Creighton Douglas S, Marsh Doug, Gruca Mark, Walter Melissa
Physical Therapy Program, School of Health Science, Oakland University, Rochester, MI, USA.
Physician and Statistician, Melvindale, MI, USA.
J Back Musculoskelet Rehabil. 2017 Sep 22;30(5):1053-1059. doi: 10.3233/BMR-169644.
Cervical mobilization and manipulation have been shown to improve cervical range of motion and pain. Cervical rotatory thrust manipulation has been associated with adverse patient reaction and damage to the V3 segment of the vertebral artery (VA).
To document and describe the effects of an upper cervical (UC) traction based mobilization on participants with restricted and painful cervical rotation and to document if the mobilization changed blood flow velocity through the vertebral artery.
This case series examined the effects of a traction based spinal mobilization on two different groups of participants. Group I included 93 participants with restricted bilateral cervical rotation that was also painful at end range. Group II included 30 different participants whose VA blood flow velocity was examined during the same mobilization. Pre- and post-mobilization active cervical rotation, pain intensity levels, and VA blood flow velocity during mobilization was documented.
Paired T-tests were used to determine statistical significance for changes in cervical rotation, and VA blood flow velocity during mobilization. Ninety-three participants in group I demonstrated an average increase of 16 degrees of cervical rotation. No participant demonstrated an increase in pain, and no participant in group II (N= 30) demonstrated a change in VA blood flow velocity.
The application this UC traction based mobilization improved active cervical rotation, end range rotation pain response, did not cause pain during its application and did not alter blood flow through the VA during application.
颈椎松动术和整复术已被证明可改善颈椎活动范围和疼痛。颈椎旋转推扳整复术与患者不良反应以及椎动脉(VA)V3段损伤有关。
记录并描述基于上颈椎(UC)牵引的松动术对颈椎旋转受限且疼痛的参与者的影响,并记录该松动术是否改变椎动脉的血流速度。
本病例系列研究了基于牵引的脊柱松动术对两组不同参与者的影响。第一组包括93名双侧颈椎旋转受限且在终末活动范围时疼痛的参与者。第二组包括30名不同的参与者,在相同的松动术过程中对其椎动脉血流速度进行了检查。记录了松动术前和术后的主动颈椎旋转、疼痛强度水平以及松动术过程中的椎动脉血流速度。
采用配对t检验来确定颈椎旋转变化以及松动术过程中椎动脉血流速度变化的统计学意义。第一组的93名参与者颈椎旋转平均增加了16度。没有参与者疼痛加剧,第二组(n = 30)中也没有参与者椎动脉血流速度发生变化。
应用这种基于UC牵引的松动术可改善主动颈椎旋转、终末活动范围旋转时的疼痛反应,在应用过程中不会引起疼痛,且在应用过程中不会改变椎动脉的血流。