肱骨外上髁炎患者的颈椎本体感觉受损：一项病例对照研究。

Impaired cervical proprioception in patients with lateral epicondylitis: a case-control study.

作者信息

Kazemamooz Langarudi Milad, Kordi Yoosefinejad Amin, Rezaei Iman

机构信息

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

BMC Musculoskelet Disord. 2025 Aug 8;26(1):766. doi: 10.1186/s12891-025-09026-8.

DOI:10.1186/s12891-025-09026-8

PMID:40781718

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12333058/

Abstract

BACKGROUND

Lateral elbow epicondylitis (LE) is one of the most common upper-limb overuse injuries. Several studies have reported an association between LE and proprioceptive impairments in upper-limb joints, including the wrist, elbow, and shoulder. The current study aimed to assess cervical proprioception in individuals with LE.

METHODS

Thirty patients with LE and 30 asymptomatic participants (control group) were enrolled in this study. Cervical proprioception was evaluated in both groups through assessments of joint position sense (JPS), sense of movement (SOM), and sensation of force (SOF). JPS was measured using a circular pattern with a head-mounted laser, SOM was assessed using figure-of-eight (F8) and zig-zag (ZZ) tracing tasks with the same device, and SOF was evaluated using the craniocervical flexion test with a pressure biofeedback unit. Proprioceptive accuracy was quantified using absolute error values for the JPS and SOM tests, and the activation score (AS) and cumulative performance index (CPI) for the SOF test.

RESULTS

The mean absolute error in the JPS test was significantly greater in the LE group compared to the control group in all directions: Extension: p < 0.001, effect size = 1.44, 95% CI = -3.00 to -1.41, Flexion: p < 0.001, effect size = 2.02, 95% CI = -3.02 to -1.79, Right rotation: p < 0.001, effect size = 1.93, 95% CI = -3.05 to -1.76, Left rotation: p < 0.001, effect size = 1.21, 95% CI = -2.89 to -1.16. Similarly, SOM errors were significantly higher in the LE group for both patterns (ZZ pattern: p < 0.001, effect size = 1.96, 95% CI = -8.30 to -4.82, F8 pattern: p < 0.001, effect size = 0.98, 95% CI = -8.39 to -2.60). For the SOF test, both AS and CPI scores were significantly lower in the LE group than in the control group (AS: p < 0.001, effect size = 1.14, 95% CI = 1.35 to 3.58, CPI: p < 0.001, effect size = 1.25, 95% CI = 62.91 to 151.08). All analyses demonstrated large effect sizes.

CONCLUSION

This study demonstrated that patients with LE exhibit significant cervical proprioceptive impairments compared to healthy controls, as evidenced by deficits in joint position sense, movement sense, and force sense.

摘要

背景

外侧肘上髁炎（LE）是最常见的上肢过度使用损伤之一。多项研究报告了LE与上肢关节（包括腕关节、肘关节和肩关节）本体感觉障碍之间的关联。本研究旨在评估LE患者的颈部本体感觉。

方法

本研究纳入了30例LE患者和30名无症状参与者（对照组）。通过评估关节位置觉（JPS）、运动觉（SOM）和力觉（SOF）对两组患者的颈部本体感觉进行评估。使用头戴式激光以圆形模式测量JPS，使用同一设备通过“8”字形（F8）和之字形（ZZ）追踪任务评估SOM，使用压力生物反馈单元通过颅颈屈曲试验评估SOF。使用JPS和SOM测试的绝对误差值以及SOF测试的激活分数（AS）和累积表现指数（CPI）对本体感觉准确性进行量化。

结果

在所有方向上，LE组JPS测试的平均绝对误差均显著高于对照组：伸展：p＜0.001，效应量=1.44，95%置信区间=-3.00至-1.41；屈曲：p＜0.001，效应量=2.02，95%置信区间=-3.02至-1.79；右旋：p＜0.001，效应量=1.93，95%置信区间=-3.05至-1.76；左旋：p＜0.001，效应量=1.21，95%置信区间=-2.89至-1.16。同样，LE组在两种模式下的SOM误差均显著更高（ZZ模式：p＜0.001，效应量=1.96，95%置信区间=-8.30至-4.82；F8模式：p＜0.001，效应量=0.98，95%置信区间=-8.39至-2.60）。对于SOF测试，LE组的AS和CPI分数均显著低于对照组（AS：p＜0.001，效应量=1.14，95%置信区间=1.35至3.58；CPI：p＜0.001，效应量=1.25，95%置信区间=62.91至151.08）。所有分析均显示出较大的效应量。