Kanlayanaphotporn Rotsalai, Chiradejnant Adit, Vachalathiti Roongtiwa
Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Pathumwan, Bangkok, Thailand.
Arch Phys Med Rehabil. 2009 Feb;90(2):187-92. doi: 10.1016/j.apmr.2008.07.017.
To determine the immediate effects on both pain and active range of motion (ROM) of the unilateral posteroanterior (PA) mobilization technique on the painful side in mechanical neck pain patients presenting with unilateral symptoms.
Triple-blind, randomized controlled trial.
Outpatient physical therapy, institutional clinic.
Patients (N=60), 2 physical therapists, and 1 assessor involved in this study.
The patients were randomly allocated into either preferred or random mobilization group by using an opaque concealed envelope. The first therapist performed the screening, assessing, prescribing the spinal level(s), and the grade of mobilization. The second therapist performed the mobilization treatment according to their allocated group stated in an envelope. The assessor who was blind to the group allocation conducted the measurements of pain and active cervical ROM.
Pain intensity, active cervical ROM, and global perceived effect were measured at baseline and 5 minutes posttreatment.
After mobilization, there were no apparent differences in pain and active cervical ROM between groups. However, within-group changes showed significant decreases in neck pain at rest and pain on most painful movement (P<0.001) with a significant increase in active cervical ROM after mobilization on most painful movement (P=0.002).
The results of this study did not provide support for the preference of the unilateral PA mobilization on the painful side to the random mobilization.
确定针对出现单侧症状的机械性颈部疼痛患者,对疼痛侧采用单侧后前向(PA)松动技术后,对疼痛和主动活动范围(ROM)的即时影响。
三盲随机对照试验。
门诊物理治疗机构诊所。
患者(N = 60)、2名物理治疗师和1名评估者参与本研究。
使用不透明的密封信封将患者随机分为偏好松动组或随机松动组。第一名治疗师进行筛查、评估、确定脊柱节段以及松动等级。第二名治疗师根据信封中指定的分组进行松动治疗。对分组情况不知情的评估者进行疼痛和颈椎主动ROM的测量。
在基线和治疗后5分钟测量疼痛强度、颈椎主动ROM和整体感觉效果。
松动后,两组之间在疼痛和颈椎主动ROM方面无明显差异。然而,组内变化显示静息时颈部疼痛和最疼痛动作时的疼痛显著减轻(P < 0.001),且在最疼痛动作时松动后颈椎主动ROM显著增加(P = 0.002)。
本研究结果不支持在疼痛侧优先采用单侧PA松动而非随机松动。