| Neck Type of Cervical Spondylosis(NTCS) is a common type of cervical spondylosis. With modern life and work patterns change, the mobidity increase, affecting spinal health. This is the medicine of motherland "arthralgia syndrome"and"tendon injury"category, Manipulation and functional exercise is applicated widely on treatment of NTCS, which has good efficacy. So it is significant to carry out clinical basic research about manipulation and exercise, basing on "on the Treatment of tendon injuries"which can provide important basis for the Chinese traditional medicine treatment and clinical rehabilitation pathways of NTCS.Tutor believe that the disease is " injury of tendon and muscle " on Chinese traditional medicine,and the clinical symptoms have close relation with "spasms"and"bar knot" Plain Questions—theory of consumptive said "Zong jin zhu shu gu er li ji guan ye". Imbalance of the relationship between tendon and joint can bring to neck dysfunction which refer to cervical curvature change and so on. Emphasis on treatment and rehabilitation on tendon injuries is vital,therefore,improving tendon function and maintaining spinal stability is essence for cervial spondylosis.In order to scientifically and objectively reflect the "on the Treatment of tendon injuries " mechanism and find out the key factor on pathogenesis of NTCS, soft tissue tension and neck muscle surface electromyography testing technology have been applicated in the subject.The research on role of Cervical muscle factors in the pathogenesis of cervical disease and the efficacy mechanism of manipulation and functional exercise have been done through clinical randomized controlled trials,and then Treatment and Rehabilitation integration programs will be suggested. Research Purpose:1 By studying difference of indicators from the soft tissue tension and surface electromyography measured between the normal and the NTCS to reproduce physical properties and biological properties of soft tissue changes in NTCS.2 Through study on changes of symptoms, signs and functional changes during the course of treatment for NTCS, revealing the advantages of manipulation with functional exercise to explain the meaning and significance of "on the Treatment of tendon injuries"3 observation the role of follow-up function exercise for rehabilitation and prevention in NTCS to guide clinic.Based on the above, in the "on the Treatment of tendon injuries "theoretical guidance, integration program on treatment and rehabilitation for NTCS is proposed.Main content1 Comparison of soft tissue tension test testSelecting 20 cases from health people and NTCS people,respectively,to evaluate stability and repeatability on soft tissue tension,progess to observe difference of index for proving objectivity of soft tissue tension to discribe NTCS patient with cervical muscle performance.2 cervical I muscle of surface electromyography testSelecting 20 cases from the normal and the NTCS,respectively,to evaluate stability and repeatability on muscle surface electromyography test.progess to observe difference of index((D0.5kg, S) for proving objectivity of surface electromyography to discribe NTCS patient with cervical muscle performance.3 The correlation coefficient between subjective indicaor (symptom signs and function changes) and objective indicator (index on soft tissue tension and surface electromyography) from experimental group(manipulation with exercise) and control group(traction pillow jaw with non-steroidal drugs)Choosing 50 cases meeting inclusion criteria,and then dividing into experimental group (manipulation+function exercise) and control group (traction pillow jaw with non-steroidal drugs) by using Random Numbers Trial group 26 cases,control group 24 cases.Observation neck pain VAS score, cervical dysfunction index NDI, Condensed Health Survey Form (SF-36), cervical soft tissue tension Test indicators (DO.5kg, S), cervical muscle surface electromyography test indicators (MF), adverse reactions and so on.During the treatment period (the first 1,2 weeks)and follow-up(following 3,4weeks), safety and effectiveness will be evaluated fully on therapeutic schedule(manipulation with function exercises),and to probe into advantages and feature on trial group,progress to reveal effect mechanisms4 observation for Subsequent follow-up function exerciseObserving NTCS pain VAS scores during the 1.5th months and the 3th months follow-up period and calculating the recurrence rate to find out functional training role to NTCS rehabilitation, prevention of recurrenceResults:1 Comparison of soft tissue tension test1.1 the stability and repeatability of normal soft tissue tension test3 different time points of the local soft tissue displacement DO.5kg, local soft tissue absorption of energy accounts for a percentage of the total amount ot work done (S),3 times the sample mean with the general linear model repeated measures statistical analysis, the measurement data was not statistical significant. Second, intraclass correlation coefficient analysis, consistence and significance of excellent.1.2 Reseach on differences in indicators from soft tissue tension test between the NTCS and the normalThe normality test of Soft tissue tension (DO.5kg)and S in the normal and the NTCS, can be considered to obey normal distribution. The data t