Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland.
J Rehabil Med. 2010 Apr;42(4):344-9. doi: 10.2340/16501977-0527.
To compare the efficacy of three 12-month training programmes on headache and upper extremity pain in patients with chronic neck pain.
A total of 180 female office workers, with chronic, non-specific neck pain were randomly assigned to 3 groups. The strength group performed isometric, dynamic and stretching exercises. The endurance group performed dynamic muscle and stretching exercises. The control group performed stretching exercises. Pain was assessed with a visual analogue scale. Each group was divided into 3 subgroups according to headache intensity.
At the 12-month follow-up headache had decreased by 69% in the strength group, 58% in the endurance group and 37% in the control group compared with baseline. Neck pain diminished most in the strength group with the most severe headache (p < 0.001). In the dose analysis, one metabolic equivalent per hour of training per week accounted for a 0.6-mm decrease in headache on the visual analogue scale. Upper extremity pain decreased by 58% in the strength group, 70% in the endurance group and 21% in the control group.
All of the training methods decreased headache. However, stretching, which is often recommended for patients, was less effective alone than when combined with muscle endurance and strength training. Care must be taken in recommending the type of training to be undertaken by patients with severe cervicogenic headache.
比较三种为期 12 个月的训练方案对慢性颈痛患者头痛和上肢疼痛的疗效。
共纳入 180 名患有慢性、非特异性颈痛的女性办公室工作人员，随机分为 3 组。力量组进行等长、动态和伸展运动。耐力组进行动态肌肉和伸展运动。对照组进行伸展运动。使用视觉模拟评分法评估疼痛。根据头痛强度，每组分为 3 个亚组。
在 12 个月的随访中，与基线相比，力量组头痛减轻了 69%，耐力组减轻了 58%，对照组减轻了 37%。在头痛最严重的力量组中，颈痛减轻最多（p < 0.001）。在剂量分析中，每周每小时代谢当量训练量可使视觉模拟评分中的头痛减少 0.6 毫米。力量组上肢疼痛减轻 58%，耐力组减轻 70%，对照组减轻 21%。
所有训练方法均可减轻头痛。然而，与单独进行相比，作为患者常用治疗手段的伸展运动与肌肉耐力和力量训练联合使用时效果较差。在建议严重颈源性头痛患者进行何种类型的训练时必须谨慎。
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