| Background:The inheritance of traditional chinese medical method is used mouth-heart-teaching method in the past. Beginners always spend a lot of time practicing in the clinic, So the learning efficiency is low, it is diffcult to exetend, and the rotary manipulation has certain risk. These problems become the main factor of effecting the exetension of rotation-traction manipulation cure the cervical spondylosis. The problem is need to be solved urgently is how to effectively promote the reasonable teaching of rotation-traction manipulation and speed up the exetension, through mathematical extraction and analysis of mechanical characteristics in the process of manipulation and its influencing factors, can be put into practice as an objective evaluation system. How to evaluate effectively the beginners whether complete mastery of operating characteristics of rotation-traction manipulation or not is the key to promote the exetension of rotation-traction manipulation.Rotation-traction manipulation is one leading therapeutic tool of Cervical spondylosis. The studies show that rotation-traction manipulation is simple convenient economical and effective, it is a worthy of choice of treatment. As for the clinical research, large sample, multi-centered, randomized controlled observation, supported by the key Technologies R&D Programme in10th national five-year plan subject, had established clinical standardized operation norms and therapeutic effect evaluation system of rotation-traction manipulation. As far as the experimental study is concerned, supported by National Natural Science Foundation of China, we have two studies to discuss the mechanism of rotation-traction manipulation and its mechanical and kinematical characteristics, we have got its mechanical and kinematical characteristics and proved the body mass index (BMI) is one of the influencing factors of rotation-traction manipulation. In order to apply fundamental research to clinical practice better, this experiment, based on the previous research results that key Technologies R&D Programme in10th national five-year plan subject and National Natural Science Foundation of China had provided, carries out a study on the influence of BMI factors in rotation-traction manipulation through kinematical biomechanical measurement in vivo, confirmed The reference value of mechanical parameters during rotation-traction manipulation among patients with different BMI levels, builded the mathematics simulation model of rotation-traction manipulation, served the building of simulation assessment operating system of rotation-traction manipulation preliminary.Objective:1、To summarize the kinematical characteristics of rotation-traction manipulation;2、To discuss the influence of BMI factors in rotation-traction manipulation;3、To build the mechanics simulation model of rotation-traction manipulation.Content:1、The comparison of kinematical biomechanical parameters during rotation-traction manipulation to volunteers with different BMI levels:to choose three groups of20volunteers each, and the BMI of each group ranged differently from the other. We measured the mechanical parameters(preload force, peak force, thrust force)、displacement、angle (angle of autonomous positioning of head and neck、 three-dimensional angle)、velocity and acceleration (velocity and acceleration of head and neck、velocity and acceleration of chest、relative velocity and acceleration of head and neck).Then we compared the variation of kinematical biomechanical parameters among different BMI levels.2、The building of mathematics simulation model of rotation-traction manipulation with different BMI levels:we can simplify the human cervical physiological and head to be Kelvin-Volgt model by the analysis of the human cervical physiological structure and the result of the studies above all.With ADAMS and Matlab/Simulink, can we build the mathematical model and physical model of rotation-traction manipulation and simulation verification. Result:1、The comparison of kinematical biomechanical parameters during rotation-traction manipulation to volunteers with different BMI levels(1) Highly significant deviation (P<0.001) showed among the preload force, peak force, thrust force by Variance analysis;(2) Between the normal group and the overweight group, significant deviation(P<0.01) showed in preload force and peak force, thrust force displayed no significant deviation (P>0.05); the mechanical parameters were of significant deviation (P<0.01) between the overweight group and the obesity group; the mechanical parameters were of deviation (P<0.05) between the normal group and the obesity group.(3) Between the before thrust’s state and the autonomous positioning, highly significant deviation (P<0.001) showed in rotation angle, the same as between the after thrust’s state and the autonomous positioning, between the before and after thrust’s state, significant deviation (P<0.01) showed in rotation angle.