Objective:To provide new insights for the evaluation and diagnosis of chronic neck pain(CNP).Methods:22 patients with CNP and 22 healthy individuals were recruited from South China Normal University,who were all colle...Objective:To provide new insights for the evaluation and diagnosis of chronic neck pain(CNP).Methods:22 patients with CNP and 22 healthy individuals were recruited from South China Normal University,who were all college students.The subjects'neck extensor muscle strength in the head neutral position,the natural anteversion position,and the maximum forward flexion position were measured by an isometric muscle strength tester respectively.The neck extensor strength of CNP patients and healthy subjects were compared.Results:In the neutral position,the maximum isometric muscle strength of neck extensor muscles was 12.31 kg for CNP patients and 15.16 kg for healthy individuals,resulting in a ratio of 81%strength in patients compared to healthy subjects.This difference was highly significant(P<0.000).In the natural anteversion position,the respective values were 12.6 kg for CNP patients and 15.05 kg for healthy individuals,with a ratio of 83%,and a significant difference between groups(P<0.001).In the maximum forward flexion position of the head,the values were 13.36 kg for CNP patients and 16.15 kg for healthy individuals,with a ratio of 82%,and a highly significant difference(P<0.000).Conclusion:The neck extensor muscle strength levels in college students with CNP were significantly lower compared to healthy college students across all measured positions.展开更多
Introduction: The goal of this study was to use a novel approach to pain relief which includes a participant using their mind to reduce or relieve their neck pain in a matter of minutes and taking continuous thermal m...Introduction: The goal of this study was to use a novel approach to pain relief which includes a participant using their mind to reduce or relieve their neck pain in a matter of minutes and taking continuous thermal medical imaging scans during the process to capture any concurrent temperature changes at the location of the self-reported pain. Previous studies using multidisciplinary approaches have shown that it is possible for a person to achieve a moderate reduction in pain over a period of time (typically two or more months). However, in this innovative study, the goal was to demonstrate rapid pain relief (in a matter of minutes) using only the mind. Case report: For this study, six subjects were selected, all of whom were experiencing long-term chronic neck pain. The subjects consisted of five adult females and one adult male. Several of the subjects also had pain that radiated into their upper back region. Each subject participated in one talk therapy session during which the subject’s neck was actively scanned by a thermal imaging (TI) camera that was programmed to take a new thermal image every thirty (30) seconds. The goal of the talk therapy session was to create a strong emotional shift by encouraging the subject to let go of negative emotions and replace buried painful feelings with feelings of positive expectation and optimism. Then, as the subject created this emotional shift, the goal was to observe if this change affected the subject’s self-reported physical pain, as well as noting any visible effects in thermal images. Results: All six subjects reported that they were able to relieve some or all of their pain by the end of the talk therapy session. As they did, there was simultaneously a significant decrease in temperature recorded on the TI images in the corresponding location in their neck and upper back region. This suggested that the pain relief the subjects reported was not merely “mind over matter”, since there were marked physiological changes taking place. Discussion and Conclusion: It’s worth noting that three of the subjects had moments during their talk therapy session where they thought about a specific painful memory that increased their negative emotions. At that moment, their self-reported pain also increased, and simultaneously, the infrared camera detected an increase in temperature in the corresponding location where the subjects reported increased pain. Subsequently, when the subjects were able to change the painful memory and once again move towards feelings of optimism, they reported pain relief, and simultaneously, the TI camera reported a decrease in temperature. Neither this potential outcome nor any other potential outcome was discussed with the subjects before or during the session. This research shows that talk therapy may be used as a new therapeutic option for people not only with neck pain, but possibly other types of pain, and that under certain circumstances, the results can be rapid.展开更多
