Ruhe Alexander, Fejer René, Walker Bruce
Murdoch University, Praxis fuer Chiropraktik Wolfsburg, Porschestrasse 1, 38440 Wolfsburg, Germany.
Chiropr Man Therap. 2011 May 24;19(1):13. doi: 10.1186/2045-709X-19-13.
Systematic literature review.
To assess differences in center of pressure (COP) measures in patients suffering from non-specific neck pain (NSNP) or whiplash-associated disorder (WAD) compared to healthy controls and any relationship between changes in postural sway and the presence of pain, its intensity, previous pain duration and the perceived level of disability.
Over the past 20 years, the center of pressure (COP) has been commonly used as an index of postural stability in standing. While several studies investigated COP excursions in neck pain and WAD patients and compared these to healthy individuals, no comprehensive analysis of the reported differences in postural sway pattern exists.
Six online databases were systematically searched followed by a manual search of the retrieved papers.
Papers comparing COP measures derived from bipedal static task conditions on a force plate of people with NSNP and WAD to those of healthy controls.
Two reviewers independently screened titles and abstracts for relevance. Screening for final inclusion, data extraction and quality assessment were carried out with a third reviewer to reconcile differences.
Ten papers met the inclusion criteria. Heterogeneity in study designs prevented pooling of the data and no direct comparison of data across the studies was possible. Instead, a qualitative data analysis was conducted. There was broad consensus that patients with either type of neck pain have increased COP excursions compared to healthy individuals, a difference that was more pronounced in people with WAD. An increased sway in antero-posterior direction was observed in both groups.
Patients with neck pain (due to either NSNP or WAD) exhibit greater postural instability than healthy controls, signified by greater COP excursions irrespective of the COP parameter chosen. Further, the decreased postural stability in people with neck pain appears to be associated with the presence of pain and correlates with the extent of proprioceptive impairment, but appears unrelated to pain duration.
系统文献综述。
评估非特异性颈部疼痛（NSNP）或挥鞭样损伤相关疾病（WAD）患者与健康对照者在压力中心（COP）测量方面的差异，以及姿势摆动变化与疼痛的存在、疼痛强度、既往疼痛持续时间和感知残疾水平之间的任何关系。
在过去20年中，压力中心（COP）一直被用作站立时姿势稳定性的指标。虽然有几项研究调查了颈部疼痛和WAD患者的COP偏移，并将其与健康个体进行了比较，但尚未对报道的姿势摆动模式差异进行全面分析。
系统检索了六个在线数据库，随后对检索到的论文进行了手工检索。
将NSNP和WAD患者在测力板上双足静态任务条件下得出的COP测量值与健康对照者的测量值进行比较的论文。
两名评审员独立筛选标题和摘要以确定相关性。由第三名评审员进行最终纳入筛选、数据提取和质量评估，以协调差异。
十篇论文符合纳入标准。研究设计的异质性阻碍了数据合并，无法对各项研究的数据进行直接比较。取而代之的是进行了定性数据分析。广泛的共识是，与健康个体相比，两种类型的颈部疼痛患者的COP偏移均增加，这种差异在WAD患者中更为明显。两组均观察到前后方向的摆动增加。
颈部疼痛患者（由于NSNP或WAD）表现出比健康对照者更大的姿势不稳定性，无论选择何种COP参数，COP偏移更大即表明了这一点。此外，颈部疼痛患者姿势稳定性的降低似乎与疼痛的存在有关，并且与本体感觉障碍的程度相关，但似乎与疼痛持续时间无关。
