Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan; Department of Rehabilitation, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Physical Therapy, Faculty of Health Science, International University of Health and Welfare, 2600-1, Kitakanemaru, Ohtawara, Tochigi 324-8501, Japan.
Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan.
J Clin Neurosci. 2020 Mar;73:57-61. doi: 10.1016/j.jocn.2020.01.046. Epub 2020 Jan 24.
The pathophysiology of dropped head syndrome (DHS) remains unknown, and its treatment algorithm and indication are not standardized. Here, we established a novel rehabilitation program, short and intensive rehabilitation program for DHS (SHAiR program), consisting of cervical paraspinal muscles exercise, range of motion exercise, cervical and thoracic mobilization, deep cervical flexor muscle exercise, hip lift exercise, anterior pelvic tilt exercise, and walking exercise. The aim of this study was to evaluate the clinical effectiveness of this program. We reviewed clinical outcomes for five consecutive patients with DHS who underwent the SHAiR program (SHAiR group). The outcomes were compared with those of other five patients with DHS who received exercise instruction (control group). Demographic data, the duration from onset of DHS, the apex of sagittal kyphosis on the lateral radiographs, and clinical outcomes including the ability to maintain normal horizontal gaze, chin brow vertical angle, and numerical rating scale (NRS) were evaluated at the initial visit and final follow-up at 7.5 months. There was no significant difference between the two groups in terms of demographic and radiographic data. The ability of horizontal gaze and NRS of cervical pain improved rapidly for all five patients in the SHAiR group as compared to no improvement for all patients in the control group. Rehabilitation for DHS was considered effective not only for localized rehabilitation such as exercise for training cervical extensor muscle function but also exercises for thoracolumbar posture improvement and the psoas muscle.
失能性低颅压综合征（DHS）的病理生理学仍然未知，其治疗方案和适应证尚未标准化。在这里，我们建立了一种新的康复方案，即 DHS 的短而集中的康复方案（SHAiR 方案），包括颈脊柱旁肌肉锻炼、活动范围锻炼、颈椎和胸椎松动、深层颈屈肌锻炼、抬腿锻炼、前骨盆倾斜锻炼和行走锻炼。本研究的目的是评估该方案的临床疗效。我们回顾了连续 5 例 DHS 患者接受 SHAiR 方案（SHAiR 组）的临床结果，并将其与接受运动指导的 5 例 DHS 患者（对照组）的结果进行比较。评估了人口统计学数据、DHS 发病后的持续时间、侧位片矢状后凸的顶点，以及包括维持正常水平凝视、颏眉垂直角和数字评分量表（NRS）在内的临床结果，在初始就诊时和 7.5 个月的最终随访时进行评估。两组在人口统计学和影像学数据方面无显著差异。与对照组所有患者均无改善相比，SHAiR 组的所有 5 例患者的水平凝视能力和颈椎疼痛 NRS 均迅速改善。DHS 的康复不仅对局部康复有效，如锻炼颈伸肌功能，对改善胸腰椎姿势和腰肌的锻炼也有效。
