一种新型数字化肌肉检测仪用于评估腓肠肌内外侧头硬度的信度研究

目的:用新型MyotonPRO数字化肌肉检测仪评估健康成年人腓肠肌肉内外侧头硬度信度研究,对比小腿三头肌内外侧头硬度。方法:两名经过培训的测试人员A、B分别用新型MyotonPRO对40例健康志愿者双侧腓肠肌内外侧头硬度进行测量,其中测试人员A在5天之后重复测量一次。计算组内相关系数(ICC)和最小检测变化值(MDC),并对利腿侧进行Bland-Altman分析,同时比较利腿与非利腿侧腓肠肌内外侧头硬度的差异性。结果:测试人员A与测试人员B的评估者间信度ICC两侧均为优秀(ICC=0.94—0.96),测试人员A的重测信度均为好(ICC=0.75—0.87),最小检测变化值为18.3 N/m;Bland-Altman分析显示,同一测试者与不同测试者之间均有较好的一致性。利腿和非利腿侧腓肠肌肉内外侧头硬度均有显著性差异(P0.00)。结论:新型MyotonPRO数字化肌肉检测仪评估健康成年人小腿腓肠肌肉内外侧头硬度信度较高,腓肠肌外侧头硬度比内侧头大。     

MyotonPRO用于评估健康青年人股四头肌肌肉弹性的信度研究

目的:检验MyotonPRO肌肉弹性测试仪测量健康青年人股直肌、股内侧肌及股外侧肌肌肉弹性的复测信度和测试者间信度。方法:本研究纳入了38例健康青年人,采用MyotonPRO评估放松状态下的股直肌、股内侧肌及股外侧肌肌肉弹性,计算组内相关系数(ICC)、绝对信度,两次测量结果绘制成Bland-Altman图并进行系统偏倚分析。结果:复测信度:组内相关系数值介于0.76—0.90,测量标准误(SEM)值介于0.05—0.09,SEM%介于4.63%—7.11%,最小真正改变量(MDC)值介于0.15—0.25,MDC%介于12.83%—19.70%;测试者间信度:ICC值介于0.86—0.97,SEM值介于0.03—0.08之间,SEM%介于3.42—5.84,MDC介于0.09—0.23,MDC%介于9.48%—16.19%。BlandAltman图形分析显示无系统性误差。结论:MyotonPRO用于健康青年人股直肌、股内侧肌、股外侧肌肌肉弹性测量具有良好的信度,可为临床提供客观依据。     

The effect of manual therapy on gastrocnemius muscle stiffness in healthy individuals

StudyDesignRandomized clinical trial.BackgroundMuscle stiffness is a potential complication after injury and has been shown to be a risk factor for injury in healthy individuals.ObjectivesThe primary purpose of this study was to assess the short-term effects of manual therapy (MT) on muscle stiffness of the gastrocnemius in both a relaxed and contracted state. The secondary purpose was to assess the reliability of a novel clinical tool (MyotonPRO) to measure muscle stiffness in the gastrocnemius in both a passive and contracted state.MethodsEighty-four consecutive healthy individuals were randomized to receive Manual Therapy (MT group) directed at the right-side ankle and foot or no treatment (CONTROL group). Muscle stiffness of the gastrocnemius was assessed bilaterally in all participants at baseline and then immediately after intervention in a relaxed and contracted state. Group (MT vs. CONTROL) by side (ipsilateral vs. contralateral) by time (pre vs. post) effects were compared through a 3-way interaction utilizing mixed model ANOVA. Reliability of the MyotonPRO was assessed with two-way mixed model intraclass correlation coefficients.ResultsThere was a significant 3-way interaction for muscle stiffness of the gastrocnemius in a relaxed state (p < 0.01), but not contracted state (p = 0.54). All conditions had increased resting muscle stiffness from pre to post measures except for the ipsilateral limb of the MT group. There was not a significant interaction for muscle stiffness in a contracted state. Reliability estimates (ICC) for muscle stiffness measures ranged between 0.898 and 0.986.ConclusionThe change in muscle stiffness of the gastrocnemius in a relaxed state depended upon whether individuals received MT. Muscle stiffness measures were highly reliable based on single measurements.Level of evidenceTherapy, level 2.     

基于数字化弹性触诊仪监测偏振光结合推拿治疗中青年慢性下腰痛的临床疗效

目的 基于数字化弹性触诊仪监测红外偏振光结合推拿治疗中青年慢性下腰痛(chronic low back pain, CLBP)的临床疗效,以期为中青年CLBP的治疗提供新方法和科学依据。方法 69例中青年CLBP患者随机分为研究组(35例)和对照组(34例)。两组均给予推拿,研究组联合红外偏振光。治疗后比较两组患者的肌肉硬度和肌张力、疼痛及日常生活功能障碍评分。结果 两组患者的疼痛程度、日常生活功能障碍程度均较治疗前改善,差异均有统计学意义(P<0.05);且研究组好于对照组,差异有统计学意义(P<0.05)。两组患者双侧竖脊肌、多裂肌硬度及张力数值,均较治疗前降低,差异有统计学意义(P<0.05);研究组患者的双侧竖脊肌硬度及张力下降较对照组的明显,差异有统计学意义(P<0.05)。结论 采用红外偏振光结合推拿治疗中青年CLBP患者,与单纯推拿比较,能更好地降低竖脊肌硬度和肌张力、缓解疼痛以及改善日常生活功能障碍。