腰椎小关节紊乱症运动和动力学特征

Characteristics of motion and motion mechanics in patients with lumbar facet joint disorder

目的采用Vicon三维运动捕捉系统定量分析腰椎小关节紊乱症患者运动学、动力学情况,探索生物力学规律和机制。方法2018年1月至2020年11月,选择上海交通大学医学院附属瑞金医院门诊诊断为腰椎小关节紊乱症的患者18例作为实验组,招募无腰部疼痛的正常健康者12例作为对照组。采用Vicon三维运动捕捉系统对两组受试者进行行走测试,分析比较两组受试者步行情况和腰部运动学、动力学差异。结果与对照组相比,实验组在行走中,步长、步幅、步速均缩短(P<0.05);脊椎一直处于前屈状态,脊椎屈曲角度平均值、峰值均增大(P<0.05),最大活动范围减小(P<0.05);脊椎倾斜角度峰值和最大活动范围均减小(P<0.05);脊椎角速度平均值、峰值和脊椎角加速度平均值、峰值均减慢(P<0.05);胸部一直处于前屈状态,胸部屈曲角度平均值、峰值均增大(P<0.05);胸部倾斜角度平均值减小(P<0.05);胸部旋转角度峰值和最大活动范围均减小(P<0.05);胸部角速度平均值、峰值和胸部角加速度平均值、峰值均减小(P<0.05);平均腰部功率减小(P<0.05)。结论腰椎小关节紊乱症患者步态异常,腰部运动学和动力学存在特征性异常。

Objective The kinematics and biomechanics of patients with lumbar facet joint disorder were quantitatively analyzed with the Vicon three-dimensional(3D)motion capture system to explore the biomechanical laws and mechanisms.Methods From January 2018 to November 2020,18 patients diagnosed with lumbar facet joint disorder in the out-patient department of Ruijin Hospital affiliated to Shanghai Jiaotong University Medical College were selected as the experimental group,and 12 normal healthy persons without lumbar pain were recruited as the control group.The Vicon 3D motion capture system was used to test walking in the two groups of subjects.The gait,waist kinematics and dynamics of the two groups were analyzed and compared.Results Compared to the control group,the stride length,and stride speed in the experimental group were shorter(P<0.05);the spine was always in the state of anterior flexion,the average and peak values of spinal flexion angle increased(P<0.05),and the maximum range of motion decreased(P<0.05);the peak value of the spinal tilt angle and the maximum range of motion decreased(P<0.05);the average and peak values of spinal angular velocity and spinal angular acceleration decreased(P<0.05);the chest was always in the state of forward flexion,and the mean and peak values of chest flexion angles increased(P<0.05);the average value of the chest tilt angle decreased(P<0.05);the peak value of chest rotation angle and the maximum range of motion decreased(P<0.05);the average and peak values of chest angular velocity and chest angular acceleration decreased(P<0.05);and the average waist power decreased(P<0.05).Conclusion The gait of patients with lumbar facet joint disorder is abnormal,and there are characteristic abnormalities in lumbar kinematics and dynamics.