test for independent samples are statistically significant(P<0.01).2 Comparison of surface electromyography test test2.1 Stability and repeatability of index from surface electromyography activity in the normal In Isometric contraction process, the general linear model repeated measures statistical analysis of median frequency MF value, mean power frequency and mean MPF values during 3 different time points,3 different time measurement data was not statistically significant. Second, intraclass correlation coefficient analysis, consistence and significance of excellent.2.2 Research on difference of indictors from muscle surface electromyography in the Normal and the NTCSThe normality test of MF value and MPF value can be considered to obey normal distribution. On independent samples t test data, significance of excellent.3 The correlation coefficient between subjective indicaor (symptom signs and function changes) and objective indicator (index on soft tissue tension and surface electromyography) from experimental group(manipulation with exercise) and control group(traction pillow jaw with non-steroidal drugs)3.1 Comparison of effectClinical trial group 100%(Total effective rate), control group 95.8%(Total effective rate). Ridit analysis by two groups, P>0.05, the difference was not statistically significant,that indicates the experimental group is same as the control group in Total effective rate.3.2 Comparasion of visual analog score (VAS score)3.2.1 Comparasion of difference on VAS self before and after treatmentComparing with pro-treatment,the VAS scores of Test group at 1,2,3,4 visit significantly decreased. VAS scores of control group at 1 visit did not significantly decrease. Comparing with pro-treatment,VAS scores of Control group at,2,3,4 visit did not significantly decrease. Therefore, dysfunction is relieved obviously,but excellence at test group.3.2.2 Comprison of difference on VAS before and after treatment at each group’s visit pointComparing with the control group,the VAS scores of test group at 1,2 visit point decreased rapidly,and the 2th visit point obviously.The VAS scores of test group is same as control group in the decreasing spectrum at 3,4 visit point.therefore,the change trend is same on VAS scores between experimental group and control group after treatment.3.3 Comprison of difference on NDI scores3.3.1 Comprison of difference on NDI scores self before and after treatment at each group’s visit pointComparing with pre-treatment,the NDI scores of Test group at 1,2,3,4 visit significantly decreased, the control group at the lvisit does not reduce Significantly. Comparing with pre-treatment,NDI scores of the control group at2,3,4 visit significantly decreased, therefore, the dysfunction is significantly alleviated in the two groups, but the test group can take effect fastly.3.3.2 Comparison of difference on NDI scores before and after treatment at each group’s visit pointComparing with control group at1,2visit point, the NDI scores of test group decreased rapidly. The NDI scores of test group is same as control group in the decreasing spectrum at 3,4 visit point Therefore,the change trend is same on NDI scores between experimental group and control group after treatment.3.4 Comprison of difference on Condensed Health Survey Form (SF-36) scores3.4.1 Comprison of difference on SF-36 scores self before and after treatment at each group’s visit pointComparing with pre-treatment,the NDI scores of Test group at 1,2,3,4 visit significantly increased. NDI scores of the control group at 1 does not elevate Significantly. Comparing with pre-treatment at 2,3,4 visit, NDI scores of the control group increased significantly, therefor, the quality of life isimproved significantly at the two groups, but the test group can take effect fastly.3.4.2 Comprison of difference on SF-36 scores before and after treatment at each group’s visit point1st visit point in time, comparing with the control group, SF-36 score increased rapidly at the test group.2st and 3st visit point in time, comparing with the control group, SF-36 scores increased more significantly at the test group.4st visit point in time,the SF-36 scores of test group increasing is same as control group. Therefore,the change trend is same on SF-36 scores between experimental group and control group after treatment.3.5 Neck soft tissue tension test3.5.1 Comprison of difference on biomechanical index self before and after treatment at each group’s visit pointComparing with pre-treatment at each group’s visit point, the tender point DO.5kg at Neck pain side obviously of Test group and the control group significantly increased Therefore, soft tissue tension is improved significantly at two groups, but the test group can take effect fastly.Comparing with pre-treatment at each group’s visit point,the tender point S at Neck pain side obviously of Test group significantly increased.1st visit point in time, comparing with pre-treatment,the tender point S at Neck pain side obviously of the control group did not significantly increase.2st,3st and 4st point in time, comparing with pre-treatment, the tender point S at Neck pain side obviously of the control group significantly increased Therefor, soft tissue elasticity is relieved significantly at two groups, but the test group take effect fastly.3.5.2 