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[挥鞭伤中的运动分析]

[Motion analysis in whiplash injuries].

作者信息

Bär H F, Witte H F, Pape H G, Grifka J

机构信息

Orthopädische Universitätsklinik, St. Josef-Hospital, Ruhr-Universität Bochum.

出版信息

Orthopade. 1998 Dec;27(12):827-33.

PMID:9894237
Abstract

Motion analysis of the cervical spine is a sensitive tool in the fields of preventive and clinical biomechanics of whiplash. In the field of preventive biomechanics motion analysis contributes to validation and optimisation of dummy based crash test experiments and simulations. In the clinical field motion analysis up to now is of restricted value. Data exist about restrictions and pathologies of movement and motion of the cervical spine, coordinative disturbances, postural control, TMJ-function and oculomotor disturbances after whiplash. The standardisation of technical and clinical set-ups is necessary to establish a well proven biomechanical model of whiplash and whiplash related biomechanical dysfunction. Without this model the value of motion analysis for clinical use will be restricted due to lack of comparable data on sensitivity and specificity although motion analysis of the cervical spine is neither cost- nor time consuming and free of adverse effects. Within a prospective series of 28 patients (14 m/14 f) with a follow-up to six weeks we were lucky to describe numerically two different types of reaction to low energy (delta v < 20 km/h) rear end collision: Type I with disturbances in complex movements only, Type II with overall restriction of movement. Control of angular velocity during cyclic movements of the head was disturbed by oscillations of higher frequency in all patients. Recovery from whiplash within 6 weeks could be monitored.

摘要

颈椎运动分析是挥鞭样损伤预防和临床生物力学领域中的一项敏感工具。在预防生物力学领域,运动分析有助于基于假人的碰撞试验和模拟的验证与优化。在临床领域,到目前为止运动分析的价值有限。已有关于挥鞭样损伤后颈椎运动的限制和病理情况、协调障碍、姿势控制、颞下颌关节功能和动眼神经障碍的数据。技术和临床设置的标准化对于建立一个经过充分验证的挥鞭样损伤生物力学模型以及与挥鞭样损伤相关的生物力学功能障碍模型是必要的。没有这个模型,由于缺乏关于敏感性和特异性的可比数据,颈椎运动分析在临床应用中的价值将受到限制,尽管颈椎运动分析既不耗费成本也不耗时且无不良反应。在一个对28例患者(14例男性/14例女性)进行长达六周随访的前瞻性系列研究中,我们有幸从数值上描述了对低能量(Δv < 20 km/h)追尾碰撞的两种不同反应类型:I型仅在复杂运动中有障碍,II型则是整体运动受限。所有患者头部周期性运动期间的角速度控制都受到更高频率振荡的干扰。可以监测挥鞭样损伤在6周内的恢复情况。

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