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采用姿势康复方法的临床生物力学对既往无反应性挥鞭样相关疾病患者进行保守治疗。

Conservative treatment of a patient with previously unresponsive whiplash-associated disorders using clinical biomechanics of posture rehabilitation methods.

作者信息

Ferrantelli Joseph R, Harrison Deed E, Harrison Donald D, Stewart Denis

出版信息

J Manipulative Physiol Ther. 2005 Mar-Apr;28(3):e1-8. doi: 10.1016/j.jmpt.2005.02.006.

Abstract

OBJECTIVE

To describe the treatment of a patient with chronic whiplash-associated disorders (WADs) previously unresponsive to multiple physical therapy and chiropractic treatments, which resolved following Clinical Biomechanics of Posture (CBP) rehabilitation methods.

CLINICAL FEATURES

A 40-year-old man involved in a high-speed rear-impact collision developed chronic WADs including cervicothoracic, shoulder, and arm pain and headache. The patient was diagnosed with a confirmed chip fracture of the C5 vertebra and cervical and thoracic disk herniations. He was treated with traditional chiropractic and physical therapy modalities but experienced only temporary symptomatic reduction and was later given a whole body permanent impairment rating of 33% by an orthopedic surgeon.

INTERVENTION AND OUTCOME

The patient was treated with CBP mirror-image cervical spine adjustments, exercise, and traction to reduce forward head posture and cervical kyphosis. A presentation of abnormal head protrusion resolved and cervical kyphosis returned to lordosis posttreatment. His initial neck disability index was 46% and 0% at the end of care. Verbal pain rating scales also improved for neck pain (from 5/10 to 0/10).

CONCLUSION

A patient with chronic WADs and abnormal head protrusion, cervical kyphosis, and disk herniation experienced an improvement in symptoms and function after the use of CBP rehabilitation protocols when other traditional chiropractic and physical therapy procedures showed little or no lasting improvement.

摘要

目的

描述一名慢性挥鞭样损伤相关疾病(WADs)患者的治疗情况,该患者此前对多种物理治疗和脊椎按摩治疗均无反应,但在采用姿势临床生物力学(CBP)康复方法后症状得到缓解。

临床特征

一名40岁男性在高速追尾碰撞事故中患上慢性WADs,包括颈胸段、肩部和手臂疼痛以及头痛。患者被诊断为C5椎体确诊的碎片骨折以及颈椎和胸椎椎间盘突出。他接受了传统的脊椎按摩和物理治疗,但仅经历了症状的暂时减轻,后来一名整形外科医生评定其全身永久性损伤程度为33%。

干预与结果

对该患者采用CBP镜像颈椎调整、运动和牵引治疗,以减少头部前倾姿势和颈椎后凸。治疗后,异常头部前突症状消失,颈椎后凸恢复为前凸。其初始颈部功能障碍指数为46%,治疗结束时为0%。颈部疼痛的言语疼痛评定量表评分也有所改善(从5/10降至0/10)。

结论

一名患有慢性WADs且伴有异常头部前突、颈椎后凸和椎间盘突出的患者,在使用CBP康复方案后症状和功能得到改善,而其他传统的脊椎按摩和物理治疗方法几乎没有或没有带来持久的改善。

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