Dehner Christoph, Heym Birgit, Maier Dirk, Sander Silvia, Arand Markus, Elbel Martin, Hartwig Erich, Kramer Michael
Department for Trauma Surgery, Hand, Plastic and Reconstructive Surgery, University of Ulm, Steinhövelstrasse 9, Germany.
Gait Posture. 2008 Jul;28(1):113-9. doi: 10.1016/j.gaitpost.2007.10.007. Epub 2008 Feb 20.
Experimental in vivo study.
The objective was to investigate the balance control in patients with acute QTF grade II whiplash injuries of the cervical spine.
Tetra-ataxiametric posturography in chronic pain patients after whiplash injuries of the cervical spine has revealed an impaired regulation of balance. However, so far it is unclear if this is caused by the accident or other factors that are associated with the pain chronification process.
40 patients with acute QTF grade II whiplash injuries and 40 healthy matched controls were examined on a posturography platform. The stability index ST(Sigma) and the Fourier analysis FA(Sigma) (0.10-1.00Hz) were established for eight standing positions and sum scores were calculated. The pain index was established using a visual analog scale ranging from 0 to 100. A follow-up examination was conducted for the patients after 2 months.
The patients with acute whiplash injuries of the cervical spine achieved significantly poorer results for both ST(Sigma) and FA(Sigma) than the healthy controls. There were no differences between the eight standing positions for both ST(Sigma) and FA(Sigma). After 2 months, 17 patients had no change in the pain development, 21 patients showed an improvement in pain intensity and 2 patients had deteriorated. The subgroup of patients with improvement in pain intensity showed a significant improvement in balance control concerning the FA(Sigma) compared to patients with unchanged pain intensity.
Patients with acute whiplash injuries have a reduced balance control as compared to matched controls. This study gives an indication that post-traumatic neck pain is associated with impairments of postural control.
体内实验研究。
研究急性颈椎挥鞭样损伤II级患者的平衡控制情况。
颈椎挥鞭样损伤后慢性疼痛患者的四轴重心平衡仪姿势描记法显示平衡调节受损。然而,目前尚不清楚这是由事故引起还是与疼痛慢性化过程相关的其他因素所致。
在姿势描记平台上对40例急性颈椎挥鞭样损伤II级患者和40例健康对照者进行检查。确定八个站立位的稳定性指数ST(Σ)和傅里叶分析FA(Σ)(0.10 - 1.00Hz),并计算总分。使用0至100的视觉模拟量表确定疼痛指数。对患者在2个月后进行随访检查。
急性颈椎挥鞭样损伤患者的ST(Σ)和FA(Σ)结果均显著低于健康对照组。ST(Σ)和FA(Σ)在八个站立位之间均无差异。2个月后,17例患者疼痛情况无变化,21例患者疼痛强度改善,2例患者疼痛恶化。与疼痛强度无变化的患者相比,疼痛强度改善的患者亚组在FA(Σ)方面的平衡控制有显著改善。
与匹配的对照组相比,急性颈椎挥鞭样损伤患者的平衡控制能力降低。本研究表明创伤后颈部疼痛与姿势控制受损有关。