手法对颈椎病患者颈肌力学性能及疲劳程度影响研究

目的:揭示手法治疗颈椎病患者颈部肌群作用机制。方法:2008年8月至2009年12月,将65例颈椎病患者随机分为手法组与牵引组,手法组32例,其中30例获得随访,男10例,女20例;年龄30～65岁,平均(42.31±13.23)岁;平均病程(12.40±6.23)个月;平均体重(61.21±10.23)kg。牵引组33例,其中30例获随访,男11例,女19例;年龄30～65岁,平均(45.54±14.35)岁;平均病程(13.25±6.06)个月;平均体重(62.31±10.45)kg。分别用Biodex Ⅲ system等速测试系统和TeleMyo2400T表面肌电图仪测试颈部肌群力学性能和疲劳程度,治疗前和疗程结束各测试1次。结果:颈部肌群力学性能:在60°/s角速度和120°/s角速度等速运动时,两组治疗前峰力矩(PT)、平均功率(AP)、屈肌峰力矩/伸肌峰力矩比值(F/E)比较无统计学差异(P>0.05),治疗后PT、AP、F/E、手法组优于牵引组(P<0.05);手法组治疗前后PT、AP、F/E、比较有统计学差异(P<0.05)。疲劳程度:两组治疗前左右两侧积分肌电(IEMG)、平均功率频率(MPF)比较无统计学差异(P>0.05),治疗后IEMG、MPF手法组优于牵引组(P<0.05);手法组治疗前后右侧IEMG、MPF比较有统计学差异(P<0.05),左侧有改善趋势。结论:手法可以改善颈椎病患者颈部肌群收缩力量、做功效率,改善颈部肌群屈肌群和伸肌群的协调能力,提高颈伸肌群的放电频率,有利于恢复颈椎病患者颈部肌群的力学性能和缓解颈部肌群的疲劳。

Effects of manipulation on mechanical properties of cervical and degree of fatigue in patients with cervical spondylosis

Objective:To explore the mechanism of manipulation in treating cervical spondylosis. Methods:From August 2008 to December 2009,65 patients with cervical spondylosis were randomly divided into manipulation group and traction group. There were 32 patients in manipulation group,of which 30 cases obtained followed-up,including 10 males and 20 females,ranging in age from 30 to 65 years,with an average of(42.31±13.23) years;the mean course of diseases was(12.40±6.23) months,and the average weight was(61.21±10.23) kg. In traction group,there were 33 patients,30 cases obtained follow-up,including 11 males and 19 males,ranging in age from 30 to 65 years,with an average of(45.54±14.35)years;the mean course of diseases was(13.25±6.06) months and average weight was(62.31±10.45) kg. Biodex Ⅲ Isokinetic Testing System and TeleMyo 2400 T Surface EMG was applied to test the mechanical properties and fatigue of neck muscles before and after treatment. Results:The mechanical properties of neck muscles:measuring in the 60°/s and 120°/s angular velocity,there were no significant difference(P>0.05) in peak torque (PT),average power (AP),peak torque of flexor /extensor peak torque ratio(F/E) before treatment,while manipulation group was improved more than traction group in PT,AP,F/E after treatment(P<0.05),and there was significant difference(P<0.05). For the degree of fatigue:there was no significant difference (P>0.05) in IEMG、MPF compared by two groups before treatment,but the manipulation group was improved more than the traction group in IEMG、MPF after treatment(P<0.05),and there was significant difference(P<0.05) on the right side. Conclusion:Manipulation can improve contraction forces and work efficiency of neck muscle,coordination ability of flexors and extensors muscles,efficiency of neck muscle,and recover mechanical properties and can alleviate fatigue of neck muscles in patients with cervical spondylosis.