Nansel D, Peneff A, Cremata E, Carlson J
Division of Basic Science, Palmer College of Chiropractic-West, Sunnyvale, CA 94087.
J Manipulative Physiol Ther. 1990 Jul-Aug;13(6):297-304.
The initial effectiveness as well as the temporal stability of the effect of cervical spinal manipulation with respect to the amelioration of goniometrically verified cervical lateral-flexion passive end-range asymmetry was examined. Responses of two groups of pain-free subjects were compared: a) those exhibiting end-range asymmetries of greater than 10 degrees who, in addition, had suffered previous neck trauma, and; b) those who happened to exhibit end-range asymmetries of greater than 10 degrees but who had no history of prior neck trauma. All subjects received a single lower cervical adjustment delivered to the side of most-restricted end-range, and goniometric reassessments were performed 30 min, 4 hr, and 48 hr following the adjustment. A dramatic amelioration of asymmetry was observed in both groups at 30 min and 4 hr postmanipulation. Furthermore, the magnitudes of these short-term effects were similar for the two groups. However, by 24 hours, a difference in the temporal responses of the groups had become readily apparent. By 48 hours, the difference was even more striking; whereas 14 of 16 of the subjects with no previous neck trauma continued to exhibit asymmetries of less than 10 degrees (mean +/- SEM = 3.8 +/- 1.0 degrees), 12 of the 16 subjects with previous neck trauma had regained asymmetries of greater than 10 degrees (mean +/- SEM = 11.4 +/- 1.7 degrees). These results indicate that among asymptomatic (pain-free) individuals, the mere presence of passive end-range asymmetry as well as the magnitude of the short-term ameliorative effect of cervical manipulation do not distinguish these two categories of subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
研究了颈椎手法治疗在改善经角度测量证实的颈椎侧屈被动终末范围不对称方面的初始效果及其效果的时间稳定性。比较了两组无痛受试者的反应:a)那些终末范围不对称大于10度且既往有颈部外伤史的受试者;b)那些偶然出现终末范围不对称大于10度但无既往颈部外伤史的受试者。所有受试者均接受一次针对终末范围受限最严重一侧的下颈椎调整,并在调整后30分钟、4小时和48小时进行角度测量重新评估。手法治疗后30分钟和4小时,两组的不对称情况均有显著改善。此外,两组的这些短期效果大小相似。然而,到24小时时,两组的时间反应差异已很明显。到48小时时,差异更为显著;16名无既往颈部外伤史的受试者中有14名仍表现出小于10度的不对称(平均值±标准误=3.8±1.0度),而16名有既往颈部外伤史的受试者中有12名恢复到大于10度的不对称(平均值±标准误=11.4±1.7度)。这些结果表明,在无症状(无痛)个体中,单纯的被动终末范围不对称的存在以及颈椎手法治疗的短期改善效果大小并不能区分这两类受试者。(摘要截断于250字)