Musoro wemusoro unogona kunge uri kunyanya kukonzera nyaya, kunyanya kana izvi zvichatanga kuitika kakawanda. Kunyanya zvakadaro, misoro inogona kuva dambudziko guru kana chirwere chinowanikwa chepfungwa chinenge chichiita migraine. Kurwadziwa kwemukoko kazhinji chiratidzo chinokonzerwa nekukuvara kwepasi uye / kana mamiriro pamwe nechepamusoro pemutsipa wekervical, kana kumusoro nehuro. Nenzira yakanaka, nzira dzakasiyana-siyana dzokurapa dzinowanikwa kubatsira kubatsira kubata misoro. Chiropractic kuchengetedza inonyanya kuzivikanwa nzira yokurapa inoshandiswa iyo inowanzokurudzirwa kurwadziwa kwemutsipa, misoro uye migraines. Chinangwa chekutsvakurudza kwekutsvakurudza ndekutsvaga kubudirira kwechiropractic spinal manipulative therapy for migraine.

Chiropractic Spinal Manipulative Therapy for Migraine: Chidzidzo Chekudzidza Chimwe Chete-Chiremera Chechipiri-Chichirongwa Chichirongwa Chirwere Chirwere

 

ngovepo

 

ziviso

 

Migraine inokanganisa 15% yehuwandu hwevanhu, uye ine hutano hwakawanda uye hupfumi hwemagariro evanhu. Pharmacological management inotanga kurapa. Zvisinei, mishonga yakaoma uye / kana prophylactic inogona kuregererwa nekuda kwemigumisiro yechirwere kana kupesana. Nokudaro, isu tinotarisira kuongorora kushanda kwechiropractic spinal manipulative therapy (CSMT) yeigraineurs mune imwechete-yakafukidzirwa placebo-inochengetedzwa kushandiswa kwechipatara chirongwa (RCT).

 

Method uye Analysis

 

Sekureva kwesimba rekuverenga, makumi mapfumbamwe evatori vechikamu anodiwa muRCT. Vatori vechikamu vanozoitwa zvakasarudzika mune rimwe remapoka matatu: CSMT, placebo (sham manipulation) uye kutonga (zvakajairika zvisiri zvemanyorerwo manejimendi). I-RCT ine zvikamu zvitatu: 90? Mwedzi inomhanya-mukati, mwedzi mitatu inopindira uye kuongororwa kwekutsvaga pakupera kwekupindira uye 1, 3 uye 3 mwedzi? Iyo yekupedzisira yekupedzisira poindi ndeye migraine frequency, nepo migraine nguva, migraine kusimba, misoro indekisi (frequency x nguva x kusimba) uye mushonga wekushandisa ndiwo echipiri magumo ekupedzisira. Kuongorora kwekutanga kuchaongorora shanduko mumigraine frequency kubva kune yekutanga kusvika kumagumo ekupindira uye yekutevera, uko mapoka CSMT uye placebo uye CSMT nekutonga zvichaenzaniswa. Nekuda kwekuenzanisa kwemapoka maviri, p kukosha pazasi pe6 ichaonekwa seinokosha. Kune ese ese maperero ekupedzisira uye ongororo, ap kukosha pazasi 12 ichashandiswa. Mhedzisiro yacho ichaunzwa pamwe inoenderana p tsika uye 0.025% CIs.

 

Maitiro uye Kuparadzirwa

 

RCT ichatevera mitemo yekuongorora keriniki kubva kuMunyika Yese Inonzi Headache Society. Dare reNorway Regional Committee yeAradic Research Research neNorwegian Social Science Data Services rakagamuchira basa racho. Nzira ichaitwa maererano nehutauriri hweHelsinki. Migumisiro ichabudiswa pamisangano yesayenzi uye mumagazini ekuongorora-peer.

 

Trial Registration Number

 

NCT01741714.

