[1]周红海,苏少亭△,秦明芳,等.颈椎定点旋转手法运动学及相关个体影响因素研究[J].中国中医骨伤科杂志,2018,26(12):24-29.
　ZHOU Honghai SU Shaoting QIN Mingfang LU Yan TIAN Junming.Study on the Kinematics of Cervical Spindle Rotation Manipulation and Related Individual Influencing Factors[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(12):24-29.
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颈椎定点旋转手法运动学及相关个体影响因素研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年12期
页码:
24-29
栏目:
临床研究
出版日期:
2018-12-03

文章信息/Info

Title:
Study on the Kinematics of Cervical Spindle Rotation Manipulation and Related Individual Influencing Factors
文章编号:
1005-0205(2018)12-0024-06
作者:
周红海1; 苏少亭1△; 秦明芳2; 陆延1; 田君明1
1广西中医药大学骨伤学院(南宁,530001) 2广西中医药大学附属瑞康医院 △通信作者 E-mail:787456782@qq.com
Author(s):
ZHOU Honghai1 SU Shaoting1△ QIN Mingfang2 LU Yan1 TIAN Junming1
1College of Orthopaedics and Traumatology,Guangxi University of Traditional Chinese Medicine,Nanning 530001,China; 2Ruikang Hospital Affiliated To Guangxi University of Traditional Chinese Medicine,Nanning 530001,China.
关键词:
颈椎;  定点旋转手法;  寰枢关节;  运动学;  个体影响因素
Keywords:
cervical vertebrae;  fixed rotation manipulation;  atlanto-axial joint;  kinematics;  individual influencing factors
分类号:
R681.5
文献标志码:
A
摘要:
目的:研究颈椎定点旋转手法操作的在体运动学参数并进行初步分析验证,并在患者颈椎正侧位+开口位X线片上测量相关个体参数指标,分析其对颈椎定点旋转手法的影响,从而增加手法操作的科学性与规范性。方法:手法操作前在患者X线片测量相关个体参数(寰椎前后弓长度、枢椎前后长度、寰椎前弓宽度、枢椎宽度、寰椎倾斜角、枢椎倾斜角、寰椎椎弓根高度、枢椎椎弓根高度、齿状突横经、寰枢关节最大纵径); 采用运动捕捉系统获取30例诊断为寰枢关节紊乱的患者在接受颈椎定点旋转手法治疗过程中相关运动学参数(前屈角度、侧屈角度、旋转角度、再扳旋角度差),再分析不同患者个体骨性结构参数的差异对定点旋转手法的影响。结果:1)初步获得颈椎定点旋转手法相关参考数值:前屈角度35.69°±4.09°,侧屈角度34.94°±3.47°,旋转角度31.12°±2.76°,再扳旋角度差4.50°±1.05°,操作者左、右手施展颈椎定点旋转手法过程中的运动学参数差异均无统计学意义(P>0.05)。2)多元线性回归分析结果:枢椎倾斜角是前屈角度的重要影响因素; 寰椎前后弓长度、枢椎椎弓根高度是侧屈角度的重要影响因素; 寰枢关节纵径、枢椎倾斜角、枢椎前后长度是旋转角度的重要影响因素; 寰椎前后弓长度是再旋转角度的重要影响因素。结论:颈椎定点旋转手法是集合前屈、侧屈、旋转为一体的复合动作,同一施术者左右手操作无差异,不同患者的个体参数会影响该手法操作。
Abstract:
Objective:To study the in vivo kinematics parameters of cervical fixed-point rotation manipulation, and measure the related bone structure parameters on the X-rays of the patients to analyze the influence of the fixed-point rotation manipulation on the cervical spine, so as to increase the scientific and normative nature of the manipulation. Methods: The bone structure parameters(anterior and posterior length of atlas, anterior and posterior length of axis, width of anterior arch of atlas, width of axis, angle of inclination of atlas, angle of inclination of axis, height of pedicle of atlas)were measured before manipulation. Axial pedicle height, odontoid transverse meridian, maximum longitudinal diameter of atlantoaxial joint, kinematics parameters(flexion angle)of 30 patients diagnosed as atlantoaxial joint disorder were obtained by motion capture system. The influence of different individual bone structure parameters on fixed point rotation manipulations was analyzed. Results: 1)The reference values of cervical spine rotation manipulation were obtained: flexion angle(35.69°±4.09°), lateral flexion angle(34.94°±3.47°), rotation angle(31.12°±2.76°), rotation angle difference(4.50°±1.05°). There was no significant difference in the kinematic parameters between the left and right hand in the process of cervical vertebra fixed-point rotation(P>0.05). 2)The results of multiple linear regression analysis showed that: the angle of inclination of axis was an important factor affecting the angle of anterior flexion; the length of the anterior and posterior arch of atlas and height of pedicle of axis are important factors influencing lateral flexion angle; the longitudinal diameter of atlantoaxial joint, the angle of inclination of axis and the length of anterior and posterior axis are the important factors influencing rotation angle, and the length of anterior and posterior arch of atlas is the important factor of rerotation angle. Conclusion: The fixed-point rotation manipulation of cervical vertebrae is a combination of flexion, lateral flexion and rotation. There is no significant difference between the left and right hand operation of the same operator, and the individual parameters of different patients will affect the manipulation.

