Pressure force on tissues in various osteopathic techniques (pilot study)

D. Mokhov, E. Tregubova, Y. Potekhina, L. M. Smirnova, N. Y. Kolyshnitsyn, D. .. Miroshnichenko
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Abstract

Introduction. The main tool of the osteopathic physician, which carries out most of the diagnostic and therapeutic actions, is the hands. To conduct scientifi c research in osteopathy, it is necessary to understand the nature of the impact and its quantitative characteristics, in particular, the pressure force of the physician′s hands on the patient′s body. In the available literature, it was possible to fi nd single instrumental studies of the pressure force of the osteopath′s hands during performing cranial techniques. Similar studies about the performance of other techniques could not be found in the available literature.Aims: to measure by an instrumental method the pressure force of the osteopath hands during various osteopathic techniques (cranial, visceral, structural).Materials and methods. The study was conducted on the basis of the Mokhov Institute of Osteopathy Clinic in January 2023. The study involved 6 lecturers of the Institute of Osteopathy (St. Petersburg), their experience as an osteopath is at least 5 years; the age is from 33 to 53 years. As patients, the residents of the Osteopathy Department of Mechnikov North-West Medical State University were involved. There were 2 men and 4 women, aged from 24 to 26 years, with a normosthenic constitution and a body mass index from 19,5 to 24. The following devices were used to measure the pressure strength of the osteopathic physician′s hands: Fsr402 resistive pressure sensors (Arduino Italy) and A402 (Tekscan USA), FlexiForce Prototyping Kit with FlexiForce MicroView software (Tekscan USA), and a device for determining skin elasticity and human skin scars (strain gauge attached to a caliper, Patent RU 2763 843 C1). Each physician demonstrated several osteopathic techniques on one patient. During the execution of each technique, three measurements were made, and the arithmetic mean was calculated. Structural, visceral and cranial techniques of osteopathic correction were performed.Results. The Friedman test showed a statistically signifi cant difference in pressure strength for different techniques (p<0,01). The greatest pressure force was measured during the mobilization of the descending colon (3,6±0,3 Newton); the minimum force was measured during the mobilization of the thoracic spine in the extension (1,5±0,3 Newton). When performing each technique, there was a range (the difference between the minimum and maximum values) between physicians from 0,95 Newton for performing a frontal bone lift to 1,8 Newton for mobilizing the sigmoid colon. Conclusion. The pilot study showed that during performing different techniques, the pressure strength of the osteopathic physician′s hands differed signifi cantly. It is advisable to continue the study on a more representative sample.> <0,01). The greatest pressure force was measured during the mobilization of the descending colon (3,6±0,3 Newton); the minimum force was measured during the mobilization of the thoracic spine in the extension (1,5±0,3 Newton). When performing each technique, there was a range (the difference between the minimum and maximum values) between physicians from 0,95 Newton for performing a frontal bone lift to 1,8 Newton for mobilizing the sigmoid colon.Conclusion. The pilot study showed that during performing different techniques, the pressure strength of the osteopathic physician′s hands differed signifi cantly. It is advisable to continue the study on a more representative sample.
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各种骨科技术对组织施加的压力(初步研究)
介绍。整骨疗法医生的主要工具是手,它执行大多数诊断和治疗行动。为了进行整骨疗法的科学研究,有必要了解影响的性质及其定量特征,特别是医生的手对患者身体的压力。在现有文献中,有可能找到整骨医生在进行颅骨技术时手部压力的单一仪器研究。关于其他技术性能的类似研究在现有文献中找不到。目的:用仪器测量整骨师在各种整骨技术(颅、内脏、结构)中手部的压力。材料和方法。该研究于2023年1月在Mokhov骨科研究所诊所的基础上进行。该研究涉及6名骨科研究所(圣彼得堡)讲师,他们作为骨科医生的经验至少为5年;年龄从33岁到53岁。作为患者,梅奇尼科夫西北医科大学骨科的住院医生参与了研究。男2名,女4名,年龄24 ~ 26岁,体质正常,体重指数19.5 ~ 24。以下设备用于测量骨科医生手部的压力强度:Fsr402电阻压力传感器(Arduino意大利)和A402 (Tekscan美国),带FlexiForce MicroView软件的FlexiForce原型工具包(Tekscan美国),以及用于测定皮肤弹性和人体皮肤疤痕的设备(连接在卡尺上的应变计,专利号RU 2763 843 C1)。每位医生在一名患者身上展示了几种整骨疗法。在每种技术的执行过程中,进行了三次测量,并计算了算术平均值。采用结构、内脏和颅骨技术进行整骨矫正。Friedman检验显示,不同技术的压力强度差异有统计学意义(p < 0.01)。降结肠活动时测得最大压力(3,6±0,3牛顿);测量胸椎伸展活动时的最小力(1.5±0.3牛顿)。在执行每一项技术时,医生之间存在一个范围(最小值和最大值之间的差异),从执行额骨提升的0.95牛顿到移动乙状结肠的1.8牛顿。试点研究表明,在执行不同的技术,骨科医生的手的压力强度有显著差异。明智的做法是在一个更有代表性的样本上继续研究。
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