Taylor David N
Director, Multimed Center, Inc., Greenfield, MA.
J Chiropr Humanit. 2011 Dec;18(1):74-85. doi: 10.1016/j.echu.2011.07.001. Epub 2011 Dec 6.
The purpose of this article is to discuss a theoretical basis for wellness chiropractic manipulative care and to develop a hypothesis for further investigation.
A SEARCH OF PUBMED AND OF THE MANUAL, ALTERNATIVE, AND NATURAL THERAPY INDEX SYSTEM WAS PERFORMED WITH A COMBINATION OF KEY WORDS: chiropractic, maintenance and wellness care, maintenance manipulative care, preventive spinal manipulation, hypomobility, immobility, adhesions, joint degeneration, and neuronal degeneration. Articles were collected, and trends were identified.
The search revealed surveys of doctors and patients, an initial clinical pilot study, randomized control trials, and laboratory studies that provided correlative information to provide a framework for development of a hypothesis for the basis of maintenance spinal manipulative therapy. Maintenance care optimizes the levels of function and provides a process of achieving the best possible health. It is proposed that this may be accomplished by including chiropractic manipulative therapy in addition to exercise therapy, diet and nutritional counseling, and lifestyle coaching.
It is hypothesized that because spinal manipulative therapy brings a joint to the end of the paraphysiological joint space to encourage normal range of motion, routine manipulation of asymptomatic patients may retard the progression of joint degeneration, neuronal changes, changes in muscular strength, and recruitment patterns, which may result in improved function, decreased episodes of injuries, and improved sense of well-being.
本文旨在探讨整脊保健手法治疗的理论基础,并提出一个有待进一步研究的假设。
通过结合关键词“整脊疗法”“维持与保健护理”“维持手法治疗”“预防性脊柱手法治疗”“活动度降低”“活动受限”“粘连”“关节退变”及“神经退变”,检索了PubMed以及手法、替代和自然疗法索引系统。收集文章并确定相关趋势。
检索发现了针对医生和患者的调查、一项初步临床试点研究、随机对照试验以及实验室研究,这些研究提供了相关信息,为建立维持性脊柱手法治疗基础的假设提供了框架。维持性护理可优化功能水平,并提供实现最佳健康状态的过程。建议除运动疗法、饮食和营养咨询以及生活方式指导外,还可纳入整脊手法治疗来实现这一点。
据推测,由于脊柱手法治疗可使关节达到旁生理关节空间的极限以促进正常活动范围,对无症状患者进行常规手法治疗可能会延缓关节退变、神经变化、肌肉力量改变及募集模式的进展,进而可能改善功能、减少损伤发作次数并提升幸福感。