From the Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran (AHK, LG, AMA); and Department of Physical Therapy, University of North Georgia, Dahlonega, Georgia (MRN).
Am J Phys Med Rehabil. 2020 Feb;99(2):133-141. doi: 10.1097/PHM.0000000000001298.
The aim of the study was to determine whether strength and range of motion deficits are present in patients with unilateral chronic neck pain at contralateral side to pain and at other regions.
Forty-nine patients with unilateral chronic neck pain and 98 asymptomatic subjects participated in this case-control study. Range of motion and muscle strength of the cervical, shoulder, trunk, and hip regions were assessed bilaterally using inclinometer and dynamometer, respectively.
Chronic neck pain patients demonstrated reduced cervical, shoulder, and trunk range of motion in their ipsilateral side to pain comparing the asymptomatic participants (P < 0.05). The ipsilateral side to pain cervical and shoulder range of motion were also significantly lower than the contralateral side to pain (P < 0.05). Significant differences were also observable in the contralateral side to pain comparing the asymptomatic group (P < 0.05). Cervical, shoulder, and scapulothoracic muscles were found weaker both in the ipsilateral side to pain and contralateral side to pain comparing the asymptomatic group (P < 0.05). Ipsilateral side to pain and contralateral side to pain in hip flexors were also found to be significantly weaker than the asymptomatic group (P < 0.01).
The results revealed range of motion and strength deficits in the pain-free regions of the body in unilateral chronic neck pain patients. Findings support the regional interdependence theory and emphasize the need for managing seemingly intact neighboring and more remote regions in unilateral chronic neck pain patients.
本研究旨在确定单侧慢性颈痛患者在疼痛对侧及其他区域是否存在力量和运动范围缺陷。
本病例对照研究纳入了 49 例单侧慢性颈痛患者和 98 例无症状对照者。使用测斜仪和测力计分别评估双侧颈椎、肩部、躯干和髋关节的运动范围和肌肉力量。
与无症状对照者相比，慢性颈痛患者患侧的颈椎、肩部和躯干运动范围减小（P < 0.05）。患侧的颈椎和肩部运动范围也明显低于对侧（P < 0.05）。与无症状组相比，对侧也存在显著差异（P < 0.05）。与无症状组相比，患侧和对侧的颈椎、肩部和肩胛带肌肉力量均减弱（P < 0.05）。患侧和对侧的髋关节屈肌力量也明显弱于无症状组（P < 0.01）。
研究结果显示单侧慢性颈痛患者无痛区域存在运动范围和力量缺陷。研究结果支持区域相互依存理论，并强调在单侧慢性颈痛患者中需要对看似正常的相邻和更远区域进行管理。
