Download PDF
MSK – Muskuloskelettale Physiotherapie 2021; 25(05): 250-259
DOI: 10.1055/a-1555-2109
Originalarbeit

Konservative Rehabilitation nach Fraktur im Bereich der Halswirbelsäule – ein Fallbericht

FallberichtConservative Rehabilitation after a Fracture in the Region of the Cervical Spine – A Case ReportCase Report
Andreas Danler
Therapie- und Gesundheitszentrum Rosenheim
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Nackenschmerz ist einer der häufigsten Gründe, warum Patient(inn)en Physiotherapie in Anspruch nehmen. Liegt eine traumatische Fraktur im Bereich der Halswirbelsäule den Schmerzen zugrunde, kommt es häufig zu einer operativen Versorgung. Dieses Fallbeispiel beschreibt den Rehabilitationsprozess eines jungen Mannes nach einer erlittenen Fraktur im Bereich der Halswirbelsäule, die konservativ versorgt wurde. Im Mittelpunkt der Physiotherapie standen vertrauensbildende Maßnahmen, computergestützte Untersuchungsmethoden der Beweglichkeit, manualtherapeutische Interventionen und eine graduierte Trainingstherapie. Darüber hinaus wurde der Patient in Bezug auf den Rehabilitationsprozess interviewt.

Abstract

Neck pain is one of the most frequent reasons for patients to seek physiotherapy. If the pain is caused by a traumatic fracture in the region of the cervical spine, surgical treatment is often used. This case study describes the rehabilitation process of a young man who suffered a fracture in the region of the cervical spine and received conservative therapy. Physiotherapy focused on confidence-building measures, computerized examination methods for range of motion, manual therapy interventions and graduated training therapy. On top of this, the patient was interviewed with regard to the rehabilitation process.

Schlüsselwörter

Fraktur der Halswirbelsäule - konservative Therapie - Bewegungsausmaß - wiederholte Messungen

Key words

fracture of the cervical spine - conservative therapy - range of motion - repeated measurements

Zusatzmaterial

    Zusatzmaterial (Messungen der aktiven HWS-Bewegungen zu den drei Messzeitpunkten) finden Sie unter: https://doi.org.10.1055/a-1555-2109
  • Supplementary material


