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广泛存在触觉空间感知障碍和感觉运动控制障碍的慢性非特异性颈痛伴神经病理性特征患者。

Widespread impairment of tactile spatial acuity and sensory-motor control in patients with chronic nonspecific neck pain with neuropathic features.

机构信息

Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain.

Departamento de Fisioterapia, Facultad de Ciencias de la Salud. Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain.

出版信息

Musculoskelet Sci Pract. 2020 Jun;47:102138. doi: 10.1016/j.msksp.2020.102138. Epub 2020 Feb 25.

Abstract

OBJECTIVE

To assess differences in tactile spatial acuity and in sensory-motor control between patients with chronic nonspecific neck pain (CNSNP) with and without neuropathic features (NF), as well as asymptomatic.

METHODS

183 participants were included, 135 had CNSNP classified by the Self-report version of Leeds Assessment of Neuropathic Symptoms and Signs scale in order to identify pain with NF: (1) CNSNP with NF (n = 67), (2) CNSNP with No-NF (n = 68), and (3) asymptomatic subjects (n = 48). The following tests in the following order were assessed after determining the participants' clinical characteristics: 1) two-point discrimination, 2) joint position error, and 3) craniocervical flexion test.

RESULTS

Both neck pain groups showed a significant reduction in their ability to discriminate two points in the trapezium and masseter, as well as a significant deficit of a moderate to large magnitude in craniocervical motor control compared with the asymptomatic group. However, only the CNSNP with NF group showed a significant impairment of the two-point discrimination in the tibia (d = 0.57) and a significant impairment of the kinesthetic sense (neck rotation, d = 0.73; neck lateroflexion, d = 0.69), compared with the asymptomatic group. Significant differences in pain intensity, disability and psychological factors between the CNSNP groups were also found, observing the poorest results in the NF group.

CONCLUSIONS

Patients with CNSNP with NF have a greater sensory, motor and psychological impairment than those without NF, more pain intensity, disability and negative psychological factors, as well as more impaired tactile spatial acuity in areas remote to the pain and impaired cervical kinesthetic sense.

摘要

目的

评估慢性非特异性颈痛(CNSNP)患者中伴有和不伴有神经病理性特征(NF)的患者之间的触觉空间感知和感觉运动控制的差异,以及无症状患者。

方法

纳入 183 名参与者,其中 135 名参与者根据 Leeds 评估神经性症状和体征量表的自我报告版本进行分类,以识别伴有 NF 的疼痛:(1)伴有 NF 的 CNSNP(n=67),(2)不伴有 NF 的 CNSNP(n=68)和(3)无症状受试者(n=48)。在确定参与者的临床特征后,按以下顺序评估以下测试:1)两点辨别,2)关节位置误差,和 3)颅颈屈伸试验。

结果

两个颈痛组在辨别梯形和咬肌的两点能力方面均显著降低,并且与无症状组相比,颅颈运动控制能力也显著降低,幅度为中等到较大。然而,只有伴有 NF 的 CNSNP 组在胫骨的两点辨别(d=0.57)和动觉感觉(颈部旋转,d=0.73;颈部侧屈,d=0.69)方面表现出明显的损害,与无症状组相比。还发现伴有 NF 的 CNSNP 组在疼痛强度、残疾和心理因素方面存在显著差异,在 NF 组观察到最差的结果。

结论

伴有 NF 的 CNSNP 患者比不伴有 NF 的患者具有更大的感觉、运动和心理障碍,疼痛强度、残疾和消极心理因素更多,并且在远离疼痛的区域和受损的颈部动觉感觉方面触觉空间感知更差。

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