添加神经松动技术对神经根型颈椎病患者的疗效
滑块和张力器神经动力学动员技术对神经根型颈椎病患者的有效性:一项随机对照试验
研究概览
详细说明
颈神经根病 (CR) 是一种脊神经的神经根受压或受损的疾病,导致疼痛和症状蔓延到颈部以外,放射到肩部和上肢。 颈神经根病主要是由于占位性病变引起的神经根的撞击和炎症引起的,该病变减小了椎间孔的尺寸,作为关节骺关节的退行性病变,或者与颈椎间盘紊乱有关。
CR 患者主诉颈部、肩胛周围和手部和手臂神经根疼痛。 以及神经系统症状,例如感觉障碍(感觉异常或麻木)、受影响神经根肌无力伴腱反射减弱或这些体征和症状的组合。
据报告,CR 年发病率为每 10 万人中 85 例,患病率为 3.5/1000 人。 C7 神经根最常受到影响,超过一半的病例影响此水平。
几项研究利用治疗练习、手法治疗、颈托、颈椎牵引、姿势教育和不同药物(例如药物和类固醇注射)对不同阶段的颈神经根病进行保守治疗。
神经动员(NM)是一种提高神经灵活性、降低神经系统动态敏感性、增加血流量、缓解疼痛的手法治疗方法;为此,改善神经活动性和减轻疼痛可以增加关节活动范围(ROM)。
神经动员技术(NM)通过两种技术来实现:“滑动/滑动”和“张力”。 张紧器技术从神经两端产生张力,而滑块则通过执行关节运动,以最小的应变拉长神经床,从而使神经相对于其周围结构滑动。 此外,滑块通常不如张紧器具有攻击性,并且可以在疾病早期阶段使用它们。
这两种技术都有助于防止粘连的形成,降低神经内压,减少神经内水肿,增加神经氧合,并减轻缺血性疼痛。
在临床研究中使用滑块和张紧器 NM 技术的研究表明,在治疗具有神经相关症状的肌肉骨骼颈部疾病时,生物力学因素发生了显着变化,例如患者的疼痛、残疾、活动范围、耐力和肌肉力量的自我报告。
那么,在常规物理治疗中加入张紧器神经松动技术与滑块神经松动技术治疗神经根型颈椎病可能会产生哪些效果?
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Cairo Governorate
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Cairo、Cairo Governorate、埃及
- Cairo University
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参与标准
资格标准
适合学习的年龄
- 成人
接受健康志愿者
描述
纳入标准:
- 当前持续或间歇性疼痛已持续超过 3 个月。
- 上肢的运动、反射和/或感觉变化。
- 受影响手臂的深部腱反射减弱。
- 沿神经走行的感觉异常或麻木。
- 正中神经上肢神经张力 1 (ULNT) 测试、Spurlings 测试、压缩测试、颈椎牵引测试、颈椎向症状侧旋转小于 60° 以及 Valsalva 动作呈阳性。
- 上肢单侧受累。
排除标准:
- 引起颈部疼痛或 CTS 的病理外科手术史。
- 医疗危险信号的临床体征或症状; (感染、癌症和心脏受累)。
- 因严重病理、上颈韧带功能不全、不明原因的颅神经功能障碍和骨折的体征和症状而出现颈部疼痛的患者。
- 任何系统性疾病,如风湿病和结核病、颈椎病或多发性硬化症。
- 已知全身性疾病会导致糖尿病等全身周围神经病变。
- 上运动神经元疾病,如中风和肌萎缩侧索硬化症 (ALS)。
- 受累神经根的感觉完全丧失。
- 双侧放射状手臂疼痛的初步报告。
- 无法忍受计划中的干预。
- 孕妇。
- 胸廓出口综合征
- 旋前圆肌综合征
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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有源比较器:对照组A(常规治疗)
常规治疗包括热敷、颈部肌肉伸展、颈椎等长锻炼。
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热敷、颈部肌肉伸展、颈椎等长运动
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实验性的:实验B组(常规治疗基础上张力神经动员)
除常规治疗外,正中神经神经紧张动员
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除常规治疗外,正中神经张力器神经动员
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实验性的:实验C组(常规治疗基础上滑动神经动员)
除常规治疗外,正中神经滑动神经动员
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除常规治疗外,正中神经神经滑动动员
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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视觉模拟量表
大体时间:从基线开始,到治疗 4 周结束。
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测量颈部疼痛,评分范围从 0 到 10,最低评分 0(无痛),最高评分 10(最痛)。
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从基线开始,到治疗 4 周结束。
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阿拉伯语版颈部残疾指数
大体时间:从基线开始,到治疗 4 周结束。
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评估颈部疼痛患者的残疾程度,以%分表示。
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从基线开始,到治疗 4 周结束。
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颈椎活动范围
大体时间:从基线开始,到治疗 4 周结束。
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使用 CROM 装置测量完整的颈椎旋转(以度为单位)
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从基线开始,到治疗 4 周结束。
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握力
大体时间:从基线开始,到治疗 4 周结束。
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使用液压测功机测量手的握力,单位为千克。
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从基线开始,到治疗 4 周结束。
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神经传导研究
大体时间:从基线开始,到治疗 4 周结束。
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正中神经的运动传导研究,测量传导速度(米/秒)、远端潜伏期(毫秒)和幅度(毫伏)。
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从基线开始,到治疗 4 周结束。
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F波
大体时间:从基线开始,到治疗 4 周结束。
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正中神经的 F 波用于测量潜伏期(毫秒)。
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从基线开始,到治疗 4 周结束。
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H-反射
大体时间:从基线开始,到治疗 4 周结束。
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正中神经的 H-Reflex 可测量潜伏期 (ms)、振幅 (mV)、H-R 比 (%)。
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从基线开始,到治疗 4 周结束。
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合作者和调查者
出版物和有用的链接
一般刊物
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