Dimitriadis Zacharias, Kapreli Eleni, Strimpakos Nikolaos, Oldham Jacqueline
Physiotherapy Department, Technological Educational Institute of Lamia, 3rd km Old National Road Lamia-Athens, 35100 Lamia, Greece.
Man Ther. 2013 Jun;18(3):248-53. doi: 10.1016/j.math.2012.10.014. Epub 2012 Nov 28.
Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P < 0.05). Neck muscle strength (r > 0.5), kinesiophobia (r < -0.3) and catastrophizing (r < -0.3) were significantly associated with maximal mouth pressures (P < 0.05), whereas MEP was additionally negatively correlated with neck pain and disability (r < -0.3, P < 0.05). Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.
呼吸肌力量是目前认为在慢性颈痛患者中会受到影响的一个参数。本研究旨在检验慢性颈痛患者的呼吸力量是否降低，以及其呼吸力量与哪些颈部疼痛问题相关。在这项对照横断面研究中，招募了45例慢性颈痛患者和45名匹配良好的健康对照者。通过最大口腔压力评估呼吸肌力量。此外，还对受试者的疼痛强度和残疾程度、颈部肌肉力量、颈深屈肌耐力、颈部活动范围、头部前倾姿势和心理状态进行了评估。配对t检验显示，慢性颈痛患者的最大吸气压力（MIP）（r = 0.35）和最大呼气压力（MEP）（r = 0.39）降低（P < 0.05）。颈部肌肉力量（r > 0.5）、运动恐惧（r < -0.3）和灾难化思维（r < -0.3）与最大口腔压力显著相关（P < 0.05），而MEP还与颈部疼痛和残疾呈负相关（r < -0.3，P < 0.05）。颈部肌肉力量是MIP和MEP预测模型中唯一仍具有显著意义的预测因素。可以得出结论，慢性颈痛患者存在呼吸肌无力。这种无力似乎是颈部疼痛患者整体和局部肌肉系统受损的结果，心理状态似乎也有额外的影响。建议临床医生在常规评估慢性颈痛患者时考虑其呼吸系统，并适当调整治疗方案。
