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量化挥鞭样损伤相关疾病亚急性期的功能障碍——一项横断面研究

Quantifying Impairments in the Subacute Phase of Whiplash Associated Disorders-A Cross-Sectional Study.

作者信息

Ragnarsdóttir Harpa, Oddsdóttir Guðný Lilja, Gíslason Magnús Kjartan, Briem Kristín

机构信息

Research Centre of Movement Science, Department of Physiotherapy, University of Iceland, 102 Reykjavík, Iceland.

Elja Physiotherapy, 220 Hafnarfjordur, Iceland.

出版信息

Life (Basel). 2025 Mar 31;15(4):562. doi: 10.3390/life15040562.

Abstract

Whiplash-Associated Disorders (WADs) often result from traffic accidents, leading to persistent symptoms, including neck pain, disability, dizziness, and central sensitization (CS). A key concern is cervical range of motion (cROM) impairment and sensorimotor dysfunction, which contribute to prolonged disability. This study assessed functional performance in individuals with subacute (>1, <3 months) WADs (n = 122) compared to healthy controls (n = 45). Clinical measures included cROM, movement control (Butterfly test), and position sense (Head-Neck Relocation Test, HNRT). Patient-reported outcomes included neck disability, pain intensity, central sensitization, and dizziness. Mixed and linear models evaluated group differences and the influence of demographic and symptom-related factors. WAD patients had significantly reduced cROM and impaired movement control ( < 0.001). Neck disability ( < 0.001) and pain intensity ( = 0.015) affected cROM within the WAD group. Interaction effects revealed greater amplitude accuracy (AA) impairments at greater difficulty levels ( = 0.043), while time on target (TOT) differences decreased ( < 0.001). Dizziness was associated with increased undershoot ( < 0.001), while pain negatively impacted both AA ( = 0.003) and TOT ( = 0.037). Position sense did not differentiate WAD patients from controls. Findings suggest task-dependent sensorimotor deficits, highlighting the need for multimodal assessment. Early CS screening may optimize rehabilitation and prevent chronic disability.

摘要

挥鞭样损伤相关疾病(WADs)通常由交通事故引起,导致持续症状,包括颈部疼痛、功能障碍、头晕和中枢敏化(CS)。一个关键问题是颈椎活动范围(cROM)受损和感觉运动功能障碍,这会导致残疾时间延长。本研究评估了亚急性(>1个月,<3个月)WADs患者(n = 122)与健康对照组(n = 45)的功能表现。临床测量包括cROM、运动控制(蝴蝶试验)和位置觉(头颈复位试验,HNRT)。患者报告的结果包括颈部功能障碍、疼痛强度、中枢敏化和头晕。混合模型和线性模型评估了组间差异以及人口统计学和症状相关因素的影响。WAD患者的cROM显著降低,运动控制受损(<0.001)。颈部功能障碍(<0.001)和疼痛强度(=0.015)影响WAD组内的cROM。交互作用显示,在难度较大的水平上,幅度准确性(AA)受损更严重(=0.043),而目标时间(TOT)差异减小(<0.001)。头晕与下冲增加相关(<0.001),而疼痛对AA(=0.003)和TOT(=0.037)均有负面影响。位置觉在区分WAD患者和对照组方面没有差异。研究结果表明存在任务依赖性感觉运动缺陷,强调了多模式评估的必要性。早期CS筛查可能会优化康复并预防慢性残疾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0a3/12028745/b9fbc8b27bc6/life-15-00562-g001.jpg

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