Publication History

Received: 07 March 2021

Accepted: 09 April 2021

Article published online:
14 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Vos T, Abajobir AA, Abate KH. et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1211-1259
    CrossrefPubMedSearch in Google Scholar
  • 2 Holm LW, Carroll LJ, Cassidy D. et al. The burden and determinants of neck pain in whiplash-associated disorders after traffic collisions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976) 2008; 33: S52-9
    CrossrefPubMedSearch in Google Scholar
  • 3 Carroll LJ, Holm LW, Hogg-Johnson S. 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. Spine (Phila Pa 1976) 2008; 33: S83-92
    CrossrefPubMedSearch in Google Scholar
  • 4 Sterling M, Jull G, Kenardy J. Physical and psychological factors maintain long-term predictive capacity post-whiplash injury. Pain 2006; 122: 102-108
    CrossrefPubMedSearch in Google Scholar
  • 5 Walton DM, Carroll LJ, Kasch H. et al. An Overview of Systematic Reviews on Prognostic Factors in Neck Pain: Results from the International Collaboration on Neck Pain (ICON) Project. Open Orthop J 2013; 7: 494-505
    CrossrefPubMedSearch in Google Scholar
  • 6 Dall’Alba PT, Sterling MM, Treleaven JM. et al. Cervical range of motion discriminates between asymptomatic persons and those with whiplash. Spine (Phila Pa 1976) 2001; 26: 2090-2094
    CrossrefPubMedSearch in Google Scholar
  • 7 Dvir Z, Prushansky T, Peretz C. Maximal versus feigned active cervical motion in healthy patients: the coefficient of variation as an indicator for sincerity of effort. Spine (Phila Pa 1976) 2001; 26: 1680-1688
    CrossrefPubMedSearch in Google Scholar
  • 8 Röijezon U, Djupsjöbacka M, Björklund M. et al. Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study. BMC Musculoskelet Disord 2010; 11: 222
    CrossrefPubMedSearch in Google Scholar
  • 9 Falla D, Jull G, Rainoldi A. et al. Neck flexor muscle fatigue is side specific in patients with unilateral neck pain. Eur J Pain 2004; 8: 71-77
    CrossrefPubMedSearch in Google Scholar
  • 10 Kumbhare DA, Balsor B, Parkinson WL. et al. Measurement of cervical flexor endurance following whiplash. Disabil Rehabil 2005; 27: 801-807
    CrossrefPubMedSearch in Google Scholar
  • 11 Prushansky T, Gepstein R, Gordon C. et al. Cervical muscles weakness in chronic whiplash patients. Clin Biomech (Bristol, Avon) 2005; 20: 794-798
    CrossrefPubMedSearch in Google Scholar
  • 12 Falla DL, Jull GA, Hodges PW. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp Brain Res 2004; 157: 43-48
    CrossrefPubMedSearch in Google Scholar
  • 13 Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine (Phila Pa 1976) 2004; 29: 2108-2114
    CrossrefPubMedSearch in Google Scholar
  • 14 Schomacher J, Falla D. Function and structure of the deep cervical extensor muscles in patients with neck pain. Man Ther 2013; 18: 360-366
    CrossrefPubMedSearch in Google Scholar
  • 15 Field S, Treleaven J, Jull G. Standing balance: a comparison between idiopathic and whiplash-induced neck pain. Man Ther 2008; 13: 183-191
    CrossrefPubMedSearch in Google Scholar
  • 16 Elliott JM, Courtney DM, Rademaker A. et al. The Rapid and Progressive Degeneration of the Cervical Multifidus in Whiplash: An MRI Study of Fatty Infiltration. Spine (Phila Pa 1976) 2015; 40: E694-700
    CrossrefPubMedSearch in Google Scholar
  • 17 Hides JA, Richardson CA, Jull GA. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine (Phila Pa 1976) 1996; 21: 2763-2769
    CrossrefPubMedSearch in Google Scholar
  • 18 Sterling M, Jull G, Vicenzino B. et al. Development of motor system dysfunction following whiplash injury. Pain 2003; 103: 65-73
    CrossrefPubMedSearch in Google Scholar
  • 19 Sterling M, Jull G, Vicenzino B. et al. Physical and psychological factors predict outcome following whiplash injury. Pain 2005; 114: 141-148
    CrossrefPubMedSearch in Google Scholar
  • 20 Gagnier JJ, Riley D, Altman DG. et al. The CARE guidelines: consensus-based clinical case reporting guideline development. Dtsch Arztebl Int 2013; 110: 603-608
    CrossrefPubMedSearch in Google Scholar