<span style="font-family:Verdana;">Background: Neck pain is a real public health problem. It</span><span style="font-family:Verdana;">s</span><span style="font-famil...<span style="font-family:Verdana;">Background: Neck pain is a real public health problem. It</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> treatment use</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> different techniques, such as functional rehabilitation, whose results are not widely popularized, from developing countries in Black Africa. Objective: To assess the result of rehabilitation of chronic common neck pain (CCNP) at the CNHU-HKM in Cotonou. Methods: Cross-sectional, retrospective, descriptive and analytical study. It was carried out from May to September 2020, based on the files of former patients followed in functional rehabilitation department at CNHU-HKM in Cotonou, from 2015 to 2019, for CCNP. The result of rehabilitation was assessed based on the progress, between the start and the end of the rehabilitation sessions, of pain intensity, mobility of </span><span style="font-family:Verdana;">the cervical spine, muscle strength and functional capacity of the patient. A</span><span style="font-family:Verdana;">nova and chi-square tests were used for the analysis of factors associated with the result of rehabilitation. Results: The sample consisted to 73 patients. They were predominantly female (58.90%), with a mean age of 53.60 ± 14.08 years. Th</span><span style="font-family:Verdana;">e neck pain, at least of moderate intensity (97.26%), was p</span><span style="font-family:Verdana;">resent since 12.54 ± 8.54 months, on average. Patients have done 10 to 20 functional rehabilitation sessions, the result of which was satisfactory in 67.12%. This result was mainly associated with patient’s age, sports practice and the seniority of pain progression. Discussion-Conclusion: Rehabilitation results in the management of CCNP are interesting. They prove the need to sensitize patients and prescribers on the importance of early treatment of CCNP.</span></span>展开更多
AIM: To assess the presence of spinal accessory neuropathy in patients with chronic neck pain.METHODS: Patients with pain either regional or focal in the neck or shoulders for at least 6 mo(chronic neck pain) were rec...AIM: To assess the presence of spinal accessory neuropathy in patients with chronic neck pain.METHODS: Patients with pain either regional or focal in the neck or shoulders for at least 6 mo(chronic neck pain) were recruited randomly from the Rheumatology and Rehabilitation Outpatient Clinic at the Faculty of Medicine-Suez Canal University. Two groups were compared: 30 patients with chronic neck pain with mean age(36.97 ± 12.45 years) and 10 apparently healthy controls. Trapezius muscle examination including inspection and range of motion both active and passive was performed. A full clinical neurological examination was carried out to exclude peripheral neuropathy and motor neuron disease. According to the subject's type of work, cases were categorized into labor-intensive and non-labor intensive tasks. A nerve conduction study(NCS) was performed on spinal accessory nerves at both sides for all patients and controls. Parameters including latencies and amplitudes of compound motor action potential(CMAP) were compared with the chronicity of neck pain using the neck disability score. This cross sectional study was carried in the Rheumatology and Rehabilitation Department, at Suez Canal University Hospital, Ismailia, Egypt.RESULTS: Physical examination revealed that 80% of cases had spinal trapezius muscle spasm. Restricted neck motion was present in 16.6% of cases. No one suffered from muscle wasting or weakness. Pain was bilateral in 18 patients(60%), localized to the right side in six patients(20%) and localized to the left side in six patients(20%). The causes of neck pain in the patients studied were nonspecific, due to physical stresses, cervical spondylosis and mild cervical disc herniation. Mean disease duration in patients with labor-intensive tasks was(3.9 ± 2.1 years), which was longer than that in patients with non-labor intensive tasks(3.1 ± 1.9 years); however, this difference was statistically insignificant. Spinal accessory NCSs were performed while subjects were in sitting positions and relaxed with naturally suspended arms to minimize muscular movement. The results of electrophysiological studies revealed that mean right and left latencies of the spinal accessory nerve were 2.96 ± 0.69 ms, 2.98 ± 0.61 ms in the patient group and 2.44 ± 0.38 ms, 2.33 ± 0.36 ms in control group respectively. These differences were statistically significant with P = 0.028 and 0.006 respectively. Spinal accessory NCS showed normal CMAP amplitude in both patients and controls. Comparing the results of the neck disability index(NDI) to different characteristics in patients with chronic neck pain, showed that patients with labor-intensive work had a higher NDI score mean(34.7 ± 9.5) compared to those with non-labor-intensive work, with significant statistical difference(P = 0.011). In addition, mean NDI scores were higher in males, and patients aged over 40 years and this difference was statistically significant(P = 0.007 and P = 0.009 respectively). Correlation studies between right and left spinal accessory nerve latencies and disability percent calculated using the NDI revealed a positive correlation. Moreover, there was a positive correlation between age and disability percent.CONCLUSION: This study demonstrates electrophysiological evidence of demyelination in a significant proportion of patients with chronic cervical pain.展开更多
