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作者信息

Pagnez Maria Alice Mainenti, Corrêa Leticia Amaral, Almeida Renato Santos, Meziat-Filho Ney Armando, Mathieson Stephanie, Ricard François, Nogueira Leandro Alberto Calazans

机构信息

Physiotherapy Department, Rehabilitation Science Postgraduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil; Academic Department, Madrid School of Osteopathy, Rio de Janeiro, Brazil.

Physiotherapy Department, Rehabilitation Science Postgraduate Program, Augusto Motta University Centre, Rio de Janeiro, Brazil.

出版信息

J Manipulative Physiol Ther. 2019 Feb;42(2):108-116. doi: 10.1016/j.jmpt.2019.03.003. Epub 2019 Apr 25.

DOI:10.1016/j.jmpt.2019.03.003

PMID:31029470

Abstract

OBJECTIVE

The purpose of this study was to compare the cross-sectional area of the sciatic nerve in different positions of spinal manipulation using flexion-distraction technique.

METHODS

Thirty healthy participants were assessed in 6 different flexion-distraction technique positions of varying lumbar, knee, and ankle positions. Participants stood in the following 3 positions with the lumbar in the neutral position: (A) with knee extended, (B) with knee flexed, and (C) with the knee extended and ankle dorsiflexion. Participants then stood in the following 3 positions with the lumbar flexed: (D) with the knee extended, (E) with the knee flexed, and (F) with knee extended and ankle dorsiflexion. The cross-sectional area (CSA) of the sciatic nerve was measured with ultrasound imaging in transverse sections in the posterior medial region of the left thigh. The CSA values measured at each position were compared.

RESULTS

We analyzed 180 ultrasound images. The cross-sectional area of the sciatic nerve (in mm) in position B (mean; standard deviation) (59.71-17.41) presented a higher mean cross-sectional area value compared with position D (51.18-13.81; P =.005), position F (48.71-15.16; P = .004), and position C (48.37-16.35; P = .009).

CONCLUSION

The combination of knee extension and ankle dorsiflexion reduced the CSA of the sciatic nerve, and flexing the knee and keeping the ankle in the neutral position increased it.

摘要

目的

本研究旨在比较采用屈伸牵引技术进行脊柱手法治疗时，坐骨神经在不同位置的横截面积。

方法

30名健康参与者在6种不同的屈伸牵引技术位置接受评估，这些位置的腰椎、膝盖和脚踝位置各不相同。参与者在腰椎处于中立位时站在以下3个位置：(A)膝关节伸直；(B)膝关节屈曲；(C)膝关节伸直且踝关节背屈。然后参与者在腰椎屈曲时站在以下3个位置：(D)膝关节伸直；(E)膝关节屈曲；(F)膝关节伸直且踝关节背屈。通过超声成像在左大腿后内侧区域的横断面上测量坐骨神经的横截面积(CSA)。比较每个位置测量的CSA值。

结果

我们分析了180张超声图像。与位置D(51.18 - 13.81；P = 0.005)、位置F(48.71 - 15.16；P = 0.004)和位置C(48.37 - 16.35；P = 0.009)相比，位置B的坐骨神经横截面积(单位：mm)(平均值；标准差)(59.71 - 17.41)呈现出更高的平均横截面积值。