Vassiliou Timon, Kaluza Gert, Putzke Caroline, Wulf Hinnerk, Schnabel Michael
Department of Anesthesiology and Critical Care, University Hospital Marburg, Baldingerstrasse 1, 35033 Marburg, Germany.
Pain. 2006 Sep;124(1-2):69-76. doi: 10.1016/j.pain.2006.03.017. Epub 2006 May 11.
The aim of this study was to compare the effect of a physical therapy regimen including active exercises with the current standard treatment on reduction of pain 6 weeks and 6 months after whiplash injury caused by motor vehicle collision. Two hundred patients were enrolled in a prospective randomized controlled trial. In the standard group, treatment consisted of immobilization with a soft collar over 7 days. In the physical therapy group, patients were scheduled for 10 physical therapy appointments including active exercises within 14 days after enrollment. Pain intensity was rated by all patients daily during the first week, the sixth week, and 6 months after recruitment, using a numeric rating scale (0-10). Data analyses were performed by comparing the mean (over 1 week) pain scores between the two different treatment groups. Ninety-seven patients were randomly assigned to the standard treatment group and 103 to the physical therapy group. During the first week, there was no significant difference in mean pain intensity between the standard treatment group (4.76+/-2.15) and the physical therapy group (4.36+/-2.14). However, after 6 weeks, mean pain intensity was significantly (p=0.002) lower in the physical therapy group (1.49+/-2.26 versus 2.7+/-2.78). Similarly, after 6 months, significantly (p<0.001) less pain was reported in the physical therapy group (1.17+/-2.13) than the standard treatment group (2.33+/-2.56). We conclude that a physical therapy regimen which includes active exercises is superior in reducing pain 6 weeks and 6 months after whiplash injury compared to the current standard treatment with a soft collar.
本研究的目的是比较包括主动运动的物理治疗方案与当前标准治疗对机动车碰撞所致挥鞭伤后6周和6个月疼痛减轻的效果。200名患者被纳入一项前瞻性随机对照试验。在标准组中，治疗包括使用软颈托固定7天。在物理治疗组中，患者在入组后14天内安排10次物理治疗，包括主动运动。在招募后的第一周、第六周和6个月，所有患者每天使用数字评分量表（0 - 10）对疼痛强度进行评分。通过比较两个不同治疗组之间的平均（超过1周）疼痛评分进行数据分析。97名患者被随机分配到标准治疗组，103名患者被分配到物理治疗组。在第一周，标准治疗组（4.76±2.15）和物理治疗组（4.36±2.14）的平均疼痛强度没有显著差异。然而，6周后，物理治疗组的平均疼痛强度显著更低（p = 0.002）（1.49±2.26对2.7±2.78）。同样，6个月后，物理治疗组（1.17±2.13）报告的疼痛明显（p < 0.001）少于标准治疗组（2.33±2.56）。我们得出结论:与当前使用软颈托的标准治疗相比，包括主动运动的物理治疗方案在减轻挥鞭伤后6周和6个月的疼痛方面更具优势。
