Journal of chiropractic medicine最新文献_第8页

Dendrogram for Anthropometric and Biomechanical Variables Causing Foot Deformities by Using Hierarchical Cluster Analysis: A Cross-Sectional Study 使用层次聚类分析导致足部畸形的人体测量和生物力学变量的树形图:一项横断面研究

Journal of chiropractic medicine

Pub Date : 2022-06-01 DOI: 10.1016/j.jcm.2022.02.009

Başar Öztürk PhD , Yusuf Çelik PhD

Objective

The purpose of this study was to determine the factors associated with pathomechanical conditions and to determine the clustering tendency of the variables by dendrogram.

Methods

The cross-sectional study was carried out with 108 physiotherapy students aged 21.36 ± 1.35 years. The variables included in the study were quadriceps (Q), subtalar, and valgus angles and medial longitudinal arch (MLA) and hallux valgus angles. The MLA and metatarsal width were measured and navicular drop tests performed under weighted and nonweighted conditions. Hierarchical cluster analysis was used to determine the clustering tendency of the variables and see how these clusters might converge.

Results

Two main clusters of variables were obtained using hierarchical cluster analysis. In the first main cluster, the weighted and nonweighted metatarsal widths of the left and right sides, age, hallux valgus angle, and subtalar pronation angles of the left and right sides were found to be significantly related to each other. In the second main cluster, the weighted and nonweighted MLA, knee valgus and Q angles, weight, body mass index, weighted and nonweighted navicular drop values, gender, and height were found to be significantly related to each other.

Conclusion

The relationships between variables such as MLA, hallux valgus angles, knee valgus and Q angles, weight, body mass index, weighted and nonweighted navicular drop values, gender, and height seem to be associated with pathomechanical conditions.

目的通过树形图确定与病理力学状况相关的因素，并确定变量的聚类趋势。方法对108名物理治疗学生(21.36±1.35岁)进行横断面研究。纳入研究的变量包括股四头肌(Q)、距下、外翻角、内侧纵弓(MLA)和拇外翻角。测量MLA和跖骨宽度，并在加权和非加权条件下进行舟形落差试验。采用层次聚类分析来确定变量的聚类倾向，并观察这些聚类如何收敛。结果采用层次聚类分析得到两个主要的变量聚类。在第一个主群中，发现左右两侧加权和非加权跖骨宽度、年龄、拇外翻角和左右距下旋前角之间存在显著相关。在第二个主要聚类中，加权和非加权MLA、膝关节外翻和Q角、体重、体重指数、加权和非加权舟骨落差值、性别和身高之间存在显著相关。结论MLA、拇外翻角、膝外翻角、Q角、体重、体重指数、加权和非加权舟骨落差、性别、身高等变量与病理力学条件有关。

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引用次数: 3

Conservative Management of Knee Pain Associated With a Benign Femoral Osteochondroma in a Youth Athlete: A Case Report 一例青年运动员良性股骨骨软骨瘤并发膝关节疼痛的保守治疗

Journal of chiropractic medicine

Pub Date : 2022-06-01 DOI: 10.1016/j.jcm.2022.01.006

Morgan R. Price DC

Objective

The purpose of this case report is to describe the conservative treatment of a patient with musculoskeletal knee pain associated with a benign femoral osteochondroma.

Clinical Features

An 11-year-old boy with acute left knee pain for 1 week's duration presented for chiropractic evaluation. He attributed the pain to nontraumatic provocation during football and a pre-existing benign osteochondroma located in his left femoral epiphysis. He had pain throughout his posteromedial knee and distal thigh, attributed to acute irritation of the surrounding adductor and medial hamstring musculature. His orthopedic surgeon had recommended delaying surgical excision. The patient presented for conservative pain management to continue participating in football.

Intervention and Outcome

A trial of conservative care was performed for 3 visits throughout 6 days. It consisted of therapeutic exercise in the form of end-range isometric exercises and gentle manual therapy, with self-management strategies including Kinesio Taping and cryotherapy. After 3 visits the patient's acute pain declined and his function and ranges of motion returned to baseline, which allowed him to continue participating in youth football unrestricted.

Conclusion

A young athlete with knee pain, likely associated with a distal femoral osteochondroma, was managed with a short course of chiropractic care. The patient was able to continue participating in youth football and required no further care.

