Barnes Precious L, Laboy Francisco, Noto-Bell Lauren, Ferencz Veronica, Nelson Jeffrey, Kuchera Michael L
Human Performance & Biomechanics Laboratory, Department of Osteopathic Manipulative Medicine, Center for Chronic Disorders of Aging, Philadelphia College of Osteopathic Medicine, 4170 City Ave, Philadelphia, PA 19131, USA.
J Bodyw Mov Ther. 2013 Jan;17(1):89-94. doi: 10.1016/j.jbmt.2012.10.004. Epub 2012 Dec 5.
Few objective measures have been used to document change in myofascial tissues after OMT.
Paraspinal tissues associated with cervical somatic dysfunction (SD) will demonstrate quantifiable change in myofascial hysteresis characteristics after a given OMT technique but not after a Sham intervention.
MATERIALS & METHODS: 240 subjects were palpated for cervical articular SD. A randomly selected intervention (5 OMT techniques or a Sham) was applied to the cervical SD clinically considered to be most severe. A durometer (SA201(®); Sigma Instruments, Cranberry, PA, USA) objectively measured myofascial structures overlying each cervical spinal segment pre- and post- intervention. Using a single consistent piezoelectric impulse, this durometer quantified four hysteresis (tissue texture) characteristics--fixation, mobility, frequency, and motoricity.
Baseline changes in median hysteresis values were noted for each OMT technique but not for Sham interventions. Notably, segmental counterstrain OMT resulted in significant motoricity change compared to adjacent segmental myofascial measures (p-value 0.04) along with a suggestive trend in the mobility component (p-value 0.12).
When comparing treated to untreated cervical segments, the most significant change occurred post-counterstrain OMT with no overall change following Sham. Overall, quantifiable objective change occurs in myofascial tissues post-OMT, in addition to the noted clinical palpable change.
很少有客观指标用于记录整骨手法治疗（OMT）后肌筋膜组织的变化。
与颈椎躯体功能障碍（SD）相关的椎旁组织在接受特定的整骨手法治疗技术后，肌筋膜滞后特性会出现可量化的变化，但在假干预后则不会。
对240名受试者进行颈椎关节SD触诊。将随机选择的干预措施（5种整骨手法治疗技术或假干预）应用于临床上认为最严重的颈椎SD。使用硬度计（SA201(®)；Sigma Instruments，美国宾夕法尼亚州克兰伯里）在干预前后客观测量每个颈椎节段上方的肌筋膜结构。该硬度计使用单一一致的压电脉冲，量化了四个滞后（组织质地）特征——固定性、移动性、频率和动力性。
每种整骨手法治疗技术均观察到中位滞后值的基线变化，但假干预未观察到。值得注意的是，与相邻节段的肌筋膜测量结果相比，节段性对抗牵张整骨手法治疗导致动力性有显著变化（p值为0.04），移动性成分也有提示性趋势（p值为0.12）。
在比较治疗的颈椎节段和未治疗的颈椎节段时，对抗牵张整骨手法治疗后变化最为显著，假干预后无总体变化。总体而言，除了明显的临床可触及变化外，整骨手法治疗后肌筋膜组织出现了可量化的客观变化。
