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膈肌后外侧区域在触诊和手法骨科学治疗中的重要性。

The Importance of the Posterolateral Area of the Diaphragm Muscle for Palpation and for the Treatment of Manual Osteopathic Medicine.

机构信息

Department of Cardiology, Foundation Don Carlo Gnocchi IRCCS, Institute of Hospitalization and Care with Scientific Address, Milan, Italy.

Osteopathic Manipulative Medicine, Heritage College of Osteopathic Medicine-Dublin, Dublin, Ohio, USA.

出版信息

Complement Med Res. 2022;29(1):74-82. doi: 10.1159/000517507. Epub 2021 Jul 8.

Abstract

The eupneic act in healthy subjects involves a coordinated combination of functional anatomy and neurological activation. Neurologically, a central pattern generator, the components of which are distributed between the brainstem and the spinal cord, are hypothesized to drive the process and are modeled mathematically. A functionally anatomical approach is easier to understand although just as complex. Osteopathic manipulative treatment (OMT) is part of osteopathic medicine, which has many manual techniques to approach the human body, trying to improve the patient's homeostatic response. The principle on which OMT is based is the stimulation of self-healing processes, researching the intrinsic physiological mechanisms of the person, taking into consideration not only the physical aspect, but also the emotional one and the context in which the patient lives. This article reviews how the diaphragm muscle moves, with a brief discussion on anatomy and the respiratory neural network. The goal is to highlight the critical issues of OMT on the correct positioning of the hands on the posterolateral area of the diaphragm around the diaphragm, trying to respect the existing scientific anatomical-physiological data, and laying a solid foundation for improving the data obtainable from future research. The correctness of the position of the operator's hands in this area allows a more effective palpatory perception and, consequently, a probably more incisive result on the respiratory function.

摘要

在健康受试者中,平稳呼吸的动作涉及功能解剖学和神经激活的协调组合。从神经学角度来看,一个中枢模式发生器,其组成部分分布在脑干和脊髓之间,被假设为驱动这个过程,并通过数学模型进行模拟。虽然功能解剖学方法更容易理解,但同样复杂。整骨治疗(OMT)是整骨医学的一部分,它有许多手法技术来接近人体,试图改善患者的体内平衡反应。OMT 所依据的原则是刺激自我修复过程,研究人的内在生理机制,不仅考虑到身体方面,还考虑到情感方面和患者所处的环境。本文回顾了膈肌的运动方式,并简要讨论了解剖学和呼吸神经网络。目的是强调 OMT 在正确定位手在后外侧膈肌区域的关键问题,试图尊重现有的科学解剖生理数据,并为改善未来研究中可获得的数据奠定坚实基础。在这个区域,操作者手的位置正确可以更有效地进行触诊感知,从而对呼吸功能产生更有针对性的效果。

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