Ellingson Arin M, Yelisetti Vishal, Schulz Craig A, Bronfort Gert, Downing Joseph, Keefe Daniel F, Nuckley David J
Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.
Clin Biomech (Bristol). 2013 Aug;28(7):731-5. doi: 10.1016/j.clinbiomech.2013.07.006. Epub 2013 Aug 2.
Neck pain afflicts 30-50% of the U.S. population annually; however we currently have poor diagnostic differentiation techniques to inform individualized treatment. Planar neck kinematics has been shown to be correlated with neck pain, but neck motion is much more complex than pure planar activities. Our objective was to define a methodology for determining aberrant neck kinematics and assess it.
We examined a complex neck kinematic activity of neck circumduction and computed the pathway of motion using the instantaneous helical axis approach in 81 patients with non-specific neck pain and in 20 non-matched symptom free subjects. Neck circumduction, or rolling of the head, represents a complex neck kinematic activity, investigating the innate coupled motion of the cervical spine at the end ranges of motion in all directions. Instance of discontinuities in the helical axis patterns, or folds, were identified and labeled as occurrences of aberrant motion.
The instances of aberrant motion, or folds, which are nearly non-existent in the healthy sample group, are present in both the pre- and post-treatment neck pain patients. Following a treatment intervention of the symptomatic patients, pain and neck disability index decreased significantly (P<0.001) concomitant with a decrease in the number of folds (P=0.021).
The present study highlights a new technique using an instantaneous helical axis approach to detect subtle abnormalities in the pathway of motion of the head about the trunk, during a neck circumduction exercise.
颈部疼痛每年困扰着30%-50%的美国人口；然而，我们目前缺乏能够为个体化治疗提供依据的有效诊断鉴别技术。平面颈部运动学已被证明与颈部疼痛相关，但颈部运动比单纯的平面活动要复杂得多。我们的目标是定义一种确定异常颈部运动学的方法并对其进行评估。
我们检查了颈部环转这一复杂的颈部运动学活动，并使用瞬时螺旋轴方法计算了81例非特异性颈部疼痛患者和20例无匹配症状的健康受试者的运动路径。颈部环转，即头部滚动，代表一种复杂的颈部运动学活动，研究颈椎在各个方向运动终末范围内的固有耦合运动。识别并标记螺旋轴模式中的不连续点（即褶皱）实例，将其视为异常运动的发生情况。
在健康样本组中几乎不存在的异常运动实例（即褶皱），在治疗前和治疗后的颈部疼痛患者中均有出现。对有症状患者进行治疗干预后，疼痛和颈部功能障碍指数显著降低（P<0.001），同时褶皱数量减少（P=0.021）。
本研究突出了一种新技术，即使用瞬时螺旋轴方法在颈部环转运动过程中检测头部围绕躯干运动路径中的细微异常。
