Manual Therapy最新文献_第10页

Cochrane physical and rehabilitation medicine: A new field to bridge between best evidence and the specific needs of our field of competence Cochrane物理和康复医学:在最佳证据和我们领域能力的特定需求之间建立桥梁的新领域

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.06.012

Stefano Negrini, Carlotte Kiekens, William Levack, Frane Grubisic, Francesca Gimigliano, Elena Ilieva, Meyer Thorsten

引用次数: 4

Is thoracic spine posture associated with shoulder pain, range of motion and function? A systematic review 胸椎姿势与肩痛、活动度和功能有关吗?系统回顾

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.07.008

Eva Barrett , Mary O'Keeffe , Kieran O'Sullivan , Jeremy Lewis , Karen McCreesh

Introduction

Excessive thoracic kyphosis is considered a predisposing factor for shoulder pain, though there is uncertainty about the nature of the relationship between shoulder pain and thoracic spine posture. The aim of this systematic review was to investigate the relationship between thoracic kyphosis and shoulder pain, shoulder range of motion (ROM) and function.

Methods

Two reviewers independently searched eight electronic databases and identified relevant studies by applying eligibility criteria. Sources of bias were assessed independently by two reviewers using a previously validated tool (Ijaz et al., 2013). Data were synthesised using a level of evidence approach (van Tulder et al., 2003).

Results

Ten studies were included. Four studies were rated as low risk of bias, three at moderate risk of bias and three at high risk of bias. There is a moderate level of evidence of no significant difference in thoracic kyphosis between groups with and without shoulder pain. One study at high risk of bias demonstrated significantly greater thoracic kyphosis in people with shoulder pain (p < 0.05). There is a strong level of evidence that maximum shoulder ROM is greater in erect postures compared to slouched postures (p < 0.001), in people with and without shoulder pain.

Conclusions

Thoracic kyphosis may not be an important contributor to the development of shoulder pain. While there is evidence that reducing thoracic kyphosis facilitates greater shoulder ROM, this is based on single-session studies whose long-term clinical relevance is unclear. Higher quality research is warranted to fully explore the role of thoracic posture in shoulder pain.

过度的胸后凸被认为是引起肩痛的一个易感因素，尽管肩痛和胸椎姿势之间的关系的性质还不确定。本系统综述的目的是探讨胸后凸与肩关节疼痛、肩关节活动度和功能之间的关系。方法2名审稿人独立检索8个电子数据库，应用入选标准筛选相关研究。两名审稿人使用先前经过验证的工具独立评估偏倚来源(Ijaz et al.， 2013)。采用证据水平法对数据进行综合(van Tulder等人，2003年)。结果纳入10项研究。4项研究被评为低偏倚风险，3项为中等偏倚风险，3项为高偏倚风险。有中等水平的证据表明，有无肩痛的两组在胸后凸方面没有显著差异。一项高风险偏倚研究显示，肩关节疼痛患者的胸后凸明显加重(p <0.05)。有强有力的证据表明，与懒散的姿势相比，直立姿势的最大肩部活动度更大(p <0.001)，在有和没有肩痛的人群中。结论胸后凸可能不是引起肩痛的重要因素。虽然有证据表明减少胸后凸可促进更大的肩部活动度，但这是基于单次研究，其长期临床相关性尚不清楚。需要更高质量的研究来充分探讨胸位在肩关节疼痛中的作用。

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引用次数: 61

Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus? 多模式颈椎物理治疗是否能改善颈源性躯体耳鸣患者的耳鸣?

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.08.005

S. Michiels , P. Van de Heyning , S. Truijen , A. Hallemans , W. De Hertogh

Background

Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with CST, but no experimental studies are available.

Objective

To investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with CST.

Design

Randomized controlled trial.

Patients

Patients with a combination of severe subjective tinnitus (Tinnitus Functional Index (TFI): 25–90 points) and neck complaints (Neck Bournemouth Questionnaire (NBQ) > 14 points).

