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持续性自然椎间关节滑动手法治疗颈源性头晕患者的姿势和临床疗效:一项随机对照试验。

Postural and clinical outcomes of sustained natural apophyseal glides treatment in cervicogenic dizziness patients: A randomised controlled trial.

机构信息

Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.

ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy.

出版信息

Clin Rehabil. 2021 Nov;35(11):1566-1576. doi: 10.1177/02692155211012413. Epub 2021 Apr 26.

DOI:10.1177/02692155211012413
PMID:33896213
Abstract

OBJECTIVE

To evaluate how self-report and posturographic measures could be affected in patients with cervicogenic dizziness undergoing sustained natural apophyseal glides.

DESIGN

Randomised controlled single-blind study.

SETTING

Tertiary rehabilitation centre.

SUBJECTS

Patients affected by cervicogenic dizziness, diagnosed by applying accepted criteria. Forty-one patients (19 male, 22 female: mean age 44.3 ± 14.8 years) receiving treatment, and 39 patients (18 male, 21 female: mean age 43.8 ± 13.9 years) receiving placebo were included in the study.

INTERVENTIONS

The treatment group underwent sustained natural apophyseal glides, while the placebo was constituted by a detuned laser. Both groups received their interventions six times over 4 weeks.

MAIN MEASURES

Outcomes were tested by means of self-report measures such as perceived dizziness, neck disability, anxiety and depression. Also, cervical range of motion and posturography testing with power spectra frequency were analysed.

RESULTS

When compared to placebo, treated patients demonstrated a significant decrease in perceived dizziness (post-treatment total Dizziness Handicap Inventory score 20.5 ± 5.3 as compared to 26.2 ± 6 baseline), neck disability and pain (Neck Disability Index and Neck Pain Index post-treatment scores 12.5 ± 4.3 and 45.6 ± 15.1, respectively, as compared to baseline scores of 15.1 ± 4.8 and 62.5 ± 14.3), as well as significant improvement in cervical range of motion and some posturographic parameters.

CONCLUSION

Sustained natural apophyseal glides may represent a useful intervention in reaching short-term beneficial effects in patients with cervicogenic dizziness, with respect to self-perceived symptoms, proprioceptive integration and cervical range of motion improvement.

摘要

目的

评估颈椎源性头晕患者接受持续自然关节滑动治疗后,自我报告和平衡测试结果可能受到的影响。

设计

随机对照单盲研究。

地点

三级康复中心。

患者

符合颈椎源性头晕诊断标准的患者。共纳入 41 例患者(19 名男性,22 名女性;平均年龄 44.3±14.8 岁)接受治疗,39 例患者(18 名男性,21 名女性;平均年龄 43.8±13.9 岁)接受安慰剂治疗。

干预措施

治疗组接受持续自然关节滑动治疗,而安慰剂组则采用失谐激光治疗。两组均在 4 周内接受 6 次干预。

主要观察指标

采用自我报告评估,如头晕感知、颈部残疾、焦虑和抑郁等;同时进行颈椎活动度和平衡测试,并分析功率谱频率。

结果

与安慰剂组相比,治疗组患者的头晕感知(治疗后总眩晕障碍量表评分 20.5±5.3,基线时为 26.2±6)、颈部残疾和疼痛(颈部残疾指数和颈部疼痛指数治疗后评分分别为 12.5±4.3 和 45.6±15.1,基线时为 15.1±4.8 和 62.5±14.3)显著降低,颈椎活动度和一些平衡测试参数也显著改善。

结论

持续自然关节滑动治疗可能是颈椎源性头晕患者的一种有效干预措施,可在短期内改善患者的自我感知症状、本体感觉整合和颈椎活动度。

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