Bicalho Eduardo, Vieira Leonardo, Makita Daniel K, Rivas Luis
Osteopathy, Brazilian College of Osteopathy, Sorocaba, BRA.
Osteopathy, Brazilian Academy of Fascias, Belo Horizonte, BRA.
Cureus. 2020 Apr 16;12(4):e7700. doi: 10.7759/cureus.7700.
The capital element in the field of osteopathy and several other manual therapy methods, is the somatic dysfunction (SD), a functional imbalance that can involve different tissues and mechanisms in its genesis and maintenance. The main challenges found in the clinical scope are to understand the interaction, hierarchy, and relevance of the SD. Several manual tests are available to functionally evaluate the SD, each one with its applicability to analyze the different parameters of the SD. The so-called inhibitory tests are a category of functional manual tests that can be added to the diagnostic context of the SD. It is a particular type of test in which the evaluator applies manual mechanical stimuli to dysfunctional tissues and assesses the biological responses that occur simultaneously with the application of the stimulus. Its use can consider biomechanical and neurological principles in such a way that different conditions can be analyzed. The objective of this article is to review well-established knowledge and recent scientific discoveries about the SD and its local and global repercussions, in an attempt to offer ideas that can be applied to better understand the mechanisms that imply the use of inhibitory tests as complementary clinical diagnostic tools. It will be discussed some of the possible mechanisms involved in the physiology of the inhibitory tests, their practical applications in some distinct conditions, as well as new proposals of utilization based on the sensitization of metameric related structures under a dysfunctional state.
整骨疗法及其他几种手法治疗方法领域的核心要素是躯体功能障碍（SD），这是一种功能失衡，其发生和维持可能涉及不同组织和机制。临床领域发现的主要挑战是理解SD的相互作用、层级关系及相关性。有多种手法测试可用于对SD进行功能评估，每种测试都有其适用于分析SD不同参数的用途。所谓的抑制性测试是一类功能性手法测试，可纳入SD的诊断范畴。这是一种特殊类型的测试，评估者对手法治疗功能失调的组织施加机械刺激，并评估与刺激施加同时发生的生物学反应。其应用可兼顾生物力学和神经学原理，从而能够分析不同情况。本文的目的是回顾关于SD及其局部和全身影响的既定知识和最新科学发现，试图提供一些观点，以便更好地理解使用抑制性测试作为辅助临床诊断工具所涉及的机制。将讨论抑制性测试生理学中涉及的一些可能机制、它们在某些特定情况下的实际应用，以及基于功能失调状态下节段相关结构致敏作用的新应用建议。
