急性单侧颈痛伴颈部活动受限患者的压痛阈研究  

Pressure Pain Thresholds for Patients with Acute Unilateral Neck Pain and Neck Mobility Deficits

作　　者：叶济灵 徐丽丽[1] 方仲毅 蔡斌[1] 蔡宗远 王辉 YE Jiling;XU Lili;FANG Zhongyi;CAI Bin;TSAI Tsungyuan;WANG Hui(Rehabilitation Department,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;School of Biomedical Engineering,Shanghai Jiao Tong University,Shanghai 200030,China;Rehabilitation Department,Zouping People’s Hospital,Shandong,Zouping 256200,China)

机构地区：[1]上海交通大学医学院附属第九人民医院康复医学科,上海200011 [2]上海交通大学生物医学工程学院,上海200030 [3]山东省邹平市人民医院运动康复科,山东邹平256200

出　　处：《医用生物力学》2022年第5期863-867,共5页Journal of Medical Biomechanics

基　　金：上海交通大学“交大之星”计划(YG2021QN68)。

摘　　要：目的研究急性单侧颈痛伴颈部活动受限患者脊柱及下肢的压痛阈值(pressure pain threshold,PPT)及其与颈部疼痛、颈椎活动范围(range of motion,ROM)的相关性,通过与健康人对照,建立精准的量化评定指标。方法纳入48名急性单侧颈痛伴颈部活动受限患者(实验组)及48名健康成年人(对照组)。使用手持式压痛测试仪测试头夹肌、斜方肌上束、菱形肌、腰方肌、腘绳肌、腘窝、腓肠肌、足底筋膜PPT,并记录患者的疼痛评分和颈椎关节ROM。结果实验组颈部后伸、患侧旋转、患侧侧屈角度与对照组有明显差异(P<0.05);实验组患侧斜方肌上束、头夹肌、腓肠肌中下部PPT与健侧及对照组相比有明显差异(P<0.05)。颈部疼痛与颈部后伸、患侧侧屈、患侧旋转ROM有相关性(P<0.05)。颈部疼痛与头夹肌、斜方肌上束、腓肠肌中点以及腓肠肌肌腹下端PPT有相关性(P<0.05)。结论急性单侧颈痛伴颈部活动受限患者斜方肌、头夹肌及腓肠肌PPT降低,且与颈部疼痛、活动范围受限显著相关。研究结果为临床颈痛患者评定提供定量参考依据。Objective To study pressure pain threshold(PPT)of the spine and lower limbs for patients with acute unilateral neck pain and neck mobility deficits,and its relationship with cervical pain and cervical range of motion(ROM),so as to establish accurate quantitative assessment index by comparison with healthy controls.Methods A total of 48 patients with unilateral neck pain and neck mobility deficits(experimental group),as well as 48 healthy adults(control group)were included.The PPTs of the splenius capitis,upper fibers of trapezius,rhomboideus major,quadratus lumborum,midpoint of hamstring,popliteal fossa,mid and lower point of gastrocnemius,and plantar fascia at base of the second metatarsal were tested by using a handheld thresholds algometer.The pain score and cervical ROM were recorded.Results There were significant differences in neck extension as well as rotation and lateral flexion of the affected side between experimental group and control group.The PPTs of splenius capitis,trapezius,mid and lower part of gastrocnemius in the affected side in experimental group were significantly different from those in the healthy side and in control group(P<0.05).There was a negative correlation between neck pain and ROMs of neck extension,lateral flexion of the affected side and rotation of the affected side(P<0.05).A correlation between neck pain and the PPTs of splenius capitis,upper trapezius,midpoint of gastrocnemius muscle and lower part of gastrocnemius muscles was also found(P<0.05).Conclusions The PPTs of trapezius muscle,splenius capitis and gastrocnemius decrease in patients with acute neck pain and unilateral mobility deficits,and they are significantly correlated with neck pain and mobility deficits.This study provides references for quantitative assessment of patients with neck pain in clinic.

关 键 词：急性颈痛 活动受限 压痛阈值 

分 类 号：R318.01[医药卫生—生物医学工程]