Comprison of difference on biomechanical index before and after treatment at each group’s visit point1st visit point in time.comparing with control group, the DO.5kg of Test group significantly increased.2st,3st and 4st visit point in time, the increasing spectrum of the DO.5kg of test group is same as control group.Therefor,the change trend is same on DO.5kg between experimental group and control group after treatment.1st visit point in time, comparing with the control group,the S increased rapidly at the test group.2st,3st and 4st visit point in time, the increasing spectrum of the S of test group is same as control group.Therefore.the change trend is same on S between experimental group and control group after treatment.3.6 Neck muscle surface EMG testing 3.6.1 Two groups of indicators of surface electromyography to visit their own point of view of cervical muscle before and after treatmentTest group was lateral neck paraspinal neck muscles, sternocleidomastoid during isometric contraction of the value of surface EMG indicators MF point of view in one visit after treatment than before treatment no significant changes (P> 0.05), No.2,3,4 a visit to view before treatment after treatment were significantly lower than (P<0.05, P<0.05, P<0.05); control group was lateral neck paraspinal neck muscles during isometric contraction of the surface EMG MF value index 1,2 a visit after treatment than before treatment point of view no significant change (P> 0.05, P> 0.05),3,4 a visit to view after treatment were significantly lower than before treatment (P<0.05, P<0.05); That both groups can significantly improve the cervical paraspinal muscle fatigue resistance, but the faster onset of the experimental group.3.6.2 cervical muscle groups of the visit to view the difference between the surface EMG indicators compared before and after treatment1.2.3 point in time when the second visit, significant lateral cervical paraspinal neck muscles, the sternocleidomastoid muscle during isometric contraction of the value of surface EMG test indicators MF decreased faster than the control group (P<0.001, P<0.001, P<0.001), at the point the 4th visit to improve the test results with the control group no significant difference (P>0.05), the same trend.3.7 Neck muscle tension test D0.5g values and VAS, NDI, SF-6 correlation between scoresSide of the experimental group was tender point DO.5kg neck pain and neck pain VAS score difference, cervical dysfunction index NDI score, concise health SF-6 normal test score difference, P values were 0.874,0.806,0.824, Can be considered approximately normal distribution. Correlation DO.5kg difference and VAS, NDI, SF-6 difference in the correlation coefficient R was 0.800,0.734, 0.723, linear mixed effects model checking, T respectively,24.44,16.34,14.09, P <0.001, P<0.001, P<0.001, significance tests were statistically significant. With the passage of time that EMG test indicators and trends to improve symptoms, function, quality of life improvement in the same trend relevant.3.8 Neck EMG test MF value and VAS, NDI, SF-6 scores correlationSide of the neck neck pain study group was isometric paraspinal muscle testing the difference between MF and neck pain VAS scores, NDI index score of cervical dysfunction, concise health SF-6 normal test score difference, P values were 0.835,0.799,0.815, can be considered approximately normal distribution. Difference and correlation MF VAS, NDI, SF-6 difference in the correlation coefficient R were 0.811,0.752,0.736. Linear mixed model checking, T respectively,15.82,17.17,12.29, P<0.001, P<0.001, P<0.001, significance tests were statistically significant. With the passage of time that EMG test indicators and trends to improve symptoms, function, quality of life improvement in the same trend relevant.4 Observation for subsequent follow-up function exercise1.5 months after treatment, no difference in recurrence rate at each group; 3 months after treatment, recurrence rates are different at each group.Conclusions1 Application of soft tissue tension test and Surface electromyography test can distinguish the NTCS from the normal.Reliability and objectivity of soft tissue tension test Surface electromyography test on cervical muscle is confirmed.For the NTCS, neck soft tissue and biological properties and physical properties of neck soft tissue are reproduced.2 The correlation coefficient between subjective indicaor (symptom signs and function changes) and objective indicator (index on soft tissue tension and surface electromyography) from experimental group(manipulation with exercise) and control group(traction pillow jaw with non-steroidal drugs)Tendon and muscle changes and symptom signs have relavance,so tendon and muscle injuries is key incidence factor Trough Comprison of the experimental group and the control group,the impication and significance of "on the Treatment of tendon injuries "can be interpreted objectively. 3 subsequent follow-up functional exercise studyFollow-up function exercise can reduce effectively recurrence rate and have clinical significance on prevention and rehabilitation. Based on the above, in the "on the Treatment of tendon injuries"theoretical guidance, integrated program of treatment and rehabilitation on NTCS is proposed... |
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