整复手法对骶髂关节错位骨盆及下肢生物力学的影响

The Effect of Orthopedic Manipulation on the Biomechanics of Sacroiliac Joint Dislocation in the Pelvis and Lower Limbs

目的:观察骶髂关节错位患者在整复手法复位后腰背肌肌张力和对称性,骨盆、下肢生物力学的变化。方法:选取2022年5月至2023年3月期间就诊于福建中医药大学附属第二人民医院的骶髂关节错位患者120例,先理筋手法,再行整复手法,前错位60例,采用屈髋屈膝复位法,后错位60例,采用后伸扳法,隔日治疗1次,共治疗7次。对比治疗前后VAS评分、后表链肌张力K值、后表链肌张力对称值、骨盆倾斜、扭转、水平旋转情况,以及下肢支撑相、摆动相、足偏角的变化。结果:治疗后,骶髂关节前、后错位患者的VAS评分,后表链肌张力系数K值、肌张力对称性差值均较治疗前降低(P<0.05);治疗后,骶髂关节前、后错位患者的骨盆的倾斜、扭转、水平旋转角度均较治疗前减小(P<0.05);治疗后,骶髂关节前、后错位患者的步态周期中的支撑相较治疗前延长(P<0.05),摆动相较治疗前缩短(P<0.05),骶髂关节前错位患者较治疗前足偏角变大(P<0.05),后错位患者足偏角较治疗前变小(P<0.05)。结论:整复手法可以降低骶髂关节错位患者腰背肌肌张力,使两侧腰背肌趋于平衡,且能纠正骨盆的偏歪,改善下肢步态。

Objective:To observe the changes in tension and symmetry of the lumbar dorsal muscle,as well as the biomechanics of the pelvis and lower limbs in patients with sacroiliac joint dislocation after reduction with reduction techniques.Method:120 patients with sacroiliac joint dislocation,including 60 cases of anterior and 60 cases of posterior dislocation,were selected from the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from May 2022 to March 2023.Muscle management techniques were performed first,followed by reduction techniques.The anterior dislocation was treated with hip flexion and knee flexion reduction,while the posterior dislocation was treated with posterior extension and pulling.The treatment was performed once every other day,with a total of 7 treatments.Compare the VAS score,K value of posterior catenary muscle tension,symmetrical value of posterior catenary muscle tension,pelvic tilt,torsion,horizontal rotation,as well as changes in lower limb support phase,swing phase,and foot deviation angle before and after treatment.Result:After treatment,the VAS scores,posterior superficial chain muscle tone coefficient K values,and muscle tone symmetry difference values of patients with anterior and posterior misalignment of sacroiliac joints were reduced compared with those before treatment(P<0.05);after treatment,the tilt,torsion,and horizontal rotation angles of the pelvis of patients with anterior and posterior misalignment of sacroiliac joints were reduced compared with those before treatment(P<0.05);after treatment,the gait cycle of patients with anterior and posterior misalignment of sacroiliac joints in the support phase was lengthened(P<0.05)and swing phase was shortened(P<0.05)compared with the pre-treatment phase,the foot deviation angle became larger(P<0.05)in patients with anterior misalignment of sacroiliac joints compared with the pre-treatment phase,and the foot deviation angle in patients with posterior misalignment became smaller(P<0.05)compared with the pre-treatment phase.Conclusion:Reconstructive techniques can reduce the tension of the lower back muscles in patients with sacroiliac joint dislocation,balance both sides of the lower back muscles,correct pelvic deviation,and improve lower limb gait.