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1.
坐位腰椎旋转手法时腰椎单元内在应力和位移的实时监测 总被引:6,自引:2,他引:4
目的:用三维有限元法,分析施行坐位腰椎旋转手法时退变腰椎单元的内在应力及位移分布的特点,以探讨手法的作用机制、安全性及其合理性。方法:使用正常L4,5腰椎CT片,以Mimics软件系统逐层重建,建立L4,5三维有限元模型。根据手法原理,将坐位腰椎旋转手法进行分解,把各项力学参数代入三维有限元模型进行计算分析。观察手法作用时腰椎间盘的位移和内在应力的变化。结果:最大的应力集中点分布于环椎体峡部、椎弓根、上位椎体小关节面的下端。椎间盘的应力集中分布于环前外侧部,右后外侧部应力大于左后外侧部。最大位移出现在上位椎体的上关节。左侧小关节面相对位移较大,左侧椎间孔变大;右侧椎小关节面间移位小,右侧椎间孔变小,椎间盘右后外侧部向后突出。结论:模拟坐位腰椎旋转手法时,向健侧旋转优于向患侧旋转。 相似文献
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早期手法矫正系列石膏固定治疗先天性马蹄内翻足 总被引:11,自引:0,他引:11
目的 评价早期应用手法矫正系列石膏固定(Ponseti方法)治疗先天性马蹄内翻足的效果。方法 从1997年5月-2001年12月保守治疗出生后3个月内的先天性马蹄内翻足22例共30个足。患儿的平均年龄为生后第23d,方法 采用Ponseti的手法矫正和连续长腿石膏固定,每周更换石膏一次。在石膏固定结束后,患儿穿戴矫形支具至少1年。结果 本组平均治疗时间10.5周,平均随访2年4个月。27个足(90%)的畸形获得满意矫正,3个足因支具穿戴欠配合,随访时仍有残余畸形,需广泛软组织松解术矫正。结论 Ponseti的“旋后外展”手法矫正方法和连续长腿石膏固定,可使不同畸形程度的先天性马蹄内翻足在早期获得充分的矫正,石膏固定结束后应佩戴矫形支具至少1年,以防畸形复发。 相似文献
3.
手法治疗神经根型颈椎病的X线椎体位移观察及分析 总被引:5,自引:0,他引:5
目的:观察手法治疗后神经根型颈椎病的X线椎体位移改变方法:收集140例神经根型颈椎病的病人,对治疗前后X线椎体位移改变进行观察,并与70例正常人群进行比较。结果:两组颈4、5、6椎体位移治疗前比较,有显著性差异(P〈0.05,P〈0.01);手法治疗后能够改善椎体的水平及角度位移,治疗前比较有显著性差异(P〈0.05.P〈0.01);治疗后临床控制69.3%,好转22.9%,总有效率92.1%。结论:神经根型颈椎病椎体位移改变可能是其发病原因之一,手法治疗改善颈椎椎体异常位移,提高颈椎的稳定性是手法治疗神经根型颈椎病取得较好疗效的因素之一。 相似文献
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Steven R. Passmore Michael G. Johnson Saleh M. Aloraini Stephan Cooper Mina Aziz Cheryl M. Glazebrook 《Journal of manipulative and physiological therapeutics》2019,42(1):23-33
ObjectiveThe purpose of this study was to quantify the impact of a single lumbar spinal manipulation (SM) intervention on the leg movement performance of degenerative lumbar spinal stenosis (LSS) patients in a small-scale registered randomized clinical trial.MethodsParticipants with LSS (n = 14) were tested at baseline for pain, lumbar range of motion, and behavioral or kinematic motor performance (using an established Fitts’ Law foot-pointing task), then underwent covariate adaptive randomization to receive SM or no intervention. Postintervention all dependent measures were repeated. Experimenters were blinded to patient group allocation. University ethics board approval was attained.ResultsFor the primary outcome movement time, there was no significant difference between groups. As predicted by Fitts’ Law, all participants had longer movement times as task difficulty increased. Secondary kinematic outcomes yielded no significant between-group differences. Consistent with Fitts’ Law, kinematic measures changed significantly with task difficulty. Pairwise comparisons revealed the kinematic variables were more adversely affected by greater movement amplitudes than target size changes. No exploratory differences in pain or lumbar range of motion were observed.ConclusionChanges in motor performance were not observed in this chronic pain population after a single SM intervention compared with a control group. Given the sample size, the study may have been underpowered to detect meaningful differences. Fitts’ Law was observed for the lower extremity–pointing task for an LSS population and may provide an objective measure of motor performance. 相似文献
6.
