J Orthop Sports Phys Ther. 2019 Nov;49(11):845-854. doi: 10.2519/jospt.2019.8547. Epub 2019 Jun 1.
Persistent symptoms post concussion can arise from a range of sources, including the neck. There is little description of neck assessment findings in people with persistent symptoms post concussion.
To assess people with persistent symptoms following a concussion and determine whether the neck has also been injured, and to evaluate the potential of the neck to contribute to their symptoms.
A consecutive series of participants (n = 20) referred for neck assessment were prospectively recruited by 2 providers of a multidisciplinary concussion service for people with persistent symptoms. Data were collected at initial assessment and on completion of neck treatment, which included standard questionnaires (Rivermead Post Concussion Symptoms Questionnaire, Neck Disability Index, Dizziness Handicap Inventory); patient-reported measures of headache, dizziness, and neck pain; physical examination findings; and details of comorbidities.
Participants were evaluated at a mean of 7.5 weeks post concussion (median, 5 weeks). On neck assessment, 90% were considered by the clinician to have a neck problem contributing to their current symptoms. Multiple findings were consistent with this view, including moderate-to-severe Neck Disability Index scores (mean ± SD, 33.4 ± 9.5 points), frequent neck pain (85%), frequent moderate-to-severe pain on occiput-C4 segmental assessment (85%), a positive flexion-rotation test (45%), and muscle tenderness (50%-55%).
Multiple findings were indicative of concurrent neck injury, particularly involving the upper cervical spine. These neck-related findings are important to recognize, as they have the potential to contribute to persistent symptoms post concussion and may respond to neck treatment. This study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616001183471). .
脑震荡后持续存在的症状可能源于多种原因，包括颈部。脑震荡后持续存在症状的患者颈部评估结果的描述很少。
评估脑震荡后持续存在症状的患者，确定颈部是否也受伤，并评估颈部对其症状的潜在影响。
通过多学科脑震荡服务的 2 名提供者，对连续系列（n=20）因颈部评估而转介的患者进行前瞻性招募。在初始评估和颈部治疗完成时收集数据，包括标准问卷（Rivermead 脑震荡后症状问卷、颈部残疾指数、头晕障碍量表）；患者报告的头痛、头晕和颈部疼痛；体格检查结果；以及合并症的详细信息。
参与者在脑震荡后平均 7.5 周（中位数为 5 周）接受评估。在颈部评估中，90%的患者被临床医生认为颈部问题对其当前症状有影响。多项发现与这一观点一致，包括中重度颈部残疾指数评分（平均值±标准差，33.4±9.5 分）、频繁颈部疼痛（85%）、枕骨-C4 节段评估时频繁出现中重度疼痛（85%）、前屈-旋转试验阳性（45%）和肌肉压痛（50%-55%）。
多项发现提示同时存在颈部损伤，特别是涉及上颈椎。这些与颈部相关的发现很重要，因为它们有可能导致脑震荡后持续存在的症状，并可能对颈部治疗有反应。本研究在澳大利亚和新西兰临床试验注册中心（ACTRN12616001183471）进行了前瞻性注册。
