Vigotsky Andrew D, Bruhns Ryan P
Kinesiology Program, Arizona State University, Phoenix, AZ 85004, USA.
College of Medicine, University of Arizona, Tucson, AZ 85724, USA.
Pain Res Treat. 2015;2015:292805. doi: 10.1155/2015/292805. Epub 2015 Dec 16.
Manual therapy has long been a component of physical rehabilitation programs, especially to treat those in pain. The mechanisms of manual therapy, however, are not fully understood, and it has been suggested that its pain modulatory effects are of neurophysiological origin and may be mediated by the descending modulatory circuit. Therefore, the purpose of this review is to examine the neurophysiological response to different types of manual therapy, in order to better understand the neurophysiological mechanisms behind each therapy's analgesic effects. It is concluded that different forms of manual therapy elicit analgesic effects via different mechanisms, and nearly all therapies appear to be at least partially mediated by descending modulation. Additionally, future avenues of mechanistic research pertaining to manual therapy are discussed.
长期以来,手法治疗一直是物理康复计划的一个组成部分,尤其是用于治疗疼痛患者。然而,手法治疗的机制尚未完全明确,有人认为其疼痛调节作用源于神经生理学,可能由下行调节回路介导。因此,本综述的目的是研究对不同类型手法治疗的神经生理反应,以便更好地理解每种治疗镇痛效果背后的神经生理机制。得出的结论是,不同形式的手法治疗通过不同机制产生镇痛效果,几乎所有治疗似乎至少部分由下行调节介导。此外,还讨论了与手法治疗相关的机制研究的未来方向。