林氏腰椎提拉旋转斜扳手法力学特点分析

目的 采用多点薄膜压力测试系统研究腰椎提拉旋转斜扳手法，以阐明手法的力学特点。 方法 21名男性推拿操作者分专家组、熟练者组、初学者组，连续在压力测试系统上操作7次，每人均重复3次，将收集的图形及数据指标进行处理分析。结果 专家组手法操作时间-力曲线的图形规律，平均预加载力为(147.25±26.04) N，持续时间为(0.98±0.20) s，谷值平均值(79.22±9.50) N，最大冲击力(706.26±56.21) N，扳动时间(0.44±0.09) s，扳动速度(1 666.33±411.91) N/s，冲量(310.95±56.67) N·s。熟练者手法与专家组手法图形基本相似，各组指标相差不大，但平均最大冲击力相对较小，为(464.51±53.49) N。初学者手法图形轨迹大致可分为3类，Ⅰ类杂乱无章型，无规律可循；Ⅱ类只有冲击相无预加载相，且最大冲击力大小不一；Ⅲ类既有冲击相又有预加载相，且力量较稳定，但两者力度均偏小。结论 多点薄膜压力测试系统可很好地显示林氏腰椎提拉旋转斜扳手法力学特点，是林氏手法动力学参数量化研究较理想的测试工具。试验结果为手法的直观显示、量化、标准化提供了科学依据。
Objective To study the mechanical characteristics of lumbar vertebral manipulation by lifting-rotating and oblique-pulling using multi-film pressure measurement system. Methods Twenty-one male operators were divided into groups of experts, skilled operators and beginners. Everyone completed 7 actions of Lin’s lumbar manipulation continuously, and repeated 3 times. The graphs and data were collected and processed. Results The time-force curve by the experts had regularity. The average pre-load force was (147.25±26.04) N, duration was (0.98±0.20) s, the average minimum force was (79.22±9.50) N, the maximum impact force was (706.26±56.21) N, the flip time was (0.44±0.09) s, and flip speed was (1 666.33±411.91) N/s, the impulse was (310.95±56.67) N·s. The curve graphs and the index by the skilled operators were similar to those by the experts, but the average maximum impact force was (464.51±53.49) N, which was relatively smaller. The curve graphs by the beginners could be broadly divided into three categories. Class Ⅰ was chaotic and unregulated; Class Ⅱ only had impact force and did not have pre-load force, and the maximum impact force varied in size; Class Ⅲ had both impact force and pre-load force, but the forces were relatively small and stable. Conclusions The multi-film pressure measurement system can preferably display the mechanical characteristics of manipulation by lifting-rotating and oblique-pulling, which is an ideal testing tool for quantitative research on mechanical parameters of Lin’s lumbar vertebral manipulation. The experimental results provide a scientific basis for visualization, quantification and standardization of the manipulation.