| Lateral ankle sprain is one of the most common sports injuries in daily life.If not treated properly or treated in time,it will become a chronic course of disease,which will bring great inconvenience and trouble to people's life and work.Traditional Chinese Medicine thinks that the ankle sprain belongs to the category of "tendon injury".Therefore,the tendon manipulation has become one of the main methods of the treatment of ankle sprain in Chinese medicine,in which the rotating-traction-poking manipulation is the most representative.The clinical effect of this manipulation has been proved by a large sample and multicenter randomized controlled clinical trial,and is worthy to be popularized and applied in clinical practice.The clinical promotion of manipulation is inseparable from inheritance.At present,the inheritance mode of manipulation is mainly based on master and apprentice.By this way,the novice can only master the operation flow of manipulation,and the operation skills and essence of manipulation still need to spend a lot of time in clinical practice,which leads to low learning efficiency.In addition,as a medical operation technique,the manipulation of rotating-traction-poking lacks objective and standardized technical index,which makes the operation of clinician blind and random.In order to solve the problem of inheritance and standard of manipulation,we need to innovate the traditional mode of inheritance and establish a standardized system of manipulation.The quantitative study of the operational characteristics and the analysis of influencing factors are the breakthrough points of solving the problem.We should make full use of the modern scientific and technological means to express quantitatively the operational characteristics of the manipulation.In this research,we use the mechanical sensor developed by ourselves,and combine with motion capture technology to quantify the operating characteristics of the rotating-traction-poking manipulation,The factors that may affect the manipulation are analyzed,and the mechanical and kinematic parameters and operation rules of the manipulation of the rotating-traction-poking manipulation are obtained.This provides a reference and evaluation standard for the clinical standardized operation of manipulation,and lays a foundation for the teaching,training and basic research of manipulation.Objectives1 To obtain the quantitative mechanical and kinematic parameters of the rotating-traction-poking manipulation.2 To summarize the operating characteristics of the rotating-traction-poking manipulation.3 To analyze the possible factors affecting the manipulation of rotating-tracti on-poking manipulation.MethodsWe collected 60 cases of ankle sprain patients in the clinic,and registered the individual characteristics of the patients(height,weight,body mass index,ankle circumference,foot circumference).The dynamic and kinematic parameters(the maximum force of the thumb,index finger,middle finger in the rotating,traction and poking stage,the time of the manipulation,the displacement and angle of the traction-poking stage,the line velocity and the acceleration of the manipulation)of rotating-traction-poking manipulation for 60 patients were measured by a self-developed mechanical data measuring instrument combined with a motion capture system in real time by the same manipulation operator.The dynamic and kinematic parameters were extracted and the correlation between operation parameters was analyzed by Pearson correlation method.According to the analysis results,the operating characteristics of rotating-traction-poking manipulation were summarized.At the same time,multiple linear regression analysis was carried out on the individual characteristics and manipulation parameters of rotating-traction-poking manipulation,and the possible influencing factors of rotating-traction-poking manipulation were discussed in this study.Results1 The mechanics and kinematics parameter quantification of rotating-traction-poking manipulation1.1 The mechanics parameter of the manipulationThe mean value of maximum force in thumb,index finger and middle finger was 18.89N,10.26N,9.5 1N in the process of rotating manipulation,respectively.In the course of traction,the mean maximum force was 18.61N,13.25N and 8.33N,respectively.The mean of maximum force in the process of poking was 26.5N,8.61N and 10.62N,respectively.1.2 The kinematics parameter of the manipulationDuring the manipulation,the mean time of rotating the ankle joint for 6 circles was 11.36s,and the mean time of traction-poking was 3.42s per 1 time.The mean displacement values of traction and poking were 36.94mm and 22.44mm respectively.The mean angles of traction and poking were 23.27° and 22.76° respectively,the mean linear velocity