  • 21 Spitzer WO, Skovron ML, Salmi LR. et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine (Phila Pa 1976) 1995; 20: 1-73
    CrossrefPubMedSearch in Google Scholar
  • 22 Thoomes-de Graaf M, Fernandez-De-Las-Penas C, Cleland JA. The content and construct validity of the modified patient specific functional scale (PSFS 2.0) in individuals with neck pain. J Man Maip Ther 2020; 28: 49-59
    CrossrefPubMedSearch in Google Scholar
  • 23 Smart KM, Blake C, Staines A. et al. Clinical indicators of ‘nociceptive’, ‘peripheral neuropathic’ and ‘central’ mechanisms of musculoskeletal pain. A Delphi survey of expert clinicians. Man Ther 2010; 15: 80-87
    CrossrefPubMedSearch in Google Scholar
  • 24 Struyf F, Nijs J, Mottram S. et al. Clinical assessment of the scapula: a review of the literature. Br J Sports Med 2014; 48: 883-890
    CrossrefPubMedSearch in Google Scholar
  • 25 Schneider GM, Jull G, Thomas K. et al. Derivation of a clinical decision guide in the diagnosis of cervical facet joint pain. Arch Phys Med Rehabil 2014; 95: 1695-1701
    CrossrefPubMedSearch in Google Scholar
  • 26 van Dillen LR, McDonnell MK, Susco TM. et al. The immediate effect of passive scapular elevation on symptoms with active neck rotation in patients with neck pain. Clin J Pain 2007; 23: 641-647
    CrossrefPubMedSearch in Google Scholar
  • 27 Manning DM, Dedrick GS, Sizer PS. et al. Reliability of a seated three-dimensional passive intervertebral motion test for mobility, end-feel, and pain provocation in patients with cervicalgia. J Man Manip Ther 2012; 20: 135-141
    CrossrefPubMedSearch in Google Scholar
  • 28 Ingram LA, Snodgrass SJ, Rivett DA. Comparison of cervical spine stiffness in individuals with chronic nonspecific neck pain and asymptomatic individuals. J Orthop Sports Phys Ther 2015; 45: 162-169
    CrossrefPubMedSearch in Google Scholar
  • 29 Cook C, Brown C, Isaacs R. et al. Clustered clinical findings for diagnosis of cervical spine myelopathy. J Man Manip Ther 2010; 18: 175-180
    CrossrefPubMedSearch in Google Scholar
  • 30 Sterling M. Testing for sensory hypersensitivity or central hyperexcitability associated with cervical spine pain. J Manipulative Physiol Ther 2008; 31: 534-539
    CrossrefPubMedSearch in Google Scholar
  • 31 Sterling M, Treleaven J, Jull G. Responses to a clinical test of mechanical provocation of nerve tissue in whiplash associated disorder. Man Ther 2002; 7: 89-94
    CrossrefPubMedSearch in Google Scholar
  • 32 Kibler WB, Sciascia A, Dome D. Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. Am J Sports Med 2006; 34: 1643-1647
    CrossrefPubMedSearch in Google Scholar
  • 33 Jull G, Kristjansson E, Dall’Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. Man Ther 2004; 9: 89-94 689X(03)00086–9
    CrossrefSearch in Google Scholar
  • 34 Helgadottir H, Kristjansson E, Mottram S. et al. Altered alignment of the shoulder girdle and cervical spine in patients with insidious onset neck pain and whiplash-associated disorder. J Appl Biomech 2011; 27: 181-191
    CrossrefPubMedSearch in Google Scholar
  • 35 Janda V. Manuelle Muskelfunktionsdiagnostik. 4. Aufl.. München: Urban & Fischer Verlag/Elsevier GmbH; 2009
    Search in Google Scholar
  • 36 Tjell C, Rosenhall U. Smooth pursuit neck torsion test: a specific test for cervical dizziness. Am J Otol 1998; 19: 76-81
    Search in Google Scholar
  • 37 Danler A. HWS-Bewegungen analysieren – Physiotherapeutische Bewegungsdiagnostik. physiopraxis 2020; 18: 40-43
    Thieme ConnectSearch in Google Scholar
  • 38 Kristjansson E, Oddsdottir GL. “The Fly”: a new clinical assessment and treatment method for deficits of movement control in the cervical spine: reliability and validity. Spine (Phila Pa 1976) 2010; 35: E1298-1305
    CrossrefPubMedSearch in Google Scholar
  • 39 De Koning CHP, van den Heuvel SP, Staal JB. et al. Clinimetric evaluation of active range of motion measures in patients with non-specific neck pain: a systematic review. Eur Spine J 2008; 17: 905-921
    CrossrefPubMedSearch in Google Scholar
  • 40 Youdas JW, Carey JR, Garrett TR. Reliability of measurements of cervical spine range of motion-- comparison of three methods. Phys Ther 1991; 71: 98-104 discussion 105–6.
