Propriozeption der HWS: Ist ein koordinatives Training bei Nackenbeschwerden sinnvoll?[1]

Zusammenfassung

Diese Literaturarbeit untersuchte, ob ein propriozeptives Training an der HWS bessere Resultate erzielt als andere physiotherapeutische Interventionen. Die wenigen qualitativ guten Studien liefern Hinweise für die Effektivität eines propriozeptiven Trainings. Kopfpositionierungs-, okulomotorische und Augen-Kopf-Koordinationsübungen führen zusätzlich zu vermehrter Schmerzreduktion und verbesserter Tiefensensibilität. Zur Beurteilung koordinativer Störungen im klinischen Alltag ist der Joint position error (JPE) ein geeignetes Messinstrument. Er stellt die Abweichung von der natürlichen Kopfposition nach einer aktiven HWS-Bewegung dar.

Abstract

This review aims to assess whether a tailored sensorimotor exercise program achieves better results in patients with neck disorders than other treatments. The few good quality studies indicated the proprioceptive training’s effectiveness. In addition, exercises on cervical joint position sense, oculomotor exercises and exercises for eye-head coordination produce higher pain reduction and better joint position sense. The joint position error seems to be an appropriate tool for the clinical assessment of sensorimotor control disturbances in neck disorders. It shows the deviation from natural head position after active neck movement.

Schlüsselwörter

Nackenschmerzen - Propriozeption - Sensomotorik - Wahrnehmung der Gelenkposition - joint position error

Key words

neck pain - proprioception - sensorimotor control - joint position sense - joint position error