Keywords: Statistics & Nzira dzekutsvaga

 

Simba uye Kukwana kweChidzidzo ichi

 

• Chidzidzo chacho chichava chekutanga katatu-yakagadzirirwa maitiro ekurapa randomised clinical trial (RCT) kuongorora kushanda kwechiropractic spinal manipulative therapy kupfurikidza ne placebo (sham manipulation) uye kudzora (rambai muchigadzirisa mararamiro ekugadzirisa pasina kutora kupindira mubhuku) kune migraineurs.
• Yakasimba mukati mekugadzirisa, sezvo imwe chiropractor inenge ichitungamirira matanho ose.
• RCT ine mikana yekupa kwete kusarudzwa kwemasvomhu yekugadzirisa migraineurs.
• Ngozi yekudonha inowedzerwa nekuda kwekuomeserwa kwakatemwa nzira uye 17? Mwedzi yekureba kweiyo RCT.
• Nzvimbo inogamuchirwa yakawanda inogamuchirwa haisati yave yakagadzirirwa kurapwa; saka, kune ngozi yekusapofumadza, apo muongorori anopa maitiro asingagoni kupofumadzwa nekuda kwezvikonzero zviri pachena.

 

kumashure

 

Migraine inowanzova noutano hwehutano nehuwandu hwehutano uye hupfumi hwehupfumi. Pachangobva kuitika Global Burden of Disease study, migraine yakarongerwa sechikamu chechitatu chakajairika. [1]

 

 

About 15% yehuwandu hwevanhu vane migraine. [2, 3] Migraine inowanzoita unilateral nekupuruzira uye kuenzanisa / kwakanyanya misoro inowedzerwa nekuita kwesekuita, uye inoperekedzwa nefotophobia uye phonophobia, kuda kurutsa uye dzimwe nguva kurutsa. [4] Migraine inowanikwa mumhando mbiri huru, migraine isina aura uye migraine ine aura (pazasi). Aura inodzoserwa kukanganiswa kwehuropi kwemaonero, ekufunga uye / kana ekutaura basa, kunoitika pamberi pemusoro. Zvisinei, kusiyana kwemukati memunhu kubva pakurwisa kuenda kurwisa kwakajairika. [5, 6] Kwakatangira migraine kunopikisana. Izvo zvinorwadza zvinokonzeresa zvinogona kubva kubva kuhutatu hwemitsipa, yepakati uye / kana nzira dzeparutivi. [7, 8] Kuwedzera kwekurwadziwa kwekurwadziwa kwezvimiro kunosanganisira ganda, mhasuru, arteri, periosteum uye majoini. Ganda rinotarisisa kune ese maitiro ehurombo, asi epasi uye emutsipa mhasuru dzinogona kunyanya kuve maronda uye hunyoro mune migraine. [9-11] Saizvozvowo, iyo yekumberi supraorbital, yepamberi temporal, yekumashure uye occipital arteri anonzwa kurwadziwa . [9, 12]

 

Notes

 

Rudzi Rwenyika Dzepasi Dzekushaya Matambudziko-II Kuongorora Zvokuongorora Migraine

 

Migraine pasina Aura

• A. Kurwisa kushanu kana kuzadzisa nzira dzeB D
• B. Kurwiswa nemusoro kunogara 4 72? H (isina kurapwa kana kurapwa zvisina kubudirira)
• C. Musoro unobata zvinhu zviviri zvinotevera:
• 1. Unilateral nzvimbo
• 2. Kuchengetedza unhu
• 3. Kutambura kwakakomba kana kurwadza kwakanyanya
• 4. Yakasvibiswa kana kuti inokonzera kudzivisa kuita zvekuita nguva dzose
• D. Pakati pemusoro musoro pane chimwe cheizvi:
• 1. Nausea uye / kana kurutsa
• 2. Photophobia uye phonophobia
• E. Hazvirevi kune chimwe chirwere
• Migraine ane aura
• A. Kurwisa kuviri kunozadzisa nzira dzeB D
• B. Aura inosanganisira imwe yeiyo inotevera, asi hapana kushaya simba kwemuti:
• 1. Zviratidzo zvekuona zvakakwana zvinosanganisira zviratidzo zvakanaka (kureva, zviedza zvinopenya, mavara kana mitsara) uye / kana zvinhu zvisina kunaka (kureva, kurasikirwa kwemaonero). Kutambura kwakakomba kana kurwadza kwakanyanya
• 2. Zviratidzo zvinoshandiswa zvakakwana zvinosanganisira zviratidzo zvakanaka (kureva, mapini nemasese) uye / kana zvinhu zvisina kunaka (kureva, kushaya simba)
• 3. Kudzokorora zvakakwana dysphasic mutauriri kukanganisa
• C. Zvimwe zviviri zvezvinotevera:
• 1. Homonymous zviratidzo zvinoratidzika uye / kana kusawirirana kwezviratidzo zvinonzwa
• 2. Chiratidzo chimwechete cheaura chinokura zvishoma nezvishoma pamusoro pe5? Min uye / kana zvakasiyana zviratidzo zveaura zvinoitika zvichiteedzana pamusoro? 5? Min
• 3. Chiratidzo chega chega chinogara? 5 uye? 60? Min
• D. Musoro kuzadzisa nzira BD ye1.1 Migraine isina aura inotanga panguva yeaura kana kutevera aura mukati me60? Min
• E. Hazvirevi kune chimwe chirwere