    CrossrefPubMedSearch in Google Scholar
  • 41 Tousignant M, Duclos E, Laflèche S. et al. Validity study for the cervical range of motion device used for lateral flexion in patients with neck pain. Spine (Phila Pa 1976) 2002; 27: 812-817
    CrossrefPubMedSearch in Google Scholar
  • 42 Malik AA, Robinson S, Khan WS. et al. Assessment of Range of Movement, Pain and Disability Following a Whiplash Injury. Open Orthop J 2017; 11: 541-545
    CrossrefPubMedSearch in Google Scholar
  • 43 Ris I, Juul-Kristensen B, Boyle E. et al. Chronic neck pain patients with traumatic or non-traumatic onset: Differences in characteristics. A cross-sectional study. Scand J Pain 2017; 14: 1-8
    CrossrefPubMedSearch in Google Scholar
  • 44 Thoomes-de Graaf M, Thoomes E, Fernández-de-Las-Peñas C. et al. Normative values of cervical range of motion for both children and adults: A systematic review. Musculoskelet Sci Pract 2020; 49: 102182
    CrossrefPubMedSearch in Google Scholar
  • 45 Ishii T, Mukai Y, Hosono N. et al. Kinematics of the cervical spine in lateral bending: in vivo three-dimensional analysis. Spine (Phila Pa 1976) 2006; 31: 155-160
    CrossrefPubMedSearch in Google Scholar
  • 46 Caneiro JP, Roos EM, Barton CJ. et al. Infographic. Roadmap to managing a person with musculoskeletal pain irrespective of body region. Br J Sports Med 2020; 54: 554-555
    CrossrefPubMedSearch in Google Scholar
  • 47 Sterling M. Physiotherapy management of whiplash-associated disorders (WAD). J Physiother 2014; 60: 5-12
    CrossrefPubMedSearch in Google Scholar
  • 48 Bialosky JE, Beneciuk JM, Bishop MD. et al. Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. J Orthop Sports Phys Ther 2018; 48: 8-18
    CrossrefPubMedSearch in Google Scholar
  • 49 Vicenzino B, Paungmali A, Teys P. Mulligan’s mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther 2007; 12: 98-108
    CrossrefPubMedSearch in Google Scholar
  • 50 Schomacher J, Petzke F, Falla D. Localised resistance selectively activates the semispinalis cervicis muscle in patients with neck pain. Man Ther 2012; 17: 544-548
    CrossrefPubMedSearch in Google Scholar
  • 51 Lluch E, Schomacher J, Gizzi L. et al. Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio- cervical flexion test. Man Ther 2014; 19: 25-31
    CrossrefPubMedSearch in Google Scholar
  • 52 Helgadottir H, Kristjansson E, Mottram S. et al. Altered scapular orientation during arm elevation in patients with insidious onset neck pain and whiplash-associated disorder. J Orthop Sports Phys Ther 2010; 40: 784-791
    CrossrefPubMedSearch in Google Scholar
  • 53 Falla D, Jull G, Hodges P. Training the cervical muscles with prescribed motor tasks does not change muscle activation during a functional activity. Man Ther 2008; 13: 507-512
    CrossrefPubMedSearch in Google Scholar
  • 54 Khan K, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med 2009; 43: 247-252
    CrossrefPubMedSearch in Google Scholar
  • 55 Cook C, Lawrence J, Michalak K. et al. Is there preliminary value to a within- and/or between-session change for determining short-term outcomes of manual therapy on mechanical neck pain?. J Man Manip Ther 2014; 22: 173-180
    CrossrefPubMedSearch in Google Scholar
  • 56 Wulf G, Lewthwaite R. Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychon Bull Rev 2016; 23: 1382-1414
    CrossrefPubMedSearch in Google Scholar
  • 57 Sterling AC, Cobian DG, Anderson PA. et al. Annual frequency and magnitude of neck motion in healthy individuals. Spine (Phila Pa 1976) 2008; 33: 1882-1888
    CrossrefPubMedSearch in Google Scholar
  • 58 Worsfold C. When range of motion is not enough: towards an evidence-based approach to medico-legal reporting in whiplash injury. J Forensic Leg Med 2014; 25: 95-99
    CrossrefPubMedSearch in Google Scholar
  • 59 Hermann KM, Reese CS. Relationships among selected measures of impairment, functional limitation, and disability in patients with cervical spine disorders. Phys Ther 2001; 81: 903-914
    CrossrefPubMedSearch in Google Scholar
  • 60 Hill AB. The environment and disease: Association or causation?. Proc R Soc Med 1965; 58: 295-300
    PubMedSearch in Google Scholar