[1]霍路遥 符碧峰 冯天笑 卜寒梅 苏瑾 吴思 李远栋 王平△ 冯敏山 杨光.颈椎旋提手法教学机器人用于旋提手法规范化培训的自身对照研究[J].中国中医骨伤科杂志,2021,29(05):6-11.
　HUO Luyao FU Bifeng FENG Tianxiao BU Hanmei SU JinWU Si LI Yuandong WANG Ping FENG Minshan YANG Guang.A Self-Controlled Study of Cervical Rotatory LiftingManipulation Teaching Robot for StandardizedTraining of Rotatory Lifting Manipulation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(05):6-11.
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颈椎旋提手法教学机器人用于旋提手法规范化培训的自身对照研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年05期
页码:
6-11
栏目:
实验研究
出版日期:
2021-05-15

文章信息/Info

Title:
A Self-Controlled Study of Cervical Rotatory LiftingManipulation Teaching Robot for StandardizedTraining of Rotatory Lifting Manipulation
文章编号:
1005-0205(2021)05-0006-06
作者:
霍路遥1 符碧峰1 冯天笑1 卜寒梅1 苏瑾1 吴思1 李远栋1 王平1△ 冯敏山2 杨光1
1天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,国家中医药管理局区域中医骨伤科诊疗中心(天津,300192)2中国中医科学院望京医院
Author(s):
HUO Luyao1 FU Bifeng1 FENG Tianxiao1 BU Hanmei1 SU Jin1WU Si1 LI Yuandong1 WANG Ping1△ FENG Minshan2 YANG Guang1
1First Teaching Hospital of Tianjin University of Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Regional Orthopedics and Traumatology Diagnosis and Treatment Center of National Administration of Traditional Chinese Medicine,Tianjin 300192,China; 2Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 101002,China.
关键词:
颈椎旋提手法;  教学机器人;  规范化培训;  自身对照
Keywords:
cervical rotatory lifting manipulation;  teaching robot;  standardized training;  self-controlled study
分类号:
R681.5
文献标志码:
A
摘要:
目的:评价旋提手法教学机器人在颈椎旋提手法操作规范化培训中的效果。方法:选取已熟练掌握颈椎治疗手法且临床工作5 a以上的20名骨伤科医师,通过旋提手法教学机器人采集每位医师在体质量指数(BMI)设定为正常状态下的手法操作的关键力学参数(预牵引力、提扳力、最大作用力、提扳时间、旋转幅度、俯仰幅度)。然后通过旋提手法教学机器人对20名医师进行2周手法规范化培训,培训后再次使用该系统进行考核并采集数据。比较培训前和培训后总合格率、合格次数、变异系数(CV)等数据指标。结果:培训前总合格率为25%,合格次数为1.30(1,1.75); 培训后总合格率为90%,合格次数为2.50(2,3),P值均<0.05,差异有统计学意义(χ2=17.289,Z=-3.510)。培训前预牵引力、提扳力、最大作用力合格率分别为73.30%、36.70%、26.70%,培训后分别为95.00%、91.70%、90.00%,P值均<0.05,差异有统计学意义; 培训前后的提扳时间、旋转幅度、俯仰幅度合格率经检验P值分别为0.079、0.591、0.094,差异无统计学意义。培训前预牵引力(15.41±5.42)N、提扳力(9.75±4.77)N、最大作用力(19.15±6.72)N的变异系数分别为0.352、0.489、0.351,培训后预牵引力(16.46±1.44)N、提扳力(9.98±1.99)N、最大作用力(26.70±3.72)N的变异系数分别为0.087、0.199、0.139,培训后受力作用参数更加稳定。结论:旋提手法教学机器人用于颈椎旋提手法规范化培训的效果良好,经过培训可达到手法操作的标准统一化。
Abstract:
To evaluate the efficacy of rotator manipulation teaching robot in the standardized training of cervical vertebra rotator manipulation.Methods:20 orthopedic surgeons who have mastered cervical vertebra treatment techniques and worked clinically for more than 5 years were selected.The key mechanical parameters(pre-traction force,pull-up force,maximum acting force,pull-up time,rotation amplitude,pitch amplitude)of each doctor’s manual operation under the normal state set by body mass index(BMI)were collected by the rotary pull-up manual teaching robot.Then,20 doctors were given a 2-week standardized training of manipulation by the rotary manipulation teaching robot.After the training,the system was used again for assessment and data collection.The total pass rate,pass times,coefficient of variation(CV)and other data before and after training were compared.Results:The total pass rate was 25%,and the pass times were 1.30(1,1.75)before training.After training,the total pass rate was 90%,the pass times were 2.50(2,3)(P<0.05),and the difference was statistically significant(χ2=17.289,Z=-3.510).The qualification rates of pre-traction,pulling force and maximum force before training were 73.30%,36.70% and 26.70% respectively,and those after training were 95.00%,91.70% and 90.00% respectively(P<0.05),and those differences were statistically significant.After the training,the pass rate of lift and pull time,rotation amplitude and pitch amplitude were 0.079,0.591 and 0.094 respectively,with no statistical significance.The CV of pre-traction(15.41±5.42)N,pulling force(9.75±4.77)N and maximum force(19.15±6.72)N before training were 0.352,0.489 and 0.351 respectively,and the CV of pre-traction(16.46±1.44)N,pulling force(9.98±1.99)N and maximum force(26.70±3.72)N after training were 0.087,0.199 and 0.139 respectively.The mechanical parameters were more stable after training.Conclusion:The robot can be used in the standardized training of cervical vertebra rotation technique,and the training can reach the unified standard of manipulation after training.

