Gagnon Dany H, Longtin Christian, Berbiche Djamal, Gaudreault Nathaly
School of Rehabilitation, Université de Montréal, Montreal, Canada; Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, Canada.
School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada.
Man Ther. 2016 Feb;21:287-91. doi: 10.1016/j.math.2015.05.002. Epub 2015 May 21.
This study aims to quantify the force applied during posterior-to-anterior lumbar vertebrae mobilizations of different grades (I to IV) and compare that force between experienced physiotherapists and final year physiotherapy students. Four experienced physiotherapists and four final year physiotherapy students participated in this study along with five healthy asymptomatic individuals. A manual therapy table positioned over three force plates allowed for measurements of the force oscillation frequency and intensity applied during grade I, II, III and IV posterior-to-anterior (PA) mobilizations at two lumbar vertebral levels (L2 and L4). Mixed model ANOVAs were used to compare the force applied between the experienced physiotherapists and students, and between the various grades. The results showed that the mean oscillation frequency was similar between the groups for all grades. Grade I and grade IV PA mobilizations showed similar mean oscillation frequency as did grade II and III PA mobilizations. The minimum and maximum force applied was higher for the physiotherapists than for the students for all mobilization grades (p values < 0.05). Similar mean maximum force values were recorded for PA mobilizations between grade I and II and between grade III and grade IV. Grade III and IV PA mobilizations yielded higher mean maximum force values than those recorded during grade I and grade II PA mobilizations. The method used in this study allowed for quantification of the force applied during lumbar PA mobilizations. Experienced physiotherapists apply greater force than physiotherapy students across all grades, despite similar oscillation frequency.
本研究旨在量化不同等级（I至IV级）腰椎后前向松动术中所施加的力，并比较经验丰富的物理治疗师和物理治疗专业最后一年学生之间的施力情况。四名经验丰富的物理治疗师、四名物理治疗专业最后一年的学生以及五名健康无症状个体参与了本研究。放置在三个测力板上的手动治疗床能够测量在两个腰椎水平（L2和L4）进行I级、II级、III级和IV级后前向（PA）松动术时所施加的力振荡频率和强度。采用混合模型方差分析来比较经验丰富的物理治疗师与学生之间以及不同等级之间所施加的力。结果显示，所有等级的组间平均振荡频率相似。I级和IV级PA松动术的平均振荡频率相似，II级和III级PA松动术的平均振荡频率也相似。在所有松动术等级中，物理治疗师施加的最小和最大力均高于学生（p值<0.05）。I级和II级之间以及III级和IV级之间的PA松动术记录到的平均最大力值相似。III级和IV级PA松动术产生的平均最大力值高于I级和II级PA松动术期间记录到的力值。本研究中使用的方法能够量化腰椎PA松动术中所施加的力。尽管振荡频率相似，但经验丰富的物理治疗师在所有等级中施加的力均大于物理治疗专业学生。
