Observation of the Dynamics of a Clinical Picture in a Chronic Cervicobrachial Syndrome with the Aid of the Principles of McKenzie Concept
Abstract
Aim: Comparison of the intensity of the selected indicators (disability, pain intensity, motion range, m. trapezius and m. sternocleidomastoideus tone) in the course of treatment in two groups of patients with posterior derangement compared with posterolateral derangement, with lateral flexion dysfunction within the framework of classification by McKenzie method. Patient sample: The research sample consisted of 33 patients with chronic pain in cervical spine, clinically evaluated as cervicobrachial syndrome.
The patients were divided into two groups. Both groups were treated with McKenzie method.
The first group consisted of patients with a posterior derangement (n=10). The second group consisted of patients with combination of a posterior derangement and dysfunction into lateral flexion (n=23).
Evaluation methods: The disability was evaluated by Neck disability index (NDI) questionnaire. For the evaluation of pain intensity the Pain disability index /PDI/ was used.
The motion range was measured by goniometry in degrees. For the measurement of m. trapezius and m. sternocleidomastoideus muscle tone the surface EMG method was used by means of 2-channel EMG-biofeedback 2000 x-pert, Firm Schuhfried (in μV).
Results: In the 1. group, the assessment of disability, pain intensity and cervical spine motion range , and monitored muscles tone showed after one month and subsequently three months after the treatment a significant drop of monitored parameters (p<0.01) which is the evidence of clinical improvement. In the 2nd group a significant reduction in disability, pain intensity and motion range increase followed one month after the treatment (p<0.01) due to derangement reduction.
Three months after the treatment, compared with the first group, there was no further clinical improvement. In the second group no significant muscle tone change in the monitored muscles occurred probably due to the occurrence of lateral flexion dysfunction.
Conclusion: In the course of the treatment we were able to record the changes of the parameters monitored which were in compliance with the clinical picture of the syndromes according to McKenzie.