拇指施力点对颈椎定点旋转手法安全性的影响

Effect of Thumb Force Application Point on the Safety of Cervical Fixed-point Rotation Maneuver

目的为手法治疗规范提供指引,提高颈椎定点旋转手法的可控性,降低治疗风险。方法采用前瞻性随机对照,招募62名Ⅰ、Ⅱ级颈痛患者,随机分成a、b两组,由同1名测试者行颈椎定点旋转手法,治疗a组时拇指作用在正中线旁2cm位置,治疗b组时拇指作用在正中线位置,用压力测量仪器测量记录手法过程中出现咔哒声响时拇指的峰值力。结果两组受试者的一般资料特征相比较,差异均无统计学意义(P>0.05)。a组拇指峰值压力低于b组,两组差异有统计学意义(P<0.05)。拇指峰值压力与年龄、体重、身高均呈负相关。结论在实施颈椎定点旋转手法时,鉴于拇指在作用于关节突时所产生的顶推力较为轻微,且其相对可控性较强,操作风险相对较低,因此,推荐优先选择关节突作为拇指的施力点。

Objective The purpose is to provide guidance for the specification of manual treatment,improve the controllability of cervical fixed-point rotation method,and reduce the risk of treatment.Methods using prospective randomized control,recruit 62 patients with I,neck pain,randomly divided into two groups of a,b,by 1 tester cervical fixed-point rotation technique,treatment group a thumb in the center of 2cm position,treatment group b thumb action in the midline position,with pressure measuring instrument measurement during the click sound of the thumb peak force.Results No difference of differences(P>0.05).Peak thumb pressure in group a was lower than that in group b,and the difference in peak thumb pressure between the two groups was significant(P<0.05).There was no significant correlation with age,weight or height.Conclusion The thumb produces less top thrust in the articular process,which is relatively controllable,and the operation risk is small.Therefore,when the cervical fixed point rotation technique,the thumb force point is recommended on the articular process.