Faculty of Sport, University of Ljubljana, Gortanova 22, SI-1000 Ljubljana, Slovenia.
Landspitali, University Hospital, Reykjavik, Iceland.
Gait Posture. 2023 Mar;101:21-27. doi: 10.1016/j.gaitpost.2023.01.011. Epub 2023 Jan 16.
Patients with mild traumatic brain injury (mTBI) suffer from sensorimotor impairments. Evidence is emerging that cervical spine plays an important role in mTBI, but it is not known how cervicocephalic kinaesthetic sensibility measured during dynamic unpredictable head movements and measures of position sense, cervical induced postural balance and eye movement control differ between mTBI, whiplash associated disorders (WAD) patients, idiopathic neck pain patients and healthy controls.
Are cervical sensorimotor deficits present in mTBI patients and do they differ from sensorimotor deficits found in traumatic and nontraumatic neck pain patients and whether they differ from healthy controls.
Twenty idiopathic neck pain patients, 18 WAD, 17 mTBI and 20 healthy controls were enroled in the study. Frequency and velocity of centre of pressure movements were measured during parallel stance in the neutral and neck torsion positions, gain and smooth pursuit neck torsion difference of eye movements during smooth pursuit neck torsion test (SPNTT) and cervicocephalic kinaesthesia using Butterfly and head-to-neutral relocation test.
Statistically significant differences in postural balance, both tests of cervicocephalic kinaesthesia and SPNTT were observed between healthy controls and all patient groups. No differences were observed between patient groups for SPNTT, Butterfly and head-to-neutral relocation test, but differences were present in postural balance between mTBI and both groups of patients with neck pain disorders. Differences were found in the ML direction for mTBI, but not differences were found for AP direction.
Results of our study show that mTBI present with similar impairment in cervical driven sensorimotor deficits as patients with neck pain disorders, but they differ from healthy individuals. Clinical practice would benefit from identifying cervical spine related sensorimotor impairments in patients with mTBI. This could enable to design more targeted prevention and rehabilitation programs to minimise cervical spine related disorders in concussion patients.
轻度创伤性脑损伤 (mTBI) 患者存在感觉运动障碍。有证据表明颈椎在 mTBI 中起着重要作用，但目前尚不清楚在动态不可预测的头部运动期间测量的颈颅运动感觉以及位置感觉、颈椎诱发姿势平衡和眼球运动控制的测量值在 mTBI、挥鞭样损伤相关障碍 (WAD) 患者、特发性颈痛患者和健康对照者之间有何不同。
mTBI 患者是否存在颈椎感觉运动缺陷，与创伤性和非创伤性颈痛患者的感觉运动缺陷有何不同，与健康对照者有何不同。
本研究纳入了 20 名特发性颈痛患者、18 名 WAD 患者、17 名 mTBI 患者和 20 名健康对照者。在中立位和颈部扭转位的平行站立位期间，测量了中心压力点运动的频率和速度，在平滑跟踪颈部扭转测试 (SPNTT) 和使用蝴蝶和头部到中立位置重新定位测试进行颈颅运动感觉期间测量了眼球运动的增益和平滑跟踪颈部扭转差异。
在姿势平衡、两种颈颅运动感觉测试和 SPNTT 方面，健康对照组与所有患者组之间均存在统计学显著差异。在 SPNTT、蝴蝶和头部到中立位置重新定位测试方面，患者组之间没有差异，但在 mTBI 与颈痛障碍患者组之间存在姿势平衡差异。在 ML 方向发现了 mTBI 的差异，但在 AP 方向没有发现差异。
我们的研究结果表明，mTBI 存在与颈痛障碍患者相似的颈椎驱动感觉运动缺陷，但与健康个体不同。临床实践将受益于识别 mTBI 患者的颈椎相关感觉运动障碍。这可以设计更有针对性的预防和康复计划，以最大限度地减少脑震荡患者的颈椎相关疾病。
