Yahia A, Ghroubi S, Jribi S, Mâlla J, Baklouti S, Ghorbel A, Elleuch M H
Service de médecine physique, rééducation et réadaptation fonctionnelle, hôpital Habib Bourguiba, université du Sud, street el Ain Km 0,5, 3029 Sfax, Tunisia.
Ann Phys Rehabil Med. 2009 Sep-Oct;52(7-8):556-67. doi: 10.1016/j.rehab.2009.07.033. Epub 2009 Aug 15.
We sought to establish whether chronic neck pain patients suffering from vertigo and instability have true balance disorders.
Ninety-two patients having suffered from chronic neck pain for at least 3 months were enrolled in the present study. Patients with a history of neck trauma or ear, nose and throat, ophthalmological or neurological abnormalities were excluded. The patients were evaluated in a clinical examination (neck mobility) and a test of dynamic and static balance on the Satel((R)) platform in which mediolateral (Long X) and anterior-posterior deviations (Long Y) were monitored. Our patients were divided into three groups: a group of 32 patients with neck pain and vertigo (G1), a group of 30 patients with chronic neck pain but no vertigo (G2) and a group of 30 healthy controls.
All groups were comparable in terms of age, gender, weight and shoe size. Osteoarthritis was found in 75% and 70% of the subjects in G1 and G2, respectively. Neck-related headache was more frequent in G1 than in G2 (65.5% versus 40%, respectively; p=0.043). Restricted neck movement was more frequent in G1 and concerned flexion (p<0.001), extension (p<0.001), rotation (p<0.001), right inclination (p<0.001) and left inclination (p<0.001). Balance abnormalities were found more frequently in G1 than in G2 or G3. Static and dynamic posturographic assessments (under "eyes open" and "eyes shut" conditions) revealed abnormalities in statokinetic parameters (Long X and Long Y) in G1.
Our study evidenced abnormal static and dynamic balance parameters in chronic neck pain patients with vertigo. These disorders can be explained by impaired cervical proprioception and neck movement limitations. Headache was more frequent in these patients.
我们试图确定患有眩晕和不稳定症状的慢性颈部疼痛患者是否存在真正的平衡障碍。
本研究纳入了92名患有慢性颈部疼痛至少3个月的患者。排除有颈部外伤史或耳鼻喉、眼科或神经科异常病史的患者。对患者进行临床检查（颈部活动度）以及在Satel((R))平台上进行动态和静态平衡测试，监测其左右（长X）和前后偏差（长Y）。我们的患者分为三组：一组32例颈部疼痛伴眩晕患者（G1组），一组30例慢性颈部疼痛但无眩晕患者（G2组）和一组30例健康对照者。
所有组在年龄、性别、体重和鞋码方面具有可比性。G1组和G2组分别有75%和70%的受试者患有骨关节炎。G1组颈部相关头痛比G2组更常见（分别为65.5%对40%；p = 0.043）。G1组颈部活动受限更常见，涉及前屈（p < 0.001）、后伸（p < 0.001）、旋转（p < 0.001）、右侧倾斜（p < 0.001）和左侧倾斜（p < 0.001）。G1组平衡异常比G2组或G3组更常见。静态和动态姿势描记评估（在“睁眼”和“闭眼”条件下）显示G1组在静动参数（长X和长Y）方面存在异常。
我们的研究证明了患有眩晕的慢性颈部疼痛患者存在异常的静态和动态平衡参数。这些障碍可由颈部本体感觉受损和颈部活动受限来解释。这些患者头痛更常见。
