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[1]鄧真,王輝昊,王寬,等.石氏傷科頸椎定位旋轉(zhuǎn)扳法的動力學參數(shù)在體測量[J].中醫(yī)正骨,2018,30(03):17-21.
　DENG Zhen,WANG Huihao,WANG Kuan,et al.In vivo measurement of kinetic parameters of cervical fixed-position rotary pulling manipulation of Shi's department of traumatology[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(03):17-21.
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石氏傷科頸椎定位旋轉(zhuǎn)扳法的動力學參數(shù)在體測量()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年03期
頁碼:
17-21
欄目:
頸椎疾患
出版日期:
2018-03-20

文章信息/Info

Title:
In vivo measurement of kinetic parameters of cervical fixed-position rotary pulling manipulation of Shi's department of traumatology
作者:
鄧真; 王輝昊; 王寬; 沈知彼; 陳威燁; 詹紅生
上海中醫(yī)藥大學附屬曙光醫(yī)院,上海市中醫(yī)藥研究院骨傷科研究所,上海 201203
Author(s):
DENG Zhen; WANG Huihao; WANG Kuan; SHEN Zhibi; CHEN Weiye; ZHAN Hongsheng
Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,The Institute of Traumatology and Orthopedics Affiliated to Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203,China
關鍵詞:
頸椎;  手法; 整骨;  扳法;  動力學
Keywords:
Keywords cervical vertebrae;  manipulation; osteopathic;  pulling manipulation;  kinetics
摘要:
目的:探討石氏傷科頸椎定位旋轉(zhuǎn)扳法動力學參數(shù)的特征及各參數(shù)之間的相互關系。方法:招募34名無明顯手法治療禁忌證的健康志愿者,男29名、女5名,年齡(22.30±4.60)歲。由同一位操作者分別對所有受試者進行石氏傷科頸椎定位(C5棘突)旋轉(zhuǎn)扳法操作,左右兩側(cè)各操作1次。手法操作前,分別在受試者C5棘突兩側(cè)和雙側(cè)頦結(jié)節(jié)處粘貼測力片。采用Runinsense運動力學測量系統(tǒng)記錄測定的力-時間曲線圖,通過分析力-時間曲線圖獲取預載荷、載荷峰值、扳動力、扳動時間和施術(shù)時間等動力學參數(shù)。結(jié)果:34名受試者全部完成試驗,未發(fā)生不良事件。左右兩側(cè)施術(shù)時間比較,差異無統(tǒng)計學意義[(2 362.65±559.28)ms,(2 403.24±645.33)ms,t=3.591,P=0.631]。C5棘突左側(cè)的預載荷、扳動力均大于右側(cè)[(7.84±4.03)kg,(6.42±3.20)kg,t=3.374,P=0.042;(6.93±3.21)kg,(6.90±2.36)kg,t=3.363,P=0.049]; C5棘突兩側(cè)的載荷峰值、扳動時間比較,兩側(cè)間差異均無統(tǒng)計學意義[(14.78±4.78)kg,(13.33±4.50)kg,t=3.202,P=0.069;(159.12±34.50)ms,(148.82±33.00)ms,t=3.271,P=0.056]。左側(cè)頦結(jié)節(jié)處的載荷峰值、扳動力均大于右側(cè)[(7.68±2.90)kg,(6.68±2.82)kg,t=3.025,P=0.034;(4.49±2.10)kg,(3.42±2.03)kg,t=3.403,P=0.017],扳動時間小于右側(cè)[(165.59±33.59)ms,(182.94±55.21)ms,t=3.786,P=0.025]; 雙側(cè)頦結(jié)節(jié)處的預載荷比較,差異無統(tǒng)計學意義[(3.18±1.29)kg,(3.27±1.30)kg,t=3.423,P=0.067]。C5棘突左側(cè)的扳動時間比右側(cè)頦結(jié)節(jié)處的扳動時間短(t=3.356,P=0.042),C5棘突右側(cè)的扳動時間比左側(cè)頦結(jié)節(jié)處的扳動時間短(t=3.307,P=0.038)。左側(cè)頸椎定位旋轉(zhuǎn)扳法操作時,C5棘突左側(cè)的預載荷與載荷峰值呈正相關(r=0.747,P=0.000); 載荷峰值與扳動力呈正相關(r=0.551,P=0.003); C5棘突左側(cè)其他動力學參數(shù)相互之間均不存在直線相關關系。右側(cè)頦結(jié)節(jié)處的預載荷與載荷峰值、扳動力均呈正相關(r=0.756,P=0.001; r=0.413,P=0.023); 載荷峰值與扳動力呈正相關(r=0.908,P=0.007); 右側(cè)頦結(jié)節(jié)處的其他動力學參數(shù)相互之間均不存在直線相關關系。右側(cè)頸椎定位旋轉(zhuǎn)扳法操作時,C5棘突右側(cè)的預載荷與載荷峰值呈正相關(r=0.861,P=0.002),與扳動時間呈負相關(r=-0.434,P=0.031); 載荷峰值與扳動力呈正相關(r=0.728,P=0.001); C5棘突右側(cè)的其他動力學參數(shù)相互之間均不存在直線相關關系。左側(cè)頦結(jié)節(jié)處的預載荷與載荷峰值、扳動力均呈正相關(r=0.758,P=0.002; r=0.434,P=0.027); 載荷峰值與扳動力呈正相關(r=0.917,P=0.000); 左側(cè)頦結(jié)節(jié)處的其他動力學參數(shù)相互之間均不存在直線相關關系。結(jié)論:在頸椎兩側(cè)施行石氏傷科頸椎定位旋轉(zhuǎn)扳法的施術(shù)時間相同,但作用力特征存在一定差異; 手法操作過程具有“寸勁”的特征; 手法作用力的大小與預載荷有關。
Abstract:
ABSTRACT Objective:To explore the characteristics of kinetic parameters of cervical fixed-position rotary pulling manipulation of Shi's department of traumatology and the relationship between these parameters.Methods:Thirty-four healthy volunteers without obvious contraindications for manipulation were recruited.They consisted of 29 males and 5 females and their ages were 22.30+/-4.60 years.The cervical fixed-position(C5 spinous process)rotary pulling manipulation of Shi's department of traumatology was performed on all subjects by the same doctor on the left and the right side respectively.Force measuring sensors were fixed on both sides of C5 spinous process and bilateral mental tubercles of subjects before the manipulation.The force-time curve chart was drawn and recorded by using Runinsense kinematic measuring