Biomechanics Department, Fisi(ON) Health Group, RetiaTech, Las Rozas, Spain.
San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, Madrid, Spain.
PLoS One. 2020 Sep 9;15(9):e0238424. doi: 10.1371/journal.pone.0238424. eCollection 2020.
Traumatic cervical spine injuries are amongst the traffic injuries that can cause most harm to a person. Classifying subtypes of clinical presentations has been a method used in other pathologies to diagnose more efficiently and to address the appropriate treatment and the prognosis. The management of patients suffering from cervical injuries could be improved by classifying the severity of the impairment. This will allow clinicians to propose better treatment modalities according to the severity of the injury.
The present study is a retrospective cohort study performed with the clinical data from 772 patients stored at Fisi-(ON) Health Group. All the patients treated for cervical spine injuries are evaluated using the EBI-5® system, which is based on inertial measurement unit (IMU) technology. The normalized range of motion of each patient was incorporated into a single index, the Neck Functional Holistic Analysis Score (NFHAS).
Clustering analysis of the patients according to their NFHAS resulted in five groups. The Kruskal-Wallis H test showed that there were statistically relevant differences in the ROM values and NFHAS of the patients depending on the cluster they were assigned to: FE X2(4) = 551.59, p = 0.0005; LB ROM X2(4) = 484.58, p = 0.0005; RT ROM X2(4) = 557.14, p = 0.0005; NFHAS X2(4) = 737.41, p = 0.0005. Effect size with ηp2 for the comparison of groups were: FE = 0.76, LB = 0.68, RT = 0.76 and NFHAS = 0.96.
The NFHAS is directly correlated to the available ROM of the patient. The NFHAS serves as a good tool for the classification of cervical injury patients. The degree of impairment shown by the cervical injury can now be staged correctly using this new classification.
外伤性颈椎损伤是交通事故中对人体危害最大的损伤之一。在其他病理学中，对临床表现进行分类亚型一直是一种更有效地诊断和确定适当治疗和预后的方法。通过对损伤程度进行分类，可以改善颈椎损伤患者的管理。这将使临床医生能够根据损伤的严重程度提出更好的治疗方法。
本研究是一项回顾性队列研究，对 Fisi-（ON）健康集团储存的 772 名颈椎损伤患者的临床数据进行了研究。所有接受颈椎损伤治疗的患者均使用基于惯性测量单元（IMU）技术的 EBI-5®系统进行评估。每位患者的运动范围（ROM）均归一化为单一指数，即颈椎整体功能分析评分（NFHAS）。
根据 NFHAS 对患者进行聚类分析，结果分为五组。Kruskal-Wallis H 检验显示，根据患者所属聚类，ROM 值和 NFHAS 存在统计学差异：FE X2(4) = 551.59，p = 0.0005；LB ROM X2(4) = 484.58，p = 0.0005；RT ROM X2(4) = 557.14，p = 0.0005；NFHAS X2(4) = 737.41，p = 0.0005。组间比较的效应大小（ηp2）为：FE = 0.76，LB = 0.68，RT = 0.76，NFHAS = 0.96。
NFHAS 与患者的可用 ROM 直接相关。NFHAS 是颈椎损伤患者分类的良好工具。使用这种新的分类方法，现在可以正确地对颈椎损伤的损伤程度进行分期。
