本文關(guān)鍵詞：圖像分析與三維動(dòng)作分析法對(duì)前交叉韌帶損傷后軸移試驗(yàn)的量化比較研究　出處：《上海體育學(xué)院》2014年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 前交叉韌帶損傷 軸移試驗(yàn) 圖像分析 三維動(dòng)作分析 陽(yáng)性差值 最大波幅 臨床等級(jí)

【摘要】：目的：本項(xiàng)研究是利用圖像分析法和三維動(dòng)作分析法對(duì)前交叉韌帶損傷后的軸移試驗(yàn)進(jìn)行量化對(duì)比分析，觀察兩種方法是否能夠找到合理的測(cè)試指標(biāo)用于量化軸移試驗(yàn)。 方法：本研究選取國(guó)家體育總局運(yùn)動(dòng)醫(yī)學(xué)研究所創(chuàng)傷外科的單側(cè)膝關(guān)節(jié)前交叉韌帶損傷入院手術(shù)患者12人；記錄受試者年齡、患肢、受傷時(shí)間、雙膝關(guān)節(jié)KT-2000數(shù)值等基本數(shù)據(jù)；在預(yù)手術(shù)之前分別對(duì)受試者的健側(cè)和患側(cè)膝關(guān)節(jié)進(jìn)行軸移試驗(yàn)并判斷臨床等級(jí)，再通過(guò)圖像分析法和三維動(dòng)作分析法對(duì)雙膝關(guān)節(jié)的軸移試驗(yàn)進(jìn)行測(cè)試和分析；計(jì)算在此過(guò)程中股骨外側(cè)髁投射在脛骨外側(cè)平臺(tái)結(jié)節(jié)和腓骨頭所在直線上的投影點(diǎn)與脛骨外側(cè)平臺(tái)結(jié)節(jié)的距離為b值，在整個(gè)軸移試驗(yàn)的過(guò)程中從開(kāi)始到結(jié)束時(shí)b達(dá)到峰值，兩個(gè)階段的b值之差為最大波幅。若膝關(guān)節(jié)軸移試驗(yàn)陽(yáng)性，，則能計(jì)算膝關(guān)節(jié)彈動(dòng)前后的b值差得到b值的陽(yáng)性差值，彈動(dòng)開(kāi)始至軸移試驗(yàn)開(kāi)始的b值之差為彈動(dòng)開(kāi)始值。 結(jié)果：（1）圖像分析法中，也能夠得到類(lèi)似三維動(dòng)作分析法中b值呈現(xiàn)出來(lái)的曲線特征，但不能達(dá)到全部為典型波形；b值的陽(yáng)性差值與軸移試驗(yàn)彈動(dòng)開(kāi)始有顯著相關(guān)性（r=0.77、p＜0.01）；最大波幅與患者其他數(shù)據(jù)無(wú)明顯相關(guān)性。 （2）三維動(dòng)作分析法中，前交叉韌帶損傷膝關(guān)節(jié)及正常膝關(guān)節(jié)的b值結(jié)果的曲線均能夠得到特異性波形，分別呈現(xiàn)“雙峰狀”和“單峰狀”曲線； b值的陽(yáng)性差值與膝關(guān)節(jié)前交叉韌帶損傷的時(shí)間（r=0.65、p＜0.05）和臨床等級(jí)（r=0.61、p＜0.05）有顯著相關(guān)性；雙膝關(guān)節(jié)之間健側(cè)最大波幅大于患側(cè)，具有顯著性差異（n=12，p＜0.01）；且兩者具有相關(guān)性（r=0.65、p＜0.05）。 （3）圖像分析法和三維動(dòng)作分析法對(duì)軸移試驗(yàn)的量化結(jié)果中，對(duì)比兩者得出的陽(yáng)性差值、最大波幅和彈動(dòng)開(kāi)始值均無(wú)明顯相關(guān)性。（4）圖像分析法量化軸移試驗(yàn)結(jié)果中，軸移試驗(yàn)的臨床等級(jí)對(duì)應(yīng)的b值的陽(yáng)性差值為（Mean±SD）：Ⅰ級(jí)（4.80±4.26mm）、Ⅱ級(jí)（8.01±4.55mm）、Ⅲ級(jí)（4.03±2.91mm），陽(yáng)性差值結(jié)果與臨床等級(jí)之間的關(guān)系不呈現(xiàn)特殊性關(guān)系。三維動(dòng)作分析法量化軸移試驗(yàn)結(jié)果中，軸移試驗(yàn)的臨床等級(jí)對(duì)應(yīng)的b值的陽(yáng)性差值為（Mean±SD）：Ⅰ級(jí)（1.05±0.23mm）、Ⅱ級(jí)（1.44±0.41mm）、Ⅲ級(jí)（1.90±0.77mm），陽(yáng)性差值結(jié)果隨著臨床等級(jí)的升高而增加；軸移試驗(yàn)的臨床等級(jí)對(duì)應(yīng)的最大波幅為（Mean±SD）：Ⅰ級(jí)（9.12±3.85mm）、Ⅱ級(jí)（11.16±1.89mm）、Ⅲ級(jí)（13.59±2.40mm），陽(yáng)性差值結(jié)果也隨著臨床等級(jí)的升高而增加。 結(jié)論：利用圖像分析法通過(guò)b值的曲線變化能夠較敏感的觀察到前交叉韌帶損傷膝關(guān)節(jié)軸移試驗(yàn)時(shí)的旋轉(zhuǎn)穩(wěn)定性變化，但是用于量化前交叉韌帶損傷膝關(guān)節(jié)軸移試驗(yàn)時(shí)準(zhǔn)確度尚有不足；三維動(dòng)作分析法能夠較好的量化軸移試驗(yàn)，能夠得到前交叉韌帶損傷膝關(guān)節(jié)軸移試驗(yàn)的具體的量化指標(biāo)，并且和軸移試驗(yàn)的臨床等級(jí)相關(guān)聯(lián)。