目的:报告一例伴有良性股骨骨软骨瘤的膝关节骨骼肌疼痛患者的保守治疗。临床特征:一名11岁男孩，急性左膝疼痛持续1周，提出整脊评估。他将疼痛归因于足球期间的非创伤性刺激和他左股骨骺处已有的良性骨软骨瘤。由于周围内收肌和内侧腘绳肌的急性刺激，患者整个膝后内侧和大腿远端疼痛。他的骨科医生建议延迟手术切除。患者提出保守的疼痛管理继续参加足球。干预措施和结果保守治疗试验进行了3次就诊，共6天。它包括以末端等距运动和温和的手工疗法形式进行的治疗性运动，以及包括肌内效贴敷和冷冻疗法在内的自我管理策略。3次就诊后，患者的急性疼痛减轻，功能和活动范围恢复到基线，这使他能够继续不受限制地参加青少年足球比赛。结论一例年轻运动员膝关节疼痛，可能与股骨远端骨软骨瘤相关，采用短期捏脊治疗。病人能够继续参加青少年足球比赛，不需要进一步的护理。

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引用次数: 0

Comparison of the Effect of Osteopathic Manipulations and Exercises on the Myoelectric Activity of the Pelvic Floor: A Randomized Controlled Trial 骨科手法和运动对骨盆底肌电活动影响的比较:一项随机对照试验

Journal of chiropractic medicine

Pub Date : 2022-06-01 DOI: 10.1016/j.jcm.2022.02.005

Giselle Notini Arcanjo PhD , Juliana Lerche Vieira Rocha Pires MSc , Maria Edna Mateus Jacinto PT , Josué Magalhães Colares PT , Lurdyanne Maria Cavalcante Belo PT , Pedro Olavo de Paula Lima PhD , José Vilaça-Alves PhD

Objective

The purpose of this clinical trial was to compare the effects of 4 different interventions on electromyographic activity of the pelvic floor muscles in women with stress urinary incontinence (UI).

Methods

Fifty-one women with stress UI were randomized into 4 groups: a global osteopathic protocol (myofascial, visceral, and articular techniques); 1 manipulation technique (high-velocity, low-amplitude/thrust) of the sacroiliac joint and T10-L2; training of the pelvic floor muscles; and no intervention (control). Electromyographic activity of the pelvic floor muscles was evaluated at 5 different times (baseline, immediately after the procedure, 30 minutes, 1 hour, and 4 weeks after intervention).

Results

Forty women completed the study. There were no immediate or late effects on the myoelectric activity of any type of muscle fiber in any of the groups analyzed.

Conclusion

There were no significant between-groups differences of electromyography in women with symptoms of stress UI.

目的本临床试验的目的是比较4种不同的干预措施对女性压力性尿失禁(UI)盆底肌电图活动的影响。方法51例应激性尿失忆症女性随机分为4组:采用整体整骨疗法(肌筋膜、内脏和关节技术);1 .骶髂关节及T10-L2的高速、低振幅/推力手法;盆底肌肉的训练;没有干预(控制)。在5个不同时间(基线、手术后立即、30分钟、1小时和干预后4周)评估盆底肌的肌电活动。结果40名女性完成了这项研究。在分析的任何组中，对任何类型的肌纤维的肌电活动都没有立即或后期的影响。结论应激性尿失禁症状女性的肌电图在两组间无显著差异。

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引用次数: 0

Associations Between Early Chiropractic Care and Physical Therapy on Subsequent Opioid Use Among Persons With Low Back Pain in Arkansas 阿肯色州腰痛患者早期捏脊治疗和物理治疗对阿片类药物使用的影响

Journal of chiropractic medicine

Pub Date : 2022-06-01 DOI: 10.1016/j.jcm.2022.02.007

Mahip Acharya BPharm , Divyan Chopra MS , Allen M. Smith PharmD , Julie M. Fritz PhD, PT , Bradley C. Martin PharmD, PhD

Objective

The objective of this study was to estimate the association between early use of physical therapy (PT) or chiropractic care and incident opioid use and long-term opioid use in individuals with a low back pain (LBP) diagnosis.

