颈椎整骨手法的运动学与动力学研究  

Kinematic and Dynamic Study on Traditional Chinese Cervical Manipulation

作　　者：童美萍 王辉昊[1,2] 詹红生[1,2] 潘富伟 王逸松 王玉鹏 TONG Meiping;WANG Huihao;ZHAN Hongsheng;PAN Fuwei;WANG Yisong;WANG Yupeng(Shi's Center of Orthopedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Institute of Traumatology,Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [2]上海市中医药研究院骨伤科研究所,上海201203

出　　处：《医用生物力学》2023年第1期65-70,共6页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(81973871);上海市慢性筋骨病临床医学研究中心(20MC1920600);上海申康医院发展中心临床三年行动计划项目(SHDC2020CR1051B)。

摘　　要：目的 同步采集和分析两种颈椎整骨手法的运动学与动力学参数,归纳其生物力学特征。方法 由1位高年资医师对10位健康受试者完成颈椎定位定向扳法和颈椎侧屈手法操作,施术者粘贴荧光标志球用于捕捉手法动作,并用压力触感手套和无线表面肌电系统采集并分析动力学参数和表面肌电信号。结果 上臂肌肉是颈椎整骨手法的主发力肌,其中肱二头肌的贡献率最高。颈椎定位定向扳法的运动幅度、速度、扳动作用力和时间都大于颈椎侧屈手法。颈椎定位定向扳法中施术者各肌肉的积分肌电值(integrate electromyography,iEMG)和均方根值(root mean square,RMS)都大于颈椎侧屈手法。结论 颈椎整骨手法运动幅度、三维活动角度,扳动瞬间的载荷强度和时间,具备高速、低幅和力强的特点,体现出中医学中关于“寸劲”的生物力学特征。研究结果可以为进一步规范手法教学、训练以及提升临床安全性提供参考。Objective To simultaneously collect and analyze the kinematic and dynamic parameters for two techniques of traditional Chinese cervical manipulation(TCCM),and quantitatively describe its biomechanical characteristics.Methods A senior practitioner completed the TCCM(positioning and directional rotation pulling,lateral flexion,respectively) on 10 healthy subjects,and the fluorescent marker balls were pasted on the operator to capture manipulation movements.The dynamic parameters and the surface electromyography(sEMG) signals were collected by pressure-sensitive gloves and wireless sEMG acquisition system.Results The upper arm muscle was the main force muscle during TCCM,and biceps brachii had the highest contribution rate.The range of motion(ROM),speed,pulling force,and time during cervical spine positioning and directional rotation pulling were all greater than those during cervical spine lateral flexion.The integrate electromyography(iEMG) and root mean square(RMS) for each muscle of the operator during cervical spine positioning and directional rotation pulling were higher than those during cervical spine lateral flexion.Conclusions The overall ROM,three-dimensional(3D) motion angle,load intensity and time during CCTM have the characteristics of high speed,low amplitude and strong force,reflecting the biomechanical characteristics of ‘cunjin'(one-inch punch) in traditional Chinese medicine.This study provides references for further standardizing manual teaching and training and improving clinical safety.

关 键 词：颈椎整骨手法 颈椎 运动学 动力学 表面肌电 

分 类 号：R318.01[医药卫生—生物医学工程]