- 期刊
SNAGS鬆動術與深層頸屈肌穩定訓練對頸痛患者於關節活動度與疼痛之介入成效：隨機對照單盲試驗
The Effects of Sustained Natural Apophyseal Glides (SNAGS) and Deep Neck Flexor Stabilization Exercise on Range of Motion and Pain in Patients With Neck Pain: A Single Blind Randomized Controlled Trial
摘要
背景與目的：關於頸痛患者之治療，目前尚無研究提出可同時增加頸關節活動度與降低靜止狀況下頸痛之治療方式。本研究目的為比較持續性小面關節鬆動術（Sustained Natural Apophyseal Glide, SNAGS）與深層屈肌訓練對頸痛患者頸關節活動度與靜止疼痛之立即與完整療程介入療效。方法：50位頸痛患者隨機分配至SNAGS組（鬆動組）、深層屈肌穩定訓練組（穩定組）及常規物理治療組（控制組）。受試者接受為期6週共12次之治療，並於治療前、第1次治療後與第12次治療後進行評估。評估參數為頸椎各方向動作角度、疼痛程度與自覺進步指數。結果：經12次治療後，相較於控制組，鬆動組與穩定組在頸椎各方向動作角度均有顯著增加；於1次介入後，僅鬆動組增加之角度可達最小臨床重要差異值。三組經12次治療後皆可顯著降低疼痛，然只有穩定組可於1次介入後顯著降低疼痛。此外，三組經12次治療後於自覺進步指數上皆有進步，但無組間差異。結論：經多次介入，SNAGS與頸深層屈肌訓練皆可改善頸痛患者之活動角度與疼痛，但SNAGS有較佳的增進角度立即效果，頸深層屈肌訓練則有較立即的緩解疼痛效果。臨床意義：關節活動度限制較嚴重之患者可優先選擇SNAGS關節鬆動術介入；而疼痛較顯著之患者可優先選擇頸部深層屈肌穩定訓練。
並列摘要
Background and Purpose: The aim of the present study was to investigate the immediate and long-term treatment effects of Sustained Natural Apophyseal Glides (SNAGS) and stabilization exercise on the range of motion (ROM) and pain intensity at rest in patients with neck pain. Methods: Fifty patients with neck pain were randomly allocated to the SNAGS group, the stabilization group, or the control group (conventional physical therapy). All interventions were performed 2 times per week over 6 weeks. Participants underwent examination at baseline, after the 1st training session, and after the 12th training session, with the measurement of neck ROM, pain intensity, and global rating of change (GRC) scales. Results: After the 12th training session, both the SNAGS and the stabilization group increased neck ROM in all movement directions comparing to those at the baseline test. Only the SNAGS group achieved the value of Minimum Clinically Important Difference in neck ROM after the 1st training session. All the three groups reduced neck pain after the 12th training session, but only the stabilization group reduced neck pain after the 1st training session. In addition, although there was no group difference, each group showed positive values of the GRC scales after the 12th training session, indicating the participants were somewhat satisfied with the recovery of their symptoms. Conclusion: Both SNAGS of cervical spine and stabilization exercise of deep neck flexors could improve neck ROM and reduce neck pain at rest concurrently. However, SNAGS had better immediate effect on increasing neck ROM, but stabilization exercise had better immediate effect on reducing pain intensity. Clinical Relevance: In clinic, we suggest that SNAGS technique could be applied on patients with more restricted joint motion first, and for the patients with severe neck pain, stabilization exercise should be chosen first.
延伸閱讀
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