Intervention

All patients received cervical physical therapy for 6 weeks (12 sessions). Patients were randomized in an immediate-start therapy group (n = 19) and a 6-week delayed-start therapy group (n = 19).

Measurements

TFI and NBQ-scores were documented at baseline, after the wait-and-see period in the delayed-start group, after treatment and after 6 weeks follow-up. The Global Perceived Effect (GPE) was documented at all measuring moments, except at baseline.

Results

In all patients (n = 38) TFI and NBQ-scores decreased significantly after treatment (p = 0.04 and p < 0.001). NBQ-scores remained significantly lower after follow-up (p = 0.001). Immediately after treatment, 53% (n = 38) experienced substantial improvement of tinnitus. This effect was maintained in 24% of patients after follow-up at six weeks.

Conclusion

Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect.

Trial registration

NCT02016313.

耳鸣可能与许多不同的病因有关，如听力损失或噪音创伤，但它也可能与颈椎的体感系统有关，称为颈源性躯体耳鸣(CST)。病例研究表明，颈椎治疗对CST患者的耳鸣主诉有积极作用，但没有实验研究。目的探讨多模式颈椎物理疗法对CST患者耳鸣主诉的治疗效果。设计随机对照试验。伴有严重主观性耳鸣(耳鸣功能指数(TFI): 25-90分)和颈部不适(颈部伯恩茅斯问卷(NBQ) >14分)。所有患者均接受宫颈物理治疗6周(12个疗程)。患者随机分为立即开始治疗组(n = 19)和延迟6周开始治疗组(n = 19)。stfi和nbq评分分别记录于基线、延迟启动组等待观察期后、治疗后和6周随访后。除基线外，所有测量时刻均记录了全球感知效应(GPE)。结果所有患者(n = 38)治疗后TFI和nbq评分均显著降低(p = 0.04, p <0.001)。随访后nbq得分仍显著降低(p = 0.001)。治疗后立即，53% (n = 38)的耳鸣明显改善。在随访6周后，24%的患者保持了这种效果。结论颈椎物理治疗对耳鸣合并颈部主诉患者主观耳鸣主诉有积极作用。然而，需要更大规模的研究，使用更敏感的结果测量来证明这种效果。registrationNCT02016313审判。

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引用次数: 36

Comparison of two angles of approach for trigger point dry needling of the lumbar multifidus in human donors (cadavers) 供体(尸体)腰椎多裂触发点干针两入路角度的比较

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.08.008

Mary C. Hannah, Janet Cope, Alec Palermo, Walker Smith, Valerie Wacker

Study design

Descriptive comparison study.

Objective

To assess the accuracy of two needle angle approaches for dry needling of the lumbar multifidus.

Background

Low back pain is a leading cause of disability around the world; the lumbar multifidus plays a vital role in low back health. Manual therapy such as dry needling can improve pain mediation and motor control activation of the lumbar multifidus. Clinicians practicing dry needling at the lumbar multifidus typically use an inferomedial approach considered non-controversial. Clinicians practicing electromyography and nerve conduction studies commonly sample the lumbar multifidus in a directly posteroanterior approach that may provide another option for dry needling technique.

Methods

Four human donors were used for a total of eight needle placements—four with an inferomedial orientation and four with a posteroanterior orientation. Each needle was placed from 1 to 1.5 cm lateral to the spinous process of L4 to the depth of the lumbar lamina. Each lower lumbar spine was then dissected to determine the structures that the needle traversed and the needle's final resting place.

Results

All four inferomedial approach needles ended at the lamina of the vertebrae below. All four posterior-anterior approach needles ended in the lamina of the same level.

Conclusions

All eight needles traversed the lumbar multifidus and ended in the lumbar lamina with little possibility of the needle entering the subarachnoid space. Thus both the inferomedial and the posteroanterior angles of approach are efficacious for clinicians to use in dry needling of the lumbar mulifidus.