 

Pharmacological manejimendi ndiyo yekutanga nzira yekurapa kune vane migraineurs. Nekudaro, vamwe varwere havashiviriri akanyanya uye / kana prophylactic mushonga nekuda kwemhedzisiro kana zvinopesana nekuda kwekukanganiswa kwezvimwe zvirwere kana nekuda kwekuda kudzivirira mushonga kune zvimwe zvikonzero. Ngozi yekurapa kunyanyoshandiswa nekuda kwekugara uchirwiswa nemigraine inomiririra njodzi huru yehutano nematambudziko akananga uye asina kunangana. Kuwanda kwemishonga inonyanyisa kushandisa musoro (MOH) ndeye 1 is2% muhuwandu hwevanhu, [13-15] ndiko kuti, inenge hafu yevagari vanotambura nemusoro usingaperi (mazuva gumi nemusoro kana kupfuura pamwedzi) vane MOH. [15] Migraine inokonzeresa kurasikirwa kwemazuva mazana maviri nemakumi manomwe ebasa pagore pavanhu chiuru kubva paguru revanhu. [16] Izvi zvinoenderana angangoita mazana matatu nemazana emakore ekushanda makore akarasika pagore muNorway nekuda kwemigraine. Mari yehupfumi pamigraineur yaifungidzirwa kunge $ 270 muUSA uye 1000 kuEurope pagore. [17, 3700] Nekuda kwekuwanda kwemigraine, mutengo wese pagore waifungidzirwa kunge uri $ 655 bhiriyoni muUSA uye -579 bhiriyoni munyika dzeEU, Iceland, Norway neSwitzerland panguva iyoyo. Migraine inodhura zvakanyanya kupfuura kusagadzikana kwetsinga senge dementia, multiple sclerosis, chirwere chaPasinson nesitiroko. [18] Nekudaro, dzisiri-dzemishonga kurapwa nzira dzakakodzera.

 

Nzira ye Diversified uye nzira yeGonstead ndiyo inonyanya kushandiswa chiropractic manipulative treatment inhudziro mubasa, yakashandiswa ne91% ne59%, maererano nayo, [21, 22] pamwe chete nedzimwe nzira dzebhuku uye dzisiri dzebhuku, kureva, dzakanaka mararamiro ehutachiona, rupemene uye kuputika kwepachiviri, kugadziriswa, kugadziriswa kwemashure uye kudzidzira pamwe chete nehuwandu hwezvokudya uye dietetic mazano.

 

Mamwe mashoma emushonga wekurapa (SMT) akasarudzika akaedzwa (RCTs) achishandisa iyo Diversified nzira yakaitiswa migraine, zvichiratidza mhedzisiro pane migraine frequency, migraine nguva, migraine kusimba uye mushonga unoshandiswa. [23-26] Zvisinei, zvakajairika zvekare RCTs ndiyo nzira yekukanganisa kwakadai sekusarongeka kwemusoro kuongororwa, kureva kuti, bvunzo yemibvunzo yakashandiswa haina kujeka, [27] isina kukwana kana isina maitiro ehurongwa, kushomeka kweboka re placebo, uye ekupedzisira uye echipiri magumo ekupedzisira asina kutaurwa. [28-31] Mukuwedzera , maRCT apfuura haana kutevedzera zvakarayirwa kiriniki kubva kuInternational Headache Society (IHS). [32, 33] Parizvino, hapana maRCT akashandisa nzira yeGonstead chiropractic SMT (CSMT). Nokudaro, tichifunga nezvekukanganisa kwemaitiro muRCT dzakapfuura, kliniki ye-placebo-inodzorwa RCT ine yakagadziridzwa nzira yehutano inoramba ichiitirwa migraine.

