基于表面肌电频域及非线性分析评估手法治疗神经根型颈椎病的疗效研究OA

Background Manual therapy is a standard conservative treatment for cervical spondylotic radiculopathy(CSR);however,clinical electrophysiological evidence regarding its efficacy in improving neuromuscular function in CSR patients remains insufficient.Objective This study aimed to elucidate the electrophysiological effects of cervical rotation-traction manipulation and tendon-regulating manipulation on the affected muscles of CSR patients using frequency-domain and nonlinear analysis of surface electromyography(sEMG).Methods Sixty patients with CSR admitted to Wangjing Hospital,China Academy of Chinese Medical Sciences,from April 2024 to April 2025 were enrolled and randomly assigned to either the cervical rotation-traction manipulation group or the tendon-regulating manipulation group(n=30 each).Electrophysiological characteristics-frequency-domain indices[median frequency(MDF),mean power frequency(MNF)]and nonlinear index[sample entropy(SampEn)]-of the affected wrist flexors,wrist extensors,biceps brachii,triceps brachii,and deltoid muscles were measured at pre-treatment(T0),mid-treatment(T1),and post-treatment(T2).Independent samples t-tests and analysis of variance(ANOVA)were employed to evaluate the treatment effects.Results At T1 and T2,the MDF of the biceps and triceps brachii in the cervical rotation-traction manipulation group were significantly higher than those in the tendon-regulating manipulation group(P<0.05).At T1,the MNF of the biceps and triceps brachii in the cervical rotation-traction manipulation group were higher than those in the tendon-regulating manipulation group(P<0.05);at T2,only the MNF of the biceps brachii was higher in the cervical rotation-traction manipulation group(P<0.05).At T1,the SampEn values of the biceps and triceps brachii in the cervical rotation-traction manipulation group were significantly higher than those in the tendon-regulating manipulation group(P<0.05).Within the cervical rotation-traction manipulation group,MDF,MNF,and SampEn showed statistically significant differences among muscles at all time points(T0-T2)(P<0.05),with effect sizes(η2)ranging from 0.308-0.413 for MDF and MNF,and 0.090-0.107 for SampEn.In the tendon-regulating manipulation group,significant differences among muscles were observed for MDF and MNF at all time points(P<0.001,η2=0.108-0.164),whereas no significant differences were found for SampEn(P>0.05,η2=0.036-0.051).Conclusion The electrophysiological regulation effect of cervical rotation-traction manipulation on the affected muscles of CSR patients is superior to that of tendon-regulating manipulation,particularly in improving the frequency-domain and nonlinear indices of key muscle groups(biceps and triceps brachii),providing an objective basis for clinical selection of manual therapies.