研究设计:描述性比较研究。目的评价两种针角入路干刺腰椎多裂的准确性。背景:腰痛是世界范围内致残的主要原因;腰椎多裂肌在腰背部健康中起着至关重要的作用。干针等手工疗法可以改善腰多裂肌的疼痛调解和运动控制激活。临床医生在腰椎多裂肌处进行干针刺通常使用内侧入路，这被认为是没有争议的。进行肌电图和神经传导研究的临床医生通常采用直接后前入路取样腰椎多裂肌，这可能为干针技术提供另一种选择。方法采用4名人体供体共8次置针，其中4例为内侧定向，4例为后前方定向。每根针放置于腰4棘突外侧1 ~ 1.5 cm至腰椎板深度处。然后解剖每根下腰椎，以确定针穿过的结构和针的最终静止位置。结果4根内侧入路针均止于椎板下方。所有四根前后入路针均止于同一水平的椎板。结论8根针均穿过腰椎多裂肌，最终进入腰椎椎板，进入蛛网膜下腔的可能性很小。因此，临床医生使用内侧夹角和后前夹角干刺腰椎多裂肌是有效的。

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引用次数: 10

The Star Excursion Balance Test: Criterion and divergent validity on patients with femoral acetabular impingement 星偏移平衡试验:股骨髋臼撞击的判据及发散效度

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.07.015

Ann-Christin Johansson , Hillevi Karlsson

Background

A valid functional test, evaluating dynamic balance control, might be valuable clinic tool for evaluation of treatment outcome on patients with femoral acetabular impingement (FAI).

Objectives

The aim of this study was to evaluate criterion and divergent validity of the Star Excursion Balance Test (SEBT) on patients with bilateral FAI- changes, with unilateral clinical symptoms.

Method

In this cross sectional correlational and comparative study fifteen patients with bilateral FAI with unilateral symptoms and 15 controls participated. Criterion validity was determined by analysing agreement between SEBT and The Copenhagen Hip and Groin Outcome Score (HAGOS), The Hip Sports Activity Scale (HSAS), pain and leg strength on FAI patients. Divergent validity was determined by comparing SEBT on FAI patients with controls and by comparing SEBT on patient's symptomatic and asymptomatic hips.

Results/findings

SEBT posterolateral and posteromedial direction had high criterion validity in relation to HAGOS subscale pain intensity and symptoms (r^s = 0.75, p = 0.001, respectively r^s = 0.70, p = 0.004). Criterion validity was low in relation to HAGOS subscales sports, recreation, participation in physical activity and quality of life. SEBT in the posterolateral and posteromedial direction had good divergent validity (p = 0.006, respectively p = 0.001) and in the posterolateral direction SEBT could differentiate between patient's symptomatic and asymptomatic hip (p = 0.005).

Conclusions

SEBT in posterolateral and posteromedial direction has good criterion validity in relation to pain and other symptoms. In the posterolateral and posteromedial direction SEBT also had divergent validity. Clinically it is recommended to combine SEBT in the posterolateral and posteromedial direction with other measurements on patients with FAI.

背景一项有效的功能测试，评估动态平衡控制，可能是评估股骨髋臼撞击(FAI)患者治疗效果的有价值的临床工具。目的本研究的目的是评估星偏移平衡试验(SEBT)对双侧FAI-改变患者的标准和发散效度，伴有单侧临床症状。方法对15例伴有单侧症状的双侧FAI患者和15例对照患者进行横断面相关性比较研究。通过分析SEBT与哥本哈根髋关节和腹股沟结局评分(HAGOS)、髋关节运动量表(HSAS)、FAI患者疼痛和腿部力量之间的一致性来确定标准的效度。通过比较FAI患者与对照组的SEBT以及比较患者有症状和无症状髋关节的SEBT来确定分歧效度。结果/发现sebt后外侧和后内侧方向与HAGOS亚量表疼痛强度和症状有较高的标准效度(rs = 0.75, p = 0.001, rs = 0.70, p = 0.004)。HAGOS量表的运动、娱乐、参与体育活动和生活质量的效度较低。SEBT在后外侧和后内侧方向具有良好的发散效度(p = 0.006, p = 0.001)，在后外侧方向可以区分患者有无症状的髋关节(p = 0.005)。结论后外侧和后内侧方向sebt对疼痛和其他症状有较好的标准效度。在后外侧和后内侧方向上，SEBT也有不同的效度。临床上建议FAI患者将后外侧和后内侧方向的SEBT与其他测量相结合。

