挥鞭样损伤的研究进展

doi:10.3969/j.issn.1006-9771.2019.00.005

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (3): 324-329.doi: 10.3969/j.issn.1006-9771.2019.00.005

挥鞭样损伤的研究进展

蔡亚飞¹, 洪毅^1,2, 王方永^1,2, 任伟靖¹, 宋明洁¹

1.首都医科大学康复医学院，北京市 100068
2.中国康复研究中心北京博爱医院脊柱外科，北京市 100068

收稿日期:2018-09-04 修回日期:2018-11-26 出版日期:2019-03-25 发布日期:2019-04-02
通讯作者: 洪毅,E-mail: hongyihhyy@163.com
作者简介:蔡亚飞(1993-)，女，汉族，河北保定市人，硕士研究生，主要研究方向：脊髓损伤与康复。通讯作者：洪毅，男，汉族，主任医师，教授，硕士研究生导师，主要研究方向：脊柱外科与康复。王方永，男，汉族，主任医师，副教授，硕士研究生导师，主要研究方向：脊柱外科与康复。
基金资助:
中国康复研究中心项目(No. 2017ZX-23; No. 2017ZX-02; No. 2015ZX-1)

Advance in Whiplash-associated Disorders (review)

CAI Ya-fei¹, HONG Yi^1,2, WANG Fang-yong^1,2, REN Wei-jing¹, SONG Ming-jie¹

1.Capital Medical University School of Rehabilitation, Beijing 100068, China
2.Department of Spine Surgery, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2018-09-04 Revised:2018-11-26 Published:2019-03-25 Online:2019-04-02
Contact: HONG Yi, E-mail: hongyihhyy@163.com; WANG Fang-yong, E-mail: wfybeijing@163.com
Supported by:
China Rehabilitation Research Center Project (No. 2017ZX-23; No. 2017ZX-02; No. 2015ZX-1)

摘要/Abstract

摘要： 挥鞭样损伤临床表现多种多样，常见症状为颈痛、头痛、颈椎活动受限等。其机制复杂，不仅与突然的加速-减速机制传导至颈椎关节面、相关韧带、肌肉和神经等造成一系列症状相关，最近发现还可能与脑脊液低容量、纤维肌痛以及中枢神经系统上行网状系统损伤有关。对于不伴有神经功能损伤的患者，进行针对颈部腹侧深层肌肉的等长收缩以及耐力的运动训练可显著改善患者症状，经超声可实时动态检测运动训练组与保守观察组深层与浅层肌肉形变以及形变速率模式不同。运动训练可改善肌肉运动模式，同时修复受损的颈部肌肉。

关键词: 挥鞭样损伤, 机制, 颈部肌肉, 运动训练, 超声, 综述

Abstract: Whiplash-associated disorders usually appear as symptoms of neck pain, headache, and limited cervical spine activities, etc. Its mechanism is complicated, which is related with the sudden acceleration-deceleration mechanism conducted to the cervical vertebral joint, ligaments, muscles and nerves. Recently, it was found that low capacity of cerebrospinal fluid, fibromyalgia, and injury of central nervous system are also associated with those symptoms. The focus of exercise on equal length contraction and endurance of neck deep muscles can significantly improve the symptoms of patients without neurological injury. Ultrasound can be used to dynamically detect deformation and deformation rate patterns of both deep and shallow muscle in the exercise group and the conservative observation group. It is suggested that exercise can improve muscle movement patterns and repair damaged neck muscles at the same time.

Key words: whiplash-associated disorders, mechanism, neck muscles, exercise, ultrasound, review

中图分类号:

R681.5

蔡亚飞, 洪毅, 王方永, 任伟靖, 宋明洁. 挥鞭样损伤的研究进展[J]. 《中国康复理论与实践》, 2019, 25(3): 324-329.

CAI Ya-fei, HONG Yi, WANG Fang-yong, REN Wei-jing, SONG Ming-jie. Advance in Whiplash-associated Disorders (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(3): 324-329.