system.The kinetic parameters,including preload,peak load,thrust force,thrust time and operating time,were obtained through analyzing the force-time curve chart.Results:The trials were finished in all subjects and no adverse events occurred.There was no statistical difference in operating time between the left side and the right side(2 362.65+/-559.28 vs 2 403.24+/-645.33 ms,t=3.591,P=0.631).The preload and the thrust force were greater on the left side compared to the right side of C5 spinous process(7.84+/-4.03 vs 6.42+/-3.20 kg,t=3.374,P=0.042; 6.93+/-3.21 vs 6.90+/-2.36 kg,t=3.363,P=0.049).There was no statistical difference in peak load and thrust time between the left side and the right side of C5 spinous process(14.78+/-4.78 vs 13.33+/-4.50 kg,t=3.202,P=0.069; 159.12+/-34.50 vs 148.82+/-33.00 ms,t=3.271,P=0.056).The peak load and the thrust force were greater and the thrust time was shorter on the left mental tubercle compared to the right mental tubercle(7.68+/-2.90 vs 6.68+/-2.82 kg,t=3.025,P=0.034; 4.49+/-2.10 vs 3.42+/-2.03 kg,t=3.403,P=0.017; 165.59+/-33.59 vs 182.94+/-55.21 ms,t=3.786,P=0.025).There was no statistical difference in preload between the bilateral mental tubercles(3.18+/-1.29 vs 3.27+/-1.30 kg,t=3.423,P=0.067).The thrust time was shorter on the left side of C5 spinous process compared to the right mental tubercle(t=3.356,P=0.042),and was shorter on the right side of C5 spinous process compared to the left mental tubercle(t=3.307,P=0.038).When cervical fixed-position rotary pulling manipulation was performed on the left side,the preload was positively correlated with the peak load on the left side of C5 spinous process(r=0.747,P=0.000),and the peak load was positively correlated with the thrust force(r=0.551,P=0.003).There was no linear correlation between other kinetic parameters on the left side of C5 spinous process.The preload was positively correlated with the peak load and the thrust force(r=0.756,P=0.001; r=0.413,P=0.023)and the peak load was positively correlated with the thrust force(r=0.908,P=0.007)at the right mental nodule.There was no linear correlation between other kinetic parameters on the right mental nodule.When cervical fixed-position rotary pulling manipulation was performed on the right side,the preload was positively correlated with the peak load(r=0.861,P=0.002)and was negatively correlated with the thrust time(r=-0.434,P=0.031)and the peak load was positively correlated with the thrust force(r=0.728,P=0.001)on the right side of C5 spinous process.There was no linear correlation between other kinetic parameters on the right side of C5 spinous process.The preload on the left mental nodule was positively correlated with the peak load and the thrust force(r=0.758,P=0.002; r=0.434,P=0.027),and the peak load was positively correlated with the thrust force(r=0.917,P=0.000).There was no linear correlation between other kinetic parameters on the left mental nodule.Conclusion:The operating time is the same and the characteristics of applied force is a little different when cervical fixed-position rotary pulling manipulation of Shi's department of traumatology is performed on both sides of cervical vertebrae.“High-velocity low-amplitude”is the characteristic of the manipulation,and the magnitude of the applied force is related to that of the preload.

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備注/Memo

備注/Memo:
基金項目:國家自然科學基金項目(81473702,81503596,81202707,81001528); 上海市科學技術(shù)委員會科研計劃項目(14401970402,16401970102,15401934100); 上海市衛(wèi)生和計劃生育委員會項目(2017ZZ02024,20170242,ZXYXZ201703,ZYKC201602006,ZY3-LCPT-2-1005); 上海市市級醫(yī)院新興前沿技術(shù)聯(lián)合攻關項目(SHDC12014121); 詹紅生上海市名老中醫(yī)學術(shù)經(jīng)驗研究工作室建設項目(SHGZS-2017025,SZYMZYGZS4013) 通訊作者:王輝昊 E-mail:[email protected]
更新日期/Last Update: 2018-08-02