Background:The pathogenesis of neck pain in the brain,which is the fourth most common cause of disability,remains unclear.Furthermore,little is known about the characteristics of dynamic local functional brain activit...Background:The pathogenesis of neck pain in the brain,which is the fourth most common cause of disability,remains unclear.Furthermore,little is known about the characteristics of dynamic local functional brain activity in cervical pain.Objective:The present study aimed to investigate the changes of local brain activity caused by chronic neck pain and the factors leading to neck pain.Methods:Using the amplitude of low-frequency fluctuations(ALFF)method combined with sliding window approach,we compared local brain activity that was measured by the functional magnetic resonance imaging(fMRI)of 107 patients with chronic neck pain(CNP)with that of 57 healthy control participants.Five pathogenic factors were selected for correlation analysis.Results:The group comparison results of dynamic amplitude of low-frequency fluctuation(dALFF)variability showed that patients with CNP exhibited decreased dALFF variability in the left inferior temporal gyrus,the middle temporal gyrus,the angular gyrus,the inferior parietal marginal angular gyrus,and the middle occipital gyrus.The abnormal dALFF variability of the left inferior temporal gyrus was negatively correlated with the average daily working hours of patients with neck pain.Conclusions:The findings indicated that the brain regions of patients with CNP responsible for audition,vision,memory,and emotion were subjected to temporal variability of abnormal regional brain activity.Moreover,the dALFF variability in the left inferior temporal gyrus might be a risk factor for neck pain.This study revealed the brain dysfunction of patients with CNP from the perspective of dynamic local brain activity,and highlighted the important role of dALFF variability in understanding the neural mechanism of CNP.展开更多
文摘Objective:To provide new insights for the evaluation and diagnosis of chronic neck pain(CNP).Methods:22 patients with CNP and 22 healthy individuals were recruited from South China Normal University,who were all college students.The subjects'neck extensor muscle strength in the head neutral position,the natural anteversion position,and the maximum forward flexion position were measured by an isometric muscle strength tester respectively.The neck extensor strength of CNP patients and healthy subjects were compared.Results:In the neutral position,the maximum isometric muscle strength of neck extensor muscles was 12.31 kg for CNP patients and 15.16 kg for healthy individuals,resulting in a ratio of 81%strength in patients compared to healthy subjects.This difference was highly significant(P<0.000).In the natural anteversion position,the respective values were 12.6 kg for CNP patients and 15.05 kg for healthy individuals,with a ratio of 83%,and a significant difference between groups(P<0.001).In the maximum forward flexion position of the head,the values were 13.36 kg for CNP patients and 16.15 kg for healthy individuals,with a ratio of 82%,and a highly significant difference(P<0.000).Conclusion:The neck extensor muscle strength levels in college students with CNP were significantly lower compared to healthy college students across all measured positions.
文摘Introduction: The goal of this study was to use a novel approach to pain relief which includes a participant using their mind to reduce or relieve their neck pain in a matter of minutes and taking continuous thermal medical imaging scans during the process to capture any concurrent temperature changes at the location of the self-reported pain. Previous studies using multidisciplinary approaches have shown that it is possible for a person to achieve a moderate reduction in pain over a period of time (typically two or more months). However, in this innovative study, the goal was to demonstrate rapid pain relief (in a matter of minutes) using only the mind. Case report: For this study, six subjects were selected, all of whom were experiencing long-term chronic neck pain. The subjects consisted of five adult females and one adult male. Several of the subjects also had pain that radiated into their upper back region. Each subject participated in one talk therapy session during which the subject’s neck was actively scanned by a thermal imaging (TI) camera that was programmed to take a new thermal image every thirty (30) seconds. The goal of the talk therapy session was to create a strong emotional shift by encouraging the subject to let go of negative emotions and replace buried painful feelings with feelings of positive expectation and optimism. Then, as the subject created this emotional shift, the goal was to observe if this change affected the subject’s self-reported physical pain, as well as noting any visible effects in thermal images. Results: All six subjects reported that they were able to relieve some or all of their pain by the end of the talk therapy session. As they did, there was simultaneously a significant decrease in temperature recorded on the TI images in the corresponding location in their neck and upper back region. This suggested that the pain relief the subjects reported was not merely “mind over matter”, since there were marked physiological changes taking place. Discussion and Conclusion: It’s worth noting that three of the subjects had moments during their talk therapy session where they thought about a specific painful memory that increased their negative emotions. At that moment, their self-reported pain also increased, and simultaneously, the infrared camera detected an increase in temperature in the corresponding location where the subjects reported increased pain. Subsequently, when the subjects were able to change the painful memory and once again move towards feelings of optimism, they reported pain relief, and simultaneously, the TI camera reported a decrease in temperature. Neither this potential outcome nor any other potential outcome was discussed with the subjects before or during the session. This research shows that talk therapy may be used as a new therapeutic option for people not only with neck pain, but possibly other types of pain, and that under certain circumstances, the results can be rapid.