[Abstract]:Objective: the purpose of this study is to quantitatively compare and analyze the axial displacement test after anterior cruciate ligament injury by image analysis and three-dimensional motion analysis, and observe whether the two methods can find reasonable test indicators to quantify the axial displacement test.
Methods: the cruciate ligament injury were admitted to surgery 12 unilateral knee joint trauma surgery were selected in this study by the National Research of sports medicine; record the participants' age, limb, double knee injury time, KT-2000 value and other basic data; in the pre surgery respectively before the contralateral and ipsilateral knee joint of subjects the pivot shift test and to determine the clinical level, then analysis of the double knee pivot shift test test and analysis and 3D motion by image analysis in the process; calculation of the lateral femoral condyle projection in the lateral tibial tubercle and fibular head where the projection point on the line and the distance of the lateral tibial tubercle the B value in the whole process of shift test shaft from beginning to end when B reached the peak, the two stages of the b value is the difference of the maximum amplitude. If the knee pivot shift test positive, can calculate the knee spring The positive difference of the b value is obtained by the difference of B value before and after. The difference between the starting point of the elastic movement and the b value at the beginning of the axis shift test is the starting value of the elastic movement.
Results: (1) image analysis method, analysis method can obtain b value curves show similar 3D action, but not all of the typical waveform; positive difference b value and the pivot shift test flick had significant correlation (r=0.77, P < 0.01); the large amplitude and other data patients with no obvious correlation.
(2) the 3D motion analysis, anterior cruciate ligament injury of knee joint and knee joint of the normal value of B curve can be specific waveform, respectively presented "Shuangfeng" and "single peak" curve; time of cruciate ligament injury of knee joint and the positive difference between the b value before (r=0.65, P < 0.05) and clinical grade (r=0.61, P < 0.05) there is significant correlation between the double knee joint; the maximum amplitude is larger than the contralateral side, with a significant difference (n=12, P < 0.01); both of them have good correlation (r=0.65, P < 0.05).
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