基于躯干细化模型腰椎间盘突出症患者与健康人群在三种日常活动下的运动学差异研究
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1.清华大学;2.深圳市第二人民医院;3.深圳清华大学研究院生物医用材料及植入器械重点实验室

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深圳市科技计划项目


the Study of kinematic differences between patients with lumbar disc herniation and healthy people in three activities of daily living based on refined trunk model
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1.Tsinghua University;2.Department of Orthopedics,Shenzhen Second People’s Hospital,Shenzhen,China National Research Center for Rehabilitation Technical Aids,Beijing,China Department of Orthopedics,Shenzhen Second People’s Hospital,Shenzhen,China;3.Biomechanics and Biotechnology Lab, Research Institute of Tsinghua University in Shenzhen

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    摘要:

    目的:建立由不同腰椎节段和集成胸椎、骨盆构成的躯干细化模型,对比分析腰椎间盘突出症患者与健康人群在三种日常活动下的运动学差异,并与采用全腰节段的躯干简略模型作对比,探讨进行腰椎间盘突出症患者运动学分析时采用躯干细化模型的必要性。方法:使用NDI运动捕捉系统采集15名健康男性和7名男性腰椎间盘突出症患者在水平行走,躯干前屈,对侧拾物中各节段的运动学参数,分别通过两种模型比较患者与健康人群的运动学差异。 结果:水平行走过程中,患者增大了胸椎节段和骨盆的旋转,全腰节段的运动角度无明显变化,但L4L5节段旋转角度显著减小;躯干前屈过程中,患者所有腰椎节段的屈伸角度都不同程度地减小,L3L4节段屈伸角度与健康人群差异性较大;对侧拾物过程中矢状面上的表现与躯干前屈类似,但患者的L3L4节段和L4L5节段侧弯角度显著低于健康人群。结论:腰椎间盘突出症患者在日常活动中主要限制了损伤腰椎节段的运动。在某些运动中,只有躯干细化模型才能发现损伤腰椎节段的异常运动。因此,在进行腰椎间盘突出症患者的运动学分析时,有必要将腰椎细分成5个独立节段。

    Abstract:

    Objective: Compare the kinematic differences between patients with lumbar disc herniation (LDH) and healthy people during three daily activities by a refined trunk model compose of different lumbar segments, lumped thoracic and pelvis. Compare the trunk refined model and trunk simplified model adopting the whole lumbar segment and discuss the necessity of using the refined trunk model for the kinematic analysis of LDH patients. Method:Motion capture system NDI was used to collect kinematic parameters of each segment of 15 healthy men and 7 male LDH patients during level walking, trunk flexion, and contralateral pickup, then compare the kinematic differences between patients and healthy people by the two models respectively. Result:During level walking, the patients increased the rotation of the thoracic segment and pelvis. No significant change in the motion angle of whole lumbar segment but the rotation angle of the L4L5 segment was significantly reduced; during trunk flexion, the flexion angle of the patients' all lumbar segments was reduced by varying degrees, and the flexion angle of the L3L4 segment was significantly different from that of healthy people; during contralateral pickup, the performance on the sagittal plane is similar to that of flexion. However, the lateral bending angle of patients' L3L4 segment and L4L5 segment was significantly lower than that in the healthy people. Conclusion:LDH Patients mainly restrict the motion of injured lumbar spine segments in daily activities. In some motions, only refined model can discover abnormal motion of the injured lumbar segment. Therefore, it is necessary to subdivide the lumbar spine into 5 independent segments when analyze the kinematic character of LDH patients.

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  • 收稿日期:2019-10-28
  • 最后修改日期:2019-12-12
  • 录用日期:2019-12-16
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