Soon Benjamin T C, Schmid Annina B, Fridriksson Elias J, Gresslos Elizabeth, Cheong Philip, Wright Anthony
University of Queensland, St Lucia, Australia.
J Manipulative Physiol Ther. 2010 Nov-Dec;33(9):652-8. doi: 10.1016/j.jmpt.2010.08.014. Epub 2010 Oct 15.
Cervical mobilization has been shown to elicit effects on pain perception, autonomic function, and motor function in subjects who experience musculoskeletal pain. The improvement in motor function may be a direct effect of the treatment or secondary to a hypoalgesic effect. This study tested whether it is possible to alter motor function following joint mobilization in situations where motor performance is not impaired by pain.
Twenty-four asymptomatic subjects participated in this double-blind, controlled, within-subjects crossover study. Pressure pain thresholds and electromyographic activity of the superficial neck flexor muscles were compared with repeated-measures analysis of variance between a posteroanterior cervical mobilization, manual contact, and noncontact condition.
The results indicate no significant change in the pressure pain threshold (P =.846) after posteroanterior cervical mobilization. There was no significant difference in superficial neck flexor muscle activity during the craniocervical flexion test (P =.713). Post hoc power analysis demonstrated the ability to detect a 15% difference in electromyographic activity with 70% power.
The improvement in motor function demonstrated in previous studies was not replicated, suggesting that either it is only possible to produce an effect when motor function is impaired or the change in motor function is secondary to the pain inhibitory effect of the treatment.
对于患有肌肉骨骼疼痛的受试者,颈椎松动术已被证明可对疼痛感知、自主神经功能和运动功能产生影响。运动功能的改善可能是治疗的直接效果,也可能是痛觉减退效应的继发结果。本研究测试了在运动表现未因疼痛而受损的情况下,关节松动术后是否有可能改变运动功能。
24名无症状受试者参与了这项双盲、对照、受试者内交叉研究。通过重复测量方差分析,比较了颈椎后前向松动术、手法接触和非接触条件下的压力疼痛阈值以及颈部浅层屈肌的肌电活动。
结果表明,颈椎后前向松动术后压力疼痛阈值无显著变化(P = 0.846)。在颅颈屈曲试验期间,颈部浅层屈肌活动无显著差异(P = 0.713)。事后功效分析表明,有能力以70%的功效检测到肌电活动15%的差异。
先前研究中所证明的运动功能改善未得到重复,这表明要么只有在运动功能受损时才可能产生效果,要么运动功能的改变是治疗的疼痛抑制效应的继发结果。