Methods

A retrospective cohort study was conducted using data from Arkansas All Payers’ Claims Database. Adults with incident LBP diagnosed in primary care or emergency departments between July 1, 2013, and June 30, 2017, were identified. Participants were required to be opioid naïve in the 6-month baseline period and without cancer, cauda equina syndrome, osteomyelitis, lumbar fracture, and paraplegia/quadriplegia in the entire study period. PT and chiropractic treatment were documented over the ensuing 30 days starting on the date of LBP. Any opioid use and long-term opioid use (LTOU) in 1-year follow-up were assessed. Multivariable logistic regressions controlling for covariates were estimated.

Results

A total of 40 929 individuals were included in the final sample, with an average age of 41 years and 65% being women. Only 5% and 6% received PT and chiropractic service, respectively, within the first 30 days. Sixty-four percent had incident opioid use, and 4% had LTOU in the follow-up period. PT was not associated with incident opioid use (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.98-1.18) or LTOU (OR, 1.19; 95% CI, 0.97-1.45). Chiropractic care decreased the odds of opioid use (OR, 0.88; 95% CI, 0.80-0.97) and LTOU (OR, 0.56; 95% CI, 0.40-0.77).

Conclusion

In this study we found that receipt of chiropractic care, though not PT, may have disrupted the need for opioids and, in particular, LTOU in newly diagnosed LBP.

本研究的目的是评估诊断为腰痛(LBP)的个体早期使用物理治疗(PT)或脊椎指压治疗与阿片类药物使用和长期阿片类药物使用之间的关系。方法采用阿肯色州所有付款人索赔数据库的数据进行回顾性队列研究。2013年7月1日至2017年6月30日期间在初级保健或急诊科诊断的成人LBP事件被确定。参与者被要求在6个月的基线期服用阿片类药物naïve，并且在整个研究期间没有癌症、马尾综合征、骨髓炎、腰椎骨折和截瘫/四肢瘫痪。从腰痛发生之日起的30天内记录PT和捏脊治疗。随访1年评估阿片类药物使用情况和长期阿片类药物使用情况。对控制协变量的多变量logistic回归进行了估计。结果最终样本共40929人，平均年龄41岁，女性占65%。只有5%和6%的人分别在前30天内接受了理疗和脊椎按摩服务。在随访期间，64%的人有阿片类药物使用，4%的人有LTOU。PT与阿片类药物使用事件无关(优势比[OR]， 1.07;95%可信区间[CI]， 0.98-1.18)或LTOU (or, 1.19;95% ci, 0.97-1.45)。捏脊疗法降低了阿片类药物使用的几率(OR, 0.88;95% CI, 0.80-0.97)和LTOU (OR, 0.56;95% ci, 0.40-0.77)。结论:在本研究中，我们发现接受整脊治疗(尽管不是PT)可能会扰乱对阿片类药物的需求，特别是新诊断的LBP患者的LTOU。

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引用次数: 4

Intra-Rater Reliability of Ultrasound Measurements of Diaphragm Thickness and Contractility in Individuals with Nonspecific Chronic Neck Pain 非特异性慢性颈痛患者超声测量膈膜厚度和收缩性的内部可靠性

Journal of chiropractic medicine

Pub Date : 2022-06-01 DOI: 10.1016/j.jcm.2022.02.006

Alieh Zendehdel Jadehkenari MSc , Hamid Reza Haghighatkhah MD , Javad Sarrafzadeh PhD , Ismail Ebrahimi Takamjani PhD , Amir Massoud Arab PhD , Maryam Ziaeifar PhD

Objective

This study aimed to determine within-day intra-rater reliability of ultrasound measurements of the right and left hemidiaphragm thickness and contractility (quantified by percentage thickness change) in supine position during deep breathing in individuals with nonspecific chronic neck pain.

Methods

Seventeen volunteers (20-55 years of age) participated in this observational study. Bilateral diaphragm muscle thickness and contractility (percentage thickness change) were compared between 2 measurement sessions administered by a radiologist using B-mode real-time ultrasound (30 minutes apart). Intraclass correlation coefficient (ICC [3, 3]) as well as the standard error of measurement (SEM), minimal detectable change (MDC), and the coefficient of variation (CV) were used to determine the intra-rater reliability.