文摘<span style="font-family:Verdana;">Background: Neck pain is a real public health problem. It</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> treatment use</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> different techniques, such as functional rehabilitation, whose results are not widely popularized, from developing countries in Black Africa. Objective: To assess the result of rehabilitation of chronic common neck pain (CCNP) at the CNHU-HKM in Cotonou. Methods: Cross-sectional, retrospective, descriptive and analytical study. It was carried out from May to September 2020, based on the files of former patients followed in functional rehabilitation department at CNHU-HKM in Cotonou, from 2015 to 2019, for CCNP. The result of rehabilitation was assessed based on the progress, between the start and the end of the rehabilitation sessions, of pain intensity, mobility of </span><span style="font-family:Verdana;">the cervical spine, muscle strength and functional capacity of the patient. A</span><span style="font-family:Verdana;">nova and chi-square tests were used for the analysis of factors associated with the result of rehabilitation. Results: The sample consisted to 73 patients. They were predominantly female (58.90%), with a mean age of 53.60 ± 14.08 years. Th</span><span style="font-family:Verdana;">e neck pain, at least of moderate intensity (97.26%), was p</span><span style="font-family:Verdana;">resent since 12.54 ± 8.54 months, on average. Patients have done 10 to 20 functional rehabilitation sessions, the result of which was satisfactory in 67.12%. This result was mainly associated with patient’s age, sports practice and the seniority of pain progression. Discussion-Conclusion: Rehabilitation results in the management of CCNP are interesting. They prove the need to sensitize patients and prescribers on the importance of early treatment of CCNP.</span></span>
文摘AIM: To assess the presence of spinal accessory neuropathy in patients with chronic neck pain.METHODS: Patients with pain either regional or focal in the neck or shoulders for at least 6 mo(chronic neck pain) were recruited randomly from the Rheumatology and Rehabilitation Outpatient Clinic at the Faculty of Medicine-Suez Canal University. Two groups were compared: 30 patients with chronic neck pain with mean age(36.97 ± 12.45 years) and 10 apparently healthy controls. Trapezius muscle examination including inspection and range of motion both active and passive was performed. A full clinical neurological examination was carried out to exclude peripheral neuropathy and motor neuron disease. According to the subject's type of work, cases were categorized into labor-intensive and non-labor intensive tasks. A nerve conduction study(NCS) was performed on spinal accessory nerves at both sides for all patients and controls. Parameters including latencies and amplitudes of compound motor action potential(CMAP) were compared with the chronicity of neck pain using the neck disability score. This cross sectional study was carried in the Rheumatology and Rehabilitation Department, at Suez Canal University Hospital, Ismailia, Egypt.RESULTS: Physical examination revealed that 80% of cases had spinal trapezius muscle spasm. Restricted neck motion was present in 16.6% of cases. No one suffered from muscle wasting or weakness. Pain was bilateral in 18 patients(60%), localized to the right side in six patients(20%) and localized to the left side in six patients(20%). The causes of neck pain in the patients studied were nonspecific, due to physical stresses, cervical spondylosis and mild cervical disc herniation. Mean disease duration in patients with labor-intensive tasks was(3.9 ± 2.1 years), which was longer than that in patients with non-labor intensive tasks(3.1 ± 1.9 years); however, this difference was statistically insignificant. Spinal accessory NCSs were performed while subjects were in sitting positions and relaxed with naturally suspended arms to minimize muscular movement. The results of electrophysiological studies revealed that mean right and left latencies of the spinal accessory nerve were 2.96 ± 0.69 ms, 2.98 ± 0.61 ms in the patient group and 2.44 ± 0.38 ms, 2.33 ± 0.36 ms in control group respectively. These differences were statistically significant with P = 0.028 and 0.006 respectively. Spinal accessory NCS showed normal CMAP amplitude in both patients and controls. Comparing the results of the neck disability index(NDI) to different characteristics in patients with chronic neck pain, showed that patients with labor-intensive work had a higher NDI score mean(34.7 ± 9.5) compared to those with non-labor-intensive work, with significant statistical difference(P = 0.011). In addition, mean NDI scores were higher in males, and patients aged over 40 years and this difference was statistically significant(P = 0.007 and P = 0.009 respectively). Correlation studies between right and left spinal accessory nerve latencies and disability percent calculated using the NDI revealed a positive correlation. Moreover, there was a positive correlation between age and disability percent.CONCLUSION: This study demonstrates electrophysiological evidence of demyelination in a significant proportion of patients with chronic cervical pain.