 

Iyo SMT mashandiro ekuita pane migraine haina kuzivikanwa. Zvinopikiswa kuti migraine inogona kutanga kubva mukuomarara kweanociceptive afferent mhinduro dzinosanganisira yepamusoro kervical spine (C1, C2 uye C3), zvichitungamira kune hypersensitivity mamiriro enzira yetrigminal inoburitsa ruzivo rwekunzwa kwechiso uye zvizhinji zvemusoro. [34 [35] Tsvagiridzo yakaratidza kuti SMT inogona kukurudzira neural inhibitory masisitimu pamatanho akasiyana emusana, uye inogona kumisikidza akasiyana epakati ekudonhedza nzira dzekudzivirira. [36-40] Zvisinei, kunyange hazvo nzira dzakarongedzwa dzehupenyu dzisinganzwisiswe zvizere, pane mukana nzira dzekuwedzera dzisina kutsvagirwa dzinogona kutsanangudza mhedzisiro yeSMT ine pakurwadziswa kwekurwadziwa.

 

 

Chinangwa chechidzidzo ichi ndechokuongorora kushanda kweCSMT nekushambabo (sham shampulation) uye kutonga (rambai muchigara mune zvemishonga musarudzo musingawani kupindira kwemashoko) kune migraineurs muRCT.

 

Method uye Yakasikwa

 

Iyi i-single-blinded-placebo-inodzorwa RCT nemapoka matatu akafanana (CSMT, placebo uye kutonga). Pfungwa yedu yekutanga ndeyekuti CSMT inopa yakaderera 25% muvhareji nhamba yemigraine mazuva pamwedzi (30? Mazuva / mwedzi) zvichienzaniswa ne placebo uye kutonga kubva pekutanga kusvika kumagumo ekupindira, uye isu tinotarisira kuti kudzikiswa kumwe kuve inochengetwa pa3, 6 uye 12? mwedzi yekutevera. Kana iyo CSMT kurapwa ichishanda, ichapihwa kune vatori vechikamu vakagamuchira placebo kana kutonga mushure mekupedzisa kudzidza, ndiko kuti, mushure megumi nemaviri? Mwedzi yekutevera. Chidzidzo ichi chinotevedzera marongedzero ekurapwa emakiriniki kubva kuIHS, 12 32 uye nzira dzeCONSORT neMOIR. [33, 41]

 

Vagari vevarwere

 

Vatori vechikamu vanozotorwa munguva yaNdira kusvika Nyamavhuvhu 2013 kuburikidza neAkershus University Hospital, kuburikidza nevevashandi vese uye kushambadzira kwevezvenhau, kureva kuti, mapepa ane ruzivo rwakazara achaiswa kumahofisi evashandi vese pamwe neruzivo rwemumuromo kumatunhu eAkershus neOslo. , Noweyi. Vatori vechikamu vanogashira ruzivo rwakatumirwa nezve chirongwa chinoteverwa nehurukuro pfupi yefoni. Avo vakanyoreswa kubva kumahofisi evashandi vese vanofanirwa kutaura nemuongorori wezvekuchipatara uyo ane ruzivo rwekutaurirana rwakapihwa pamaposita kuti vawane ruzivo rwakawanda nezve chidzidzo ichi.

 

Vanokodzera vatori vechikamu vari pakati pegumi nemasere kusvika makumi manomwe emakore ezera uye vane imwe chete migraine yekurwiswa pamwedzi. Vatori vechikamu vanoonekwa maererano nemaitiro ekuongororwa kweInternational Classification ye Headache Disorders (ICHD-II) nachiremba wezvehutano muAkershus University Hospital. [18] Ivo vanongobvumidzwa kuve neco-kuitika kweye tension-mhando misoro uye kwete mamwe epamoyo ekutanga.

