Department of Physical Therapy, High Point University, One University Parkway, High Point, NC 27268, USA; Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Carrickfergus, Newtownabbey, County Antrim, UK.
Department of Physical Therapy, High Point University, One University Parkway, High Point, NC 27268, USA.
Med Hypotheses. 2018 Jan;110:90-96. doi: 10.1016/j.mehy.2017.11.008. Epub 2017 Nov 20.
Human movement is a complex orchestration of events involving many different body systems. Understanding how these systems interact during musculoskeletal movements can directly inform a variety of research fields including: injury etiology, injury prevention and therapeutic exercise prescription. Traditionally scientists have examined human movement through a reductionist lens whereby movements are broken down and observed in isolation. The process of reductionism fails to capture the interconnected complexities and the dynamic interactions found within complex systems such as human movement. An emerging idea is that human movement may be better understood using a holistic philosophy. In this regard, the properties of a given system cannot be determined or explained by its components alone, rather, it is the complexity of the system as a whole, that determines how the individual component parts behave. This paper hypothesizes that human movement can be better understood through holism; and provides available observational evidence in musculoskeletal science, which help to frame human movement as a globally interconnected complex system. Central to this, is biotensegrity, a concept where the bones of the skeletal system are postulated to be held together by the resting muscle tone of numerous viscoelastic muscular chains in a tension dependent manner. The design of a biotensegrity system suggests that when human movement occurs, the entire musculoskeletal system constantly adjusts during this movement causing global patterns to occur. This idea further supported by recent anatomical evidence suggesting that the muscles of the human body can no longer by viewed as independent anatomical structures that simply connect one bone to another bone. Rather, the body consists of numerous muscles connected in series, and end to end, which span the entire musculoskeletal system, creating long polyarticular viscoelastic myofascial muscle chains. Although theoretical, the concept of the human body being connected by these muscular chains, within a biotensegrity design, could be a potential underpinning theory for analyzing human movement in a more holistic manner. Indeed, preliminary research has now used the concept of myofascial pathways to enhance musculoskeletal examination, and provides a vivid example of how range of motion at a peripheral joint, is dependent upon the positioning of the entire body, offering supportive evidence that the body's kinetic chain is globally interconnected. Theoretical models that introduce a complex systems approach should be welcomed by the movement science field in an attempt to help explain clinical questions that have been resistant to a linear model.
人体运动是一个涉及许多不同身体系统的复杂事件组合。了解这些系统在肌肉骨骼运动中如何相互作用，可以直接为各种研究领域提供信息，包括：损伤病因学、损伤预防和治疗性运动处方。传统上，科学家通过还原论的视角来研究人体运动，将运动分解并孤立地观察。还原论的过程无法捕捉到复杂系统（如人体运动）中存在的相互关联的复杂性和动态相互作用。一个新兴的观点是，使用整体哲学可以更好地理解人体运动。在这方面，给定系统的属性不能仅通过其组件来确定或解释，而是整个系统的复杂性决定了各个组件的行为。本文假设通过整体论可以更好地理解人体运动，并提供肌肉骨骼科学中的现有观察证据，帮助将人体运动视为一个全球相互关联的复杂系统。核心是生物张力整合，这一概念假设骨骼系统的骨骼通过众多粘弹性肌肉链的静息肌肉张力以张力依赖的方式保持在一起。生物张力整合系统的设计表明，当人体运动发生时，整个肌肉骨骼系统在运动过程中不断调整，导致全局模式发生。最近的解剖学证据进一步支持了这一观点，该证据表明人体的肌肉不再被视为简单地将一块骨头连接到另一块骨头的独立解剖结构，而是由串联和端到端连接的众多肌肉组成，跨越整个肌肉骨骼系统，形成长的多关节粘弹性肌筋膜肌肉链。尽管这是一个理论，但人体通过这些肌肉链连接的概念，在生物张力整合设计中，可能是一种以更整体的方式分析人体运动的潜在基础理论。事实上，初步研究现在已经使用筋膜途径的概念来增强肌肉骨骼检查，并提供了一个生动的例子，说明外周关节的运动范围取决于整个身体的位置，提供了有力的证据，表明身体的运动链是全球相互关联的。引入复杂系统方法的理论模型应该受到运动科学界的欢迎，以帮助解释那些对线性模型具有抵抗力的临床问题。
