Suvarnnato Thavatchai, Puntumetakul Rungthip, Kaber David, Boucaut Rose, Boonphakob Yodchai, Arayawichanon Preeda, Chatchawan Uraiwan
Physical Therapy Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.
J Phys Ther Sci. 2013 Jul;25(7):865-71. doi: 10.1589/jpts.25.865. Epub 2013 Aug 20.
[Purpose] To investigate effects of thoracic manipulation versus mobilization on chronic neck pain. [Methods] Thirty-nine chronic neck pain subjects were randomly assigned to single level thoracic manipulation, single level thoracic mobilization, or a control group. The cervical range of motion (CROM) and pain ratings (using a visual analog scale: VAS) were measured before, immediately after and at a 24-hour follow-up. [Results] Thoracic manipulation significantly decreased VAS pain ratings and increased CROM in all directions in immediate and 24-hour follow-ups. The thoracic mobilization group significantly increased in CROM in most directions at immediate follow-up and right and left rotational directions at the 24-hour follow-up. Comparisons between groups revealed the CROM for the manipulation group to increase significantly more than for control subjects in most directions at immediate follow-up and flexion, left lateral flexion and left rotation at the 24-hour follow-up. The CROM for the thoracic mobilization group significantly increased in comparison to the control group in flexion at immediate follow-up and in flexion and left rotation at the 24-hour follow-up. [Conclusion] The study demonstrated reductions in VAS pain ratings and increases in CROM at immediate and 24-hour follow-ups from both single level thoracic spine manipulation and thoracic mobilization in chronic neck pain.
[目的] 探讨胸椎整复手法与松动术对慢性颈部疼痛的影响。[方法] 39例慢性颈部疼痛患者被随机分为单节段胸椎整复手法组、单节段胸椎松动术组或对照组。在治疗前、治疗后即刻及24小时随访时测量颈椎活动度（CROM）和疼痛评分（采用视觉模拟评分法：VAS）。[结果] 在即刻和24小时随访中，胸椎整复手法均显著降低VAS疼痛评分，并增加了各个方向的CROM。胸椎松动术组在即刻随访时多数方向的CROM显著增加，在24小时随访时左右旋转方向的CROM显著增加。组间比较显示，在即刻随访时，整复手法组在多数方向上的CROM增加幅度显著大于对照组；在24小时随访时，整复手法组在屈曲、左侧屈和左旋方向上的CROM增加幅度显著大于对照组。在即刻随访时，胸椎松动术组在屈曲方向上的CROM较对照组显著增加；在24小时随访时，胸椎松动术组在屈曲和左旋方向上的CROM较对照组显著增加。[结论] 该研究表明，单节段胸椎整复手法和胸椎松动术在慢性颈部疼痛的即刻和24小时随访中均能降低VAS疼痛评分并增加CROM。
