基于运动捕捉技术比较2种颈椎手法治疗后颈椎活动范围的差异

Comparison of motion range of cervical spine after two cervical manipulations based on motion capture technique

背景:颈椎旋转手法治疗神经根型颈椎病疗效肯定,但手法使用不当易造成不良后果。通过对比临床上较为常用且均有一套标准操作流程的斜扳与旋提手法,为临床提供手法安全性指导。目的:利用运动捕捉技术测量颈椎斜扳和旋提手法治疗后颈椎活动范围的差异,探索2种手法的运动特征及安全性。方法:选取20名健康受试者(男、女各10人),随机分为2组,各10人(男5人,女5人)。分别对2组受试者行颈椎斜扳和旋提手法。测量两组受试者颈椎主动运动、被动运动以及亚生理区活动度。试验经广州医科大学附属顺德医院伦理委员会批准。结果与结论:斜板组与旋提组主动运动活动度和被动运动活动度比较差异无显著性意义(P>0.05)。斜扳组亚生理区活动度大于旋提组,且斜扳组左侧亚生理区活动度大于右侧(P<0.05),但不同性别的亚生理区活动度接近(P>0.05);而旋提组左右两侧及男女之间亚生理区活动度接近(P>0.05)。提示颈椎旋提手法亚生理区活动度较斜扳手法小,更稳定均衡。

BACKGROUND:Cervical rotation manipulation has a positive effect on the treatment of cervical spondylotic radiculopathy,but improper use of manipulation can easily cause adverse consequences.By comparing the inclined pull manipulation and rotation-traction manipulation that are commonly used in clinical practice and have a set of standard operating procedures,it provides clinical safety guidance for the manipulation.OBJECTIVE:To measure the difference in range of motion of cervical spine in the inclined pull manipulation and rotation-traction manipulation by motion capture technology,and to investigate the movement characte ristics and the safety of two kinds of manipulations.METHODS:Totally 20 healthy subjects(10 males and 10 females)were selected and randomly divided into two groups.The 10 subjects(5 males and 5 females)in each group were subjected to inclined pull manipulation(group 1)and rotation-traction manipulation(group 2),respectively,to measure the active and passive movements of cervical spine and the range of motion of the subphysiological areas.This study was approved by the Medical Ethics Committee of Shunde Hospital Affiliated to Guangzhou Medical U niversity.RESULTS AND CONCLUSION:The active and passive ranges of motion of the group of inclined pull method and the group of rotation-traction manipulation were not significantly different(P>0.05).The range of motion in the subphysiological region of the group of inclined pull method was larger than that in the group of rotation-traction manipulation;the range of motion in the left subphysiological region was larger than that in the right region in the group of inclined pull method(P<0.05).However,the range of motion in the subphysiological region was similar between both sexes(P>0.05).The range of motion in the subphysiological region was similar between the left and right sides between both sexes in the group of rotation-tra ction manipulation(P>0.05).It is concluded that the subphysiological area of cervical rotation-traction manipulation is smaller than that of inclined pull method,and the technique is more stable and balanced.