Results

The right and left hemidiaphragm thickness showed good to excellent reliability at the end of deep inspiration (ICC, 0.90; 95% confidence interval [CI], 0.72-0.96; and ICC, 0. 93; 95% CI, 0.81-0.97, respectively) as well as at the end of deep expiration (ICC, 0.91; 95% CI, 0.75-0.96; ICC, 0.91; 95% CI, 0.77-0.97; SEM, 0.19; MDC, 0.54; and CV, 7.84%, respectively) and the percentage thickness change (ICC, 0.83; 95% CI, 0.54-0.94; and ICC, 0.93; 95% CI, 0.82-0.97, respectively).

Conclusion

This study found that diagnostic ultrasound measurements of the right and left hemidiaphragm thickness and contractility in supine position during deep breathing in individuals with nonspecific chronic neck pain was reliable. The SEM, MDC, and CV reported may allow for accurate interpretation of diaphragm assessment in a clinical research setting.

目的:本研究旨在确定非特异性慢性颈痛患者在仰卧位深呼吸时左右半膈厚度和收缩力(以厚度变化百分比量化)的超声测量在一天内的可靠性。方法17例志愿者(年龄20 ~ 55岁)参加观察性研究。由放射科医生使用b型实时超声(间隔30分钟)进行两次测量，比较双侧膈肌厚度和收缩力(厚度变化百分比)。采用类内相关系数(ICC[3,3])以及测量标准误差(SEM)、最小可检测变化(MDC)和变异系数(CV)来确定组内信度。结果深吸气结束时左右半膈厚度呈良好至极好的信度(ICC, 0.90;95%置信区间[CI]， 0.72-0.96;ICC为0。93;95% CI，分别为0.81-0.97)以及深度过期结束时(ICC, 0.91;95% ci, 0.75-0.96;国际刑事法庭,0.91;95% ci, 0.77-0.97;SEM, 0.19;争取民主变革运动,0.54;和CV分别为7.84%)和厚度变化百分比(ICC, 0.83;95% ci, 0.54-0.94;和ICC, 0.93;95% CI分别为0.82-0.97)。结论本研究发现，非特异性慢性颈痛患者仰卧位深呼吸时左右膈厚度和收缩力的诊断超声测量是可靠的。扫描电镜，MDC和CV报告可能允许在临床研究设置隔膜评估的准确解释。

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引用次数: 0

Intrarater Reliability of Diaphragm Excursion and Resting Thickness Using Ultrasound Imaging in Subjects With Nonspecific Chronic Low Back Pain 非特异性慢性腰痛患者超声成像膈肌偏移和静息厚度的内部可靠性

Journal of chiropractic medicine

Pub Date : 2022-03-01 DOI: 10.1016/j.jcm.2022.02.001

Maryam Ziaeifar PhD , Shohreh Noorizadeh Dehkordi PhD , Hamid Reza Haghighatkhah MD , Javad Sarrafzadeh PhD , Amir Masoud Arab PhD , Alieh Zendehdel Jadehkenari MSc

Objective

The purpose of this study was to establish within-day intrarater reliability values of ultrasound measurements (excursion and resting thickness).

Methods

Seventeen volunteers met the inclusion criteria for this preliminary study. The right and left hemidiaphragm excursion and resting thickness were compared between 2 measurement sessions using M-mode and B-mode real-time ultrasound, respectively (30 min apart). Intraclass coefficients, coefficients of variation, standard errors of measurement, and minimal detectable changes were calculated to determine intrarater reliability.

Results

The intraclass coefficients of right hemidiaphragm excursion were 0.91 and 0.94 during quiet and deep breathing, respectively. The intraclass coefficient of left hemidiaphragm excursion was 0.95 during quiet breathing. The intraclass coefficients of diaphragm resting thickness were 0.99 and 0.97 in the right and left hemidiaphragm, respectively, which showed high intrarater reliability for ultrasound measurements of both sides of the diaphragm.

Conclusion

This preliminary study suggests that diagnostic ultrasonography could be used as a potential method for measuring the resting thickness and excursion of the right and left hemidiaphragm in people with chronic low back pain. Future research with a larger sample size is needed to confirm these findings.