基金supported by the Science and Technology Support Program of Sichuan Province(2018JY0562)the National Natural Science Foundation of China(81722050,81973962 and U1808204)the Key Project of Research and Development of Ministry of Science and Technology(2018AAA0100705).
文摘Background:The pathogenesis of neck pain in the brain,which is the fourth most common cause of disability,remains unclear.Furthermore,little is known about the characteristics of dynamic local functional brain activity in cervical pain.Objective:The present study aimed to investigate the changes of local brain activity caused by chronic neck pain and the factors leading to neck pain.Methods:Using the amplitude of low-frequency fluctuations(ALFF)method combined with sliding window approach,we compared local brain activity that was measured by the functional magnetic resonance imaging(fMRI)of 107 patients with chronic neck pain(CNP)with that of 57 healthy control participants.Five pathogenic factors were selected for correlation analysis.Results:The group comparison results of dynamic amplitude of low-frequency fluctuation(dALFF)variability showed that patients with CNP exhibited decreased dALFF variability in the left inferior temporal gyrus,the middle temporal gyrus,the angular gyrus,the inferior parietal marginal angular gyrus,and the middle occipital gyrus.The abnormal dALFF variability of the left inferior temporal gyrus was negatively correlated with the average daily working hours of patients with neck pain.Conclusions:The findings indicated that the brain regions of patients with CNP responsible for audition,vision,memory,and emotion were subjected to temporal variability of abnormal regional brain activity.Moreover,the dALFF variability in the left inferior temporal gyrus might be a risk factor for neck pain.This study revealed the brain dysfunction of patients with CNP from the perspective of dynamic local brain activity,and highlighted the important role of dALFF variability in understanding the neural mechanism of CNP.
文摘目的:比较不同姿势颈部抗阻训练对慢性非特异性颈痛(chronic non-specific neck pain,CNSNP)的干预效果,为CNSNP探寻一种更高效的运动疗法。方法:51例CNSNP患者(年龄41.0±5.0岁)随机分为3组:俯卧姿颈部抗阻训练组(A组,n=17)、坐姿颈部抗阻训练组(B组,n=17)和俯卧姿对照组(C组,n=17)。测试指标包括视觉模拟评分(visual analog score,VAS)、颈椎功能障碍指数(neck disability index,NDI)、颅颈角(craniocervical angle,CVA)、颈椎活动度(range of motion,ROM)和均方根振幅(root mean square,RMS)。所有指标均在干预前和干预4周后进行测量。结果:A组的干预效果优于B组和C组。A组的颈部疼痛评分(VAS)、颈椎功能障碍指数(NDI)、颅颈角(CVA)、颈椎屈曲活动度(ROM)、颈椎伸展活动度(ROM)、RMS(斜方肌上束,屈曲;胸锁乳突肌,静息;胸锁乳突肌,伸展)较B组和C组均存在显著性差异(P<0.05)。A组的RMS(斜方肌上束,静息)较B组无显著性差异(P>0.05)、较C组存在显著性差异(P<0.05)。结论:俯卧姿颈部抗阻训练能更有效地降低颈部肌肉的VAS和RMS,增加颈部ROM和CVA。
文摘颈椎病(cervical spondylosis,CS)是在颈部退变基础上引起颈椎周围组织结构和功能改变而产生的一系列临床综合征,患者的身心健康和生活质量常受到严重影响,既往研究多关注CS躯体功能障碍,忽视了中枢可塑性在该病发生发展中的重要性。功能磁共振成像(functional magnetic resonance imaging,fMRI)技术的推广应用则为CS中枢重塑和临床疗效提供了可视化的证据。本文通过查阅近年来国内外关于CS中枢功能改变的文献并进行综述,结果发现研究主要集中在CS慢性脊髓压迫、CS慢性颈痛和颈性眩晕等方向,患者多表现出脑区的异常神经元活动、功能连接改变和脑网络的改变;同时,本文提出了当前研究不足及发展方向,以期为未来CS的诊断、治疗、预后提供更多的神经影像学参考和借鉴。
