The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Queensland, Australia.
Phys Ther. 2022 May 5;102(5). doi: 10.1093/ptj/pzac027.
The Neck Disability Index (NDI) is a self-rated disability tool originally developed for whiplash-associated disorders and validated in cervical musculoskeletal conditions. It is now commonly used to assess neck disability in migraine, but it is unknown whether NDI scores relate to migraine and hypersensitivity, cervical musculoskeletal dysfunction, or both. This single-blinded observational study aimed to determine whether the presence of cervical musculoskeletal dysfunction, migraine features, and hypersensitivity predict NDI scores and whether alternate versions of the NDI (NDI-physical, NDI-8, NDI-5) relate more to cervical musculoskeletal dysfunction.
Migraine and neck pain features, the Headache Impact Test (HIT-6), NDI, Allodynia Symptom Checklist (ASC12), and pressure pain thresholds were assessed in 104 participants with migraine and neck pain, 45 previously identified with cervical musculoskeletal dysfunction and 59 without. The NDI score was regressed on the presence or absence of cervical dysfunction, migraine features, HIT-6, total pressure pain threshold, and ASC12 while accounting for neck pain features. The presence of cervical dysfunction was regressed on the scores of NDI versions.
The ASC12 (standardized ß = 0.20) and HIT-6 (standardized ß = 0.18) were significantly predictive of total NDI score, as were neck pain intensity (standardized ß = 0.32) and frequency (standardized ß = 0.44). No scores from alternate NDI versions related to cervical dysfunction.
The NDI score is a complex measure of neck disability influenced by migraine disability and hypersensitivity beyond the presence of cervical musculoskeletal dysfunction. This has implications for the clinical interpretation of NDI scores in patients with migraine.
Many patients with migraine and neck pain report neck disability; therefore, it is important to understand if migraine impacts neck disability. The results of this study indicate that clinicians need to consider migraine-related disability and hypersensitivity when managing neck disability in this population.
颈部残疾指数（NDI）是一种自评残疾工具，最初是为与挥鞭伤相关的疾病开发的，并在颈椎肌肉骨骼疾病中得到验证。现在常用于评估偏头痛患者的颈部残疾，但尚不清楚 NDI 评分与偏头痛和过敏、颈椎肌肉骨骼功能障碍或两者之间的关系。这项单盲观察性研究旨在确定颈椎肌肉骨骼功能障碍、偏头痛特征和过敏是否预测 NDI 评分，以及 NDI 的替代版本（NDI-物理、NDI-8、NDI-5）是否与颈椎肌肉骨骼功能障碍更相关。
104 名偏头痛伴颈痛患者，45 名先前被诊断为颈椎肌肉骨骼功能障碍，59 名无颈椎肌肉骨骼功能障碍，评估偏头痛和颈痛特征、头痛影响测试（HIT-6）、NDI、感觉过敏症状检查表（ASC12）和压痛阈值。在考虑颈痛特征的情况下，将 NDI 评分回归到颈椎功能障碍的存在或不存在、偏头痛特征、HIT-6、总压痛阈值和 ASC12。将 NDI 版本的分数回归到颈椎功能障碍的存在。
ASC12（标准化ß=0.20）和 HIT-6（标准化ß=0.18）与总 NDI 评分显著相关，颈痛强度（标准化ß=0.32）和频率（标准化ß=0.44）也是如此。替代 NDI 版本的任何分数都与颈椎功能障碍无关。
NDI 评分是一种复杂的颈部残疾衡量标准，受偏头痛残疾和过敏影响，超出颈椎肌肉骨骼功能障碍的存在。这对偏头痛患者 NDI 评分的临床解释有影响。
许多偏头痛伴颈痛患者报告颈部残疾；因此，了解偏头痛是否会影响颈部残疾很重要。这项研究的结果表明，在管理该人群的颈部残疾时，临床医生需要考虑与偏头痛相关的残疾和过敏。
