Objectives of Study:
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1. By collecting the clinical data such as the maximum force of manual preloading, the direction of pulling force, the pulling time, the movement track and other biomechanical indexes during the operation of Lumbar Oblique-pulling Manipulation from doctors of different ages, the model database of Lumbar Oblique-pulling Manipulation is established, which is initially transformed into the digital model platform of lumbaroblique pulling method.
2. To establish a manipulation simulation platform, to provide reference for clinical and basic research, and to lay a foundation for the study of the mechanism of Lumbar Oblique-pulling Manipulation.
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Description for medicine or protocol of treatment in detail:
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The researcher inquire about the patient's medical history, carry out the special physical examination of lumbago and carry out the relevant imaging examination, rule out the relevant contraindications, meet the inclusion criteria, and obtain the informed consent of the patient, as the subject of this study.
The subjects fill in the Oswestry disability index (ODI) scale and are assessed by visual analog scale (VAS). The soft tissue tension of 6 points on both sides is measured. The average value of each mark point is measured 3 times and the corresponding body characteristic data (height, weight, etc.) are collected.
All the subjects are randomly divided into three groups, and three doctors with different seniority performed the operation of lumbar oblique pull.
The lumbar muscles are relaxed by the methods of Gun and rolling manipulation. Only the oblique pull method is applied on the left side, that is, the oblique pull method is applied on the left side during operation. The specific manipulation of manipulation is as follows: the right side of the subject lies, the upper leg bends the hip and knees, and the lower leg relaxes and straightens naturally; the performer stands on the right side of the subject, with the left elbow or hand against the front of the shoulder of the subject (here is the relative fixed end), and the right elbow or hand against the hip (the movable end); the two elbows or hands coordinate to apply force, waiting for the subject When the waist is relaxed, and then the waist is twisted to the position with obvious resistance, stop for a moment, and then apply "smart force and inch strength" (make a sudden and rapid pull with increased amplitude), with or without "click" of the bullet. Ask the patient after pulling to prevent the occurrence of adverse events.
It is measured by the phantom high-speed camera produced by York Technology Co., Ltd. Then, PCC software is used to record the operation time of the lumbar oblique pull method, and the angular velocity of the pull part is calculated by the angular velocity calculation formula. The maximum force of the right elbow is measured when the pull is performed. The tactile high sensitivity sensor was placed on the left hip of the subject (the right elbow of the operator) to measure directly.
After the operation, the patient cooperate with the doctor to measure the soft tissue tension: Lumbar 4, lumbar 5, sacral 1 spinous process side open 1.5 inch position, a total of 6 points of soft tissue tension on both sides, each mark point measured 3 times to take the average value. And VAS score.
Analyze and sort out the above data, establish the mechanical database of Lumbar Oblique-pulling Manipulation by collecting the successful data, and establish the preliminary mathematical model. By comparing the model with the clinical data, the mathematical model and the mechanical database of the Lumbar Oblique-pulling Manipulation are gradually improved, and the database is transformed into the model platform of the Lumbar Oblique-pulling Manipulation.
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Exclusion criteria:
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1. Those who are unable to carry out relevant lumbar X-ray examination due to various reasons, such as: pregnant or lactating women, etc.;
2. Patients with congenital spinal diseases;
3. Extreme lateral type of lumbar disc herniation;
4. Patients with severe heart, liver and kidney damage, blood and respiratory diseases and severe mental diseases;
5. Those who have infectious diseases such as liver disease, AIDS and serious trauma not cured;
6. Those with serious digestive system diseases and severe malnutrition;
7. Suffering from other major diseases or not suitable for manual treatment, acute trauma, etc..
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