School of Physiotherapy, 325 Great King Street, University of Otago, Dunedin, 9054, New Zealand.
Back in Motion Ltd, 27-29 Albany Street, Dunedin, 9016, New Zealand.
Musculoskelet Sci Pract. 2017 Jun;29:91-98. doi: 10.1016/j.msksp.2017.03.002. Epub 2017 Mar 14.
Concussion is typically defined as a mild brain injury, and yet the brain is unlikely to be the only source of persistent post-concussion symptoms. Concurrent injury to the cervical spine in particular is acknowledged as a potential source of common persistent symptoms such as headache, dizziness and neck pain.
To describe the cervical spine findings and outcomes of treatment in a series of patients with persistent post-concussion symptoms, and describe the clinical characteristics of a cervicogenic component when it is present.
Retrospective chart review of a consecutive series of patients with concussion referred to a physiotherapist for cervical spine assessment.
Patient charts for all patients over a calendar year referred by a concussion service provider to a physiotherapist for cervical spine assessment were de-identified and transferred to the research team. Clinical data were independently extracted by two research assistants and analysed using descriptive statistics.
RESULTS/FINDINGS: Data were analysed from 46 patient charts. Those with a cervicogenic component (n = 32) were distinguished from those without a cervicogenic component (n = 14) by physical examination findings, particularly pain on manual segmental examination. Physiotherapy treatment of the cervicogenic component (n = 21) achieved improvements in function (mean increase of 3.8 in the patient-specific functional scale), and pain (mean decrease of 4.6 in the numeric pain-rating scale).
The clinical characteristics described give preliminary support to the idea that the cervical spine may contribute to persistent post-concussion symptoms, and highlight the value of physiotherapy assessment and treatment of the cervical spine following a concussive injury.
脑震荡通常被定义为轻度脑损伤，但大脑不太可能是持续性脑震荡后症状的唯一来源。特别是颈椎同时受伤被认为是常见持续性症状（如头痛、头晕和颈部疼痛）的潜在来源。
描述一系列持续性脑震荡后症状患者的颈椎检查结果和治疗结果，并描述存在颈源性成分时的临床特征。
对一系列因脑震荡而向物理治疗师转诊进行颈椎评估的患者进行连续病例系列的回顾性图表审查。
将过去一年中因脑震荡服务提供商转诊给物理治疗师进行颈椎评估的所有患者的病历进行去识别，并转移到研究团队。两名研究助理独立提取临床数据，并使用描述性统计进行分析。
结果/发现：对 46 份患者病历的数据进行了分析。有颈源性成分的患者（n=32）与没有颈源性成分的患者（n=14）在体格检查发现方面有所不同，特别是在手动节段检查时疼痛。颈源性成分的物理治疗（n=21）改善了功能（患者特定功能量表平均增加 3.8）和疼痛（数字疼痛评分量表平均降低 4.6）。
所描述的临床特征初步支持颈椎可能对持续性脑震荡后症状有贡献的观点，并强调了在脑震荡后进行颈椎物理治疗评估和治疗的价值。
