两种颈椎旋转手法所致咔哒声响的比较

关键词：颈椎  旋转手法  咔哒声响  亚生理区

Keywords:cervical vertebra  rotatory manipulation  cracking sounds  sub-physiological area

摘要：

      摘要 目的:研究两种颈椎旋转手法作用时咔哒声响次数，并进行比较分析。 方法:72名健康在校大学生，随机分为两组：实验1组和对照1组，均采用先向左后向右扳动的颈椎旋转手法，其中实验1组施行常规快速颈椎旋转手法，左右各2次；对照1组施行慢速颈椎旋转手法，左右各2次。间隔1周后进行第二轮实验，仍然随机分为两组，实验2组和对照2组，均采用先向右后向左扳动的颈椎旋转手法，其中实验2组仍施行常规快速颈椎旋转手法，左右各2次，对照2组仍施行慢速颈椎旋转手法，左右各2次。运用自行设计的声响采集系统对手法所致的咔哒声响进行采集，分析其发出声响的次数，并进行统计学分析。 结果: 第一次旋转时，实验1组和对照1组在亚生理区内继续向左旋转出现的咔哒声响次数差异有显著性意义（t=4.077, P=0.009），向右旋转出现的咔哒声响次数差异同样有显著性意义（t=2.017, P=0.047）；实验2组和对照2组在亚生理区内继续向左旋转出现的咔哒声响次数差异有显著性意义（t=2.014, P=0.048），向右旋转出现的咔哒声响次数差异同样有显著性意义（t=3.281, P=0.002）；实验1组在亚生理区内继续向左旋转出现的咔哒声响次数跟向右旋转相比差异有显著性意义（t=1.87, P=0.007），向左产生的声响次数少于向右者；实验2组在亚生理区内继续向左旋转出现的咔哒声响次数跟向右旋转相比差异也有显著性意义（t=4.077, P=0.009），向右产生的声响次数少于向左者；对照1组在亚生理区内继续向左旋转出现的咔哒声响次数跟向右旋转相比差异无显著性意义（t=0.499, P=0.620），对照2组在亚生理区内继续向左旋转出现的咔哒声响次数跟向右旋转相比差异也无显著性意义（t=1.825, P=0.072）。第2次重复实施颈部旋转手法时产生咔哒声响次数的比较结果发现，四组受试者在全部操作过程中出现了极少的咔哒声响，两两比较组间差异无显著性意义（P＞0.05）。 结论：在颈椎旋转手法时，在亚生理区采用闪动力能引发较多的咔哒声响；使用闪动力向一侧旋转产生咔哒声响后，会影响到向对侧旋转时咔哒声响的产生。

Abstract:

      Abstract Objective：To study the difference of frequency of cracking sounds caused by two different kinds of cervical rotatory manipulation. Method: Seventy-two healthy university students were divided into two teams randomly: the first experimental group and the first control group. Conventional rapid cervical rotatory manipulation was performed in the first experimental group and uniform slow cervical rotatory manipulation was performed in the first control group. Both of the two rotatory manipulations were rotated to the left then to the right. An other experiment was fulfilled a week after the first one. In this experiment, the students were also divided into two teams randomly again: the second experimental group and the second control group. Conventional rapid cervical rotatory manipulation was performed in the second experimental group and uniform slow cervical rotatory manipulation was performed in the second control group. Both two rotatory manipulations were rotated to the right then to the left. Each student was operated twice on the left side and right side in both experiments. A set of equipment designed for acoustic signal acquisition was applied to collect the cracking sounds of manipulations, followed by statistical analysis of the data collected. Result: At the first rotation, the frequency of cracking sounds were significantly different in the sub-physiological area of the fist experimental group and the first control group(to the left, t=4.077, P=0.009; to the right, t=2.017, P=0.047). the frequency of cracking sounds were also significantly different in the sub-physiological area of the second experimental group and the second control group(to the left, t=2.014, P=0.048; to the right, t=3.281, P=0.002). For the first experimental group, the frequency of cracking sounds were significantly different in the sub-physiological area between to the left and to the right（t=1.87, P=0.007）. For the second experimental group, the frequency of cracking sounds is also significantly different in the sub-physiological area between to the left and to the right（t=4.077, P=0.009）. For the first control group, the frequency of cracking sounds were not significantly different in the sub-physiological area between to the left and to the right（t=0.499, P=0.620）. For the second control group, the frequency of cracking sounds were also not significantly different in the sub-physiological area between to the left and to the right（t=1.825, P=0.072）.While at the second time, the frequency of cracking sounds were scarce and almost the same（P＞0.05）. Conclusion: If sudden force was used in the cervical rotatory manipulation in the sub-physiological area, it could cause more cracking sounds. The cracking sounds of the rotation to the opposite side would be affected and decreased after the cracking sounds were caused by the rapid rotation to one side.