颈椎旋转(提)手法的在体力学测量

Mechanical measurement during cervical rotational manipulation in vivo

目的:研究颈椎旋转手法操作过程中力学参数的特征及其相互关系。方法:运用生物力学实测方法测量同一操作者对15例患者施行旋转手法过程中的力学参数(作用力、作用时间和加速度),再通过数学方法,计算出旋转手法扳动过程所产生的位移及冲量。结果:①颈椎旋转手法的力学参数平均值:预加载力15.15±5.11kg,最大作用力27.24±8.81kg,扳动力14.29±5.15kg,扳动时间114.33±16.98ms,最大加速度为-0.35±0.11g,扳动位移为9.34±2.67mm,扳动冲量为22.49±7.11Ns;②左手操作与右手操作的旋转手法力学参数相比较,除最大加速度、扳动时间和扳动冲量以外,余项P值均>0.05,差异无显著性意义;③预加载力和扳动力相比较,两者间差异无显著性意义(P>0.05);④经Pearson相关分析,预加载力、最大作用力和扳动力呈显著的正相关性(R>0.8,P<0.001)。结论:左右手施行旋转手法时作用力特征(包括预加载力、最大作用力、扳动力)是相近的;旋转手法从缓慢上牵开始到扳动操作结束整个过程具有一定的规律性:扳动力的大小取决于预加载力的大小。

Objective：To study the characteristics and the correlation of mechanical parameters during cervical rotational manipulation. Method： Biomechanical method was adopted to measure the mechanical parameters during cervical rotational manipulation that performed by the same therapist in 15 patients. The displacement and the thrust impulse that happened during cervical manipulation can be counted by mathematical calculation. Result： （1） The average value of parameters during cervical rotational manipulation were as follows： Preload force was 15.15± 5.11kg; Peak force was 27.24±8.81kg; Thrust force was 14.29±5.15kg; Thrust duration was 114.33±16.98ms; Peak acceleration was -0.35±0.11g; Thrust displacement was 9.34±2.67mm; Thrust impulse was 22.49±7.11Ns; （2） Except the peak acceleration,thrust duration and thrust impulse, the mechanical parameters of rotational manipulation were no difference between the performance of the left hand and the right （P〉0.05）; （3）The preload force of rotational manipulation was similar to the thrust force （P〉0.05）. （4）The preload force,peak force and thrust force were of prominent positive correlation by Pearson correlation analysis（R〉0.8,P〈0.001）.Condusion：The characteristics of force during manipulation （include preload,peak force and thrust force） were paralleled between left side operation and right. The process of cervical rotational manipulation should obey some rules, such as from slow traction to rapidly thrusting, and the thrust force was depended on preload force.