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DOI: 10.1055/s-0029-1245389
© Georg Thieme Verlag KG Stuttgart · New York
Wirkung einer schmerzlindernden analgetischen Mobilisationstechnik bei Anwendung auf symptomatische oder asymptomatische HWS-Segmente bei Patienten mit Nackenschmerzen[1]
Randomisierte, kontrollierte StudieThe Effect of an Analgesic Mobilisation Technique when Applied at Symptomatic or Asymptomatic Levels of the Cervical Spine in Subjects with Neck PainA Randomized Controlled TrialPublication History
Manuskript eingetroffen: 27.10.2009
24. 11.2009
Publication Date:
19 May 2010 (online)
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Zusammenfassung
Ziel dieser einfach verblindeten randomisierten kontrollierten Studie war der Vergleich der Wirkungen einer manuellen Behandlungstechnik für Nackenschmerzen und Bewegungsempfindung bei Anwendung auf die verschiedenen HWS-Segmente. Für die Untersuchung wurden Patienten mit Nackenschmerzen (n = 126) rekrutiert und randomisiert in 2 Gruppen (A oder B) eingeteilt. Gruppe A erhielt eine einmalige 4-minütige schmerzlindernde Traktion im am stärksten symptomatischen Zygoapophysealgelenk des HWS-Segments, bei dem Bewegung und Schmerzen miteinander zusammenhingen. Gruppe B bekamen dieselbe Behandlung, jedoch 3 Segmente vom entsprechenden Segment entfernt. Schmerzintensität und Bewegungsempfindung wurden mithilfe einer numerischen Rating-Skala (NRS) gemessen. Die statistische Analyse umfasste einen t-Test für gepaarte und ungepaarte Stichproben. Die Vorher- und Nachher-Testergebnisse zeigten signifikante Verbesserungen bei beiden Mobilisationsarten, obwohl zwischen den beiden Gruppen kein signifikanter Unterschied bestand. Ähnliche Resultate finden sich in der Fachliteratur zur HWS-Manipulation. Die Ergebnisse dieser Studie werfen die Frage auf, ob präzise Symptomlokalisationstests für die Schmerzbehandlung notwendig sind. Die Begrenzungen der Studie erlauben jedoch keine Verallgemeinerung der Ergebnisse.
Abstract
The purpose of this single-blinded, randomised controlled trial was to compare the effects of a manual treatment technique on neck pain and movement sensation when applied in different segments of the cervical spine. Consecutive patients with neck pain (n = 126) were recruited and randomly allocated to 2 groups (A or B). Group A received a single 4-minute pain-alleviating traction at the most symptomatic zygapophyseal joint of the cervical segment, where movement was correlated with pain. Group B received the same treatment 3 segments away from the concordant segment. Pain intensity and sensation of movement were assessed with a numeric rating scale (NRS). Statistical analysis included a t-test for paired and unpaired samples. Pre- and post-test findings demonstrated significant improvements in both types of mobilisation although there was no significant difference between the 2 groups. Similar results have been reported in the literature for cervical manipulation. The findings of this study question the necessity of precise symptom localisation tests for a pain treatment. However, limitations of the study prevent generalisation of these results.
Schlüsselwörter
Mobilisation - randomisierte kontrollierte Studie - Behandlungsspezifität - Symptomlokalisationstest - Traktion
Key words
mobilisation - randomised controlled trial - specificity of treatment - symptom localisation tests - traction
1 Der Originalartikel The Effect of an Analgesic Mobilization Technique when Applied at Symptomatic or Asymptomatic Levels of the Cervical Spine in Subjects with Neck Pain: A Randomized Controlled Trial ist erschienen in: The Journal of Manual and Manipulative Therapy (JMMT) 2009; 17: 101 – 108.
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1 Der Originalartikel The Effect of an Analgesic Mobilization Technique when Applied at Symptomatic or Asymptomatic Levels of the Cervical Spine in Subjects with Neck Pain: A Randomized Controlled Trial ist erschienen in: The Journal of Manual and Manipulative Therapy (JMMT) 2009; 17: 101 – 108.
Jochen Schomacher
PT, OMT, MCMK, DPT, BSc und MSc Phys, Freiberuflicher Dozent in der physiotherapeutischen Weiterbildung
Kappeliweg 9
8703 Erlenbach ZH
Schweiz
Email: Jochen-Schomacher@web.de