1 Die Arbeit wurde im Rahmen des SVOMP-Nachdiplomstudiums zur Dipl.-Manualtherapeutin OMT SVOMP erstellt.

Literatur

• 1 André-Deshays  C, Berthoz A, Revel M. Eye-head coupling in humans. I. Simultaneous recording of isolated motor units in dorsal neck muscles and horizontal eye movements.  Experimental brain research. 1988;  69 399-406
• 2 André-Deshays C, Revel M, Berthoz A. Eye head coupling in humans. II. phasic components.  Experimental brain research. 1991;  84 359-366
• 3 Armstrong B, McNair P, Williams M. Head and Neck Position Sense in Whiplash Patients and Healthy Individuals and the Effect of the Cranio-Cervical Flexion Action.  Clinical Biomechanics. 2005;  20 675-684
• 4 Armstrong B, McNair P, Taylor D. Head and Neck Position Sense.  Sports Medicine. 2008;  38 101-117
• 5 Bolton P. The somatosensory system of the neck and its effects on the central nervous system.  Journal of Manipulative and Physiological Therapeutics. 1998;  21 553-563
• 6 Bove M, Courtine G, Schieppati M. Neck muscle vibration and spatial orientation during stepping in place in humans.  Journal of Neurophysiology. 2002;  88 2232-2241
• 7 Boyd-Clark L, Briggs C, Galea M. Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine.  Spine. 2002;  27 694-701
• 8 Courtine G, Papaxanthis C, Laroche D. et al . Gait-dependent integration of neck muscle afferent input.  Neuroreport. 2003;  14 2365-2368
• 9 Dall’Alba P, Sterling M, Treleaven J. et al . Cervical range of motion discriminates between asymptomatic persons and those with whiplash.  Spine. 2001;  26 2090-2094
• 10 Feipel V, Salvia P, Klein H. et al . Head repositioning accuracy in patients with whiplash-associated disorders.  Spine. 2006;  31 E51-E58
• 11 Fitz-Ritson D. Phasic Exercises for Cervical Rehabilitation after „Whiplash“ trauma.  Journal of Manipulative and Physiological Therapeutics. 1995;  18 21-24
• 12 Gandevia S, McCloskey D, Burke D. Kinaesthetic signals and muscle contraction.  Trends in Neurosciences. 1992;  15 62-65
• 13 Gimse R, Tjell C, Bjørgen I. et al . Disturbed eye movements after whiplash due to injuries to the posture control system.  Journal of Clinical and Experimental Neuropsychology. 1996;  18 178-186
• 14 Hall M, Ferrell W, Sturrock R. et al . The effect of the hypermobility syndrome on knee joint proprioception.  British Journal of Rheumatology. 1995;  34 121-125
• 15 Heikkilä H, Aström P. Cervicocephalic Kinesthetic Sensibility in Patients with Whiplash Injury.  Scandinavian Journal of Rehabilitation Medicine. 1996;  28 133-138
• 16 Heikkilä H, Johansson M, Wenngren B. Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study.  Manual Therapy. 2000;  5 151-157
• 17 Herzog W, Scheele D, Conway J. Electromyographic responses of back and limb muscles associated with spinal manipulative therapy.  Spine. 1999;  24 146-153
• 18 Hides J, Stokes M, Saide M. et al . Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain.  Spine. 1994;  19 165-172
• 19 Hodges P, Richardson C. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds.  Archives of Physical Medicine and Rehabilitation. 1999;  80 1005-10 012
• 20 Humphreys B, Irgens P. The Effect of a Rehabilitation Exercise Program on Head Repositioning Accuracy and Reported Levels of Pain in Chronic Neck Pain Subjects.  Journal of Whiplash & Related Disorders. 2002;  1 99-112
• 21 Jull G, Kristjansson E, Dall’Alba P. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients.  Manual Therapy. 2004;  9 89-94
• 22 Jull G, Falla D, Treleaven J. et al . Retraining Cervical Joint Position Sense: The Effect of Two Exercise Regimes.  Journal of Orthopaedic Research. 2007;  25 404-412
• 23 Kristjansson E, Dall’Alba P, Jull G. Cervicocephalic kinaesthesia: reliability of a new test approach.  Physiotherapy Research International. 2001;  6 224-235
• 24 Kristjansson E, Dall’Alba P, Jull G. A study of five cervicocephalic relocation tests in three different subject groups.  Clinical Rehabilitation. 2003;  17 768-774
• 25 Kristjansson E. The cervical spine and proprioception. Boyling J, Jull G Grieve’s Modern Manual Therapy Edinburgh; Churchill Livingstone 2005 3rd ed
• 26 Kulkarni V, Chandy M, Babu K. Quantitative study of muscle spindles in suboccipital muscles of human foetuses.  Neurology India. 2001;  49 355-359
• 27 Lee H, Teng C, Chai H. et al . Test-retest reliability of cervicocephalic kinesthetic sensibility in three cardinal planes.  Manual Therapy. 2006;  11 61-68
• 28 Lee H, Wang J, Yao G. et al . Association between cervicocephalic kinesthetic sensibility and frequency of subclinical neck pain.  Manual Therapy. 2007;  13 419-425
• 29 Lennerstrand G, Han Y, Velay J. Properties of eye movements induced by activation of neck muscle proprioceptors.  Graefe’s Archive for Clinical and Experimental Ophthalmology. 1996;  324 703-709
