Palmgren Per J, Sandström Peter J, Lundqvist Fredrik J, Heikkilä Hannu
Department of Research, Scandinavian College of Chiropractic, Solna, Sweden.
J Manipulative Physiol Ther. 2006 Feb;29(2):100-6. doi: 10.1016/j.jmpt.2005.12.002.
The objective of this study was to examine alteration in head repositioning accuracy (HRA), range of motion, and pain intensity in patients with chronic cervical pain syndrome without a history of cervical trauma.
The study was a prospective, randomized, controlled trial. Forty-one patients with chronic cervical pain were randomly assigned to either a control group or a chiropractic treatment group. All patients were clinically examined, given general information on cervical pain, and provided with training instructions based on the clinical evaluation. The treatment included sessions with high-velocity and low-amplitude manipulation, proprioceptive neuromuscular facilitation, ischemic compression of myofascial trigger points, and spinal rehabilitation exercises aiming to normalize cervical range of motion (CROM) and HRA. Subjective pain intensity, cervical kinesthetic sensibility, and CROM were recorded before and after the study period.
There was no difference between the treatment patients and the control subjects at the beginning with regard to age, sex, subjective pain intensity, range of motion, and HRA. At the 5-week follow-up, the treatment patients showed significant reductions in pain and improvement of all HRA aspects measured whereas the control subjects did not show any reduction in pain and improvement in only one HRA aspect. No significant difference was detected in CROM.
The results of this study suggest that chiropractic care can be effective in influencing the complex process of proprioceptive sensibility and pain of cervical origin. Short, specific chiropractic treatment programs with proper patient information may alter the course of chronic cervical pain.
本研究的目的是检查无颈椎创伤史的慢性颈痛综合征患者头部重新定位准确性(HRA)、活动范围和疼痛强度的变化。
该研究是一项前瞻性、随机、对照试验。41例慢性颈痛患者被随机分为对照组或整脊治疗组。所有患者均接受临床检查,获得有关颈痛的一般信息,并根据临床评估提供训练指导。治疗包括高速低振幅手法治疗、本体感觉神经肌肉促进法、肌筋膜触发点的缺血性按压以及旨在使颈椎活动范围(CROM)和HRA正常化的脊柱康复锻炼。在研究期前后记录主观疼痛强度、颈部动觉敏感性和CROM。
治疗组患者与对照组在年龄、性别、主观疼痛强度、活动范围和HRA方面在开始时无差异。在5周随访时,治疗组患者疼痛显著减轻,所测量的所有HRA方面均有改善,而对照组患者疼痛未减轻,仅一个HRA方面有改善。CROM方面未检测到显著差异。
本研究结果表明,整脊治疗可有效影响颈部本体感觉敏感性和疼痛的复杂过程。简短、特定的整脊治疗方案并提供适当的患者信息可能会改变慢性颈痛的病程。