 

Maitiro ekuregedza anopesana neSMT, musana radiculopathy, nhumbu, kushushikana uye CSMT mukati memwedzi yapfuura 12? Vatori vechikamu avo panguva yeRCT vanogashira chero epamberi maitiro nema physiotherapists, chiropractors, osteopaths kana vamwe vashandi vehutano kurapa musculoskeletal marwadzo nekuremara, kusanganisira kurapa kwekuswadzisa, kubatana pamwe nekubata, [44] akachinja yavo yekurapa musoro musoro mushonga kana nhumbu inozobviswa kubva kudzidza panguva iyoyo uye kutorwa sekusiya chikoro. Ivo vanobvumidzwa kuenderera uye nekuchinja avo akajairwa acute migraine mishonga mukati mese kuyedzwa.

 

Mukupindura pakusangana kwekutanga, vatori vechikamu vanozadzisa zvinyorwa zvekubatanidza vachakokwa kuti vawedzere kuongororwa nechiropractic muongorori. Kuongorora kunosanganisira kubvunzurudzwa uye kuongorora kwepanyama nekusimbiswa kwakanyanya pamutsara wose wemutsara. Mashoko ehurukuro uye akanyorwa pamusoro pechirongwa achagoverwa mberi uye kutaura uye muromo uye kubvumwa kwakanyorwa kuchawanikwa kune vose vanobvumirwa nevatori vechikamu panguva yekubvunzurudzwa uye nechekuongorora kliniki. Maererano nehutano hwakanaka, varwere vose vachaudzwa nezvekuvhiringidza uye kubatsirwa pamwe chete nekukanganiswa kwakashata kwekupindira kunosanganisira kunyanya kunzwira tsitsi uye kuneta pazuva rekurapa. Hapana zviitiko zvakakomba zvakashata zvakave zvataurwa nezvechiropractic Gonstead nzira. [45, 46] Vavatori vechikamu vanosarudzwa mumashandisirwo anobatsira kana kuti placebo vachawana ruzivo rwakakwana rwekuongorora kwemashoko uye inorongwa nokuda kwemasangano ekupindira e12. Boka rinodzora harifaniri kutaridzirwa kuongororo iyi.

 

Clinical RCT

 

Iko kliniki RCT inosanganisira 1 mwedzi kumhanya-mukati uye 3? Mwedzi kupindira. Nguva yenguva ichaongororwa kubva kune yekutanga kusvika kumagumo ekutevera kune ese magumo nzvimbo (Mufananidzo 1).

 

 

Run-In

 

Vatori vechikamu vanozadza yakagadziriswa diagnostic bepa musoro dhayari 1? Mwedzi usati wapindira iyo inozoshandiswa sedata rekutanga kune vese vatori vechikamu. [47, 48] Iyo dhayari yakavimbiswa inosanganisira mibvunzo yakanangana neakananga kune ekutanga uye echipiri magumo ekupedzisira. X-ray inotorwa yakamira yakamira munzvimbo yeanterioposterior uye yekupedzisira ndege yemuzongoza wese. I-X-ray ichaongororwa nechiropractic muongorori.

 

Randomisation

 

Yakagadzirirwa yakavharwa mijenya pamwe neaya matatu maitiro, ndiko kuti, kushingaira kurapwa, placebo uye iro rinodzora boka, rinogovaniswa muzvikamu zvina zvikamu nezera uye murume, kureva, 18 39 uye 40-70? Makore ezera uye varume nevakadzi, zvichiteerana. Vatori vechikamu vanozogoverwa zvakaenzana kumapoka matatu nekubvumira iwo anotora mukana kutora rimwe mugove chete. Iyo block randomisation ichaitwa nevekunze vakarovedzwa bato pasina kubatanidzwa kubva kuchipatara muongorori.

 

Kupindira

 

Kushanda kwakasimba kunosanganisira CSMT kushandisa nzira yeGonstead, [21] kureva, kushamwaridzana kwakanyanya, yakakwirira-velocity, pasi-amplitude, pfupi-yever spinal pasina chekugadziriswa kwekugadziriswa kunotungamirirwa kumusana weropachanical kusagadzikana (full spine approach) sezvinoonekwa nehuwandu chiropractic tests.