参考文献/References:

[1] 张少群,李义凯.颈椎病研究的历史沿革[J].中国康复医学杂志,2016,31(11):1273-1276.
[2] 许鸿智,林定坤,侯宇,等.以控制机械刺激为核心的治疗体系治疗中老年神经根型颈椎病的生存质量评价[J].新中医,2019,51(1):244-247.
[3] 吴烨族,林桦楠,陈海鹏,等.神经根型颈椎病的保守治疗进展[J].风湿病与关节炎,2019,8(11):69-72.
[4] 王乾,朱立国,高景华,等.旋提手法治疗神经根型颈椎病的疗效观察[J].中医正骨,2009,21(6):9-11.
[5] 朱立国,于杰,高景华,等.旋转手法治疗神经根型颈椎病对疼痛的VAS评分临床研究[J].北京中医,2005,24(5):297-298.
[6] 舒琴,李迪,孙扬,等.基于变异系数计算的DRG本土化应用分析及建议[J].中国医院管理,2019,39(8):43-45.
[7] 邓小虹.CN-DRGs分组方案(2014版)[M].北京:中国医药科技出版社,2015.
[8] NGAN J M W,CHOW D H K,HOLMES A D,et al.The kinematics and intra and inter therapist consistencies of lower cervical rotational manipul ation[J].Med Eng Phys,2005,27(5):395-401.
[9] 余顺年,马履中,郭宗和.中医推拿手法运动学与动力学特征[J].山东理工大学学报(自然科学版),2005,19(3):84.
[10] 周信文,许世雄,谢志勇,等.中医推拿手法测力分析控FZ-1-型的研制及滚法合力作用点轨迹分析[J].医用生物力学,1996,11(3):179-181.
[11] TRIANO J J,SCHULTZ A B.Motions of the head and thorax during neck manipulation[J].J Mamipulative Physiol Ther,1994,17(9):573-583.
[12] 殷苏民,陆焱焱,谭海坡,等.心肺复苏模拟人控制系统的设计[J].传感器与微系统,2010,29(5):109-115.
[13] 施楚君,陈葵,许杰州,等.医学模拟技术在临床急救技能教学中的应用探索[J].中国高等医学教育,2008,(8):101-103.
[14] SNYDER C W,VANDROMME M J,TYRA S L,et al.Effects of virtual reality simulator training method and observational learning on surgical performance[J].World JSurg,2011,35(2):245-252.
[15] 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.
[16] 付铁,张庆东,李健,等.旋提操作教学机器人的研究与应用探索[J].机械设计与制造,2020(10):270-272.
[17] 朱立国,韩涛,于杰,等.中医骨伤科旋提手法规范化操作传承模式初探[J].中医杂志,2018,59(11):927-931.
[18] 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.
[19] 冯敏山,朱立国,王尚全,等.颈椎旋提手法教学机器人的稳定性研究[J].中国骨伤,2017,30(3):241-246.
[20] 潘建西,李泽佳,宋敏,等.中医骨伤科学术流派的传承现状[J].西部中医药,2016,29(2):61-64.

备注/Memo

备注/Memo:
基金项目:国家中医药管理局中医药循证能力建设项目(2019XZZX-GK006)天津市教委科研计划项目(2019KJ064)
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更新日期/Last Update: 2021-05-15