Evans David W, Lucas Nicholas
Research Centre, British School of Osteopathy, London SE1 1JE, UK.
Man Ther. 2010 Jun;15(3):286-91. doi: 10.1016/j.math.2009.12.009. Epub 2010 Jan 18.
Due primarily to its colloquial function, 'manipulation' is a poor term for distinguishing one healthcare intervention from another. With reports continuing to associate serious adverse events with manipulation, particularly relating to its use in the cervical spine, it is essential that the term be used appropriately and in accordance with a valid definition. The purpose of this paper is to identify empirically-derived features that we propose to be necessary and collectively sufficient for the formation of a valid definition for manipulation. A final definition is not offered. However, arguments for and against the inclusion of features are presented. Importantly, these features are explicitly divided into two categories: the 'action' (that which the practitioner does to the recipient) and the 'mechanical response' (that which occurs within the recipient). The proposed features are: 1) A force is applied to the recipient; 2) The line of action of this force is perpendicular to the articular surface of the affected joint; 3) The applied force creates motion at a joint; 4) This joint motion includes articular surface separation; 5) Cavitation occurs within the affected joint.
主要由于其口语化的功能，“手法治疗”这个术语在区分一种医疗干预与另一种医疗干预时并不恰当。随着报告不断将严重不良事件与手法治疗联系起来，尤其是与在颈椎上的使用相关，必须恰当地使用该术语并依据有效的定义来使用。本文的目的是确定基于实证得出的特征，我们认为这些特征对于形成手法治疗的有效定义是必要的且总体上是充分的。本文并未给出最终定义。然而，针对特征的纳入与否给出了支持和反对的论据。重要的是，这些特征被明确分为两类：“动作”（从业者对接受者所做的事情）和“力学反应”（接受者体内发生的事情）。所提出的特征如下：1）对接受者施加一个力；2）该力的作用线垂直于受影响关节的关节面；3）施加的力在关节处产生运动；4）这种关节运动包括关节面分离；5）在受影响的关节内发生关节弹响。
