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感觉运动整合、颈部感觉运动控制以及认知-运动双重任务的代价:与健康对照相比,慢性挥鞭样损伤相关疾病和慢性特发性颈部疼痛患者是否存在差异?

Sensorimotor integration, cervical sensorimotor control, and cost of cognitive-motor dual tasking: Are there differences in patients with chronic whiplash-associated disorders and chronic idiopathic neck pain compared to healthy controls?

作者信息

Moustafa Ibrahim M, Diab Aliaa, Shousha Tamer, Raigangar Veena, Harrison Deed E

机构信息

Department of Physiotherapy, College of Health Sciences, University of Sharjah, University City Road, Sharjah, UAE.

Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt.

出版信息

Eur Spine J. 2022 Dec;31(12):3452-3461. doi: 10.1007/s00586-022-07390-w. Epub 2022 Oct 13.

Abstract

PURPOSE

The current investigation aimed to compare the sensorimotor integration, sensorimotor control, and cost of cognitive-motor dual task during walking, in persons with chronic WAD as compared to matched chronic idiopathic neck pain and normal healthy controls.

METHODS

A cross-sectional, case control design comparing 30 participants in each of two study groups (chronic WAD and chronic idiopathic neck pain) to a matched control group was conducted. Measurements included: (1) the cranio-vertebral angle (CVA), (2) left and right rotation head repositioning accuracy (HRA), (3) frontal N30 amplitudes to assess sensorimotor integration, (4) dual cognitive gait cost (DCGC).

RESULTS

A statistically significant difference for the CVA was found between groups: WAD 36.8° ± 3.4, chronic pain 44.5° ± 1.5, and controls 47.1° ± 4; p < 0.05. MANOVA revealed significant group differences for the N30 amplitude (p < 0.05), where the WAD group had the greatest amplitude. Statistically significant differences among the three groups were found for HRA left and right where the WAD group had the greatest error, (p < 0.05). Post hoc tests revealed that the WAD group had the highest dual-task cost during walking, (p < 0.05). Significant linear correlations between the CVA and N30 amplitude, HRA, and DCGC were identified in all 3 groups, (p < 0.05).

CONCLUSIONS

Compared to both a matched control group and chronic neck pain group, whiplash-injured persons have greater forward head posture, greater error in sensorimotor control, and an altered ability to perform a motor task with a simultaneous cognitive task.

摘要

目的

本研究旨在比较慢性挥鞭样损伤(WAD)患者与匹配的慢性特发性颈部疼痛患者及正常健康对照者在行走过程中的感觉运动整合、感觉运动控制以及认知 - 运动双重任务的成本。

方法

采用横断面病例对照设计,将两个研究组(慢性WAD组和慢性特发性颈部疼痛组)各30名参与者与一个匹配的对照组进行比较。测量指标包括:(1)颅椎角(CVA),(2)左右旋转头部重新定位准确性(HRA),(3)用于评估感觉运动整合的额部N30波幅,(4)双重认知步态成本(DCGC)。

结果

各组之间CVA存在统计学显著差异:WAD组为36.8°±3.4,慢性疼痛组为44.5°±1.5,对照组为47.1°±4;p<0.05。多变量方差分析显示N30波幅存在显著组间差异(p<0.05),其中WAD组波幅最大。三组之间左右HRA存在统计学显著差异,WAD组误差最大(p<0.05)。事后检验显示WAD组在行走过程中双重任务成本最高(p<0.05)。在所有3组中均发现CVA与N30波幅、HRA和DCGC之间存在显著线性相关性(p<0.05)。

结论

与匹配的对照组和慢性颈部疼痛组相比,挥鞭样损伤患者有更大的头部前倾姿势、感觉运动控制方面有更大误差,以及在执行运动任务同时进行认知任务时能力发生改变。

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