Strunk Richard G, Hawk Cheryl
Assistant Professor, Clinical Sciences/Research, Cleveland Chiropractic College, Overland Park, KS.
J Chiropr Med. 2009 Dec;8(4):156-64. doi: 10.1016/j.jcm.2009.08.002.
This feasibility study was conducted to further the development of a line of investigation into the potential effects of spinal manipulation/manual therapy on cervicogenic dizziness, balance, and neck pain in adults.
A single-group, preexperimental, feasibility study was conducted at a chiropractic college health center and a senior fitness center with a target sample size of 20 patients (40 years or older). Patients were treated by either a clinician or a chiropractic student intern for 8 weeks. The Dizziness Handicap Inventory was the primary outcome measurement, with the Short Form Berg Balance Scale (SF-BBS) and the Neck Disability Index used as secondary outcome measurements.
Twenty-seven patients were recruited over a period of 13 months. Twenty-one patients enrolled in the study; but because of 2 dropouts, 19 patients completed the treatment. A median Dizziness Handicap Inventory change score of +7 points was calculated for those dizziness patients, with 3 patients improving by at least 18 points, indicating a clinically meaningful change. Seven of the 15 patients who performed the SF-BBS attained at least a 4-point improvement with an effect size of 1.2. A median Neck Disability Index change score of +1 was calculated for those patients with neck pain. Twelve minor adverse reactions were reported by 8 patients, with 3 of those reactions lasting longer than 24 hours.
A large effect size was calculated for the SF-BBS. Most patients demonstrated improved balance, and some showed reduced dizziness and neck pain. Involving interns in care proved feasible. Further studies with comparison groups and larger samples are needed to explore the promising results of this study before any cause and effect relationship can be determined.
本可行性研究旨在进一步开展一项关于脊柱推拿/手法治疗对成人颈源性头晕、平衡能力和颈部疼痛潜在影响的系列调查。
在一所脊椎按摩疗法学院健康中心和一个老年健身中心开展了一项单组、实验前可行性研究，目标样本量为20名患者（40岁及以上）。患者由临床医生或脊椎按摩疗法专业实习学生治疗8周。头晕残障量表是主要结局指标，简短伯格平衡量表（SF - BBS）和颈部功能障碍指数用作次要结局指标。
在13个月的时间里招募了27名患者。21名患者登记参加研究；但由于2名患者退出，19名患者完成了治疗。那些头晕患者的头晕残障量表变化得分中位数为 +7分，3名患者改善至少18分，表明有临床意义的变化。15名进行SF - BBS测试的患者中有7名至少改善了4分，效应量为1.2。那些颈部疼痛患者的颈部功能障碍指数变化得分中位数为 +1。8名患者报告了12次轻微不良反应，其中3次反应持续超过24小时。
计算得出SF - BBS有较大效应量。大多数患者平衡能力得到改善，一些患者头晕和颈部疼痛减轻。让实习生参与护理被证明是可行的。在确定任何因果关系之前，需要进行有对照组和更大样本量的进一步研究，以探索本研究的有前景的结果。
