂痛患者，已有多种不同的治疗方式被描述。尽管有人提出更具针对性的方法，如颈椎松动术，可能更有效，但相关疗效研究较少。
对20例亚急性周围神经源性颈臂痛患者进行评估。除其他标准外，若存在颈椎节段性活动受限且可被视为神经源性疾病的可能病因，则纳入患者。患者被随机分为松动术组或超声组。松动术采用对侧侧方滑动技术。将肘伸展范围、症状分布以及正中神经神经组织激发试验期间的疼痛强度用作疗效指标。使用双向混合设计方差分析对结果进行分析。
在所有疗效指标上，两组间的治疗效果均存在显著差异（P≤0.0306）。对于松动术组，肘伸展角度从137.3度增加到156.7度、症状分布面积减少43.4%以及疼痛强度从7.3降至5.8均具有显著性（P≤0.0003）。对于超声组，无显著改善（P≥0.0521）。
当颈椎功能障碍可被视为神经源性疾病的病因或阻碍自然恢复的促成因素时，颈椎侧方滑动松动术对亚急性周围神经源性颈臂痛患者具有积极的即时效果。这种基于运动的方法似乎优于超声治疗。