(4) The comparison of angle’s parameters with three groups, angle of autonomous positioning of head and neck’s rotation angle and curved angle displayed no significant deviation (P>0.05), further rotation angle displayed highly significant deviation (P<0.001); Three-dimensional angle of rotating location displayed no significant deviation (P>0.05); Three-dimensional angle of before thrust’s rotation angle and curved angle displayed no significant deviation (P>0.05), flexion angle displayed deviation (P<0.05); Three-dimensional angle of after thrust’s rotation angle displayed no significant deviation (P>0.05), flexion angle and curved angle displayed deviation (P<0.05).(5) Between the normal group and the overweight group, no significant deviation(P>0.05) showed in kinematical biomechanical parameters; Between the overweight group and the obesity group, Three-dimensional angle of before thrust’s flexion angle displayed no significant deviation (P>0.05), angle of autonomous positioning of head and neck’s further rotation angle displayed highly significant deviation (P<0.001), three-dimensional angle of after thrust’s flexion angle and curved angle displayed deviation (P<0.05); Between the normal group and the obesity group, angle of autonomous positioning of head and neck’s further rotation angle displayed highly significant deviation (P<0.001), three-dimensional angle of before thrust’s flexion angle and after thrust’s curved angle displayed significant deviation (P<0.01), three-dimensional angle of after thrust’s flexion angle displayed highly significant deviation (P<0.001).(6) No significant deviation (P>0.05) showed among the velocity、acceleration and displacement by Variance analysis.2、The building of mathematics simulation model of rotation-traction manipulation with different BMI level(1) The result of simulation verification with ADAMS for acceleration curve was mainly same as its actual measurement results, its velocity was100m/s and the displacement was about4mm, as same as the actual results.(2) The result of simulation verification to the influencing factor include different mass and damping show that:the mass should2-8and the damping should0.5-0.7. So, to simulate the hard spring stiffness curve fitting stiffness with m=5kg and c=0.6N·s/mm(to simulate the part of traction constant stiffness with line k(x)=k; to simulate the part of thrust with hard spring stiffness curve k(x)=k(1+3a2x2)), it simulated the stiffness curve parameters with different BMI level, its reference value were as follows:normal group k=3.60, a=0.11; overweight group k=4.32, a=0.11; obesity group k=5.10, a=0.11.Conclusion:1、The comparison of kinematical biomechanical parameters during rotation-traction manipulation to volunteers with different BMI levels(1) We should adjust force initiation of rotation-traction manipulation according to patients’somatotype in clinical practice, the reference value of mechanical parameters during rotation-traction manipulation among patients with different BMI levels were as follows:BMI19～23:preload force14.50±4.87kg, peak force23.26±6.27kg, thrust force11.93±3.83kg;BMI23～25:preload force17.41±3.18kg, peak force27.10±4.10kg, thrust force13.37±2.63kg;BMI>25:preload force20.46±4.02kg, peak force34.85±5.58kg, thrust force15.83±3.50kg;(2) The reference value of kinematical parameters during rotation-traction manipulation among patients with different BMI levels were as follows:BMI19-23:relative velocity of head and neck75.80±28.12mm/s, relative acceleration of head and neck2860.36±1421.58mm/s2, displacement5.46±2.82mm;BMI23-25:relative velocity of head and neck67.39±24.73mm/s, relative acceleration of head and neck758.32±1440.18mm/s2, displacement5.37±1.96mm;BNI>25:relative velocity of head and neck82.93±35.69mm/s, relative acceleration of head and neck3598.73±2065.63mm/s2, displacement5.05±1.29mm;(3) the rotation angle of before and after thrust’s state is less than the autonomous positioning’s rotation angle, operational safety.(4) Patients’ somatotype should be taken into consideration while establishing the simulation assessment operating system of rotation-traction manipulation.2、The building of mathematics simulation model of rotation-traction manipulation with different BMI level(1) We can achieve the reproduction in vitro of rotation-traction manipulation through change stiffness simulation, its result of parameters was same as the actual measurement results.(2) Through changing the stiffness, with different stiffness curve parameters, can we simulate the deviation of different somatotype.Summary:The manipulation of quantitative research has been the focus of manipulation’s study, it is imptant to training and inheritance of manipulation as well as the extension that experiential manipulation be changed into quantification standard index and established the mechanical model. A wide diversity of patients’ somatotype is of certain influence on the process of force initiation in rotation-traction manipulation, the reproduction in vitro of rotation-traction manipulation can be achieved through change stiffness simulation, the deviation of different somatotype can be simulated by changing the stiffness curve. |
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