CHIROPRACTIC DEMONSTRATION PROJECTS GRANT

脊椎按摩疗法示范项目拨款

• 批准号: 2056441
• 负责人: MARUTI R GUDAVALLI
• 金额: --
• 依托单位: NATIONAL UNIVERSITY OF HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 1997-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2056441
• 关键词: backache; biomechanics; chiropractic; computer simulation; disease /disorder proneness /risk; electromyography; health service demonstration project; human subject; human tissue; intervertebral disk; muscle contraction; physical therapy; postmortem; spinal disk injury; spine

A common treatment for patients with low back pain (LBP) or lower extremity pain is the flexion-distraction therapy, which is a widely used form of chiropractic treatment in which non-impulsive loads are delivered at slow speeds. This therapy is hypothesized to result in motions of lumbar spine segments that increase the intervertebral foraminal space. The proposed study addresses the following research questions: (I). Does the flexion-distraction procedure increase the intervertebral foramina space in the lumbar spine in vitro ? (II). How reproducible are the biomechanical effects of the flexion-distraction therapy. That is, what is the intra- and inter-clinician reliability of the biomechanical parameters while administering this procedure in vitro? (III). What are the loads on the internal tissues of the spinal segments L4-L5 and L5-S1, and are the tissues at risk of injury during the flexion-distraction procedure in vitro? (IV). Is there in vivo trunk muscle activity that may alter the transmission of loads and motion to the spinal segment? In vitro experiments will be conducted on 10 unembalmed whole cadavers to quantitatively describe the three-dimensional displacements, dimensional (height, width and area) changes in the intervertebral foramina, and loads applied to the subject during the flexion-distraction therapeutic procedure for L4-L5 and L5-S1 spinal motion segments. These measurements will utilize an optoelectronic three-dimensional motion analysis system (OPTOTRAK), a three-dimensional digitizer, three-dimensional force plates and a load cell. The intra- and inter-clinician reliability of the measured biomechanical effects of this procedure will be determined based on data collected while three different clinicians administer the procedure three times on each of the 10 cadavers. A computer model developed by the investigators will be used to estimate the internal loads on the ligaments, and the intervertebral disc of the L4-L5 and L5-S1 joints under in vitro conditions of this therapeutic procedure. We will compare these loads with the failure loads of the tissues to assess the risk of injury. Finally, we will conduct in vivo experiments on 60 patients with a history of LBP at L4 to S1 spinal levels. We will quantitatively describe the loads applied to the subjects and the electromyographic activity of six superficial muscles surrounding the lumbar spine during the flexion-distraction therapeutic procedure. The proposed study will be undertaken in collaboration with investigators from the Department of Orthopedic Surgery. Loyola University Stritch School of Medicine, Maywood, Illinois and a secondary care facility, The Hinsdale Orthopedic Clinic.

腰痛患者（LBP）或较低的常见治疗 肢体疼痛是屈肌疗法，这是一种广泛使用的 交付非冲动载荷的脊椎治疗形式 以缓慢的速度。假设这种疗法会导致运动 腰椎段增加椎间孔空间。 拟议的研究解决了以下研究问题：（i）。做 屈曲分配程序增加了椎间孔 体外的腰椎空间？ （ii）。多么可重现 屈曲 - 分散疗法的生物力学作用。也就是说，什么 生物力学参数的内在和临床间可靠性 在体外管理此过程的同时？ （iii）。负载是多少 脊柱段L4-L5和L5-S1的内部组织，是 在屈曲 - 分发过程中有受伤风险的组织 体外？ （iv）。是否有体内躯干肌肉活动可能会改变 将负载和运动传输到脊柱段？ 体外 实验将在10个不满的整个尸体上进行 定量描述三维位移，尺寸 （高度，宽度和区域）椎间孔的变化，并负载 在屈曲分发治疗期间应用于对象 L4-L5和L5-S1脊柱运动段的程序。这些测量值 将使用光电子三维运动分析系统 （Optotrak），三维数字化器三维力板 和一个负载电池。临床内和临床间的可靠性 该过程的测量生物力学效应将基于 关于收集的数据，三位不同的临床医生管理 在10个尸体中的每个中，每个过程中的每个过程三次。计算机型号 研究人员开发的将用于估计内部负载 在韧带上，L4-L5和L5-S1的椎间盘 在这种治疗过程的体外条件下关节。我们将 将这些负载与组织的故障负载进行比较以评估 受伤的风险。最后，我们将在60上进行体内实验 L4至S1脊柱水平的LBP病史的患者。 我们将 定量描述用于受试者的载荷和 周围六个浅表肌肉的肌电图活性 在屈曲 - 分布治疗过程中的腰椎。这 拟议的研究将与来自 骨科手术系。洛约拉大学斯特里奇学校 医学，伊利诺伊州梅伍德和二级护理设施，欣斯代尔 骨科诊所。