参考文献

1 SpitzerW O, SkovronM L, SalmiL R, et al. Scientific monograph of the Quebec Task Force on whiplash-associated disorders: redefining “whiplash” and its management [J]. Spine, 1995, 20(8Suppl): 1S-73S.
2 StyrkeJ, StalnackeB M, BylundP O, et al. A 10-year incidence of acute whiplash injuries after road traffic crashes in a defined population in northern Sweden [J]. PM R, 2012, 4(10): 739-747.
3 CarrollL J, HolmL W, Hogg-JohnsonS, et al. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders [J]. J Manipulative Physiol Ther, 2009, 32(2 supply): S97-S107.
4 PanjabiM M. The stabilizing system of the spine. Part I. Function dysfunction, adaptation, and enhancement [J]. J Spinal Disord, 1992, 5(4): 383-389.
5 Mayoux-BenhamouM A, RevelM, ValleeC, et al. Longus colli has a postural function on cervical curvature [J]. Surg Radiol Anat, 1994,16(4): 367-371.
6 DeansG T, MagalliardJ N, KerrM, et al. Neck sprain—a major cause of disability following car accidents [J]. Injury, 1987, 18(1): 10-12.
7 BenoistM, RouaudJ P. Whiplash: myth or reality [J]. Joint Bone Spine, 2002, 69(4): 358-362.
8 RadanovB P, Di StefanoG, SchnidrigA, et al. Common whiplash: Psychosomatic or somatopsychic [J]. J Neurol Neurosurg Psychiatry, 1994, 57(4): 486-490.
9 G?belH, LindnerV, SoykaD, et al. [The International Headache Society's new headache classification system] [J]. [in German]. Schmerz, 1991, 5(1): 15-21.
10 BogdukN. Postwhiplash syndrome [J]. Aust Fam Physician, 1994, 23(12): 2303-2307.
11 De ReuckJ. Motor evoked potentials in patients with chronic whiplash-associated disorder grade II [J]. Neurol Neurochir Pol, 2017, 51(5): 372-374.
12 AndersonS E, BoeschC, ZimmermannH, et al. Are there cervical spine findings at MR imaging that are specific to acute symptomatic whiplash injury? A prospective controlled study with four experienced blinded readers [J]. Radiology, 2012, 262(2): 567-575.
13 LummelN, BitterlingH, KloetzerA, et al. Value of "functional" magnetic resonance imaging in the diagnosis of ligamentous affection at the craniovertebral junction [J]. Eur J Radial, 2012, 81(11): 3435-3440.
14 ChenJ, WangW, HanG, et al. MR investigation in evaluation of chronic whiplash alar ligament injury in elderly patients [J]. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 2015, 40(1): 67-71.
15 ZhangJ, WangF, XueQ. Development and validation of a human neck FE model for dynamic response during impact condition [J]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi, 2009, 26(2): 318-322.
16 LinnmanC, AppelL, FredriksonM, et al. Elevated [11C]-D-deprenyl uptake in chronic whiplash associated Disorder suggests persistent musculoskeletal inflammation [J]. PLoS One, 2011, 6(4): 173-182.
17 PeolssonA, PetersonG, TryggJ, et al. Multivariate analysis of ultrasound-recorded dorsal strain sequences: Investigation of dynamic neck extensions in women with chronic whiplash associated disorders [J]. Sci Rep, 2016, 3(6): 304-315.
18 DonS, De KooningM, VoogtL, et al. The effect of visual feedback of the neck during movement in people with chronic whiplash-associated disorders: an experimental study [J]. J Orthop Sports Phys Ther, 2017, 47(3): 190-199.
19 ShinonagaM. The present state and view of the cerebrospinal fluid hypovolemia research [J]. Nihon Rinsho, 2013, 71(10): 1871-1878.
20 ChenS, HagiwaraM, RoehmP C. Spontaneous intracranial hypotension presenting with severe sensorineural hearing loss and headache [J]. Otol Neurotol, 2012, 33(8): 65-66.
21 MoriyamaE, TeradaH, IshikawaS. Spinal cerebrospinal fluid leakage after motor vehicle accident－Two case reports [J]. Neurol Med Chir (Tokyo), 2009, 49(7): 306-309.
22 FerrariR. A prospective study of the 1-year incidence of fibromyalgia after acute whiplash injury [J]. RMD Open, 2015, 1(1): 1-5.
23 PetersonG, NilssonD, PetersonS, et al. Changes in dorsal neck muscle function in individuals with chronic whiplash-associated disorders: a real-time ultrasound case-control study [J]. Ultrasound Med Biol, 2016, 42(5): 1090-1102.
24 LudvigssonM L, PetersonG, DederingA, et al. One- and two-year follow-up of a randomized trial of neck-specific exercise with or without a behavioral approach compared with prescription of physical activity in chronic whiplash disorder [J]. J Rehabil Med, 2016, 48(10): 56-64.