目的建立超声测量(偏移和静息厚度)在一天内的可靠性值。方法17名志愿者符合本初步研究的纳入标准。分别采用m型实时超声和b型实时超声(间隔30 min)测量2次，比较左右半膈偏移和静息厚度。计算类内系数、变异系数、测量标准误差和最小可检测变化，以确定类内信度。结果静息呼吸和深呼吸时右半隔膜漂移的类内系数分别为0.91和0.94。安静呼吸时左膈漂移的类内系数为0.95。左右半隔膜静息厚度的类内系数分别为0.99和0.97，对两侧隔膜超声测量具有较高的类内可靠性。结论超声诊断性检查可作为慢性腰痛患者左、右膈肌静息厚度和偏移量的一种潜在测量方法。未来需要更大样本量的研究来证实这些发现。

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引用次数: 1

Chiropractic Care of a Female Veteran After Cervical Total Disk Replacement: A Case Report 1例女退伍军人颈椎全盘置换术后的捏脊护理

Journal of chiropractic medicine

Pub Date : 2022-03-01 DOI: 10.1016/j.jcm.2022.02.008

Michael Mortenson DC , Anna Montgomery MPH , Glenn Buttermann MD

Objective

The purpose of this case study is to describe chiropractic care of the cervical spine for a patient who previously underwent cervical total disk replacement (CTDR) of the C5-6 and C6-7 disks.

Clinical Features

A 42-year-old female veteran of the U.S. Army presented to a Veterans Affairs chiropractic clinic with chronic cervical pain and radiculopathy. She had previously undergone CTDR surgery of the C5-6 disk 9 years earlier, but the pain had become severe and radicular symptoms had returned in the upper left extremity. Imaging taken before the chiropractic referral demonstrated significant joint space narrowing and disk herniation of the C6-7 disk with protrusion to the left side.

Intervention and Outcome

The patient received spinal manipulative therapy, trigger-point therapy, and manual traction to the cervical spine. However, these treatments were not effective in reducing her cervical pain and radiculopathy. She then opted for CTDR of the C6-7 disk. After surgery, the patient reported that radicular symptoms were mostly relieved and cervical pain had decreased by 50%. After 6 additional spinal manipulative therapy treatments, she reported having no neurologic symptoms and that her pain had decreased more than 70% from presurgery levels.

Conclusion

This case report is the first reported example of chiropractic care after CTDR within an integrated health care environment. The patient's cervical pain and radiculopathy improved with CTDR along with postsurgical chiropractic care.

目的:本病例研究的目的是描述一名曾接受C5-6和C6-7椎间盘全椎间盘置换术(CTDR)的患者的颈椎整脊护理。临床特征:一名42岁的美国陆军女性退伍军人因慢性颈椎疼痛和神经根病来到退伍军人事务部的整脊诊所。9年前，她曾接受C5-6椎间盘CTDR手术，但疼痛变得严重，左上肢神经根症状复发。指压治疗前的影像学显示明显的关节间隙狭窄和C6-7椎间盘突出，左侧突出。干预措施和结果:患者接受脊柱推拿治疗、触发点治疗和颈椎手动牵引。然而，这些治疗并没有有效地减轻她的颈椎疼痛和神经根病。然后她选择了C6-7椎间盘的CTDR。手术后，患者报告神经根症状大部分缓解，颈椎疼痛减轻了50%。经过6次额外的脊柱推拿治疗后，她报告没有神经系统症状，疼痛比手术前水平减轻了70%以上。结论本病例报告是首例在综合卫生保健环境下CTDR后捏脊治疗的报道。患者的颈椎疼痛和神经根病在CTDR和术后捏脊治疗后得到改善。

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引用次数: 0

Intraclinician Variability in Force Application During Anteroposterior Mobilization of the Ankle Joint 踝关节前后位活动过程中力量应用的临床变异

Journal of chiropractic medicine

Pub Date : 2022-03-01 DOI: 10.1016/j.jcm.2022.01.005

Aaron J. Wholohan PhD , Ted Jedynak BPod

Objective

The purpose of this study was to quantify the variability in the force applied during 20 cycles of Maitland's grade IV anteroposterior ankle mobilization measured on 2 occasions.

