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颈胸交界处松动术与自体肌肉能量技术治疗慢性机械性颈部疼痛:一项随机对照试验。

Cervicothoracic junction mobilization versus autogenic muscle energy technique for chronic mechanical neck pain: A randomized controlled trial.

作者信息

Abbas Hoda I, Kamel Ragia M, Shafei Ayman E, Mahmoud Mayada A, Lasheen Yasser R

机构信息

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

Physical Medicine & Rehabilitation, Military Medical Academy, Faculty of Medicine, MTI University, Cairo, Egypt.

出版信息

J Man Manip Ther. 2025 Feb;33(1):36-46. doi: 10.1080/10669817.2024.2384199. Epub 2024 Jul 26.

Abstract

OBJECTIVE

Neck pain is a prevalent global health concern often accompanied by musculoskeletal symptoms. This randomized controlled trial attempted to contrast the impacts of non-thrust Maitland mobilization and Autogenic inhibition muscle energy technique on chronic mechanical neck pain associated with cervico-thoracic junction hypo-mobility.

METHODS

Sixty participants (24 males and 36 females, aged 18-45 years) were allocated randomly into three equally sized groups (A, B, C). Group A: Maitland mobilization plus conventional treatment, Group B: Autogenic Muscle energy technique plus conventional treatment, while; Group C solely received conventional treatment. Treatment was administered for four weeks, three times a week. Outcome measures: neck pain (The primary outcome measure) assessed by Visual Analog Scale (VAS), disability evaluated through Neck Disability Index (NDI), active range of motion (AROM), and joint position error (JPE) as an indicator of cervical proprioception. All measures were assessed both at baseline and after four weeks of intervention.

RESULTS

Results showed significant improvements in VAS, NDI, and increased ROM across all groups post-treatment ( < 0.001). While Groups A and B demonstrated superior outcomes compared to Group C, differences between Groups A and B were not statistically significant ( > 0.05). For VAS and NDI, Cohen-d between Groups A and B was 0.31 and 0.31, and for ROM, Cohen-d was 0.37, 0.16, 0.07, 0.29, 0.36, and 0.53 for flexion, extension, right rotation, left rotation, right bending, and left bending, respectively. Furthermore, all groups experienced a significant decrease in JPE, with Groups A and B showing greater improvement than Group C ( < 0.01). Group B exhibited significantly greater improvement in reducing JPE related to specific motions compared to Group A ( < 0.05).

CONCLUSION

Cervico-thoracic junction mobilization and the Autogenic muscle energy technique offer enhanced management for mechanical neck pain by improving pain, function, ROM, and cervical proprioception.

摘要

目的

颈部疼痛是一个普遍的全球健康问题,常伴有肌肉骨骼症状。这项随机对照试验试图对比非推力麦特兰德松动术和自体抑制肌肉能量技术对与颈胸交界处活动度降低相关的慢性机械性颈部疼痛的影响。

方法

60名参与者(24名男性和36名女性,年龄18 - 45岁)被随机分为三个同等规模的组(A、B、C)。A组:麦特兰德松动术加常规治疗;B组:自体肌肉能量技术加常规治疗;而C组仅接受常规治疗。治疗为期四周,每周三次。结果指标:通过视觉模拟量表(VAS)评估颈部疼痛(主要结果指标),通过颈部功能障碍指数(NDI)评估功能障碍,测量主动活动范围(AROM),并将关节位置误差(JPE)作为颈椎本体感觉的指标。所有指标在基线和干预四周后均进行评估。

结果

结果显示,治疗后所有组的VAS、NDI均有显著改善,ROM增加(<0.001)。虽然A组和B组的结果优于C组,但A组和B组之间的差异无统计学意义(>0.05)。对于VAS和NDI,A组和B组之间的Cohen-d分别为0.31和0.31,对于ROM,屈曲、伸展、右旋、左旋、右弯和左弯的Cohen-d分别为0.37、0.16、0.07、0.29、0.36和0.53。此外,所有组的JPE均显著降低,A组和B组的改善程度大于C组(<0.01)。与A组相比,B组在减少特定动作相关的JPE方面表现出显著更大的改善(<0.05)。

结论

颈胸交界处松动术和自体肌肉能量技术通过改善疼痛、功能、ROM和颈椎本体感觉,为机械性颈部疼痛提供了更好的治疗方法。

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