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引用次数: 11

Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts 主观和临床评估标准提示五种临床模式可识别的非特异性颈痛患者。一项针对临床专家的德尔菲调查

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.07.005

Vincent Dewitte , Wim Peersman , Lieven Danneels , Katie Bouche , Arne Roets , Barbara Cagnie

Background

Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management.

Objective

To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of ‘articular’, ‘myofascial’, ‘neural’, ‘central’ and ‘sensorimotor control’ dysfunction patterns distinguishable in patients with nonspecific neck pain.

Study design

Delphi study.

Methods

A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group.

Results

A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen ‘articular’, 16 ‘myofascial’, 20 ‘neural’, 18 ‘central’ and 10 ‘sensorimotor control’ clinical indicators reached a predefined ≥80% consensus level.

Conclusion

These indicators suggestive of a clinical dominance of ‘articular’, ‘myofascial’, ‘neural’, ‘central’, and ‘sensorimotor control’ dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients.

背景:非特异性颈痛患者是具有不同肌肉骨骼损伤的异质群体。根据临床特征对非特异性颈痛患者进行亚组分类，可能有助于更全面的诊断和指导有效的治疗。目的在一组专家中建立共识，以临床标准提示“关节”、“肌筋膜”、“神经”、“中枢”和“感觉运动控制”功能障碍模式在非特异性颈部疼痛患者中可区分。研究设计德尔菲研究。方法组织10名学术专家组成的焦点小组，对颈痛患者可识别的不同功能障碍模式进行阐述。随后，设计了一项3轮在线德尔菲调查，以获得焦点小组产生的5种不同功能障碍模式的双方同意的症状和体格检查结果。结果共有21名来自比利时和荷兰的具有颈部疼痛评估和治疗经验的肌肉骨骼物理治疗师完成了3轮delphi调查。分别有33名(回复率100.0%)、27名(81.8%)和21名(63.6%)回答了第1轮、第2轮和第3轮。18项“关节”、16项“肌筋膜”、20项“神经”、18项“中枢”和10项“感觉运动控制”临床指标达到了预定义的≥80%的共识水平。结论这些指标提示临床上以“关节”、“肌筋膜”、“神经”、“中枢”和“感觉运动控制”功能障碍模式为主，可以帮助临床医生评估和诊断非特异性颈痛患者。未来的有效性测试需要确定这些标准如何有助于改善非特异性颈部疼痛患者的物理治疗干预的结果。

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引用次数: 12

Erratum to ‘The TIDieR checklist will benefit the physiotherapy profession’ [Manual Therapy 24C (2016) V–VI] “TIDieR检查表将有益于物理治疗行业”的勘误表[手工治疗24C (2016) V-VI]

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.06.011

Tie Yamato , Chris Maher , Bruno Saragiotto , Anne Moseley , Tammy Hoffmann , Mark Elkins , Gwendolen Jull , Ann Moore

引用次数: 0

The presence of respiratory disorders in individuals with low back pain: A systematic review 腰痛患者存在呼吸系统疾病:一项系统综述

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.07.011

Nele Beeckmans , Astrid Vermeersch , Roeland Lysens , Peter Van Wambeke , Nina Goossens , Tinne Thys , Simon Brumagne , Lotte Janssens

Background

Inspiratory muscles, such as the diaphragm, play a key role in both respiration and spinal control. Therefore, diaphragm dysfunctions are often related to low back pain (LBP). However, few is known on the association between the presence of LBP and the presence of respiratory disorders (RD).

Objectives

To perform a systematic review on the relation between RD and LBP.

