School of Traditional Chinese Medicine, Southern Medical University, No. 1838, Guangzhou Avenue North, BaiYun District, Guangzhou, 510515, Guangdong Province, China.
Department of Spine Surgery, The First Affiliated Hospital of University of South China, Hengyang, 421000, Hunan Province, China.
BMC Musculoskelet Disord. 2020 Oct 28;21(1):709. doi: 10.1186/s12891-020-03735-y.
Clinical studies have found that manipulations have a good clinical effect on sacroiliac joint (SIJ) pain without specific causes. However, the specific mechanisms underlying the effect of manipulations are still unclear. The purpose of this study was to investigate the effects of three common manipulations on the stresses and displacements of the normal SIJ and the strains of the surrounding ligaments.
A three-dimensional finite element model of the pelvis-femur was developed. The manipulations of hip and knee flexion (MHKF), oblique pulling (MOP), and lower limb hyperextension (MLLH) were simulated. The stresses and displacements of the SIJ and the strains of the surrounding ligaments were analyzed during the three manipulations.
MOP produced the highest stress on the left SIJ, at 6.6 MPa, while MHKF produced the lowest stress on the right SIJ, at 1.5 MPa. The displacements of the SIJ were all less than 1 mm during the three manipulations. The three manipulations caused different degrees of ligament strain around the SIJ, and MOP produced the greatest straining of the ligaments.
The three manipulations all produced small displacements of the SIJ and different degrees of ligament strains, which might be the mechanism through which they relieve SIJ pain. MOP produced the largest displacement and the greatest ligament strains.
临床研究发现,推拿手法对于无特定病因的骶髂关节(SIJ)疼痛具有良好的临床疗效。然而,推拿手法疗效的确切机制尚不清楚。本研究旨在探讨三种常见推拿手法对正常 SIJ 应力和位移以及周围韧带应变的影响。
建立骨盆-股骨的三维有限元模型。模拟髋关节和膝关节屈曲(MHKF)、斜向牵引(MOP)和下肢过伸(MLLH)三种推拿手法。分析三种推拿手法时 SIJ 的应力和位移以及周围韧带的应变。
MOP 使左侧 SIJ 的应力最高,达到 6.6 MPa,而 MHKF 使右侧 SIJ 的应力最低,为 1.5 MPa。三种推拿手法均使 SIJ 位移小于 1mm。三种推拿手法均使 SIJ 周围韧带产生不同程度的应变,其中 MOP 引起的韧带应变最大。
三种推拿手法均使 SIJ 产生较小的位移和不同程度的韧带应变,这可能是缓解 SIJ 疼痛的机制。MOP 引起的位移和韧带应变最大。