神経動員とイブプロフェン薬理学的治療の鎮痛効果
頸腕痛患者における正中神経動員とイブプロフェン薬理学的治療の鎮痛効果
調査の概要
詳細な説明
正中神経動員とイブプロフェンはどちらも頸肩腕痛を緩和しますが、これは異なるメカニズムと異なる副作用の発症によって起こります. 正中神経モビライゼーションは、正中神経と腕神経叢の機械的刺激によって痛みを軽減する理学療法技術です。 神経とその周囲の神経組織の適切な機械的刺激は、下行神経系の痛み調節メカニズムの活性化を含む頸腕痛を軽減する可能性のあるさまざまな生理学的反応を誘発しますが、この痛みの軽減の根本的な理由のすべてが完全に解明されているわけではありません.了解した。 痛みの軽減をもたらす神経組織動員によって引き起こされる効果には、神経内浮腫の減少、神経内神経圧の変化、炎症誘発性物質の分散、および神経可動性の増加があります。
イブプロフェンは、痛み、発熱、炎症を抑えるために世界中で使用されている非ステロイド性抗炎症薬です。イブプロフェンの経口摂取は、アラキドン酸をプロスタグランジン H2 (PGH2) に変換する COX 酵素の生化学的阻害により、鎮痛効果をもたらします。 次に、PGH2 は他の酵素によって数種類のプロスタグランジンとトロンボキサン (痛みと炎症のメディエーター) に変換されます。
イブプロフェンの経口摂取に由来する副作用は、その全身作用に関連しており、一部の患者では重篤になる可能性があります。 この事実は、経口イブプロフェンが頸肩腕痛に苦しむすべてのタイプの患者に使用するのに適していない可能性があることを示唆していますが、正中神経動員には既知の副作用がほとんどまたはまったくありません. これは、頸肩腕痛の治療におけるこの 2 つの治療法の有効性の比較を決定する際の重要な点を明らかにしています。
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
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Carabobo
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Valencia、Carabobo、ベネズエラ、02001
- Centro de Medicina Fisica y de Rehabilitacion FISIOREH
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
包含基準:
- 磁気共鳴画像法で確認された頸腕痛の臨床診断
- -上肢の腕の痛み、感覚異常またはしびれの片側症状の存在 治療の適用前の少なくとも3か月連続。
- 次のすべてのテストで肯定的な結果が得られました: スパーリング、注意散漫、および上肢
除外基準:
- 非ステロイド性抗炎症薬(NSAID)の使用の禁忌
- 痛みを和らげるためのあらゆる種類の治療、療法、手順、または薬物の使用
- 抗けいれん薬、抗うつ薬または向精神薬を服用中の患者
- 脊椎の不安定性
- 脊椎骨粗鬆症
- 脊椎または脊椎の感染症。
- 遺伝性、感染性または腫瘍性の神経疾患
- 頸部狭窄症ミエロパシー
- 妊娠
- 運動恐怖症
- 内分泌疾患と更年期障害
- 脊椎手術の歴史
- 知的障害、重度の精神疾患、中毒、重度の睡眠不足、アルツハイマー病。
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:平行
- マスキング:トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:正中神経の神経動員
15 分間の正中神経モビライゼーション セッション 週 5 回 (月曜日から金曜日)、6 週間連続 正中神経モビライゼーション手順で適用される肘の最大伸展度は、ユニバーサル ゴニオメーター デバイスを使用して決定されました。
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非外科的非侵襲的正中神経神経モビライゼーション手順は、神経モビライゼーション技術の各 2 分間の適用の間に 1 分間の休憩を入れて、5 つの異なる場面で 2 分間継続的に理学療法士によって適用されました。
介入は 6 週間にわたって適用されました。
正中神経モビライゼーション治療の適用中の症状の再現を伴わない肘伸展運動の最大レベルは、ユニバーサル ゴニオメーター デバイスのベースライン使用によって決定されました。
他の名前:
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ACTIVE_COMPARATOR:イブプロフェン
患者の耐性に応じて 1 日 400 mg の経口イブプロフェンを 1 日 1 回、最大用量 1200 mg/日まで、8 時間ごとに 3 回の経口摂取に均等に分割し、6 週間続けます。
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実薬対照群は経口イブプロフェン治療を受けた。
開始用量は 400 mg/日で、患者の耐性に応じて 8 時間ごとに 3 回の経口摂取に分けて最大 1200 mg/日まで増量しました。介入は 6 週間適用されました。
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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1 時間での痛みの数値評価尺度を使用したベースラインからの変化
時間枠:ベースライン時および治療適用の 1 時間後、介入セッション 1、15、および 30 に対応
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数値評価尺度 (NRS) は、患者が痛みを自己申告するための 11 ポイントの尺度であり、頸腕痛の症状の存在と緩和を評価するために使用されました。
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ベースライン時および治療適用の 1 時間後、介入セッション 1、15、および 30 に対応
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Quik DASH スケールを使用した、罹患した上肢を含む身体機能のベースラインからの変化
時間枠:ベースラインで、治療の介入セッション 1 および 30 に対応します。
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腕、肩、手の障害 (QuickDASH) テストは、上肢のいくつかの筋骨格障害のいずれかを持つ人々の身体機能と症状を測定するように設計された自己報告式の短い質問票です。
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ベースラインで、治療の介入セッション 1 および 30 に対応します。
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1 時間でのベースライン頸椎回転可動域からの変化
時間枠:ベースライン時および治療適用の 1 時間後、介入セッション 1 および 30 に対応
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頸部回転は、頸部可動域デバイス (CROM) を使用して、回転角度の単位で評価されました。
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ベースライン時および治療適用の 1 時間後、介入セッション 1 および 30 に対応
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協力者と研究者
出版物と役立つリンク
一般刊行物
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