膝关节骨性关节炎推拿手法的力学特征和上肢核心肌群的疲劳研究

探讨膝关节骨性关节炎推拿手法的生物力学特征和生理学(表面肌电)特征,定量分析推拿手法的力学指标,建立一种客观评价推拿医生上肢核心肌群的疲劳状况的方法。招募10位推拿科医生,实时采集推拿医生拇指垂直压力和上肢表面肌电信号,研究垂直强度、次做功期与主做功期的时间比;研究操作该推拿手法时的上肢核心肌群;研究核心肌群的疲劳状况。结果表明,该推拿手法1 min内按压4次,平均垂直强度为(228±13)N,主做功期持续时间为(4.83±0.88)s,次做功期持续时间为(11.43±1.94)s,有效做功时间比为2.37±0.63。由上肢各肌肉群的平均积分肌电值(iEMG)和贡献率的降序可知,手法涉及上肢的核心肌群为拇短展肌(8.32±0.29,21.65%)、尺侧腕屈肌(5.67±0.32,14.74%)、肱三头肌(4.79±0.36,12.46%)、桡侧腕屈肌(4.60±0.12,11.96%)。在4 min的推拿过程中,拇短展肌的平均中值频率(MF)和平均功率频率(MPF)的下降程度是最大的,分别为30%和22%,即拇短展肌更易发生疲劳。因此,所研究的膝关节骨性关节炎推拿手法的生物力学特征和生理学(表面肌电)特征,为后续的人因工程研究和研制可替代推拿医生手法的自动化装置奠定良好的基础。

Study on Mechanical Characteristics of Massage for Knee Osteoarthritis and Fatigue Status of Upper Limb Core Muscle Group

The aim of this study was to investigate the biomechanical and physiological (surface electromyography) characteristics of massage for knee osteoarthritis, analyze the mechanical properties of this manipulation maneuver quantitatively, and establish a method to objectively evaluate the fatigue status of the upper limb muscle groups of the massage physicians. Ten massage physicians were recruited to collect the vertical pressure of thumb and the surface electromyogram of upper limbs in real time to calculate the vertical strength and the time ratio between secondary work period and primary work period. This paper was to study the upper limb core muscle group and the fatigue status of the core muscle groups when manipulating the massage techniques. Results showed that the frequency of press was four times in one minute. The duration of primary work period was 4.83±0.88 seconds and secondary work period was 11.43±1.94 seconds. The time ratio between the secondary work period and the primary work period was 2.37±0.63. The average vertical strength of the massage manipulation was 228±13N. According to descending order of the integrated EMG(iEMG)and contribution rate of the upper limb muscle groups, the core muscles of the upper limbs were the thumb muscle (8.32±0.29,21.65%), the flexor carpi ulnaris (5.67±0.32,14.74%), the triceps(4.79±0.36,12.46%), and the flexor carpi radialis (4.60±0.12,11.96%). In a 4 min massage process, the degree of decline of the average median frequency (MF) and average mean power frequency (MPF) of the thumb muscle were the largest. They are 30% and 22% respectively. So the thumb muscle was more prone to fatigue. Therefore, the biomechanical characteristics and physiology (surface electromyography) characteristics of the massage techniques of knee osteoarthritis in this paper will lay the foundation for the follow-up research of human engineering and the development of an automated device which can replace the manipulation of massage doctors.