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患有非特异性颈部疾病的患者通常会报告上肢功能障碍。

Patients with non-specific neck disorders commonly report upper limb disability.

作者信息

Osborn William, Jull Gwendolen

机构信息

Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Australia.

出版信息

Man Ther. 2013 Dec;18(6):492-7. doi: 10.1016/j.math.2013.05.004. Epub 2013 May 29.

Abstract

Patients with neck disorders can report difficulties with functional use of their upper limb because of their neck pain. Yet, there is little information on the frequency and specifically, the nature of these upper limb activities. This study surveyed patients with neck pain disorders (n = 103) presenting for management at private physiotherapy clinics in a large metropolitan area to investigate the frequency and nature of reduced upper limb function. Participants were asked to complete four questionnaires, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Neck Disability Index (NDI), Pictorial Fear of Activity Scale-Cervical (PFActS-C) and Patient Specific Functional Scale (PSFS). Approximately 80% of patients spontaneously reported that upper limb activities aggravated their neck pain (PSFS). Most frequently, these activities involved loading of the upper limb such as lifting. Eight activity items on the DASH were scored positive by ≥50% of participants. Participants had mild to moderately severe neck pain (NDI: range 2-68%). The DASH and NDI were moderately-highly correlated (ρ = 0.669; p < 0.001), indicating the higher the neck pain severity the greater the upper limb functional restrictions. There was a low correlation between the NDI and PFActS-C (ρ = 0.319; p = 0.001). These findings provide evidence that upper limb function is often impaired in association with neck pain disorders and suggest clinicians should routinely question patients regarding upper limb function. The DASH could be used as a suitable outcome measure in its current or possibly a modified form.

摘要

患有颈部疾病的患者可能会因颈部疼痛而报告上肢功能使用困难。然而,关于这些上肢活动的频率,特别是其性质的信息却很少。本研究对在一个大城市地区的私人理疗诊所就诊的颈部疼痛疾病患者(n = 103)进行了调查,以研究上肢功能减退的频率和性质。参与者被要求完成四份问卷,即手臂、肩部和手部功能障碍(DASH)问卷、颈部功能障碍指数(NDI)、颈部活动恐惧量表(PFActS-C)和患者特定功能量表(PSFS)。约80%的患者自发报告上肢活动会加重颈部疼痛(PSFS)。最常见的是,这些活动涉及上肢负重,如提举。DASH上的八项活动项目有≥50%的参与者得分呈阳性。参与者有轻度至中度严重的颈部疼痛(NDI:范围为2 - 68%)。DASH和NDI呈中度至高度相关(ρ = 0.669;p < 0.001),表明颈部疼痛越严重,上肢功能受限越明显。NDI和PFActS-C之间的相关性较低(ρ = 0.319;p = 0.001)。这些发现提供了证据,表明上肢功能常与颈部疼痛疾病相关受损,并建议临床医生应常规询问患者关于上肢功能的情况。DASH可以以其当前形式或可能经过修改的形式用作合适的疗效指标。

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