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慢性颈痛患者的运动障碍:创伤事件是否起重要作用?一项病例对照研究。

Motor impairment in patients with chronic neck pain: does the traumatic event play a significant role? A case-control study.

机构信息

Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 3B3, ingang 46, 9000, Ghent, Belgium.

Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 3B3, ingang 46, 9000, Ghent, Belgium; Pain in Motion International Research Group, Belgium.

出版信息

Spine J. 2018 Aug;18(8):1406-1416. doi: 10.1016/j.spinee.2018.01.009. Epub 2018 Jan 31.

Abstract

BACKGROUND CONTEXT

Motor impairment is a key sign in patients with traumatic (whiplash-associated disorder [WAD]) and non-traumatic (idiopathic neck pain [INP]) neck pain.

PURPOSE

This study aimed to analyze differences in motor impairment between two patient groups and to assess the association between motor performance and self-reported symptoms.

STUDY DESIGN

This is a case-control study.

PATIENT SAMPLE

A total of 38 patients with chronic INP, 35 patients with chronic WAD, and 30 healthy pain-free controls were included in the study.

OUTCOME MEASURES

Outcome measures used in this study were mobility (°), strength (N), repositioning accuracy (°), endurance (seconds), sway velocity (cm/s), sway area (cm), and neuromuscular control.

METHODS

Group differences of motor impairment, together with questionnaires to evaluate pain intensity, fear avoidance, pain catastrophizing, symptoms of central sensitization, and disability, were analyzed with analysis of covariance, including age as a covariate.

RESULTS

Motor impairment was observed in both patient groups with a higher degree in patients with chronic WAD. These impairments were moderately linked to self-reported disability and were in most cases associated with pain, fear avoidance, and symptoms of central sensitization (|ρ| ranging from 0.28 to 0.59).

CONCLUSIONS

Motor impairment should be addressed when treating both groups of patients, keeping in mind the association with self-reported pain and disability, fear-avoidance, and central sensitization.

摘要

背景

运动障碍是创伤性(挥鞭样损伤相关疾病[WAD])和非创伤性(特发性颈痛[INP])颈痛患者的一个主要症状。

目的

本研究旨在分析两组患者的运动障碍差异,并评估运动表现与自我报告症状之间的关联。

研究设计

这是一项病例对照研究。

患者样本

共有 38 名慢性 INP 患者、35 名慢性 WAD 患者和 30 名健康无疼痛对照者纳入本研究。

结果测量

本研究中使用的结果测量包括活动度(°)、力量(N)、定位准确性(°)、耐力(秒)、摆动速度(cm/s)、摆动面积(cm)和神经肌肉控制。

方法

分析了运动障碍的组间差异,以及评估疼痛强度、恐惧回避、疼痛灾难化、中枢敏化症状和残疾的问卷,采用协方差分析,包括年龄作为协变量。

结果

两组患者均观察到运动障碍,慢性 WAD 患者的运动障碍程度更高。这些障碍与自我报告的残疾中度相关,且在大多数情况下与疼痛、恐惧回避和中枢敏化症状相关(|ρ| 值范围为 0.28 至 0.59)。

结论

在治疗这两组患者时,应注意运动障碍问题,并考虑与自我报告的疼痛和残疾、恐惧回避和中枢敏化相关的问题。

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