| Research Background:Cervical spondylosis of neck type is due to cervical disc herniation, degeneration,resulting in patients with neck and shoulder pain, stiffness as the main manifestations of clinical common orthopedic diseases,it is the early clinical symptoms of Other types of cervical spondylosis. With the rapid development of the information society,human living environment and working style changing, the incidence of cervical spondylosis of neck type is increasing year by year; Although such diseases' symptom is lighter, easy to break out repeatedly, difficult to eradicate, causing serious physical and mental pain to the patient, also the high medical costs. Chinese medicine mainly uses the Shuj in Manipulation and the rotation reset Manipulation,relieving neck pain and stiffness symptoms by the release of the neck and shoulder muscles and fine-tune the cervical joint, to achieve qi and blood circulation, Shujing meridian clinical efficacy.What the majority of patients accept are the exact effect,simple operation, easy Line, no pain.Objective:Through the comparison of the normal group and the case group, it can observed the correlation of cervical spondylosis and cervical stiffness and dynamic changes from different points to establish a new biomechanical test method and quantitative index for the diagnosis of neck pain; Demonstrating the effect of manipulation is to provide objective basis for the manipulation treatment of Cervical spondylosis of neck type by observing the change of soft tissue stiffness and cervical X-ray before and after the treatment of manipulation.Methods:1. Sample selection, in strict accordance with the diagnostic criteria of this study,inclusion criteria, exclusion criteria,excluding the standard selection of cases (30 cases) and normal group (20 cases).2. Based on biomechanics, the cervical vertebra rigs and related test software were designed and developed, and the reliability and repeatability analysis were completed. The soft tissue tension, cervical stiffness, muscle strength test and X-ray data of 30 normal subjects were completed; Case group treated of patients by using manipulation treatment to the treatment of cervical spondylosis of the standard operation, including manipulation techniques and rotation techniques, 3 times / week,3 weeks for a course of treatment. One month follow-up. The patients were measured at the time of prior treatment, 1 week after treatment, 3 weeks after treatment, and were followed up for four time points. The measurement contents included AS visual analogue scale VAS, cervical stiffness, active neck movement (anteflexion, rear protraction, left and right lateral flexion),the cervical soft tissue tension (load displacement, absorption work ratio), cervical X-ray sequence (including cervical curvature,displacement,angle),comparing the test results and the X-ray data before and after treatment. The data were analyzed by CRF data management system, and the data obtained were used to process the data by SPSS24.0 and Excel statistical analysis software. All statistical analysis tests were conducted on both sides of the hypothesis test, assuming that the test level were taken ? = 0.05, that P value less than or equal to 0.05 will be considered the difference of the test statistically significant. The principle of the statistical description and the hypothesis test are as follows: The description of the metrological indicators will calculate the mean, standard deviation, median,minimum, maximum, quartile spacing (Q3-Q1), and the description of the count indicator will be calculated The number of cases and percentage. comparison of the metrological indicators among groups uesed t test or Wilcoxon rank sum test,and Paired t test or paired rank sum test were uesed in intra-group comparison;The count indicator used ?2 test or Fisher exact probability method,and the grade index used Wilcoxon rank test. Correlation analysis of the two variables used the Pearson correlation coefficient or the Spearman rank correlation (non-normal) method.Research result:1. the normal group of cervical stiffness maximum 0.492kg / degrees, the minimum value of 0.169kg / degrees , (Mean + standard deviation) is (0.262 + 0.080),95% confidence interval is (0.233,0.308); The maximum stiffness of cervical vertebra was 0.618kg / degree, the minimum value was 0.152kg /degree, (Mean + standard deviation) is (0.372 + 0.135) (kg / degree), 95% confidence interval (0.326, 0.421);2. Normal group Abnormal curvature of cervical spine 8 cases, accounting for 40%, cervical instability 1 case, accounting for 5%; Case group Abnormal curvature of cervical spine 25 cases, accounting for 83.3%, cervical instability 5 case,accounting for 16.7%;3. By treatment of manipulation, cervical stiffness was improved from (0.372 +0.135) (kg / degree) to (0.331+0.115) (kg / degree);The muscle strength of Flexion,posterior extension, left flexion, right flexor was improved from (9.96+1.90) kg?(6.79+1.91)kg?(9.03+1.87) kg?(8.90+2.24) kg to (11.54+2.19) kg?(7.67+2.23)kg?( 10.07+1.69) kg?( 9.98+1.89) kg; VAS score was improved from(5.30 + 1.24)to (1.70 + 0.95); Soft tissue tension energy accounted for the power ratio was improved from (38.1 + 7.2)% to (35.2 + 7.0)%. X-ray shows: there were statistical differences (p <0.05)in the cervical vertebral physiological curvature of the three periods including before manipulation treatment,3 weeks after manipulation treatment,follow-up. Vertebral slippage, angulation in the follow-up period were statistically significant (p <0.05);4. There was a positive correlation between VAS and cervical spine stiffness (r =0.4105, p <0.05).Conclusion:1. The manipulation treatment can be good at neck pain, muscle strength, muscle tension, cervical stiffness and cervical curvature ,and improve vertebral slippage,angulation.2. Cervical stiffness and degree of neck pain are related;3. Cervical stiffness can be used as an objective indicator evaluating the effectiveness of the manipulation treatmen;4. The reliability and repeatability of the cervical stiffness tester are good;... |
PDF Full Text Request