慢性颈痛患者中头部前倾姿势对呼气肌力量的影响：一项横断面研究。
The effects of forward head posture on expiratory muscle strength in chronic neck pain patients: A cross-sectional study.
作者信息
Solakoğlu Özge, Yalçın Peyman, Dinçer Gülay
机构信息
Department of Physical Medicine and Rehabilitation, Ankara University School of Medicine, Ankara, Turkey.
出版信息
Turk J Phys Med Rehabil. 2020 May 18;66(2):161-168. doi: 10.5606/tftrd.2020.3153. eCollection 2020 Jun.
OBJECTIVES
This study aims to investigate the relationship between forward head posture (FHP) and respiratory dysfunctions in patients with chronic neck pain.
PATIENTS AND METHODS
Between June 2014 and November 2016 , a total of 99 patients (11 males, 88 females; mean age 54.1±9 years; range, 38 to 75 years) with chronic neck pain were evaluated for head posture by cervical lateral radiograph measuring the anterior head translation distance (FHPmm) and C7 vertebrae position (C7°). We examined the chest expansion by subtracting chest circumference from the level of xiphoid during maximal inspiration and expiration. Pain severity and neck disability were assessed using the Visual Analog Scale (VAS) and modified Neck Disability Index (MNDI), respectively. The respiratory functions were evaluated using spirometry tests, lung volumes, and maximal inspiratory and expiratory pressures (Pi and Pe, respectively).
RESULTS
There was a negative correlation between the FHPmm with Pe% (rho: -0.314; p=0.005). A negative correlation was also observed between C7° and Pe, Pe%, forced expiratory volume in one sec (FEV1)/forced vital capacity (FVC)%, forced expiratory flow (FEF)25-75%, and FEF75% (rho:-0.245, -0.349, -0.218, -0.214, and -0.259 respectively; p=0.028, 0.002, 0.035, 0.040, and 0.012, respectively). There was a positive correlation between neck disability and VAS scores (rho: 0.424; p<0.001), while there was a negative correlation between neck disability and chest expansion, maximum voluntary ventilation (rho: -0.201 and -0.217, respectively; p=0.049 and 0.046, respectively).
CONCLUSION
Based on our study results, FHP is associated with expiratory muscle weakness in chronic neck pain patients. To evaluate respiratory dysfunction, chest expansion tests may be useful, although these tests are not specific to muscle weakness. Interventions about FHP and neck pain should focus on the effects of respiratory muscle training.
目的
本研究旨在调查慢性颈痛患者的头部前伸姿势（FHP）与呼吸功能障碍之间的关系。
患者与方法
在2014年6月至2016年11月期间，共对99例慢性颈痛患者（11例男性，88例女性；平均年龄54.1±9岁；范围38至75岁）进行了评估，通过颈椎侧位X线片测量头部前伸距离（FHPmm）和第7颈椎位置（C7°）来评估头部姿势。我们通过在最大吸气和呼气时测量剑突水平的胸围并相减来检查胸廓扩张度。分别使用视觉模拟量表（VAS）和改良颈部功能障碍指数（MNDI）评估疼痛严重程度和颈部功能障碍。使用肺量计测试、肺容积以及最大吸气和呼气压力（分别为Pi和Pe）来评估呼吸功能。
结果
FHPmm与Pe%之间存在负相关（rho：-0.314；p = 0.005）。在C7°与Pe、Pe%、一秒用力呼气容积（FEV1）/用力肺活量（FVC）%、用力呼气流量（FEF）25 - 75%以及FEF75%之间也观察到负相关（rho分别为-0.245、-0.349、-0.218、-0.214和-0.259；p分别为0.028、0.002、0.035、0.040和0.012）。颈部功能障碍与VAS评分之间存在正相关（rho：0.424；p < 0.001），而颈部功能障碍与胸廓扩张度、最大自主通气量之间存在负相关（rho分别为-0.201和-0.217；p分别为0.049和0.046）。
结论
基于我们的研究结果，FHP与慢性颈痛患者的呼气肌无力有关。为评估呼吸功能障碍，胸廓扩张度测试可能有用，尽管这些测试并非特异性针对肌无力。关于FHP和颈痛的干预措施应侧重于呼吸肌训练的效果。
Zotero 插件