Methods

Thirteen healthy adults (mean age, 25 ± 5 years; height, 170 ± 7 cm; weight, 71 ± 16 kg) received 20 cycles of Maitland's grade IV ankle mobilization on 2 sessions separated by 1 week. A force transducer was used to measure the peak force, loading rate, and impulse applied during each load cycle. Mean within-session coefficient of variation, standard error of measurement, and 95% level of agreement were estimated during each mobilization session.

Results

The mean peak force during the anteroposterior mobilization technique was 70 ± 12 N and 58 ± 10 N during sessions 1 and 2, respectively. The mean within-session coefficients of variation in peak force, loading rate, and impulse applied during 20 loading cycles were 10% to 13%, 15%, and 21% to 43%, respectively. There was a significant difference between sessions in mean peak force (−17%, t₁₂ = 2.445, P = .031) and impulse (−51%, t₁₂ = 2.306, P = .040), with large 95% levels of agreement in applied peak force (±33 N) and impulse (±128 N s) compared to their mean values (approximately ±50% and 110%, respectively).

Conclusion

The peak force and loading rate applied by an experienced practitioner during a Maitland's grade IV anteroposterior talar mobilization session varied over 20 loading cycles. Variability between repeated mobilization sessions by the same practitioner was even greater, with respect to peak applied force and loading rate. The large variability in force applied during a Maitland's grade IV talar mobilization may underpin differential clinical effects reported in the joint-mobilization literature. The findings of this study highlight the need for strategies that standardize the application of force during talar mobilization.

目的本研究的目的是量化在20个周期的Maitland四级踝关节前后位活动中施加的力的变异性。方法健康成人13例(平均年龄25±5岁;高度:170±7cm;体重(71±16 kg)接受20个周期的Maitland IV级踝关节活动，每次2次，间隔1周。力传感器用于测量每个负载周期内的峰值力、加载速率和脉冲。在每次动员期间估计平均会话内变异系数、测量标准误差和95%的一致性水平。结果第1期和第2期前后位活动技术的平均峰值力分别为70±12 N和58±10 N。在20个加载周期中，峰值力、加载率和脉冲的平均变化系数分别为10%至13%、15%和21%至43%。在平均峰值力(- 17%，t12 = 2.445,P = .031)和冲量(- 51%，t12 = 2.306,P = .040)两组之间存在显著差异，与平均值(分别约±50%和110%)相比，施加的峰值力(±33 N)和冲量(±128 N s)有95%的一致性。结论一名经验丰富的医生在Maitland级前后距动员过程中施加的峰值力和负荷率在20个负荷周期内发生了变化。由同一执业者进行的重复活动之间的可变性甚至更大，就峰值施加的力和加载率而言。在Maitland的四级距骨活动中，施加的力量的巨大可变性可能是关节活动文献中报道的不同临床效果的基础。本研究的结果强调需要制定策略，规范距骨动员过程中力量的应用。

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引用次数: 0

Coordination of Care Between Chiropractic and Behavioral Health Practitioners Within the US Department of Veterans Affairs Health Care System: A Report of 3 Patients With Pain and Mental Health Symptoms 美国退伍军人事务部医疗保健系统中脊椎按摩和行为健康从业人员之间的护理协调:3例疼痛和精神健康症状患者的报告

Journal of chiropractic medicine

Pub Date : 2022-03-01 DOI: 10.1016/j.jcm.2022.01.002

Clinton J. Daniels DC, MS , Derek R. Anderson PhD , Zachary A. Cupler DC, MS

Objective

The purpose of this case series is to describe coordination of care between chiropractic and behavioral health practitioners within an integrated hospital-based system.

Clinical Features

Three individuals presented to a US Veterans Affairs Health Care system with musculoskeletal complaints for chiropractic care. Each person demonstrated symptoms of depression or anxiety and in 2 cases indicated passive suicidal ideation.

Intervention and Outcome

The chiropractors referred the patients to a mental health provider for co-management. Different approaches to mental health care were offered to each of these patients to meet their individual preferences and needs as part of an evidence informed approach. One patient underwent individual cognitive behavioral therapy; 1 patient responded well to individual cognitive behavioral therapy before transitioning to group-based pain skills, resiliency, and mindfulness therapy; and 1 patient required additional referral to Primary Care-Mental Health Integration for pharmacologic treatment. The 3 patients responded positively to interdisciplinary care and realized functional improvements and improved patient reported outcomes as assessed with the 11-point Numerical Pain Rating Scale and Neck or Back Bournemouth Questionnaire.

