McNair Peter J, Portero Pierre, Chiquet Christophe, Mawston Grant, Lavaste Francois
Physical Rehabilitation Research Centre, Division of Rehabilitation and Occupation Studies, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand.
Man Ther. 2007 Nov;12(4):390-4. doi: 10.1016/j.math.2006.08.002. Epub 2006 Oct 27.
Despite the relatively high prevalence of cervical spine pain, the efficacy of treatment procedures is limited. In the current study, range of motion and proprioception was assessed prior to and after specific cervical spine mobilisation techniques. A 44-year-old male office worker presented with a history of cervical pain of 1 day duration. He had woken with pain, stiffness and a loss of range of motion. Examination findings indicated pain to be at C5-6 on the left side. Measurement of maximal three-dimensional cervical motion was undertaken using a Zebris system. A position matching task tested the individual's ability to actively reposition their head and neck. The treatment undertaken involved grade III down-slope mobilisations on the left side at C5-6 and C6-7 in supine lying. This technique was then progressed by placing the subject in an upright sitting position, and sustained natural apophyseal glides were performed at C6. Immediately following the treatment, the patient reported a considerable decrease in pain, less difficulty in movement and reduced stiffness. Motion analyses showed the most marked percentage improvements in range of motion after treatment were in flexion (55%), extension (35%), left rotation (56%), and left lateral flexion (22%). Ipsilateral lateral flexion with axial rotation was also notably improved following treatment. No change in proprioceptive ability was found following the treatment. The findings showed that the application of standardised specific mobilisation techniques led to substantial improvements in the range of motion and the restitution of normal coupled motion.
尽管颈椎疼痛的患病率相对较高，但治疗方法的疗效有限。在本研究中，在特定颈椎松动技术前后评估了活动范围和本体感觉。一名44岁的男性办公室职员，有为期1天的颈部疼痛病史。他醒来时感到疼痛、僵硬且活动范围受限。检查结果表明疼痛位于左侧C5 - 6。使用Zebris系统进行最大三维颈椎活动度测量。一项位置匹配任务测试了个体主动重新定位头部和颈部的能力。所采用的治疗方法包括在仰卧位对左侧C5 - 6和C6 - 7进行III级下坡松动。然后让受试者处于直立坐姿，对C6进行持续的自然关节突滑动，以此推进该技术。治疗后，患者立即报告疼痛显著减轻、活动困难减少且僵硬程度降低。运动分析表明，治疗后活动范围改善最明显的百分比分别为：前屈（55%）、后伸（35%）、左旋（56%）和左侧侧屈（22%）。治疗后同侧侧屈伴轴向旋转也有显著改善。治疗后本体感觉能力未发现变化。研究结果表明，应用标准化的特定松动技术可使活动范围得到显著改善，并恢复正常的耦合运动。
