Altered postural sway in patients suffering from non-specific neck pain and whiplash associated disorder - A systematic review of the literature.
Altered postural sway in patients suffering from non-specific neck pain and whiplash associated disorder - A systematic review of the literature.
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DOI：
10.1186/2045-709x-19-13
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发表时间：
2011-05-24
影响因子：
1.9
通讯作者：
Walker B
中科院分区：
文献类型：
--
作者：
Ruhe A;Fejer R;Walker B
系统文献综述。评估患有非特异性颈部疼痛（NSNP）或鞭打相关疾病（WAD）的患者与健康对照组相比压力中心（COP）测量的差异，以及姿势摇摆变化与疼痛存在、疼痛强度、既往疼痛持续时间和感知残疾水平之间的关系。在过去的20年里，压力中心（COP）被普遍用作站立时姿势稳定性的指标。虽然有几项研究调查了颈痛和WAD患者的COP漂移，并将其与健康个体进行了比较，但没有对已报道的姿势摇摆模式差异进行全面分析。系统地检索了六个在线数据库，然后对检索到的论文进行了人工检索。比较NSNP和WAD患者与健康对照者在力板上两足静态任务条件下获得的COP测量的论文。两位审稿人独立筛选标题和摘要的相关性。筛选最终纳入，数据提取和质量评估由第三审稿人进行，以调和差异。10篇论文符合纳入标准。研究设计的异质性阻碍了数据的汇集，也不可能对所有研究的数据进行直接比较。相反，进行了定性数据分析。人们普遍认为，与健康个体相比，任何一种颈痛患者的COP漂移都增加，这种差异在WAD患者中更为明显。两组均观察到前后方向摆动增加。与健康对照相比，颈痛患者（由于NSNP或WAD）表现出更大的姿势不稳定性，无论选择何种COP参数，都表现出更大的COP偏移。此外，颈部疼痛患者的姿势稳定性下降似乎与疼痛的存在和本体感觉损伤的程度有关，但似乎与疼痛持续时间无关。
Systematic literature review. To assess differences in center of pressure (COP) measures in patients suffering from non-specific neck pain (NSNP) or whiplash-associated disorder (WAD) compared to healthy controls and any relationship between changes in postural sway and the presence of pain, its intensity, previous pain duration and the perceived level of disability. Over the past 20 years, the center of pressure (COP) has been commonly used as an index of postural stability in standing. While several studies investigated COP excursions in neck pain and WAD patients and compared these to healthy individuals, no comprehensive analysis of the reported differences in postural sway pattern exists. Six online databases were systematically searched followed by a manual search of the retrieved papers. Papers comparing COP measures derived from bipedal static task conditions on a force plate of people with NSNP and WAD to those of healthy controls. Two reviewers independently screened titles and abstracts for relevance. Screening for final inclusion, data extraction and quality assessment were carried out with a third reviewer to reconcile differences. Ten papers met the inclusion criteria. Heterogeneity in study designs prevented pooling of the data and no direct comparison of data across the studies was possible. Instead, a qualitative data analysis was conducted. There was broad consensus that patients with either type of neck pain have increased COP excursions compared to healthy individuals, a difference that was more pronounced in people with WAD. An increased sway in antero-posterior direction was observed in both groups. Patients with neck pain (due to either NSNP or WAD) exhibit greater postural instability than healthy controls, signified by greater COP excursions irrespective of the COP parameter chosen. Further, the decreased postural stability in people with neck pain appears to be associated with the presence of pain and correlates with the extent of proprioceptive impairment, but appears unrelated to pain duration.