Hu Meng-Tzu, Su Fong-Chin, Hsu Ar-Tyan
Department of Physical Therapy, Tzu Hui Institute of Technology, Nanchou Hsian, Ping Tung, Taiwan; Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Man Ther. 2014 Oct;19(5):484-9. doi: 10.1016/j.math.2014.05.003. Epub 2014 May 22.
Manual techniques involving the use of the thumb are commonly employed by physical therapists for treating patients with vertebral disorders. The demands on the intrinsic muscles of the thumb in these manual tasks are very different from those of the pinch tasks. The aim of this study was to investigate the influence of clinical experience and different mobilization techniques on the electromyographic activity (EMG) of thumb intrinsic muscles. Fifteen participants without exposure to manual techniques (the Novice Group) and fifteen physical therapists with at least 3 years of orthopaedic experience (the Experienced Group) participated. Each participant exerted thumb tip forces with 3 different posterioanterior (PA) glide techniques including unsupported, with digital support and with thumb interphalangeal joint supported by the index finger. The exerted force was increased from 25% to 100% maximum force at 25% increments on a 6 component load cell. The thumb tip force and EMG activity of four intrinsic muscles (flexor pollicis brevis, adductor pollicis, abductor pollicis brevis, first dorsal interosseus) were recorded with surface electrodes. Both experience and technique influenced intrinsic muscle activity of the thumb. While participants of both groups generated the same magnitude of force, experienced participants generated less intrinsic muscle activity while performing PA glide through practice. However, novice participants increased activity of the intrinsic muscles in accordance with the stability status of the technique. PA glide with thumb interphalangeal joint supported by the index finger was a more stable technique as evidenced by smallest relative errors of thumb tip force.
物理治疗师在治疗脊椎疾病患者时，通常会采用涉及使用拇指的手法技术。这些手法任务中对拇指固有肌的要求与捏取任务中的要求有很大不同。本研究的目的是调查临床经验和不同的松动技术对拇指固有肌肌电图活动（EMG）的影响。15名未接触过手法技术的参与者（新手组）和15名至少有3年骨科经验的物理治疗师（经验丰富组）参与了研究。每位参与者通过3种不同的后前（PA）滑动技术施加拇指尖力，包括无支撑、有手指支撑和食指支撑拇指指间关节。在一个6分量测力传感器上，施加的力以25%的增量从最大力的25%增加到100%。用表面电极记录4块固有肌（拇短屈肌、拇收肌、拇短展肌、第一骨间背侧肌）的拇指尖力和EMG活动。经验和技术都影响了拇指固有肌的活动。虽然两组参与者产生的力大小相同，但经验丰富的参与者在通过练习进行PA滑动时产生的固有肌活动较少。然而，新手参与者根据技术的稳定状态增加了固有肌的活动。食指支撑拇指指间关节的PA滑动是一种更稳定的技术，拇指尖力的相对误差最小证明了这一点。