Study design

Systematic review.

Methods

Two reviewers searched on PubMed/MEDLINE for studies concerning LBP and RD, from 1950 up to January 2016. The search string consisted of the following key words: low back pain, dyspnea, respiratory problems, lung diseases, comorbidity, pulmonary disease, chronic obstructive, smoking, asthma, allergy, sinusitis, respiratory tract infection and hyperventilation. The aim was to evaluate a potential correlation, co-occurrence or causality between RD and LBP.

Results

A total of 16 articles were included. A significant correlation between the presence of LBP and the presence of RD such as dyspnea, asthma, different forms of allergy, and respiratory infections was found. No correlation was found between Chronic Obstructive Pulmonary Disease (COPD) and LBP, and no articles were found on the correlation between hyperventilation and LBP.

Conclusions

This is the first study providing an overview of the literature on the relation between LBP and RD. Immunological, biomechanical, psychosocial and socio-economic factors might explain this correlation. Smoking is likely to contribute. Future studies must reveal the causative relationship.

Level of evidence

Therapy, level 2a.

呼吸肌，如横膈膜，在呼吸和脊柱控制中起着关键作用。因此，横膈膜功能障碍常与腰痛有关。然而，很少有人知道腰痛的存在与呼吸系统疾病(RD)的存在之间的关系。目的对腰痛与RD的关系进行系统综述。研究设计:系统评价。方法两名审稿人在PubMed/MEDLINE检索1950年至2016年1月期间有关LBP和RD的研究。搜索字符串包括以下关键词:腰痛、呼吸困难、呼吸问题、肺部疾病、合并症、肺部疾病、慢性阻塞性肺病、吸烟、哮喘、过敏、鼻窦炎、呼吸道感染和换气过度。目的是评估RD和LBP之间的潜在相关性、共发生或因果关系。结果共纳入16篇文献。腰痛的存在与RD(如呼吸困难、哮喘、不同形式的过敏和呼吸道感染)的存在有显著的相关性。慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)与LBP之间没有相关性，也没有关于换气过度与LBP之间相关性的文章。本研究首次综述了有关腰痛和RD之间关系的文献，免疫学、生物力学、社会心理和社会经济因素可能解释了这种相关性。吸烟可能是原因之一。未来的研究必须揭示因果关系。证据治疗水平，2a级。

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引用次数: 38

Innominate segment deformation during passive hip abduction and external rotation 被动髋外展和外旋时无名节段变形

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.06.004

Divya Bharatkumar Adhia , Steve Tumilty , Ramakrishnan Mani , Stephan Milosavljevic , Melanie D. Bussey

Background

Electromagnetic palpation-digitization technique for measurement of innominate motion involves calculation of innominate rotation using the innominate vector length in the neutral (NEUT) and combined hip abduction and external rotation (HABER) test positions. The innominate vector length [i.e., the segment between anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS)] is not a rigid structure and its deformation could introduce an error influencing the final innominate rotation measurement.

Objectives

The aim of this study is to determine if there is significant deformation occurring in innominate vector length when the hip is loaded into the HABER test position.

Method

A cross sectional study using sixteen healthy individuals and a single tester was conducted. Four pelvic landmarks, left and right PSIS and ASIS, were palpated and digitized using 3D digitizing stylus of Polhemus electromagnetic tracking device, in two hip test positions, NEUT and 50° HABER. The innominate vector lengths were calculated from the 3D coordinates of pelvic landmarks, for each hip test positions.

Results and conclusion

Paired t-tests demonstrated no significant differences (p > 0.05) in the innominate vector lengths at the side of the load as well as the opposite innominate when either the right or left hip was loaded; thus indicating no significant bone deformation in innominate segment during the HABER test position.

