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斜角肌下干针治疗对颈痛患者感觉运动控制和颈椎活动度的影响:一项双盲、随机 sham 对照试验。

Effects of dry needling of the obliquus capitis inferior on sensorimotor control and cervical mobility in people with neck pain: A double-blind, randomized sham-controlled trial.

机构信息

Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Brussels, Belgium.

Division of Physiotherapy, SHRS, University of Queensland, Brisbane, Australia.

出版信息

Braz J Phys Ther. 2021 Nov-Dec;25(6):826-836. doi: 10.1016/j.bjpt.2021.07.005. Epub 2021 Sep 5.

Abstract

BACKGROUND

Impairments of sensorimotor control relating to head and eye movement control and postural stability are often present in people with neck pain. The upper cervical spine and particularly the obliquus capitis inferior (OCI) play an important proprioceptive role; and its impairment may alter cervical sensorimotor control. Dry needling (DN) is a valid technique to target the OCI.

OBJECTIVES

To investigate if a single DN session of the OCI muscle improves head and eye movement control-related outcomes, postural stability, and cervical mobility in people with neck pain.

METHODS

Forty people with neck pain were randomly assigned to receive a single session of DN or sham needling of the OCI. Cervical joint position error (JPE), cervical movement sense, standing balance and oculomotor control were examined at baseline, immediately post-intervention, and at one-week follow-up. Active cervical rotation range of motion and the flexion rotation test were used to examine the global and upper cervical rotation mobility, respectively.

RESULTS

Linear mixed-models revealed that the DN group showed a decrease of JPE immediately post-intervention compared to the sham group (mean difference [MD]= -0.93°; 95% confidence interval [CI]: -1.85, -0.02) which was maintained at one-week follow-up (MD= -1.64°; 95%CI: -2.85, -0.43). No effects on standing balance or cervical movement sense were observed in both groups. Upper cervical mobility showed an increase immediately after DN compared to the sham group (MD= 5.14°; 95%CI: 0.77, 9.75) which remained stable at one-week follow-up (MD= 6.98°; 95%CI: 1.31, 12.40). Both group showed an immediate increase in global cervical mobility (MD= -0.14°; 95%CI: -5.29, 4.89).

CONCLUSION

The results from the current study suggest that a single session of DN of the OCI reduces JPE deficits and increases upper cervical mobility in patients with neck pain. Future trials should examine if the addition of this technique to sensorimotor control training add further benefits in the management of neck pain.

摘要

背景

颈部疼痛患者常存在与头部和眼部运动控制及姿势稳定性相关的感觉运动控制障碍。上颈椎,特别是下斜方肌(OCI),具有重要的本体感受作用;其功能障碍可能改变颈椎感觉运动控制。干针(DN)是一种针对 OCI 的有效技术。

目的

研究单次 OCI 肌 DN 是否改善颈部疼痛患者的头部和眼部运动控制相关结果、姿势稳定性和颈椎活动度。

方法

40 名颈部疼痛患者被随机分配接受 OCI 的单次 DN 或假针刺。在基线、干预后即刻和一周随访时检查颈椎关节位置误差(JPE)、颈椎运动觉、站立平衡和眼动控制。主动颈椎旋转活动度和屈伸旋转试验分别用于检查整体和上颈椎旋转活动度。

结果

线性混合模型显示,DN 组干预后即刻 JPE 较假针刺组降低(平均差值[MD]=-0.93°;95%置信区间[CI]:-1.85,-0.02),一周随访时仍保持(MD=-1.64°;95%CI:-2.85,-0.43)。两组在站立平衡或颈椎运动觉方面均无影响。DN 组与假针刺组相比,上颈椎活动度在干预后即刻增加(MD=5.14°;95%CI:0.77,9.75),一周随访时仍保持稳定(MD=6.98°;95%CI:1.31,12.40)。两组患者的整体颈椎活动度均即刻增加(MD=-0.14°;95%CI:-5.29,4.89)。

结论

本研究结果表明,单次 OCI 的 DN 可减少颈部疼痛患者的 JPE 缺陷并增加上颈椎活动度。未来的试验应研究将该技术添加到感觉运动控制训练中是否会进一步改善颈部疼痛的管理。

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High-vs. low-tech cervical movement sense measurement in individuals with neck pain.颈痛患者的高、低技术颈椎运动感知测量。
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