• 30 Liu J, Thornell L, Pedrosa-Domellöf F. Muscle spindles in the deep muscles of the human neck: a morphological and immunocytochemical study.  The Journal of Histochemistry and Cytochemistry. 2003;  51 175-186
• 31 Loudon J, Ruhl M, Field E. Ability to reproduce head position after whiplash injury.  Spine. 1997;  22 865-868
• 32 Maffey-Ward L, Jull G, Wellington L. Toward a clinical test of lumbar spine kinesthesia.  The Journal of Orthopaedic and Sports Physical Therapy. 1996;  24 354-358
• 33 Palmgren P, Sandström P, Lundqvist J. et al . Improvement after Chiropractic Care in Cervicocephalic Kinesthetic Sensibility and Subjective Pain Intensity in Patients with Nontraumatic Chronic Neck Pain.  Journal of Manipulative and Physiological Therapeutics. 2006;  29 100-106
• 34 Pearcy M, Hindle R. New method for the non-invasive three-dimensional measurement of human back movement.  Clinical Biomechanics. 1989;  4 73-79
• 35 Provinciali L, Baroni M, Illuminati L. et al . Multimodal Treatment to Prevent the Late Whiplash Syndrome.  Scandinavian Journal of Rehabilitation Medicine. 1996;  28 105-111
• 36 Revel M, Andre-Deshays C, Minguet M. Cervicocephalic kinesthetic sensibility in patients with cervical pain.  Archives of Physical Medicine and Rehabilitation. 1991;  72 288-291
• 37 Revel M, Minguet M, Gergoy P. et al . Changes in Cervicocephalic Kinesthesia after a Proprioceptive Rehabilitation Program in Patients with Neck Pain: A Randomized Controlled Study.  Archives of Physical Medicine and Rehabilitation. 1994;  75 895-899
• 38 Rix G, Bagust J. Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain.  Archives of Physical Medicine and Rehabilitation. 2001;  82 911-919
• 39 Rogers R. The Effects of Spinal Manipulation on Cervical Kinesthesia in Patients with Chronic Neck Pain: A Pilot Study.  Journal of Manipulative and Physiological Therapeutics. 1997;  20 80-85
• 40 Schmid A, Brunner F, Wright A. et al . Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation.  Manual Therapy. 2008;  13 387-396
• 41 Sjölander P, Michaelson P, Jaric S. et al . Sensorimotor disturbances in chronic neck pain – Range of motion, peak velocity, smoothness of movement, and repositioning acuity.  Manual Therapy. 2006;  13 122-131
• 42 Söderlund A, Olerud C, Lindberg P. Acute whiplash-associated disorders (WAD): the effects of early mobilization and prognostic factors in long-term symptomatology.  Clinical Rehabilitation. 2000;  14 457-467
• 43 Spitzer W, Skovron M, Salmi L. et al . Scientific monograph of the Quebec Task Force on whiplash associated disorders: redifining “Whiplash” and its management.  Spine. 1995;  20 1-73
• 44 Sterling M, Jull G, Vicenzino B. et al . Characterization of Acute Whiplash-Associated Disorders.  Spine. 2004;  29 182-188
• 45 Taimela S, Takala E, Asklöf T. et al . Active Treatment of Chronic Neck Pain.  Spine. 2000;  25 1021-1027
• 46 Teng C, Chai H, Lai D. et al . Cervicocephalic kinesthetic sensibility in young and middle-aged adults with or without a history of mild neck pain.  Manual Therapy. 2007;  12 22-28
• 47 Tjell C, Rosenhall U. Smooth pursuit neck torsion test: a specific test for cervical dizziness.  The American Journal of Otology. 1998;  19 76-81
• 48 Treleaven J, Jull G, Sterling M. Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error.  Journal of Rehabilitation Medicine. 2003;  35 36-43
• 49 Treleaven J, Jull G, LowChoy N. Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety.  Journal of Rehabilitation Medicine. 2005;  37 219-237
• 50 Treleaven J. Sensimotor disturbances in neck disorders affecting postural stability, head and eye movement control.  Manual Therapy. 2008;  13 2-11
• 51 Uremović M, Cvijetić S, Pasić M B. et al . Impairment of proprioception after whiplash injury.  Collegium Antropologicum. 2007;  31 823-827
• 52 Verhagen A, Vet de H, Bie de R. et al . The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus.  Journal of Clinical Epidemiology. 1998;  51 1235-1241
• 53 Vernon H, Mior S. The Neck disability index: a study of reliability and validity.  Journal of Manipulative and Physiological Therapeutics. 1991;  14 409-415
• 54 Vernon H. Qualitative review of studies of manipulation-induced hypoalgesia.  Journal of Manipulative and Phyiological Therapeutics. 2000;  23 134-138
• 55 Vicenzino B, Collins D, Benson H. et al . An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation.  Journal of Manipulative and Physiological Therapeutics. 1998;  21 448-453
• 56 Woolf C. A new strategy for the treatment of inflammatory pain. Prevention or elimination of central sensitization.  Drugs. 1994;  47 1-9
• 57 Wright A. Hypoalgesia post-manipulative therapy: a review of a potential neurophysiological mechanism.  Manual Therapy. 1995;  1 11-16
• 58 www.pedro.fhs.usyd.edu.au/ german/tutorial_german.html

1 Die Arbeit wurde im Rahmen des SVOMP-Nachdiplomstudiums zur Dipl.-Manualtherapeutin OMT SVOMP erstellt.