枕頭對於生物力學特性、疼痛舒緩與肺功能之影響：系統性文獻回顧

The Effects of Pillow on Biomechanical Properties, Pain Relief, and Pulmonary Function: A Systematic Review

陳蓉萱(Jung-Hsuan Chen) ； 莊麗玲(Li-Ling Chuang) ； 連恒裕(Hen-Yu Lein) ； 謝宗勳(Tsung-Hsun Hsieh)

《物理治療》 46卷2期 (2021/06) Pp. 61-72

https://doi.org/10.6215/FJPT.202106_46(2).0002

摘要

背景與目的：優良的睡眠品質與良好的健康、精神狀態與心理功能有關。睡眠品質不只受到內在因素影響（例如：睡眠初期的放鬆狀態、睡眠維持、整體睡眠時間與情緒因素），對於外在因素（例如：床墊、枕頭等）也是不可忽視之因素。對於物理治療專業分析而言，過去已有多篇文獻指出枕頭之高度、材質與型態對於睡眠時之肌肉活動、顱頸對齊、肩頸壓力分布、呼吸狀態與疼痛舒緩等有不同程度之影響，進而影響睡眠品質。本篇系統性文獻回顧主要探討枕頭的不同特徵對於人體生物力學特性、疼痛舒緩與肺功能之影響。方法：本系統性文獻回顧搜尋PubMed、MEDLINE、Embase、CENTRAL與華藝線上圖書資料庫1990至2019年間之文獻，關鍵字為：枕頭（pillow）、肌肉活動（muscle activity）、對齊（alignment）、姿勢（posture）、疼痛（pain）與肺功能（pulmonary function）。由上述關鍵字搜尋之文獻依據以下標準納入，條件如下：（1）為人體試驗；（2）以中文或英文發表之文獻；（3）以枕頭特性為變因。結果：根據系統性文獻搜尋之結果，枕頭高度介於5cm至11cm可以維持最佳的肌肉張力平衡、改善顱頸對齊與減少肩頸的肌肉活動，並且能適當分散壓力，促進肌肉的放鬆與改善睡眠期間的呼吸表現，亦可保持呼吸道暢通與提升肺活量。關於枕頭的形狀，客製化的B形枕頭可以降低數字疼痛量表分數、視覺類比量表分數、頸部失能問卷分數與疾病影響概況分數，並且增加舒適程度。在比較標準泡棉枕、聚酯纖維枕與水枕3種枕頭的填充材質，結果顯示相較於其他2種枕頭，水枕在視覺類比量表分數、疾病影響概況分數、提升睡眠問卷分數與滿意度量表有更佳的表現。結論：枕頭的特性會影響睡眠期間骨骼肌肉系統之放鬆、顱頸對齊程度、肺功能、疼痛舒緩與肩頸壓力之分布。此篇回顧性文獻也提供選擇適當枕頭之指導原則，以改善睡眠品質、肺功能及減少骨骼肌肉不適與疼痛。然而，本研究的侷限面向在於方法與研究結果的異質性，未來還需要更進一步的研究來討論枕頭對於人體健康的其他面向之影響。

關鍵字

枕頭 ； 肌肉活化度 ； 姿勢 ； 疼痛 ； 肺功能

並列摘要

Background and Purpose: Good sleep quality is associated with better health, greater mental state, and greater psychological functioning. Sleep quality is not only affected by internal factors of the body (e.g., ease of sleep onset, sleep maintenance, total sleep time, and emotional factors), but also influenced by external factors (e.g., sleeping environment, light, mattress, and pillow). With the respect to the physical therapy assessment, several articles have pointed out that the different height, material, and shape of pillows may have varying degrees of influence on the muscle activity, cranio-cervical pressure, shoulder-neck pressure distribution, breathing pattern, and pain relief during sleep, which in turn affects the quality of sleep. The current systematic review is to discuss the effects of different characteristics of pillows on biomechanical properties, pain relief, and pulmonary function. Methods: This systematic literature review using the PubMed, MEDLINE, Embase, CENTRAL and Airiti Library databases was conducted from 1990 to 2019. The keywords were pillow, muscle activity, alignment, posture, pain, and pulmonary function. The documents searched according to above keywords were screened to the following inclusion criteria: (1) the subjects were humans; (2) the literatures were published in English or Chinese; (3) using pillow property as variable factor in each study. Results: According to the results of the systematic review, pillow height between 5 to 11 cm can maintain the balance of muscle tension, improve the cranio-cervical alignment and pressure distribution, reduce the muscle activity of the shoulder and neck, promote the muscular relaxation, and improve the ventilation performance during sleep. With respect to the shape of pillows, the customized B-shaped pillow can reduce the Numeric Rating Scale score, Visual Analogue Scale (VAS) score, and Neck Disability Index score, and increase the comfortable level. Regarding to the material of pillow, when compared to the standard foam and polyester fiber, the water pillow has better effects on VAS score, Sickness Impact Profile score, Sleep Questionnaire, and Satisfaction scale. Conclusion: This systematic review suggested that the characteristics of pillows could influence the musculoskeletal relaxation, cranio-cervical alignment, pulmonary function, pain relief, and pressure distribution of shoulder and neck during sleep. The results of this review may provide a selection guideline of pillows to improve sleep quality and pulmonary function, and reduce musculoskeletal discomfort and pain. The limitations of the study were the heterogeneity of methodology and study outcomes among studies. Further research is still needed to discuss the impact of pillows on different aspects of human health.

並列關鍵字

Pillow ； Muscle activity ； Posture ； Pain ； Pulmonary function