Department of Physical Therapy, HungKuang University, Taichung, Taiwan.
Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan.
BMC Musculoskelet Disord. 2022 Jul 30;23(1):728. doi: 10.1186/s12891-022-05670-6.
To better understand biomechanical factors that affect intervertebral alignment throughout active therapeutic exercise, it is necessary to determine spinal kinematics when subjects perform spinal exercises. This study aims to investigate the outcomes of active cervical therapeutic exercise on intervertebral foramen changes in neck pain patients with disc herniation.
Thirty diagnosed C4/5 and/or C5/6 disc-herniated patients receiving an 8-week cervical therapeutic exercise program were followed up with videofluoroscopic images. The dynamic changes in the foramen were computed at different timepoints, including the neutral position, end-range positions in cervical flexion-extension, protrusion-retraction, and lateral flexion movements.
The results showed that the active cervical flexion, retraction, and lateral flexion away from the affected side movements increased the area of the patients' intervertebral foramen; while the active extension, protrusion, and lateral flexion toward the affected side reduced the areas of intervertebral foramen before treatment. After the treatment, the active cervical flexion significantly increased the C2/3, C3/4, and C6/7 foramen area by 5.02-8.67% (p = 0.001 ~ 0.029), and the extension exercise significantly reduced the C2/3 and C4/5 area by 5.12-9.18% (p = 0.001 ~ 0.006) compared to the baseline. Active retraction movement significantly increased the foramen area from C2/3 to C6/7 by 3.82-8.66% (p = 0.002 ~ 0.036 with exception of C5/6). Active lateral flexion away from the affected side significantly increased the foramen by 3.71-6.78% (p = 0.007 ~ 0.046 with exception of C6/7).
The 8-week therapeutic exercises including repeated cervical retraction, extension, and lateral flexion movements to the lesion led to significant changes and improvements in intervertebral foramen areas of the patients with disc herniation.
ISRCTN61539024.
为了更好地了解在主动治疗性运动过程中影响脊柱对线的生物力学因素，有必要在受试者进行脊柱运动时确定脊柱运动学。本研究旨在探讨主动颈椎治疗性运动对颈椎间盘突出症患者椎间孔变化的影响。
对 30 例诊断为 C4/5 和/或 C5/6 椎间盘突出症的患者进行为期 8 周的颈椎治疗性运动方案，并进行视频荧光透视图像随访。在中立位、颈椎屈伸、前屈-后伸、侧屈运动的末端位置，计算椎间孔的动态变化。
结果显示，主动颈椎前屈、后伸和向患侧侧屈运动增加了患者椎间孔的面积；而主动伸展、前凸和向患侧侧屈则在治疗前减小了椎间孔的面积。治疗后，主动颈椎前屈显著增加了 C2/3、C3/4 和 C6/7 椎间孔面积 5.02%8.67%（p=0.0010.029），伸展运动显著减小了 C2/3 和 C4/5 面积 5.12%9.18%（p=0.0010.006）。主动后伸运动显著增加了 C2/3 至 C6/7 椎间孔面积 3.82%8.66%（p=0.0020.036，除 C5/6 外）。主动向健侧侧屈运动显著增加了椎间孔面积 3.71%6.78%（p=0.0070.046，除 C6/7 外）。
8 周的治疗性运动包括对病变部位的反复颈椎后伸、伸展和侧屈运动，导致椎间盘突出症患者椎间孔面积发生显著变化和改善。
ISRCTN61539024。
