Abstract
Rotation-traction (RT) manipulation is a commonly used physical therapy procedure in TCM (traditional Chinese medicine) for cervical spondylosis. This procedure temporarily separates the C3 and C4 cervical vertebrae from each other when a physician applies a jerky action while the neck is voluntarily turned by the patient to a specific position as instructed by the physician, where the cervical vertebrae are twisted and locked. However, a high rate of cervical injury occurs due to inexperienced physician interns who lack sufficient training. Therefore, we developed a cervical spine mechanism that imitates the dynamic behaviours of the human neck during RT manipulation. First, in vivo and in vitro experiments were performed to acquire the biomechanical feature curves of the human neck during RT manipulation. Second, a mass-spring-damper system with an electromagnetic clutch was designed to emulate the entire dynamic response of the human neck. In this system, a spring is designed as rectilinear and nonlinear to capture the viscoelasticity of soft tissues, and an electromagnetic clutch is used to simulate the sudden disengagement of the cervical vertebrae. Test results show that the mechanism can exhibit the desired behaviour when RT manipulation is applied in the same manner as on humans.
Highlights
Cervical spondylosis is a general and nonspecific medical term referring to degenerative changes that develop either spontaneously with age or secondarily as the result of trauma or other pathological conditions
Treatments for cervical spondylosis are typically conservative in nature, and physical modalities are the preferred treatments for spine-related disorders [3]
The biomechanical properties of RT manipulation were determined from in vivo and in vitro measurements, and a novel lumped parameter model that differs from the frequently-used Kelvin-Voigt and HuntCrossley models was proposed to capture the biomechanical properties of RT manipulation
Summary
Cervical spondylosis is a general and nonspecific medical term referring to degenerative changes that develop either spontaneously with age or secondarily as the result of trauma or other pathological conditions. A device that simulates the biomechanical behaviours of the human neck during RT manipulation and can objectively evaluate RT manipulation performance would be beneficial for training physicians and for spreading this traditional therapy around the world. The three main contributions of this work are described as follows: the biomechanical features of the cervical spine are extracted from the in vivo and in vitro experimental data, the combination of a nonlinear spring and an electromagnetic clutch is designed to capture the biomechanical behaviours of the cervical spine during RT manipulation, and the cervical spine mechanism is developed to aid inexperienced practitioners in improving their skills via objective evaluation. Experiments are implemented to verify the effectiveness of the cervical spine mechanism system for training physician interns
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