IntroductionMuscle energy technique (MET) is a therapeutic technique involving active muscle contraction by the patient. The selection of particular techniques by osteopaths is underexplored. The aim of the study was to explore the practice profile of those Australian osteopaths who use MET often in their practice compared to those who do not use the technique often.MethodsA secondary analysis of data collected from 922 participants by a practice-based research network (PBRN) for the Australian osteopathy profession was performed. Frequency of use of MET on a 4 point scale: never, rarely, sometimes, and often were binary coded as less often and often. Inferential statistics were used to explore the associations between individual practice characteristics and the frequency of MET use. Adjusted odds ratios (OR) with 95% confidence intervals (CI) and p-values were calculated from regression modelling.ResultsDichotomising participant responses resulted in less often (203, 20.5%) and often (788, 79.4%). There was a significantly greater proportion of male practitioners using MET compared to those practitioners who did not often use the technique (OR = 0.46; CI = 0.33, 0.63; p < 0.01). Australian osteopaths who often used MET were younger (36.3 vs 44.6 years old) and had fewer years in practice (9.9 vs 17.3 years) compared to osteopaths who used the technique less often.ConclusionOsteopaths who reported that they often used MET were more likely to be male, often use counterstrain and more likely to use orthopaedic testing in patient examination. The study provides an insight into how Australian osteopaths practice, particularly their use of MET.Implications for practice
- •When the responses of 922 Australian osteopaths who participated in a practice-based research network were dichotomized according to usage of MET, the majority reported they use MET frequently.
- •MET and counterstrain appear to be used in combination for musculoskeletal patient care by Australian osteopaths.
- •Australian osteopaths who reported often using MET were more likely to see patients for low back pain, perform orthopaedic testing, use neurological cranial nerve testing, and refer for diagnostic imaging.
- •The practice characteristics of osteopaths who use MET often compared to those who do not reveal insight into different practice styles within the osteopathic profession.
7.
Seyedezahra Hosseini Ghasabmahaleh Zahra Rezasoltani Afsaneh Dadarkhah Sanaz Hamidipanah Reza Kazempour Mofrad Sharif Najafi 《The American journal of medicine》2021,134(1):135-141
ObjectiveWe evaluated the efficacy of spinal manipulation for the management of nonacute lumbar radiculopathy.MethodsIn a university hospital we performed a randomized controlled trial with 2 parallel arms. Patients (n = 44) with unilateral radicular low back pain lasting more than 4 weeks were randomly allocated to manipulation and control groups. The primary outcome was the intensity of the low back pain on a visual analog scale. The secondary outcome was the Oswestry Disability Questionnaire score. We also measured spinal ranges of motion. The assessments were carried out at the baseline, immediately after intervention, and at 3 months’ follow-up. All patients underwent physiotherapy. The manipulation group received three sessions of manipulation therapy 1 week apart. For manipulation, we used Robert Maigne's technique.ResultsBoth groups experienced a decrease in back and leg pain significantly (all P ≤ 0.003). However, only the manipulation group showed significantly favorable results in the Oswestry scores (P < 0.001), and the straight leg raise test (P = 0.001). All ranges of motion increased significantly with manipulation (all P < 0.001), but the control group showed favorable results only in right and left rotations and in extension (all P < 0.001). Between-group analyses showed significantly better outcomes for manipulation in all measurements (all P ≤ 0.009) with large effect sizes.ConclusionSpinal manipulation improves the results of physiotherapy over a period of 3 months for patients with subacute or chronic lumbar radiculopathy. 相似文献
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Isabelle Pagé Éric Biner Martin Descarreaux 《Journal of manipulative and physiological therapeutics》2018,41(9):753-761