参考文献/References:

[1] 韦贵康.脊柱相关疾病学[M].北京:人民卫生出版社,2012.
[2] 王宽,邓真,王辉昊,等.力学测量在评估颈痛及手法治疗领域的应用[J].中国骨伤,2016,29(7):668-672.
[3] 韦以宗.中医整脊学供中医整脊学专业用[M].北京:中国中医药出版社,2016.
[4] 冯天有.中西医结合治疗软组织损伤的临床研究[M].北京:中国科学技术出版社,2002.
[5] Krott NL,Bloyinski GM,Cattrysse E.3-Dimensional cervical movement characteristics and the influence of thoracic treatment on a subgroup of acute neck pain patients[J].Journal of Manipulative & Physiological Therapeutics,2018,41(4):304-314.
[6] 李义凯.脊柱推拿生物力学研究的几个关键问题[J].医用生物力学,2013,28(3):255-258.
[7] 高春雨,冯敏山,朱立国,等.坐位腰椎旋转手法的在体力学参数及相关影响因素研究[J].中国中医骨伤科杂志,2018,26(8):21-25.
[8] 冯敏山,朱立国,王尚全,等.颈椎旋提手法学习过程中常见操作错误分析[J].中国中医骨伤科杂志,2017,25(8):43-47.
[9] Howarth SJ,Callaghan JP.Compressive force magnitude and intervertebral joint flexion/extension angle influence shear failure force magnitude in the porcine cervical spine.[J].Journal of Biomechanics,2012,45(3):484-490.
[10] Facchinato AP,Benedicto CC,Mora AG,et al.Clinical competency evaluation of Brazilian chiropractic interns[J].Journal of Chiropractic Education,2015,29(2):145-149.
[11] Pei Y,Mathematics DO,University TN.The influence of interpolation algorithm in the digital elevation model on slope and aspect-take mountain li as an example[J].Journal of Taiyuan Normal University,2017,11(3):89-97.
[12] 朱立国,冯敏山,魏戌,等.个体因素对颈椎旋提手法操作影响的在体力学研究[J].中国中医骨伤科杂志,2011,19(9):14-17.
[13] Hubbard TA,Pickar JG,Lawrence DJ.Radiographic analysis of the anterior to posterior open mouth(APOM)cervical spine view:frequency of atlas transverse process overlap of the inferior tip of the mastoid process[J].Journal of Manipulative & Physiological Therapeutics,2012,35(6):477-485.
[14] Anderst W,Rynearson B,West T,et al.Dynamic in vivo 3D atlantoaxial spine kinematics during upright rotation[J].Journal of Biomechanics,2017,26(3):60-64.
[15] Dugailly PM,Sobczak S,Van GB,et al.Head-trunk kinematics during high-velocity-low-amplitude manipulation of the cervical spine in asymptomatic subjects:helical axis computation and anatomic motion modeling[J].Journal of Manipulative & Physiological Therapeutics,2015,38(6):416-424.
[16] Williams S.Chiropractors' perception of occupational stress and its influencing factors:a qualitative study using responses to open-ended questions[J].Chiropractic & Manual Therapies,2016,24(1):1-7.

备注/Memo

备注/Memo:
基金项目:广西壮族自治区教育厅科研项目(200420) 广西壮族自治区卫生厅科研项目(ZD200857)
更新日期/Last Update: 2018-12-03