Yılmaz Seval, Taş Serkan, Tunca Yılmaz Öznur
Physiotherapy and Rehabilitation Department, Hacettepe University Beytepe Hospital, Ankara, Turkey.
Physiotherapy and Rehabilitation Department, Hacettepe University Beytepe Hospital, Ankara, Turkey.
J Manipulative Physiol Ther. 2018 Mar-Apr;41(3):227-233. doi: 10.1016/j.jmpt.2017.09.008. Epub 2018 Feb 15.
The purpose of this study was to investigate the presence of median nerve mechanosensitivity by comparing median nerve neurodynamic test results of patients with nonspecific neck pain (NNP) and asymptomatic individuals.
A total of 40 patients (30 women, 10 men) with NNP between the ages of 21 and 62 years (39.53 ± 10.18 years) and 38 asymptomatic individuals (23 women, 15 men) between the ages of 18 and 60 years (37.13 ± 9.64 years) participated in the study. Pressure pain threshold was assessed with digital pressure algometer, cervical joint range of motion was assessed with a universal goniometer, and median nerve mechanosensitivity was assessed with Upper Limb Neurodynamic Test 1 (ULNT1). The test step where the first sensory response was given, the location and character of the sensory response, and the final elbow extension angle were recorded during ULNT1.
Patients with NNP had significantly decreased pressure pain threshold (P < .001), decreased range of motion of cervical flexion (P < .001), and decreased cervical lateral flexion (P = .001) compared with asymptomatic individuals, whereas no change was identified in range of motion of rotation (P = .100). In ULNT1, 45% of patients with NNP reported pain and 40% of them reported stretch. A total of 65% of asymptomatic individuals reported stretch, and 13% of them reported pain. It was identified in ULNT1 that final elbow extension angle was lower in the NNP group compared with asymptomatic individuals (P = .008).
Median nerve mechanosensitivity increased, pressure pain threshold decreased, and active neck motion was limited in individuals with NNP compared with asymptomatic individuals.
本研究旨在通过比较非特异性颈部疼痛（NNP）患者和无症状个体的正中神经神经动力学测试结果，调查正中神经机械敏感性的存在情况。
共有40例年龄在21至62岁（39.53±10.18岁）的NNP患者（30名女性，10名男性）和38例年龄在18至60岁（37.13±9.64岁）的无症状个体（23名女性，15名男性）参与了本研究。使用数字压力痛觉计评估压力痛阈，使用通用角度计评估颈椎关节活动范围，使用上肢神经动力学测试1（ULNT1）评估正中神经机械敏感性。在ULNT1期间记录首次出现感觉反应的测试步骤、感觉反应的位置和特征以及最终的肘部伸展角度。
与无症状个体相比，NNP患者的压力痛阈显著降低（P<.001），颈椎前屈活动范围减小（P<.001），颈椎侧屈活动范围减小（P=.001），而旋转活动范围无变化（P=.100）。在ULNT1中，45%的NNP患者报告疼痛，其中40%报告有牵拉感。共有65%的无症状个体报告有牵拉感，其中13%报告疼痛。在ULNT1中发现，与无症状个体相比，NNP组的最终肘部伸展角度更低（P=.008）。
与无症状个体相比，NNP个体的正中神经机械敏感性增加，压力痛阈降低，颈部主动活动受限。