 

Kupindira kwe placebo kunosanganisira kunyadzisa, kureva, yakawandisa isiri-yakanangana nekubatana, yakaderera-velocity, yakaderera-amplitude sham push maneuver mune isiri-yechinangwa uye isiri yekurapa nzira yekuraira. Ese asiri ekurapa ekutaurirana anozoitwa kunze kwepamuviri mbiru pamwe neakakwana majoini slack uye pasina zvinyoro zvinyengeri kunyepedzera kuitira kuti pasave nekubatana kwakabatana kunoitika Mune zvimwe zvikamu, anenge achitora chikamu akarara akarerekera pabhenji reZenith 2010 HYLO pamwe nemuongorori akamira kurudyi kwemubatanidzwa neruoko rwake rweruboshwe rwakaiswa kurudyi rwemuchina wekutora chikamu nerumwe ruoko rwuchisimbisa. Mune zvimwe zvirongwa, mupfuri achamira kuruboshwe kwemubatirwi oisa ruoko rwake rwerudyi pamusoro pemucheto wemubatanidzi kuruboshwe ruoko rworuboshwe rwuchisimbisa, achiendesa isiri-yechinangwa yekumanikidza yekufambisa. Neimwe nzira, iwo anotora chikamu akarara munzvimbo imwechete yekumira seboka rinoshanda rekurapa negumbo repazasi rakatwasuka uye gumbo repamusoro rakachinjika negumbo repamusoro pegumbo pakazorora pabvi repazasi regumbo, mukugadzirira danho rekumira kusunda kusunda, izvo kununurwa sechinhu chisiri-chemaune munzvimbo ine gluteal. Dzimwe nzira dzekunyepedzera dzekunyepedzera dzinochinjaniswa zvakaenzana pakati pevatori vechikamu venzvimbo dzinoenderana neprotocol mukati megumi nemaviri-vhiki yekurapa nguva yekusimbisa kudzidza kwechokwadi. Iwo anoshanda uye mapoka epa placebo achagamuchira iyo yakafanana dhizaini uye yekufamba kuongororwa pamberi uye mushure mekupindira kwega kwega. Hapana chekuwedzera kubatanidza kana kuraira kuchapihwa kune vatori vechikamu panguva yekutongwa. Nguva yekurapwa ichasanganisira kubvunzana gumi nembiri, ndiko kuti, kaviri pavhiki mumavhiki ekutanga matatu? Anoteverwa kamwechete pasvondo mumasvondo maviri anotevera uye kamwe pasvondo rechipiri kusvika mavhiki gumi nemaviri asvika. Maminetsi gumi neshanu achagoverwa kubvunzana kune mumwe nemumwe anenge achipinda. Zvese zvekupindira zvichaitiswa kuAkershus University Hospital uye inotarisirwa nechiropractor ane ruzivo (AC).

 

 

 

Iboka rinodzora rinozoenderera mberi nekuchengetedza, kureva, kurapa kwemishonga pasina kupiwa rubatsiro rwechipatara nemucherechedzi wekliniki. Izvozvi zvingabviswa zvinoshandisa boka rinodzora panguva yose yekudzidza.

 

Kupofumadza

 

Mushure mega chega chikamu chekurapa, vatori vechikamu vanogashira inoshanda kana placebo kupindira vanozadza de-blinding questionnaire inotungamirwa neyekunze yakadzidziswa yakazvimirira bato isina kubatanidzwa kubva kune yekiriniki muongorori, ndiko kuti, kupa dichotomous yes kana no mhinduro se kuti kurapa kuri kushomeka kwakagamuchirwa here. Iyi mhinduro yakateverwa nemubvunzo wechipiri maererano nezvekuti vaive nechokwadi sei chekuti kurapa kwakashanda kwakagamuchirwa pa 0 10 nhamba yekuyera chiyero (NRS), apo 0 inomiririra kusava nechokwadi zvachose uye gumi inomiririra chokwadi. Boka rinodzora uye muongorori wezvekurapa anogona nekuda kwezvikonzero zviri pachena kuti asapofomadzwa. [10, 49]

 

Tevera

 

Kuongorora kwekutevera kuchaitwa pamatanho ekupedzisira akayerwa mushure mekuguma kwekupindira uye pa3, 6 uye 12? Mwedzi yekutevera. Munguva iyi, vese vatori vechikamu vacharamba vachizadza iyo yekuongorora bepa musoro wedhayari uye voidzosera pamwedzi. Panyaya yetsamba isina kudzoserwa kana kushaikwa kwetsika mudhayari, vatori vechikamu vanofonerwa nekukasira pakuona kuti kudzikisira kurangarira kusarura. Vatori vechikamu vanofonerwa nefoni kuchengetedza kuchengetedzwa.

