Tiwari Devashish, Goldberg Allon, Yorke Amy, Marchetti Gregory F, Alsalaheen Bara
Massachusetts College of Pharmacy and Health Sciences, Worcester, MA, USA.
University of Michigan-Flint, Flint, MI, USA.
Int J Sports Phys Ther. 2019 Apr;14(2):282-295.
Patients with concussion may present with cervical spine impairments, therefore accurate characterization of cervical post-concussion impairments is needed to develop targeted physical therapy interventions.
To characterize the type, frequency and severity of cervical impairments in children and adolescents referred for physical therapy after concussion.Study design: Retrospective, descriptive study.
A retrospective analysis was conducted for 73 consecutive children and adolescents who received cervical physical therapy following a concussion. Data was classified into six broad categories. The frequency and intensity of cervical impairments within and across the categories was reported.
Ninety percent of patients demonstrated impairments in at least three out of five assessment categories whereas 55% demonstrated impairments in at least four out five assessment categories. Of the five assessment categories, posture (99%) and myofascial impairment (98%) demonstrated highest impairment frequency followed by joint mobility (86%) and muscle strength (62%). Cervical joint proprioception was the least commonly evaluated assessment category.
High prevalence of cervical spine impairments was observed in the subjects included in this study with muscle tension, joint mobility, and muscle strength being most commonly affected. The categories of impairments examined in this cohort were consistent with the recommendations of the most recent clinical practice guidelines for neck pain. This study provides preliminary data to support the framework for a cervical spine evaluation tool in children and adolescents following concussion.
Level 4.
脑震荡患者可能伴有颈椎损伤，因此需要准确描述脑震荡后颈椎损伤情况，以制定有针对性的物理治疗干预措施。
描述脑震荡后接受物理治疗的儿童和青少年颈椎损伤的类型、频率和严重程度。研究设计：回顾性描述性研究。
对73例脑震荡后接受颈椎物理治疗的儿童和青少年进行回顾性分析。数据分为六大类。报告各类别内及类别间颈椎损伤的频率和强度。
90%的患者在五项评估类别中至少有三项存在损伤，而55%的患者在五项评估类别中至少有四项存在损伤。在五项评估类别中，姿势（99%）和肌筋膜损伤（98%）的损伤频率最高，其次是关节活动度（86%）和肌肉力量（62%）。颈椎关节本体感觉是评估最少的类别。
本研究纳入的受试者中颈椎损伤发生率较高，肌肉紧张、关节活动度和肌肉力量最常受到影响。该队列中检查的损伤类别与最新颈部疼痛临床实践指南的建议一致。本研究提供了初步数据，以支持针对脑震荡后儿童和青少年的颈椎评估工具框架。
4级。