Conclusion

This case series describes the recognition of mental health symptoms, referral to behavioral health providers, and the subsequent treatment approaches. This case series presents the first description of co-managed care for US veterans by a chiropractor and psychologist.

目的:本病例系列的目的是描述在综合医院系统中脊医和行为健康从业人员之间的护理协调。临床特点:三个人提出了美国退伍军人事务卫生保健系统的肌肉骨骼投诉的脊椎治疗。每个人都表现出抑郁或焦虑的症状，其中2例表现出被动的自杀意念。干预和结果脊医将患者转介给精神健康提供者进行共同管理。作为循证方法的一部分，为这些患者提供了不同的精神卫生保健方法，以满足他们的个人偏好和需求。一名患者接受了个体认知行为治疗;1例患者在过渡到基于群体的疼痛技能、弹性和正念疗法之前，对个体认知行为疗法反应良好;1名患者需要额外转诊至初级保健-精神卫生综合中心进行药物治疗。3例患者对跨学科护理反应积极，实现了功能改善，并改善了患者报告的结果，通过11分数值疼痛评定量表和颈部或背部伯恩茅斯问卷进行了评估。结论:本病例系列描述了对心理健康症状的识别，向行为健康提供者的转诊以及随后的治疗方法。本案例系列首次介绍了一名脊椎指压治疗师和心理学家对美国退伍军人共同管理护理的描述。

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引用次数: 0

Measuring Lumbar Motion Angle With a Small Accelerometer: A Reliability Study 用小型加速度计测量腰椎运动角:可靠性研究

Journal of chiropractic medicine

Pub Date : 2022-03-01 DOI: 10.1016/j.jcm.2022.02.010

Ryo Miyachi PhD , Ayaka Sano BS(Physio) , Nana Tanaka BS(Physio) , Misaki Tamai BS(Physio) , Junya Miyazaki PhD

Objective

The purpose of this study was to investigate the reliability of measuring the lumbar motion angle using a small accelerometer for movement tests in the sagittal plane, and to determine the number of measurements required to obtain reliable data.

Methods

In total, 102 healthy adults (56% women, 44% men; 20.1 ± 1.1 years of age) participated in this study. The intra- and interexaminer reliability of lumbar motion angle measurements during forward and backward trunk bending and prone hip extension were investigated. Lumbar motion angles were measured with small accelerometers placed at the thoracolumbar transition, lumbosacral transition, and thigh, during motion and at the final position. Intraclass correlation coefficients and Bland-Altman analysis were used for statistical analysis.

Results

The intraclass correlation coefficients ranged from 0.6 to 0.8 in intraexaminer analyses and from 0.5 to 0.7 in interexaminer analyses. Intraexaminer systematic biases were found only in the maximum angle of trunk forward bending. Interexaminer biases were found in all angles of trunk forward bending.

Conclusion

In the measurement of lumbar motion angle in the sagittal plane using a small accelerometer, it was necessary to repeat measurements 2 to 4 times, because a single measurement was not sufficiently reliable either within or between examiners.

目的本研究的目的是探讨在矢状面运动测试中使用小型加速度计测量腰椎运动角的可靠性，并确定获得可靠数据所需的测量次数。方法102例健康成人(女性56%，男性44%;(20.1±1.1岁)参加本研究。研究了前后躯干弯曲和俯卧髋关节伸展时腰椎运动角测量在检查人内部和检查人之间的可靠性。在运动过程中和最终体位时，用放置在胸腰段过渡段、腰骶段过渡段和大腿的小型加速度计测量腰椎运动角。采用类内相关系数和Bland-Altman分析进行统计分析。结果组内相关系数为0.6 ~ 0.8，组间相关系数为0.5 ~ 0.7。仅在躯干前屈的最大角度处发现了内测者系统偏差。在躯干前屈的各个角度都发现了鉴定人的偏差。结论使用小型加速度计测量腰椎矢状面运动角时，有必要重复测量2 ~ 4次，因为一次测量在检查者内部或检查者之间都不够可靠。

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引用次数: 2