背景:有充分的证据支持使用不同的手法治疗颈源性头痛(CgH)。然而,对于CgH患者,没有一种技术可以作为最佳的可用治疗方法。因此,这项研究的目的是发现和比较颈椎超过胸椎手法和常规物理治疗对CgH患者的临床效果。
方法:这是一个前瞻性的,2020年7月至2023年1月在大学医院进行的随机对照研究。根据选择标准选择合格的CgH患者N=96,并将其分为颈椎推拿(CSM;n=32),胸椎手法(TSM;n=32)和常规理疗(CPT;n=32)组,并接受各自的治疗4周。原发性(CgH频率)和继发性CgH疼痛强度,CgH残疾,颈部疼痛频率,颈部疼痛强度,颈痛阈值,颈椎屈曲旋转试验(CFRT),测量颈部残疾指数(NDI)和生活质量(QoL)评分.使用3×4线性混合模型分析(LMM)分析不同间隔的治疗效果,与治疗组(颈椎手法,胸椎推拿,和常规物理治疗)和时间间隔(基线,4周,8周,和6个月),统计学意义水平为P<0.05。
结果:CSM的报告,TSM和CPT组间比较。治疗4周后,CSM组显示出更显著的变化,在原发性(CgH频率)和继发性(CgH疼痛强度,CgH残疾,颈部疼痛频率,疼痛强度,痛阈值,CFRT,NDI和QoL)比TSM和CPT组(p=0.001)。在8周和6个月的随访中,与TSM和CPT组相比,CSM组的上述变量具有相同的逐渐改善(p=0.001)。
结论:当前随机临床研究的报告发现,CSM可显著改善疼痛参数(强度,频率和阈值)CgH患者的功能障碍和生活质量比胸椎手法和常规理疗。
背景:临床试验注册:CTRI/2020/06/026092试验于2020年6月24日进行了前瞻性注册。
BACKGROUND: There is ample evidence supporting the use of different manipulative therapy techniques for Cervicogenic Headache (CgH). However, no technique can be singled as the best available treatment for patients with CgH. Therefore, the objective of the
study is to find and compare the clinical effects of cervical spine over thoracic spine manipulation and conventional physiotherapy in patients with CgH.
METHODS: It is a prospective, randomized controlled
study conducted between July 2020 and January 2023 at the University hospital. N = 96 eligible patients with CgH were selected based on selection criteria and they were divided into cervical spine manipulation (CSM; n = 32), thoracic spine manipulation (TSM; n = 32) and conventional physiotherapy (CPT; n = 32) groups, and received the respective treatment for four weeks. Primary (CgH frequency) and secondary CgH pain intensity, CgH disability, neck pain frequency, neck pain intensity, neck pain threshold, cervical flexion rotation test (CFRT), neck disability index (NDI) and quality of life (QoL) scores were measured. The effects of treatment at various intervals were analyzed using a 3 × 4 linear mixed model analysis (LMM), with treatment group (cervical spine manipulation, thoracic spine manipulation, and conventional physiotherapy) and time intervals (baseline, 4 weeks, 8 weeks, and 6 months), and the statistical significance level was set at P < 0.05.
RESULTS: The reports of the CSM, TSM and CPT groups were compared between the groups. Four weeks following treatment CSM group showed more significant changes in primary (CgH frequency) and secondary (CgH pain intensity, CgH disability, neck pain frequency, pain intensity, pain threshold, CFRT, NDI and QoL) than the TSM and CPT groups (p = 0.001). The same gradual improvement was seen in the CSM group when compared to TSM and CPT groups (p = 0.001) in the above variables at 8 weeks and 6 months follow-up.
CONCLUSIONS: The reports of the current randomized clinical
study found that CSM resulted in significantly better improvements in pain parameters (intensity, frequency and threshold) functional disability and quality of life in patients with CgH than thoracic spine manipulation and conventional physiotherapy.
BACKGROUND: Clinical
trial registration: CTRI/2020/06/026092
trial was registered prospectively on 24/06/2020.