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从肌肉-骨骼概念到关节-肌筋膜复合体:一种用于物理治疗和手法治疗的实用解剖学概念

From Muscle-Bone Concept to the ArthroMyoFascial Complex: A Pragmatic Anatomical Concept for Physiotherapy and Manual Therapy.

作者信息

Noten Karl, Amstel Robbert van

机构信息

Fysio Science Department, Fysio Physics Group, 3401 IJsselstein, The Netherlands.

Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands.

出版信息

Life (Basel). 2024 Jun 25;14(7):799. doi: 10.3390/life14070799.

Abstract

BACKGROUND

In physiotherapy, the classic muscle-bone concept is used to translate basic and clinical anatomy. By defining the anatomical structures from superficial to deeper layers which frame the ArthroMyoFascial complex, our aim is to offer clinicians a comprehensive concept of within the muscle-bone concept.

METHOD

This study is a narrative review and ultrasound observation.

RESULTS

Based on the literature and ultrasound skeletonization, the ArthroMyoFascial complex is defined. This model clarifies fascial continuity at the joint level, describing anatomical structures from skin to deeper layers, including superficial fascia, deep fascia, myofascia including skeletal muscle fibers, and arthrofascia all connected via connective tissue linkages. This model enhances the understanding of the muscle-bone concept within the larger ArthroMyoFascial complex.

CONCLUSION

The ArthroMyoFascial complex consists of multiple anatomical structures from superficial to deeper layers, namely the skin, superficial fascia, deep fascia, myofascia including muscle fibers, and arthrofascia, all linked within a connective tissue matrix. This model indicates that it is a force-transmitting system between the skin and the bone. This information is crucial for manual therapists, including physiotherapists, osteopaths, chiropractors, and massage therapists, as they all work with fascial tissues within the musculoskeletal domain. Understanding fascia within the muscle-bone concept enhances clinical practice, aiding in therapeutic testing, treatment, reporting, and multidisciplinary communication, which is vital for musculoskeletal and orthopedic rehabilitation.

摘要

背景

在物理治疗中,经典的肌肉-骨骼概念用于阐释基础解剖学和临床解剖学。通过从浅至深定义构成关节肌筋膜复合体的解剖结构,我们的目的是为临床医生提供肌肉-骨骼概念内的全面概念。

方法

本研究为叙述性综述和超声观察。

结果

基于文献和超声骨骼化,定义了关节肌筋膜复合体。该模型阐明了关节层面的筋膜连续性,描述了从皮肤到深层的解剖结构,包括浅筋膜、深筋膜、包含骨骼肌纤维的肌筋膜以及均通过结缔组织连接相连的关节筋膜。该模型增进了对更大的关节肌筋膜复合体内肌肉-骨骼概念的理解。

结论

关节肌筋膜复合体由从浅至深的多个解剖结构组成,即皮肤、浅筋膜、深筋膜、包含肌纤维的肌筋膜以及关节筋膜,所有这些结构都在结缔组织基质内相连。该模型表明它是皮肤与骨骼之间的力传递系统。这一信息对包括物理治疗师、整骨疗法师、脊椎按摩师和按摩治疗师在内的手法治疗师至关重要,因为他们都在肌肉骨骼领域处理筋膜组织。在肌肉-骨骼概念内理解筋膜可增强临床实践,有助于治疗测试、治疗、报告及多学科交流,这对肌肉骨骼和骨科康复至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f83/11278034/1c5154d97a2e/life-14-00799-g001.jpg

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