首页|肌肉能量技术联合常规康复治疗对慢性非特异性颈痛患者的影响

肌肉能量技术联合常规康复治疗对慢性非特异性颈痛患者的影响

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目的 观察肌肉能量技术(MET)联合常规康复治疗方法对慢性非特异性颈痛(CNSNP)患者的影响.方法 选取2022年5月—2023年3月在四川大学华西医院康复医学中心门诊诊治的CNSNP患者54例,采用随机数字软件分为对照组和观察组,每组27例.治疗过程中共有3例患者因依从性不强而退出研究,其中对照组脱落2例,观察组脱落1例,最终对照组、观察组分别纳入25例、26例.对照组接受常规康复治疗(物理因子治疗和运动训练)联合拉伸训练,物理因子治疗主要包括磁热理疗和中频脉冲电理疗,每项20 min/次,1次/d,连续治疗,3次/周,共治疗1周;运动训练包括等长收缩训练和颈部深层屈肌群训练,3次/d,连续治疗,3次/周,共治疗1周;拉伸训练,1次/d,连续治疗,3次/周,共治疗1周.观察组在对照组常规康复治疗基础上接受MET治疗,治疗师将目标肌肉牵伸至引发疼痛或能够感觉到软组织阻力点的位置,双手分别固定肌肉起止点处并施加中等的阻力,让患者的目标肌肉进行等长收缩(强度为最大力的20%)并持续10 s后放松,然后继续拉伸该目标肌肉并到达下一个阻力点的位置,以该阻力点作为开始位置,重复3~5次,1次/d,连续治疗,3次/周,共治疗1周.分别于治疗前、治疗后采用视觉模拟疼痛评分法(VAS)评估患者疼痛程度;采用颈椎功能障碍指数调查问卷(NDI)评估患者颈椎功能障碍情况;采用田中靖久颈椎病症状量表20分法(CSR20)评估患者颈椎功能;采用《非特异性颈痛的物理治疗指南》评价临床疗效;观察治疗过程中出现的不良反应(颈部疼痛加重、恶心、呕吐、头晕、心率加快等).结果 与治疗前比较,2组治疗后VAS评分、NDI指数均明显降低(P<0.05),CSR20评分明显升高,差异均具有统计学意义(P<0.05).与对照组比较,观察组治疗后VAS评分明显更低,CSR20评分明显更高,差异均具有统计学意义(P<0.05);观察组有效率(92.31%)高于对照组(28.00%),差异具有统计学意义(P<0.05).在治疗过程中,2组均未发生不良反应.结论 MET联合常规康复治疗可有效改善CNSNP患者疼痛、颈椎功能,值得临床推广应用.
Clinical Efficacy of Muscle Energy Technology Combined with Conventional Rehabilitation Therapy on Patients with Chronic Non-Specific Neck Pain
Objective To observe the effects of muscle energy technology(MET)combined with conventional rehabilitation trerapy on patients with chronic non-specific neck pain(CNSNP).Methods A total of 54 patients with CNSNP in the outpatient de-partment of rehabilitation medical center of West China Hospital,Sichuan University from May 2022 to March 2023 were randomly divided into control group and observation group,with 27 cases in each group.During the course of treatment,three cases withdrew from the study due to poor compliance,including two cases in the control group and one case in the observation group.Finally 25 and 26 cases were included in the control group and the observation group,respectively.The control group received conventional rehabilitation trerapy(physical modality therapy and exercise training)combined with stretching training.Physical modality therapy mainly included magnetothermal therapy and medium frequency pulsed electrotherapy,with a duration of 20 minutes a time for each treatment,once a day,continuous treatment,and three times a week;exercise training included isometric contraction training and deep neck flexor muscle group training,with three times a day,continuous treatment,and three times a week;stretching training were performed once a day,continuous treatment,and three times a week.The observation group received MET therapy in addition to the conventional rehabilitation therapy in the control group.The therapist stretched the target muscle to the position where pain was trig-gered or the resistance point of soft tissue could be felt,fixed the starting and ending points of the muscle with both hands,applied moderate resistance,and allowed the patient's target muscle to perform isometric contraction(an intensity of 20%of the maximum force)and relax after 10 seconds,and then continued to stretch the target muscle and reached the position of the next resistance point,taking the resistance point as the starting position,repeated the procedure 3 to 5 times,once a day,three times a week,lasting for one week.Before treatment and one week after treatment,visual analog scale(VAS)was used to assess the pain level;neck disability in-dex(NDI)was used to evaluate cervical spine dysfunction;Yasuhisa Tanaka cervical spondylotic radiculopathy 20(CSR20)was used to evaluate cervical spine function;"Clinical practice guideline for physical therapy assessment and treatment in patients with nonspe-cific neck pain"were used to evaluate the clinical efficacy;the adverse reaction such as aggravation of neck pain,nausea,vomiting,dizziness,increased heart rate,etc.that occurred during treatment were observed.Results Compared with that before treatment,VAS scores and NDI index decreased significantly of both groups after treatment(P<0.05),CSR20 score increased significantly,and the differences were statistically significant(P<0.05).Compared with the control group,VAS score was significantly lower in the observation group after treatment,CSR20 score was significantly higher,and the differences were statistically significant(P<0.05).The effective rate in the observation group(92.31%)was higher than that of the control group(28.00%),and the difference was statis-tically significant(P<0.05).During the course of treatment,there were no adverse reactions in both groups.Conclusion MET com-bined with conventional rehabilitation therapy can effectively improve the pain and cervical spine function of patients with CNSNP,which is recommended for clinical promotion and application.

chronic non-specific neck painmuscle energy technologystretching trainingisometric contraction trainingcer-vical spine function

郑坤、杨浩伦、贾程森、张黎明

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四川大学华西医院,四川 成都 610044

四川大学华西天府医院,四川 成都 610021

慢性非特异性颈痛 肌肉能量技术 拉伸训练 等长收缩训练 颈椎功能

国家重点研发计划项目

2022YFC3602603

2024

康复学报
福建中医药大学

康复学报

CSTPCD
影响因子:0.545
ISSN:2096-0328
年,卷(期):2024.34(4)
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