 

Pfungwa Dzakapera uye Sekondari

 

Iwo ekutanga uye echipiri magumo ekupedzisira akanyorwa pazasi. Magumo ekupedzisira anonamira kune yakakurudzirwa IHS kiriniki yekuyedza nhungamiro. [32, 33] Isu tinotsanangura huwandu hwemazuva emigraine senzira yekupedzisira yekupedzisira uye tinotarisira kudzikisira 25% muvhareji yemazuva kubva pakuvamba kusvika kumagumo ekupindira, ne iyo yakafanana nhanho yekudzikiswa iri kuchengetwa pakutevera. Pamusoro peongororo dzakapfuura pamusoro pemigraine, 25% kuderedzwa kunoonekwa sekufungidzira kwakachengetedza. [30] A 25% kuderedzwa kunotarisirwawo mune yechipiri magumo ekupedzisira kubva pakutanga kusvika kumagumo ekupindira, kuchengetedza pakutevera kwehurefu hwemigraine, migraine kusimba uye nemusoro index, uko indekisi inoverengerwa sehuwandu hwemazuva emigraine (30 mazuva?) avhareji migraine kwenguva (maawa pazuva) verageavhareji kusimba (0 10 NRS). Iko 50% kuderedzwa mumushonga wemushonga kubva kune yekutanga kusvika kumagumo ekupindira uye yekutevera-inotarisirwa.

 

Notes

 

Pfungwa Dzakapera uye Sekondari

 

Pasi Pfupi Pfungwa

• 1. Nhamba yemazuva emigraine mukushanda kwakashandukirana newe placebo boka.
• 2. Nhamba yemazuva emigraine mukushanda kwakashandukirana neboka rinodzora.

Secondary End Points

• 3. Migraine muhupenyu mumaawa mashoma mukushanda kwakashandura kusvika kune placebo group.
• 4. Migraine muhupenyu mumaawa mashoma mukushanda kwakashandura kunoenderana neboka rinodzora.
• 5. Kuzvidavirira kunonzi VAS mukushanda kwakashandura kunopesana ne placebo boka.
• 6. Kuzvidzivirira kwezvakaitwa VAS mukushanda kwakashandura kune boka rinodzora.
• 7. Headache index (frequency x nguva x intensity) mukushanda kwakashandukirana newe placebo group.
• 8. Musoro wehurukuro inoshandiswa pakushandura kunoenderana neboka rekutonga.
• 9. Musoro wemishonga inoshandiswa muhutano mukushanda kunoitwa pamwe ne placebo boka.
• 10. Musoro wemishonga inorapa muhutano hwehutano nehutungamiri hweboka.

 

* Iyo data ongororo yakavakirwa pane yekumhanyisa-mwaka nguva maringe nemagumo ekupindira. Pfungwa 11 40 ichave yakadzokororwa poindi 1 10 pamusoro pa3, 6 uye 12? Mwedzi yekutevera, zvichiteerana.

 

Data Processing

 

A flow flow chati yevatori vechikamu inoratidzwa mumufananidzo 2. Baseline demographic uye zvipatara zviratidzo zvichave zvakarongwa semari uye SD dzezvipembenene zvinopfuurirana uye zviyero uye zvikamu zvezvikamu zvakasiyana. Rimwe nerimwe mapoka matatu richarondedzerwa zvakasiyana. Pfungwa dzekupedzisira uye dzepamweya dzicharatidzwa nemhando dzakakodzera dzinotsanangura muboka rimwe nerimwe uye nguva imwe neimwe. Chimiro chemagumo ekupedzisira chichaongororwa zvakajeka uye kushandurwa kunofungidzirwa kana zvichidiwa.

 

 

Kuchinja munharaunda yepamusoro uye yepamweya kubva kumucheto kusvika kumagumo ekupindira uye kutevera-kuenzaniswa kuchaenzaniswa pakati pemapoka akashanda uye placebo uye mapoka anoshingaira uye anoronga. Izvo zvisingaoneki zvinotaura kuti hapana misiyano yakakura pakati pemapoka muhuwandu hwekushanduka, asi imwe nzira inofananidzira inotaura kuti kusiyana kweiyo 25% iripo.

