背景:最近的系统评价和荟萃分析显示,慢性颈痛(CNP)患者的呼吸肌力量和呼吸力学异常改变。然而,没有研究调查CNP患者与无症状同龄人相比的膈肌功能.
目的:本研究旨在比较CNP患者和无症状对照组之间的呼吸肌力量和膈肌功能。
方法:观察性,病例对照研究。
方法:共有25名患有CNP的妇女和23名无症状对照参加了这项病例对照研究。采用视觉模拟量表和颈部残疾指数评估CNP组的疼痛和残疾特征。测量最大吸气和呼气压力(MIP和MEP)以确定呼吸肌强度。膈肌功能(深灵感中的肌肉厚度,罐头;在平静的到期结束时,Texp;肌肉厚度变化,ΔT;收缩率,CR)通过二维超声评估。
结果:MIP(p=0.001,d=1.11),ΔT(p=0.033,d=0.63),和CR(p=0.012,d=0.75)的膈肌被发现在CNP组相比,无症状的对照组,而MEP,Tins,两组间膈肌Texp相似(p>0.05)。颈痛的强度与MIP呈中度相关(r=-0.48),Tins(r=-0.46),和ΔT(r=-0.42),而NDI(r=-0.42)与Tins有中等相关性(p<0.05)。
结论:目前的研究结果表明,患有CNP的女性改变了膈肌功能。因此,筛查和靶向隔膜可以改善CNP的康复过程。然而,需要进一步的关于呼吸锻炼方法的有效性的实验研究。
Recent systematic reviews and meta-analyses show that individuals with chronic neck pain (CNP) have altered respiratory muscle strength and abnormal respiratory mechanics. However, no study has investigated the diaphragmatic function in individuals with CNP compared to asymptomatic peers.
This study aimed to compare the respiratory muscle strength and diaphragmatic function between patients with CNP and asymptomatic controls.
Observational,
case-control study.
A total of 25 women with CNP and 23 asymptomatic controls participated in this
case-control study. The visual analog scale and neck disability index were used to assess the pain and disability characteristics of the CNP group. Maximum inspiratory and expiratory pressures (MIP and MEP) were measured to determine respiratory muscle strengths. The diaphragmatic function (muscle thickness in deep inspiration, Tins; and at the end of calm expiration, Texp; muscle thickness change, ΔT; contraction ratio, CR) were evaluated by two-dimensional ultrasonography.
The MIP (p = 0.001, d = 1.11), ΔT (p = 0.033, d = 0.63), and CR (p = 0.012, d = 0.75) of the diaphragm were found significantly reduced in the CNP group compared to asymptomatic controls whilst MEP, Tins, and Texp of the diaphragm were similar between study groups (p > 0.05). The intensity of neck pain was moderately correlated with MIP (r = -0.48), Tins (r = -0.46), and ΔT (r = -0.42) while NDI (r = -0.42) had a moderate correlation with Tins (p < 0.05).
The present findings revealed that women with CNP have altered diaphragmatic function. Thus, screening and targeting diaphragm may improve the rehabilitation process in CNP. However, further experimental studies regarding the efficacy of breathing exercise approaches are needed.