Field Sandra, Treleaven Julia, Jull Gwendolen
Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072 Queensland, Australia.
Man Ther. 2008 Jun;13(3):183-91. doi: 10.1016/j.math.2006.12.005. Epub 2007 Feb 15.
Disturbances of balance have been found both in patients with whiplash-associated disorders and idiopathic neck pain. This study directly compared balance between these groups to determine if neck pain precipitated by trauma resulted in greater or different balance impairments. The study was a comparative, observational design. Thirty subjects with whiplash, 30 with idiopathic neck pain and 30 healthy controls, took part in the study. Subjects performed balance tests in comfortable, narrow and tandem stances. Balance disturbances (sway energy and/or root mean squared (RMS) amplitude) were evident in several tests between subjects with neck pain and controls. Direct comparison between the neck pain groups revealed that the whiplash group had significantly greater sway energy and RMS amplitude than the idiopathic group in comfortable stance tests on a soft surface (F > 4.4, p < 0.04). Further, the whiplash group had greater RMS, but significantly less sway energy than the idiopathic group in most narrow stance tests in the anterior posterior direction F > 5.8, p < 0.02). Both neck pain groups were also significantly less able to complete the eyes closed, tandem test compared to control subjects. In conclusion, the study has found that balance deficits exist in both subjects with whiplash-associated disorders and idiopathic neck pain compared to controls; however, differences in balance strategies may exist between the neck pain groups. Overall, subjects who have experienced trauma appear to have greater balance disturbances.
在挥鞭样损伤相关疾病患者和特发性颈部疼痛患者中均发现了平衡障碍。本研究直接比较了这两组患者的平衡能力，以确定创伤引发的颈部疼痛是否会导致更严重或不同的平衡障碍。该研究采用了比较性观察设计。30名挥鞭样损伤患者、30名特发性颈部疼痛患者和30名健康对照者参与了研究。受试者在舒适站姿、窄站姿和串联站姿下进行平衡测试。在颈部疼痛患者和对照组之间的多项测试中，均出现了平衡障碍（摆动能量和/或均方根（RMS）振幅）。颈部疼痛组之间的直接比较显示，在软表面上进行的舒适站姿测试中，挥鞭样损伤组的摆动能量和RMS振幅显著高于特发性颈部疼痛组（F>4.4，p<0.04）。此外，在大多数前后方向的窄站姿测试中，挥鞭样损伤组的RMS更大，但摆动能量显著低于特发性颈部疼痛组（F>5.8，p<0.02）。与对照受试者相比，两个颈部疼痛组完成闭眼串联测试的能力也显著更低。总之，该研究发现，与对照组相比，挥鞭样损伤相关疾病患者和特发性颈部疼痛患者均存在平衡缺陷；然而，颈部疼痛组之间的平衡策略可能存在差异。总体而言，经历过创伤的受试者似乎存在更大的平衡障碍。
