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1.上海中医药大学附属曙光医院推拿科(上海 201203)
2.上海理工大学健康科学与工程学院(上海 200093)
何天翔,男,博士,主任医师,主要从事脊柱推拿的基础与临床研究工作
刘巍峰,副主任医师,硕士研究生导师; E-mail: liuweifeng197777@163.com
收稿日期:2025-04-30,
纸质出版日期:2025-08-10
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何天翔,杨玉,许成硕,等.腰椎振荡推拿手法的施力频率对治疗效果的影响——一项基于脊柱多刚体模型的仿真研究[J].上海中医药杂志,2025,59(8):49-53.
HE Tianxiang,YANG Yu,XU Chengshuo,et al.Effect of force frequency in lumbar oscillation manipulation on therapeutic efficacy: a simulation study based on the spinal multi‑rigid‑body model[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(8):49-53.
何天翔,杨玉,许成硕,等.腰椎振荡推拿手法的施力频率对治疗效果的影响——一项基于脊柱多刚体模型的仿真研究[J].上海中医药杂志,2025,59(8):49-53. DOI: 10.16305/j.1007-1334.2025.z20250430008.
HE Tianxiang,YANG Yu,XU Chengshuo,et al.Effect of force frequency in lumbar oscillation manipulation on therapeutic efficacy: a simulation study based on the spinal multi‑rigid‑body model[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(8):49-53. DOI: 10.16305/j.1007-1334.2025.z20250430008.
目的
2
通过建立多刚体力学模型和仿真技术,研究腰椎振荡推拿手法的施力频率对腰椎各节段位移的影响,探讨不同退变程度的L
4
~L
5
和L
5
~S
1
椎间盘对施力频率的反应,为振荡推拿干预腰痛的优化提供理论依据。
方法
2
建立腰椎生物力学模型:假设椎体为刚体,将椎间盘和韧带等软组织视为弹簧和阻尼器,建立六自由度质量-弹簧-阻尼系统模型。通过调整弹性系数和阻尼系数模拟不同程度的椎间盘退变。利用Matlab/Simulink软件建立仿真模型,以正弦波变式作为输入力,模拟不同施力频率对腰椎各节段位移的影响。分别在椎间盘未退变以及L
4
~L
5
和L
5
~S
1
不同程度退变的情况下,改变施力频率,记录腰椎各节段的最大相对位移。
结果
2
在椎间盘未退变的情况下,腰椎各节段的最大相对位移在施力频率为2.5~10 Hz范围内,随着频率下降而显著增加;而在1~2.5 Hz范围内,随着频率下降则逐渐减小。当椎间盘L
4
~L
5
和L
5
~S
1
发生退变时,施力频率为2.5 Hz可引起最大位移响应。随着椎间盘退变程度的增加,腰椎各节段的最大相对位移逐渐减小。
结论
2
推拿手法在一定频率范围内,较低的施力频率能够引起更大的腰椎位移,且在接近2.5 Hz时治疗效果最佳。
Objective
2
By establishing a multi-rigid-body mechanical model and using simulation technology, this study aims to investigate the impact of applied force frequency in lumbar oscillation manipulation on segmental displacement in the lumbar spine, and to explore the response of intervertebral discs at different levels of degeneration, specifically at the L
4
-L
5
and L
5
-S
1
, to various force frequencies, providing a theoretical basis for optimizing oscillation manipulation in the intervention of low back pain.
Methods
2
A biomechanical model of the lumbar spine was established by treating vertebral bodies as rigid bodies and intervertebral discs, ligaments, and other soft tissues as springs and dampers. A six-degree-of-freedom mass-spring-damper system model was constructed. The simulation of intervertebral disc degeneration was performed by adjusting the elastic and damping coefficients. A simulation model was established using Matlab/Simulink software, with a sine wave variation as the input force to simulate the effect of different force frequencies on lumbar segmental displacement. The maximum relative displacement of the lumbar segments was recorded under conditions of non-degenerated intervertebral discs and varying levels of degeneration at L
4
-L
5
and L
5
-S
1
, with force frequency changes.
Results
2
In the case of non-degenerated intervertebral discs, the maximum relative displacement of lumbar segments significantly increased within a frequency range of 2.5-10 Hz as the frequency decreased, while it gradually decreased within the 1-2.5 Hz range. When the intervertebral discs at L
4
-L
5
and L
5
-S
1
degenerated, a force frequency of 2.5 Hz caused the maximum displacement response. As the degree of disc degeneration increased, the maximum relative
displacement of lumbar segments gradually decreased.
Conclusion
2
Within a certain frequency range, lower force frequencies lead to greater lumbar displacement, with the best therapeutic effect achieved at around 2.5 Hz.
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