背景:用于测量无名运动的电磁触诊数字化技术包括使用中立(NEUT)和髋关节外展和外旋(HABER)联合测试位置的无名向量长度计算无名旋转。无名矢量长度[即髂前上棘(ASIS)和髂后上棘(PSIS)之间的段]不是刚性结构，其变形可能会引入影响最终无名旋转测量的误差。目的:本研究的目的是确定当髋关节加载到HABER测试位置时，在未知向量长度上是否发生显著变形。方法采用横断面研究方法，选取16名健康个体和1名测试者。在NEUT和50°HABER两种髋关节测试体位，使用Polhemus电磁跟踪装置的三维数字化触针触诊并数字化左、右PSIS和ASIS四个骨盆标志。对于每个髋关节测试位置，从骨盆标志的3D坐标计算未知向量长度。结果与结论配对t检验无显著性差异(p >0.05)，在加载右髋或左髋时，载荷一侧和另一侧的无名向量长度;从而表明在HABER测试位置中无名节段没有明显的骨变形。

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引用次数: 0

Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain? A randomised control trial with a 4-month follow up 体育训练、特定运动和疼痛教育相结合是否能改善慢性颈部疼痛患者的健康相关生活质量?随机对照试验，随访4个月

Manual Therapy

Pub Date : 2016-12-01 DOI: 10.1016/j.math.2016.08.004

I. Ris , K. Søgaard , B. Gram , K. Agerbo , E. Boyle , B. Juul-Kristensen

Aim

To investigate the effect of combining pain education, specific exercises and graded physical activity training (exercise) compared with pain education alone (control) on physical health-related quality of life (HR-QoL) in chronic neck pain patients.

Methods

A multicentre randomised controlled trial of 200 neck pain patients receiving pain education. The exercise group received additional exercises for neck/shoulder, balance and oculomotor function, plus graded physical activity training. Patient-reported outcome measures (Short Form-36 Physical and Mental component summary scores, EuroQol-5D, Beck Depression Inventory-II, Neck Disability Index, Pain Bothersomeness, Patient-Specific Functioning Scale, Tampa Scale of Kinesiophobia, Global Perceived Effect) and clinical tests (Aastrand Physical Fitness, cervical Range of Motion, Pressure Pain Threshold at infraspinatus, tibialis anterior and cervical spine, Cranio-cervical Flexion, Cervical Extension muscle function, and oculomotion) were recorded at baseline and after 4 months.

Results

The exercise group showed statistically significant improvement in physical HR-QoL, mental HR-QoL, depression, cervical pressure pain threshold, cervical extension movement, muscle function, and oculomotion. Per protocol analyses confirmed these results with additional significant improvements in the exercise group compared with controls.

Conclusions

This multimodal intervention may be an effective intervention for chronic neck pain patients.

Trial registration

The trial was registered on www.ClinicalTrials.gov NCT01431261 and at the Regional Scientific Ethics Committee of Southern Denmark S-20100069.

目的探讨疼痛教育、特定运动和分级运动训练(运动)与疼痛教育(对照)相结合对慢性颈部疼痛患者身体健康相关生活质量(HR-QoL)的影响。方法对200例接受疼痛教育的颈部疼痛患者进行多中心随机对照试验。运动组接受额外的颈部/肩部、平衡和动眼肌功能锻炼，以及分级的体育活动训练。患者报告的结果测量(短表36身心成分总结评分、EuroQol-5D、Beck抑郁量表- ii、颈部残疾指数、疼痛困扰、患者特定功能量表、坦帕运动恐惧症量表、整体感知效应)和临床测试(Aastrand体能、颈椎活动度、脊下压痛阈值、胫骨前肌和颈椎、颅颈屈曲、颈椎伸肌功能、在基线和4个月后记录眼球运动。结果运动组在生理HR-QoL、精神HR-QoL、抑郁、颈压痛阈、颈伸运动、肌肉功能、眼部运动方面均有统计学意义的改善。每个方案分析证实了这些结果，与对照组相比，运动组有额外的显著改善。结论多模式干预是治疗慢性颈痛的有效方法。试验注册:该试验在www.ClinicalTrials.gov NCT01431261和丹麦南部区域科学伦理委员会S-20100069注册。

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引用次数: 36