3D打印颈椎枕的压力疼痛评估及信度分析  

Pressure pain assessment and reliability analysis of 3D printed cervical pillow

作　　者：任富超 姚远 于文强 马振江[2] 鲁德志 王金武[2] REN Fuchao;YAO Yu;YU Wenqiang(School of Rehabilitation Medicine,Weifang Medical University,Weifang,Shandong,261053)

机构地区：[1]潍坊医学院康复医学院,山东省潍坊市261053 [2]上海交通大学医学院附属第九人民医院 [3]上海大学医学院

出　　处：《中国康复医学杂志》2024年第4期522-528,共7页Chinese Journal of Rehabilitation Medicine

基　　金：国家科技部重点研发计划项目(2020YFC2008700);上海市科委项目(19441908700);上海交通大学医学院附属第九人民医院临床研究型MDT项目(201914);潍坊医学院校级大学生创新创业训练计划项目(X2021125)。

摘　　要：目的:通过信度分析压痛测量仪评估颈肩部压痛的可靠性,并为3D打印个性化颈椎枕的临床效果评估提供新方式。方法:选取健康受试者36例,分别由2位评估者使用压痛测量仪对其颈肩部肌肉的7个测量点进行2次压痛阈测量,间隔7天后再次测量,采用Spearson相关系数计算评估者内和评估者间的信度,并使用Mann-Whitney U检验比较男性与女性的压痛阈值(pressure pain thresholds,PPT)。个性化颈椎枕使用前后,使用压痛测量仪对13例颈椎病患者选取具有代表性的4个测量点进行PPT测量,用以评估3D打印颈椎枕的治疗效果。结果:除了受测点C5、C6的棘突间旁1cm右侧和肩胛上角左侧外,各受测点评估者内信度均>0.65,各受测点评估者间信度均>0.75,可信度高;C5、C6的棘突间旁1cm右侧和肩胛上角左侧的评估者内组内相关系数(intraclass correlation coefficient,ICC)分别为0.65和0.56,中等信度(P<0.01);健康男性的斜方肌右侧、肩胛上角R、C5、C6的棘突间旁1cm左侧平均值要大于女性(P<0.05);斜方肌右侧、C5、C6的棘突间旁1cm右侧和C5、6的棘突间旁1cm左侧受测点3D打印颈椎枕治疗后的PPT平均值比治疗前大,差异具有显著性意义(P<0.05),说明疼痛有改善。结论:压痛测量仪评估正常健康人颈部压痛阈值信度较高,该方法稳定可靠,可作为3D打印颈椎枕临床效果评估的有效工具。Objective:To evaluate the reliability of neck and shoulder pressure pain assessment by reliability analysis of a pressure pain measurement instrument and develop a new way to assess the clinical effectiveness of 3D printed personalized cervical pillows.Method:Thirty-six healthy subjects were selected,and two assessors used a pressure pain meter to measure the pressure pain threshold twice on 7 points of the neck and shoulder muscles of the healthy subjects.The measurements were repeated after a 7-day break.The intra-and inter-assessor reliability was determined by the Spearson correlation coefficient,and the Mann-Whitney U test was used to evaluate the pressure pain thresholds(PPT)compared between males and females.Before and after the use of the personalized cervical pillow,PPT was measured using a pressure pain meter at four representative measurement points for 13 patients with cervical spondylosis to assess the therapeutic effect of the 3D printed cervical pillow.Result:The intra-assessor reliability was>0.65 for each subject point except for lcm away from the right interspinous paraspinal of C5 and C6 and the letf tsuprascapular angle,and the inter-assessor reliability was>0.75 for each subject point with high reliability.The intra-assessor intraclasscorrelation coefficient(ICC)values for the lcm away from the right interspinous paraspinal of C5 and C6 and the left suprascapular angle were 0.65 and 0.56,respectively,with moderate reliability(P<0.01).The healthy males had greater mean values on the right trapezius,right suprascapular angle,and lcm away from the left interspinous paraspinal of C5 and C6 than women(P<0.05);the mean values of PPT after treatment with 3D-printed cervical pillows on the right oblique,lcm away from the right interspinous paraspinal of C5 and C6,and 1 cm away from left interspinous paraspinal of C5 and C6 were greater than before treatment,with statistically significant differences(P<0.05),indicating the improvement in pain.Conclusion:A valid tool for evaluating the clinical effects

关 键 词：压痛阈值 测痛仪 信度 3D打印颈椎枕 

分 类 号：R493[医药卫生—康复医学] R563.9[医药卫生—临床医学]