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联合监督与远程康复锻炼计划对患有慢性颈部疼痛的牙医疼痛和残疾状况的影响:一项随机对照试验

Effects of combined supervised and telerehabilitation exercise programs on pain and disability in dentists with chronic neck pain: a randomized controlled trial.

作者信息

Alkan Emrullah, Gelecek Nihal, Oz İlke Kara, Akcalı Aliye

机构信息

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Mardin Artuklu University, Mardin, Türkiye.

Institute of Health Sciences, Dokuz Eylul University, Izmir, Türkiye.

出版信息

BMC Musculoskelet Disord. 2025 Aug 7;26(1):759. doi: 10.1186/s12891-025-09010-2.

Abstract

BACKGROUND

This study was conducted to determine the effects of combined exercises applied with supervised and telerehabilitation methods on pain intensity, pain pressure threshold, muscular endurance, grip strength, neck and upper extremity disabilities in dentists with chronic neck pain (CNP).

METHODS

Fifty-five dentists with CNP were included in the study and randomly divided into three groups as supervised group (n = 19), telerehabilitation group (n = 19) and control group (n = 17). The participants had a mean age of 35.20 ± 4.16 years, with ages ranging from 30 to 44 years and of the participants, 43 were female (78%) and 12 were male (22%). Combined exercises consisting of resistance, stretching and postural alignment exercises were applied with supervised and telerehabilitation methods three days a week for 12 weeks. The control group received a non-resistance exercise sheet matching the other protocols. Initially, all patients were assessed for pain intensity (VAS), pain pressure threshold, grip strength (hand, lateral and pinch grip), muscular endurance (deep neck flexors, scapular, static and dynamic core), neck and upper extremity disability. The assessments were repeated after 12 weeks of training.

RESULTS

The telerehabilitation group demonstrated positive changes in pain intensity, pain pressure threshold, and neck disability that were statistically significant (p < 0.05). Supervised group has improved all assessments except dynamic core endurance and grip strength (p < 0.05). There was also a decrease in pain intensity and neck disability index in the control group (p < 0.05). When the changes resulting from exercise training were compared between the groups, it was seen that the changes in the supervised group were superior (p < 0.05).

CONCLUSIONS

The results showed that combined exercises applied under supervision were more effective than telerehabilitation or home exercises in dentists with CNP, and telerehabilitation was more effective than home program. Although the telerehabilitation method is not as effective as supervised exercise training, it can be an alternative method to reduce pain and disability for dentists who cannot participate in a regular exercise program due to their working conditions. Long-term follow-up studies are needed to determine how long the effect of exercise training applied with telerehabilitation continues in dentists with CNP.

摘要

背景

本研究旨在确定采用监督式和远程康复方法进行的联合运动对患有慢性颈部疼痛(CNP)的牙医的疼痛强度、疼痛压力阈值、肌肉耐力、握力、颈部和上肢功能障碍的影响。

方法

55名患有CNP的牙医被纳入研究,并随机分为三组:监督组(n = 19)、远程康复组(n = 19)和对照组(n = 17)。参与者的平均年龄为35.20±4.16岁,年龄范围在30至44岁之间,其中43名参与者为女性(78%),12名参与者为男性(22%)。采用监督式和远程康复方法,每周三天进行包括阻力、拉伸和姿势调整练习的联合运动,持续12周。对照组接受与其他方案相匹配的非阻力运动表。最初,对所有患者进行疼痛强度(视觉模拟评分法)、疼痛压力阈值、握力(手部、外侧和捏力握力)、肌肉耐力(深层颈部屈肌、肩胛骨、静态和动态核心)、颈部和上肢功能障碍的评估。在训练12周后重复进行评估。

结果

远程康复组在疼痛强度、疼痛压力阈值和颈部功能障碍方面表现出具有统计学意义的积极变化(p < 0.05)。监督组除动态核心耐力和握力外,所有评估指标均有所改善(p < 0.05)。对照组的疼痛强度和颈部功能障碍指数也有所下降(p < 0.05)。当比较各组运动训练所产生的变化时,发现监督组的变化更为显著(p < 0.05)。

结论

结果表明,在患有CNP的牙医中,在监督下进行的联合运动比远程康复或家庭运动更有效,且远程康复比家庭方案更有效。尽管远程康复方法不如监督式运动训练有效,但对于因工作条件无法参加常规运动计划的牙医来说,它可以作为减轻疼痛和功能障碍的替代方法。需要进行长期随访研究,以确定远程康复应用的运动训练效果在患有CNP的牙医中能持续多长时间。

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