慢性挥鞭样损伤相关疾病患者颈部特定运动与等待名单对照的效果：一项前瞻性随机对照研究

Effects of Neck-Specific Exercises Compared to Waiting List for Individuals With Chronic Whiplash-Associated Disorders: A Prospective, Randomized Controlled Study.

作者信息

Peolsson Anneli, Landén Ludvigsson Maria, Tigerfors Ann-Marie, Peterson Gunnel

机构信息

Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.

Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden; Rehab Väst, County Council of Östergötland, Motala, Sweden.

出版信息

Arch Phys Med Rehabil. 2016 Feb;97(2):189-95. doi: 10.1016/j.apmr.2015.10.087. Epub 2015 Oct 26.

OBJECTIVE

To determine whether 3 months of neck-specific exercises (NSEs) could benefit individuals with chronic whiplash-associated disorder (WAD) who were on a waiting list (WL) for treatment.

DESIGN

A prospective, randomized controlled study.

SETTING

Primary health care.

PARTICIPANTS

Individuals (N=41; 31 women, 10 men; mean age ± SD, 38±11.2y) with chronic (6-36mo) WAD, grades 2 and 3, were analyzed.

INTERVENTIONS

Patients were randomly assigned to NSEs or no treatment for 3 months.

MAIN OUTCOME MEASURES

Neck-specific disability (Neck Disability Index [NDI]), neck pain (visual analog scale), general pain-related disability (Pain Disability Index [PDI]), self-perceived performance ability (Self-Efficacy Scale [SES]), and health-related quality of life (EuroQol 5 dimensions [EQ-5D]) were measured.

RESULTS

NSEs significantly improved the NDI, SES, and EQ-5D compared with WL (P<.01). There was significant improvement (P<.0001) over time in all outcomes for NSEs, and apart from the PDI, significant worsening (P=.002-.0002) over time for the untreated group.

CONCLUSIONS

NSEs were more beneficial than no intervention while on a WL for individuals with chronic WAD.

目的

确定为期3个月的针对颈部的锻炼（NSE）是否能使处于等待治疗名单（WL）上的慢性挥鞭样损伤相关疾病（WAD）患者受益。

设计

一项前瞻性随机对照研究。

地点

初级卫生保健机构。

参与者

分析了患有慢性（6 - 36个月）2级和3级WAD的个体（N = 41；31名女性，10名男性；平均年龄±标准差，38±11.2岁）。

干预措施

患者被随机分配接受NSE或3个月不治疗。

主要观察指标

测量颈部特异性残疾（颈部残疾指数[NDI]）、颈部疼痛（视觉模拟量表）、一般疼痛相关残疾（疼痛残疾指数[PDI]）、自我感知的表现能力（自我效能量表[SES]）以及健康相关生活质量（欧洲五维度健康量表[EQ - 5D]）。

结果

与WL相比，NSE显著改善了NDI、SES和EQ - 5D（P <.01）。NSE组所有结局随时间均有显著改善（P <.0001），而未治疗组除PDI外，其他结局随时间均显著恶化（P = 0.002 - 0.0002）。

结论

对于慢性WAD患者，在处于WL期间，NSE比不干预更有益。