25 Landén LudvigssonM, PetersonG, JullG, et al. Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders—A case-control ultrasound speckle tracking analysis [J]. Man Ther, 2016, 21(1): 177-182.
26 KalawyH, St?lnackeB M, Fahlstr?mM, et al. New objective findings after whiplash injuries: High blood flow in painful cervical soft tissue: an ultrasound pilot study [J]. J Pain, 2017, 4(4): 173-179.
27 TanakaN, AtesokK, NakanishiK, et al. Pathology and treatment of traumatic cervical spine syndrome: whiplash injury [J]. Adv Orthop, 2018, 47(65): 50-56.
28 PerssonM, S?rensenJ, GerdleB. Whiplash-associated disorders (WAD): responses to pharmacological challenges and psychometric tests [J]. Scand J Pain, 2012, 3(3): 151-163.
29 Scholten-PeetersG G, BekkeringG E, VerhagenA P, et al. Clinical Practice Guideline for the Physiotherapy of Patients with Whiplash-associated Disorders [J]. Spine, 2002, 27(4): 412-422.
30 MichaleffZ A, MaherC G, LinC W, et al. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial [J]. Lancet, 2014, 384(9938): 133-141.
31 SeferiadesA, OhlinP, BillhultA, et al. Basic body awareness therapy or exercise therapy for the treatment of chronic whiplash associated disorders: a randomized comparative clinical trial [J]. Disabil Rehabil, 2016, 38(15): 442-451.
32 StewartM J, MaherC G, RefshaugeK M, et al. Randomized controlled trial of exercise for chronic whiplash-associated disorders [J]. Pain, 2007, 128(1-2): 59-68.
33 LudvigssonM L, PetersonG, O'LearyS, et al. The effect of neck-specific exercise with, or without a behavioral approach, on pain, disability, and self-efficacy in chronic whiplash-associated disorders: a randomized clinical trial [J]. Clin J Pain, 2015, 31(8): 294-303.
34 GriffinA, LeaverA, MoloneyN, et al. General exercise does not improve long-term pain and disability in individuals with whiplash-associated disorders: a systematic review [J]. J Orthop Sports Phys Ther, 2017, 47(7): 472-480.
35 PetersonG, NilssonD, TryggJ, et al. Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders [J]. Sci Rep, 2015, 5:15289.
36 PetersonG, NilssonD, TryggJ, et al. Neck-specific exercise improves impaired interactions between ventral neck muscles in chronic whiplash: a randomized controlled ultrasound study [J]. Sci Rep, 2018, 8(1): 9649.
37 RebbeckT. The role of exercise and patient education in the noninvasive management of whiplash [J]. J Orthop Sports Phys Ther, 2017, 47(7): 481-491.
38 O'LearyS, JullG, van WykL, et al. Morphological changes in the cervical muscles of women with chronic whiplash can be modified with exercise—A pilot study [J]. Muscle Nerve, 2015, 52(15): 772-779.
39 LindstromR, SchomacherJ, FarinaD, et al. Association between neck muscle coactivation, pain, and strength in women with neck pain [J]. Man Ther, 2011, 16(1): 80-86.
40 FallaD, O'LearyS, FarinaD, et al. Association between intensity of pain and impairment in onset and activation of the deep cervical flexors in patients with persistent neck pain [J]. Clin J Pain, 2011, 27(3): 309-314.
41 LindstroemR, Graven-NielsenT, FallaD. Current pain and fear of pain contribute to reduced maximum voluntary contraction of neck muscles in patients with chronic neck pain [J]. Arch Phys Med Rehabil, 2012, 93(4): 2042-2048.
42 LundJ P, DongaR, WidmerC G, et al. The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity [J]. Can J Physiol Pharmacol, 1991, 69(5): 683-694.
43 Amiri ArimiS, GhamkharL, KahlaeeA H. The relevance of proprioception to chronic neck pain: a correlational analysis of flexor muscle size and endurance, clinical neck pain characteristics, and proprioception [J]. Pain Med, 2018, 93(10): 331-342.
44 HodgesP W, CoppietersM W, MacDonaldD, et al. New insight into motor adaptation to pain revealed by a combination of modelling and empirical approaches [J]. Eur J Pain, 2013, 17(35): 1138-1146.
45 HugF, HodgesP W, TuckerK J. Effect of pain location on spatial reorganisation of muscle activity [J]. J Electromyogr Kinesiol, 2013, 23(10): 1413-1420.
46 GizziL, MuceliS, PetzkeF, et al. Experimental muscle pain impairs the synergistic modular control of neck muscles [J]. PLoS One, 2015, 10(9): e0137844.

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挥鞭样损伤的研究进展

Advance in Whiplash-associated Disorders (review)

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