Cervicogenic dizziness -: musculoskeletal findings before and after treatment and long-term outcome
Cervicogenic dizziness -: musculoskeletal findings before and after treatment and long-term outcome
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DOI：
10.1080/09638280600948383
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发表时间：
2007-01-01
影响因子：
2.2
通讯作者：
Moritz, Ulrich
中科院分区：
文献类型：
--
作者：
Malmstrom, Eva-Maj;Karlberg, Mikael;Moritz, Ulrich
目的。探讨颈源性眩晕患者的肌肉骨骼表现及其与疼痛和眩晕的关系。观察治疗效果及远期症状进展情况。22名疑似颈源性眩晕的患者(20名女性，2名男性；平均年龄37岁)在肌肉骨骼检查的指导下，在理疗前后进行了结构化的体格检查。在治疗6个月和2年后对患者进行问卷调查。大多数患者有颈后肌压痛和紧张感。所有颈椎节段均有关节突关节压痛。颈椎活动度等于或大于预期年龄和性别匹配值。颈胸段常活动不足。大多数患者存在体位失衡。动力稳定能力降低。枕下肌紧张与体位不平衡和颈部稳定性差有关。治疗后肩提肌压痛减轻，C4~C7椎旁肌、颞肌及关节突关节压痛减轻，颈胸活动度增加。脊柱旁中部肌肉压痛的减少与颈部疼痛的缓解相关。躯干、颈部和肩部的体位对准和动态稳定性均有改善。6个月后，17例患者中仍有13例颈部疼痛消失或减轻，14例患者头晕消失或减轻。术后2年，7例患者颈部疼痛消失或减轻，11例患者头晕消失或减轻。疑似颈源性眩晕的患者有一些共同的肌肉骨骼表现。基于这些发现的治疗可以长期减少颈部疼痛和头晕，但一些患者可能需要维持策略。
Purpose. To explore musculoskeletal findings in patients with cervicogenic dizziness and how these findings relate to pain and dizziness. To study treatment effects and long-term symptom progress.Method. Twenty-two patients ( 20 women, 2 men; mean age 37 years) with suspected cervicogenic dizziness underwent a structured physical examination before and after physiotherapy guided by the musculoskeletal findings. Questionnaires were sent to the patients six months and two years after treatment.Results. Dorsal neck muscle tenderness and tightness was found in a majority of the patients. Zygapophyseal joint tenderness was found at all cervical levels. Cervical range of motion was equal to or larger than expected age and gender matched values. The cervico-thoracic region was often hypomobile. Most patients had postural imbalance. Dynamic stabilization capacity was reduced. Suboccipital muscles tightness correlated with posture imbalance and poor neck stability. The treatment resulted in reduced tenderness in levator scapula, high and middle paraspinal and temporalis muscles and zygapophyseal joints at C4-C7 and increased cervico-thoracic mobility. Reduction of middle paraspinal muscle tenderness correlated with neck pain relief. Postural alignment improved, as did dynamic stabilization in trunk, neck and shoulders. After 6 months, 13 of the 17 patients had still no or less neck pain and 14 had no or less dizziness. After 2 years, 7 patients had no or less neck pain and 11 no or less dizziness.Conclusion. Patients with suspected cervicogenic dizziness have some musculoskeletal findings in common. Treatment based on these findings reduces neck pain as well as dizziness long-term but some patients might need a maintenance strategy.