图像分析与三维动作分析法对前交叉韧带损伤后轴移试验的量化比较研究

发布时间：2018-01-10 17:14

  本文关键词：图像分析与三维动作分析法对前交叉韧带损伤后轴移试验的量化比较研究　出处：《上海体育学院》2014年硕士论文　论文类型：学位论文

  更多相关文章： 前交叉韧带损伤 轴移试验 图像分析 三维动作分析 阳性差值 最大波幅 临床等级

【摘要】：目的：本项研究是利用图像分析法和三维动作分析法对前交叉韧带损伤后的轴移试验进行量化对比分析，观察两种方法是否能够找到合理的测试指标用于量化轴移试验。 方法：本研究选取国家体育总局运动医学研究所创伤外科的单侧膝关节前交叉韧带损伤入院手术患者12人；记录受试者年龄、患肢、受伤时间、双膝关节KT-2000数值等基本数据；在预手术之前分别对受试者的健侧和患侧膝关节进行轴移试验并判断临床等级，再通过图像分析法和三维动作分析法对双膝关节的轴移试验进行测试和分析；计算在此过程中股骨外侧髁投射在胫骨外侧平台结节和腓骨头所在直线上的投影点与胫骨外侧平台结节的距离为b值，在整个轴移试验的过程中从开始到结束时b达到峰值，两个阶段的b值之差为最大波幅。若膝关节轴移试验阳性，，则能计算膝关节弹动前后的b值差得到b值的阳性差值，弹动开始至轴移试验开始的b值之差为弹动开始值。 结果：（1）图像分析法中，也能够得到类似三维动作分析法中b值呈现出来的曲线特征，但不能达到全部为典型波形；b值的阳性差值与轴移试验弹动开始有显著相关性（r=0.77、p＜0.01）；最大波幅与患者其他数据无明显相关性。 （2）三维动作分析法中，前交叉韧带损伤膝关节及正常膝关节的b值结果的曲线均能够得到特异性波形，分别呈现“双峰状”和“单峰状”曲线； b值的阳性差值与膝关节前交叉韧带损伤的时间（r=0.65、p＜0.05）和临床等级（r=0.61、p＜0.05）有显著相关性；双膝关节之间健侧最大波幅大于患侧，具有显著性差异（n=12，p＜0.01）；且两者具有相关性（r=0.65、p＜0.05）。 （3）图像分析法和三维动作分析法对轴移试验的量化结果中，对比两者得出的阳性差值、最大波幅和弹动开始值均无明显相关性。（4）图像分析法量化轴移试验结果中，轴移试验的临床等级对应的b值的阳性差值为（Mean±SD）：Ⅰ级（4.80±4.26mm）、Ⅱ级（8.01±4.55mm）、Ⅲ级（4.03±2.91mm），阳性差值结果与临床等级之间的关系不呈现特殊性关系。三维动作分析法量化轴移试验结果中，轴移试验的临床等级对应的b值的阳性差值为（Mean±SD）：Ⅰ级（1.05±0.23mm）、Ⅱ级（1.44±0.41mm）、Ⅲ级（1.90±0.77mm），阳性差值结果随着临床等级的升高而增加；轴移试验的临床等级对应的最大波幅为（Mean±SD）：Ⅰ级（9.12±3.85mm）、Ⅱ级（11.16±1.89mm）、Ⅲ级（13.59±2.40mm），阳性差值结果也随着临床等级的升高而增加。 结论：利用图像分析法通过b值的曲线变化能够较敏感的观察到前交叉韧带损伤膝关节轴移试验时的旋转稳定性变化，但是用于量化前交叉韧带损伤膝关节轴移试验时准确度尚有不足；三维动作分析法能够较好的量化轴移试验，能够得到前交叉韧带损伤膝关节轴移试验的具体的量化指标，并且和轴移试验的临床等级相关联。
[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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