Wannaprom Nipaporn, Jull Gwendolen, Treleaven Julia, Warner Martin B, Kamnardsiri Teerawat, Uthaikhup Sureeporn
Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia.
Musculoskelet Sci Pract. 2022 Dec;62:102656. doi: 10.1016/j.msksp.2022.102656. Epub 2022 Aug 14.
Clavicular and scapular orientations vary between neck pain patients as do clinical features and responses (changes in pain and rotation range) to scapular repositioning. Associations between these factors are unknown.
To identify subgroups of neck pain patients based on three-dimensional (3D) measures of clavicular and scapular orientations and differences between subgroups in clinical characteristics and responses to scapular repositioning.
Cross-sectional study.
Eligible participants were recruited as part of a larger study. The 3D clavicular and scapular orientations were analyzed on the more painful side of the neck using a hierarchical cluster analysis. Clinical characteristics were neck pain location, intensity, duration, disability and presence of headache. Responses to scapular repositioning were classified as "yes and no".
Fifty-eight participants (29 responsive; 29 non-responsive to scapular repositioning) participated in the study. Analysis identified two distinct subgroups: subgroup1 had greater clavicular retraction and scapular downward rotation (n = 26) and subgroup2 had greater clavicular elevation and scapular internal rotation and anterior tilt (n = 32). Headache and dominant pain in the upper neck were more frequent in subgroup 1 while dominant pain in the lower neck was frequent in subgroup 2 (p < 0.01). Most participants who responded positively to scapular repositioning (88.5%) were in subgroup1 and most non-responsive participants (81.2%) in subgroup2.
The 3D clavicular and scapular orientations identified two subgroups of neck pain patients. Participants with predominantly downward scapular rotation were distinguished by pain in the upper neck, presence of headache and a positive response to scapular repositioning.
锁骨和肩胛骨的方位在颈部疼痛患者之间存在差异，临床特征以及对肩胛骨重新定位的反应（疼痛和旋转范围的变化）也是如此。这些因素之间的关联尚不清楚。
基于锁骨和肩胛骨方位的三维（3D）测量来识别颈部疼痛患者的亚组，并比较亚组之间在临床特征和对肩胛骨重新定位反应方面的差异。
横断面研究。
符合条件的参与者作为一项更大规模研究的一部分被招募。使用层次聚类分析在颈部疼痛更严重的一侧分析3D锁骨和肩胛骨方位。临床特征包括颈部疼痛的位置、强度、持续时间、功能障碍以及是否存在头痛。对肩胛骨重新定位的反应分为“有反应”和“无反应”。
58名参与者（29名有反应；29名对肩胛骨重新定位无反应）参与了该研究。分析确定了两个不同的亚组：亚组1有更大的锁骨后缩和肩胛骨向下旋转（n = 26），亚组2有更大的锁骨抬高、肩胛骨内旋和前倾（n = 32）。亚组1中头痛和上颈部主要疼痛更为常见，而亚组2中下颈部主要疼痛更为常见（p < 0.01）。对肩胛骨重新定位反应呈阳性的大多数参与者（88.5%）在亚组1中，而大多数无反应的参与者（81.2%）在亚组2中。
3D锁骨和肩胛骨方位确定了颈部疼痛患者的两个亚组。以肩胛骨主要向下旋转为特征的参与者以上颈部疼痛、存在头痛以及对肩胛骨重新定位有阳性反应为特点。
