| 1.ObjectiveThis study first screw lift technique research and application of the intelligent robot(1)inspection robot system for Rotation-Traction Manipulation(RTM)application effect of the technique training and assessment,(2)analysis of RTM intelligent robot systems of the homogeneity of mechanical parameters to RTM,(3)stable RTM of mechanical parameters as the research basis of followed clinical study.(4)To explore the effect of RTM on cervical sagittal parameters in patients with radicular cervical spondylosis,and further discuss its mechanism.2.Method(1)Part I:The clinical physicians were trained by the intelligent robot of RTM.Before the training,the key mechanical parameters(preloaded force,jerky force,max.applied force,jerky duration,rotation amplitude,pitch angle)of each physician’s manipulations under the three modes of normal,overweight and obese body mass indexes(BMI)were collected by the intelligent robot of rotation manipulation,which were recorded as the data before the training.After training,the system is used again for assessment and data collection,which is recorded as data after training.The pass rate,coefficient of variation(CV),key mechanical parameters and other data indexes before and after training were compared to objectively evaluate the effect of cervical spine RTM intelligent simulation robot in the standardized training of RTM.(2)Part II:This trial used a central randomized,parallel-controlled,unblinded clinical trial to test the efficacy of excellence.Patients with cervical spondylotic radiculopathy(CSR)(syndrome of qi stagnation and blood stasis)were selected.The treatment method of the experimental group was RTM treatment,and the control group was oral neck tong granule treatment.Before and after treatment,all patients underwent X-ray examination of cervical vertebra in anteroposterial-lateral position,hyperextension and flexion position,and left and right oblique position respectively.Image analysis was conducted independently by two physicians to compare the changes of cervical vertebra sagittal position parameters before and after treatment.3.Results(1)Part I:(1)Under normal,overweight and obese BMI,the qualified rate after training was 84.85%,72.73%,75.76%,significantly higher than those before training(12.12%,6.06%,3.03%)(P<0.05);(2)Under normal BMI,the qualified rate of preloaded force,jerky force,max.applied force and rotation amplitude were higher than those before training(P<0.05);There was no difference in the pass rate of jerky duration and pitch angle before and after training(P>0.05).(3)Under overweight BMI,the qualified rate of preloaded force,jerky force,max.applied force and rotation amplitude after training was significantly higher than before training(P<0.05);There was no difference in the pass rate of jerky duration and pitch angle before and after training(P>0.05).(4)Under obese BMI,the pass rate of preloaded force,jerky force,max.applied force,rotation amplitude and jerky duration after training was significantly higher than before training(P<0.05).There was no difference in pass rate of pitch angle before and after training(P>0.05).(5)For the three types of BMI,the coefficient of variation(CV)after training was multiple smaller than before training,and the ingroup homogeneity of mechanical parameters was significantly improved after training,while the degree of dispersion was reduced.(2)Part II:(1)General conditions: A total of 35 subjects were included,and 5 subjects dropped out,including 2 in the experimental group and 3 in the control group.After treatment,the experimental group of 16 cases,including 5 male,11 female,age(41.75±5.07)years,disease course(25.75±10.55)months;There were 14 subjects in the control group,including 5 males and 9 females,age(42.07±5.90)years,disease course(23.57±14.01)months.There were no significant differences in baseline data(P>0.05).(2)T1S: The T1 S of the experimental group before treatment was(19.66±7.66)°,and it recovered to(23.01±7.71)° after treatment.(24.83±5.76)°,T1 S after treatment was(25.06 ± 6.04)°,there was no significant difference before and after treatment(P>0.05).Comparing the two groups,the T1 S of the experimental group was lower than that of the control group before treatment,and the difference was statistically significant(P<0.05).Covariance analysis showed that T1 S before treatment had an effect on T1 S after treatment(P<0.000),and there was no statistically significant difference between the experimental group and the control group after treatment(P>0.05).(3)C7S: Before and after treatment,there was no significant difference in C7 S in the experimental group and the control group(P>0.05);and there was no significant difference in C7 S between the two groups(P>0.05).(4)C2-C7SVA: Before and after treatment,there was no significant difference in C2-7SVA between or within the two groups.(5)CLA: The CLA of the experimental group was(13.46±11.95)before treatment,and recovered to(17.87±13.47)after treatment which was higher than that before treatment,the difference was statistically significant(P=0.04<0.05);There was no significant difference in CLA before and after treatment in the control group(P>0.05).There was no significant difference in CLA between the experimental group and the control group before and after treatment(P>0.05).4.Conclusion(1)Part I:(1)The pass rate of the three types of BMI after training was significantly higher than that before training,indicating that the training effect of intelligent robot was good,providing a repeatable training and standardized assessment platform for clinicians;(2)The key to the operation of RTM is to master the size of the force,max.applied force of the skill is the most difficult to master,need to focus on training;(3)BMI has a certain influence on manipulation,with the increase of BMI,the more difficult to standardize the movement essentials of manipulation,should pay attention to the change of different BMI during training;(4)Attention should be paid to correct the rotation amplitude when carrying out the RTM to reduce the operation risk;(5)After training,the homogeneity of RTM mechanical parameters of all physicians was significantly improved,which could achieve the goal of standardization.(2)Part II:(1)The RTM can increase the angle of T1 S and CLA(C2-C7),which may restore the normal stress distribution of cervical vertebra to achieve therapeutic effect.(2)The effect of RTM on C2-7SVA and C7 S was not obvious. |
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