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慢性颈痛患者的左右辨别对关节位置觉和颈椎活动范围的影响:一项随机单盲临床试验

Effect of laterality discrimination on joint position sense and cervical range of motion in patients with chronic neck pain: a randomized single-blind clinical trial.

作者信息

León-Hernández Jose Vicente, Marcos-Lorenzo David, Morales-Tejera David, Cuenca-Martínez Ferran, La Touche Roy, Suso-Martí Luis

机构信息

a Department of Physiotherapy , Centro Superior de Estudios Universitarios La Salle, Universidad Autonoma de Madrid , Spain.

b Motion in Brains Research Group , Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Madrid , Spain.

出版信息

Somatosens Mot Res. 2019 Jun;36(2):136-143. doi: 10.1080/08990220.2019.1626706. Epub 2019 Jun 11.

DOI:10.1080/08990220.2019.1626706
PMID:31185773
Abstract

The main objective of the present study was to evaluate the effects of laterality discrimination training on neck joint position sense and cervical range of motion (ROM) in patients with chronic non-specific neck pain (NSCNP). Forty-eight patients with NSCNP were randomly assigned to the neck group (NG) that observed neck images or the foot group (FG) that observed foot images. Response time, response accuracy, cervical ROM, and joint position error (JPE) were the main variables. The secondary outcome measures included psychosocial variables. Differences between groups in the cervical ROM for flexion ( = .043) were obtained, being NG group the one which obtained greater values. NG showed an improvement in right rotation ( = .018) and a decrease in flexion was found in the FG ( = .039). In JPE, differences between groups were obtained in the left rotation ( = .021) and significant changes were found in the NG for flexion, extension, and left rotation movements ( < .05). Moderate associations were found between left and right accuracy regarding to post-intervention flexion and right rotation ( = 0.46,  = 0.41;  < .05) in NG. Improvements in cervical range of motion and joint position sense are obtained after the performance of the laterality discrimination task of images of the neck but not the feet. Visualization of images of the painful region presents moderate correlations with the accuracy and response time in the movements of flexion and right rotation.

摘要

本研究的主要目的是评估侧向辨别训练对慢性非特异性颈部疼痛(NSCNP)患者颈部关节位置觉和颈椎活动范围(ROM)的影响。48例NSCNP患者被随机分为观察颈部图像的颈部组(NG)或观察足部图像的足部组(FG)。反应时间、反应准确性、颈椎活动范围和关节位置误差(JPE)是主要变量。次要结局指标包括心理社会变量。获得了两组在颈椎前屈活动范围上的差异(=0.043),NG组的值更大。NG组在右旋转方面有改善(=0.018),而FG组在前屈方面有下降(=0.039)。在JPE方面,两组在左旋转上存在差异(=0.021),并且NG组在前屈、后伸和左旋转运动中发现有显著变化(<0.05)。在NG组中,干预后前屈和右旋转的左右准确性之间存在中度相关性(=0.46,=0.41;<0.05)。在执行颈部而非足部图像的侧向辨别任务后,颈椎活动范围和关节位置觉得到改善。疼痛区域图像的可视化与前屈和右旋转运动中的准确性和反应时间存在中度相关性。

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