Tan J C, Nordin M
New York University, New York.
Orthop Clin North Am. 1992 Jul;23(3):435-49.
Table 4 summarizes how physical therapy should be implemented during the acute and chronic phase of cervical disk disease. From the outset of treatment, the patient should be encouraged to return to work or other productive activities and should be taught how to be responsible for their own recovery. If passive modalities are used, they must be an adjunct to the active modalities. As soon as the patient is able to continue with an active program without unbearable pain, the passive modalities should be discontinued gradually. If neck pain becomes chronic, the accompanying psychosocial dysfunction must be addressed through behavioral modification techniques, preferably in a multidisciplinary setting. Modification of the work place, work habits, and lifestyles must be emphasized at both the acute and chronic stages. The modalities presented in this article are commonly used by physical therapists. Unfortunately, the clinical efficacy of most of these modalities has yet to be proved. A literature search on the effectiveness of various physical therapy modalities by Sievers et al showed that only 4% of the studies published from 1979 to 1985 were controlled clinical trials. This scientific output of physical therapists needs to be corrected.
表4总结了在颈椎间盘疾病的急性期和慢性期应如何实施物理治疗。从治疗一开始，就应鼓励患者重返工作或其他有意义的活动，并应教会他们如何对自己的康复负责。如果使用被动治疗方式，它们必须是主动治疗方式的辅助手段。一旦患者能够在没有难以忍受的疼痛的情况下继续进行主动治疗方案，就应逐渐停止被动治疗方式。如果颈部疼痛变成慢性，必须通过行为矫正技术来解决伴随的心理社会功能障碍，最好是在多学科环境中进行。在急性期和慢性期都必须强调对工作场所、工作习惯和生活方式的调整。本文介绍的治疗方式是物理治疗师常用的。不幸的是，这些治疗方式中的大多数的临床疗效尚未得到证实。Sievers等人对各种物理治疗方式的有效性进行的文献检索表明，1979年至1985年发表的研究中只有4%是对照临床试验。物理治疗师的这种科学产出需要得到纠正。