of the rotating ankle was 58.28mm/s,and the mean linear velocity of traction and poking was 23.81mm/s.The linear acceleration values of the rotating ankle and the traction-poking operation were 0.43mm/s2 and 0.54mm/s2 respectively.2 The correlation analysis between parameters of the rotating-traction-poking manipulation2.1 The maximum force of thumb-rotating was significantly correlated with the maximum force of thumb-traction and thumb-poking(P<0.01).The maximum force of thumb-traction was significantly correlated with the maximum force of thumb-poking(P<0.01).2.2 The maximum force of forefinger-rotating was significantly correlated with the maximum force of forefinger-traction and forefinger-poking(P<0.01).The maximum force of forefinger-traction was significantly correlated with the maximum force of forefinger-poking(P<0.01).2.3 The maximum force of medius-rotating was significantly correlated with the maximum force of medius-traction and medius-poking(P<0.01).The maximum force of medius-traction was significantly correlated with the maximum force of medius-poking(P<0.01).2.4 There was no correlation between the maximum force of thumb,index finger,middle finger and all kinematic indexes(P>0.05).3 The correlation analysis between patient individual characteristics and manipulation parameters of rotating-traction-poking manipulation.3.1 Multiple linear regression analysis showed that there was a correlation between the patient's body weight and the maximum force of the operator's thumb-rotating(P<0.05).3.2 Multiple linear regression analysis showed a significant correlation between the patient's body weight and the maximal force of the index finger and middle finger rotating(P<0.01).3.3 Multiple linear regression analysis showed a significant correlation between body mass index and the timing of rotating manipulation(P<0.01).3.4 The maximum force of the thumb,index finger,middle finger in the traction and poking stage,the time of the traction and poking manipulation,the displacement and angle of the traction-poking stage,the line velocity and the acceleration of the manipulation was not correlated with patient individual characteristics significantly.Conclusions1 By quantizing the operation characteristics of the rotating-traction-poking manipulation,the mechanical and kinematic parameters of the manipulation are obtained completely for the first time:The mean value of maximum force in thumb,index finger and middle finger was 18.89N,10.26N,9.51N in the process of rotating manipulation,respectively.In the course of traction,the mean maximum force was 18.61N,13.25N and 8.33N,respectively.The mean of maximum force in the process of poking was 26.5N,8.61N and 10.62N,respectively.The mean time of rotating the ankle joint for 6 circles was 11.36s,and the mean time of traction-poking was 3.42s per 1 time.The mean displacement values of traction and poking were 36.94mm and 22.44mm respectively.The mean angles of traction and poking were 23.27° and 22.76°respectively,the mean linear velocity of the rotating ankle was 58.28mm/s,and the mean' linear velocity of traction and poking was 23.81mm/s.The linear acceleration values of the rotating ankle and the traction-poking operation were 0.43mm/s2 and 0.54mm/s2 respectively.2 For the first time,the operating characteristics of the rotating-traction-poking manipulation are summarized as follows:(1)Thumb,index finger and middle finger are the main force-givers in the rotating-traction-poking manipulation.During rotating operation,the thumb and index finger,middle finger alternate force,the size of the force changes rhythmically and uniformly,the frequency and period of the force is always at a stable level;After the rotating operation,the traction-poking operation are carried out.The three movements are connected closely and continuously,without any time pause,but the speed of the rotating operation is greater than the speed of the traction-poking operation;During traction-poking operation,the force of thumb and middle finger during poking manipulation is larger than that of the time of the traction,and the force of the index finger during traction manipulation is greater than that of the force when the poking.(2)There was a positive correlation between the force of rotating,traction and poking operation in thumb,middle finger and index finger.There was no correlation between the force of thumb,index finger and middle finger and the speed,amplitude and time of manipulation.3 There was a positive correlation between the weight of the patient and the force of rotating method in manipulation,so the force of the finger should be adjusted according to the patient's body weight and body shape during the rotating manipulation. |
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