 

Kubva pane nguva yekutevera, kudzokororwa zvakanyorwa kwepfungwa dzepakutanga uye dzechipiri dzichawanikwa, uye kuongororwa kwemaitiro mumashure ekutanga uye okupedzisira achave ekukosha. Intra-individual correlations (cluster effect) inogona kunge iripo mune deta uye inodzokorora zviyero. Cluster effect ichazoongororwa nekuverenga kukosha kwekubatana kwehuwandu huwandu hwehuwandu hwehuwandu hwehuwandu hwehuwandu hwakasiyana hunokonzerwa nekusiyana kwevanhu. Izvo zvinowanikwa mumagumo ekupedzisira zvichaongororwa nekodzero yekuregeresa yemuenzaniso weiyo longitudinal data (yakasanganiswa yakasanganiswa mufananidzo) kuti iite nhoroondo yakakodzera yeboka rinogona kuitika. Iyo mienzaniso yakasanganiswa yakasiyana inobata zvisingabatsiri dheta, zvichiita kuti ruzivo rune ruzivo ruvepo kubva kune varwere vasina maitiro kuti vaverengwe, pamwe nekubva kuendesa. Kuzvidzora mitemo uye zvakagadziriswa kwenguva yenguva uye kugoverwa kweboka pamwe chete nekubatana pakati pezviviri kuchafungidzirwa. Kukurukurirana kuchafananidza kukanganisa kunokonzerwa pakati pemapoka maererano nenguva yekufamba mumagumo ekupedzisira uye kushanda semunibus test. Zvimwe zvinokonzerwa nevarwere zvichabatanidzwa kurongedza kuongororwa kwehutano hwehutano. Nenzira dzisina maturo dzichafungidzirwa. Nzira dzakasanganiswa dzakasiyana dzichafungidzirwa neSAS PROC MIXED nzira. Kuenzanisa kwezviviri zviviri kuchaitwa kuburikidza nekutora nguva imwe nguva paya kusiyana mukati memapoka ega ega neenhamba yep p yakafanana ne 95% CIs.

 

Zvose puro-protocol uye chinangwa-che-kubata zvinongororwa zvichaitwa kana zvakakodzera. Zvose zvinongororwa zvichaitwa nenhamba dzevanhu, dzakapofumadzwa nekuda kweboka nekugoverwa. Migumisiro yose yakaipa ichave yakanyoreswa uye inoratidzwa. Vatori vechikamu vanotarisana nemhando ipi neipi yemigumisiro yakaipisisa munguva yekuedzwa vachave nekodzero yekushevedza muchengeti wekliniki purojekiti yefaira. Iyo data ichaongororwa neSPSS V.22 uye SAS V.9.3. Nokuda kwekuenzanisa kweboka maviri mumugumo wekutanga, p values ​​pasi peC0.025 ichaonekwa seanotaridzika. Pamusoro pezvikamu zvose zvekupedzisira kumagumo uye kuongororwa, kukosha kwehuwandu hwe0.05 kuchashandiswa. Kushaya maitiro kunogona kuonekwa musina kukwana mapurisa emubvunzurudzo, asina kukwana misoro yepamusoro, kusapindirwa kwemasangano ekupindira uye / kana nekuda kwekusiya. Nzira yekushayikwa ichaongororwa uye kushayikwa kwehutano kunogadziriswa zvakakwana.

 

Power Calculation

 

Muenzaniso masvomhu kuverenga akavakirwa pamhedzisiro mune ichangobva kuburitswa yeboka rekuenzanisa kudzidza pane topiramate. [51] Isu tinofungidzira kuti iwo wepakati mutsauko mukuderedzwa kwemazuva mazhinji ne migraine pamwedzi pakati pemapoka anoshanda uye e placebo mazuva 2.5 mazuva. Musiyano iwoyo unofungidzirwa pakati pemapoka anoshanda uye ekudzivirira. SD yekudzikisa muboka rega rega inofungidzirwa kuti yakaenzana ne2.5. Pasi pekufungidzira kwe, paavhareji, 10 migraine mazuva pamwedzi pakutanga pane rimwe boka uye pasina shanduko mu placebo kana boka rinodzora panguva yekudzidza, 2.5 mazuva mazuva ekuderedzwa anoenderana nekuderedzwa ne25%. Sezvo kuongorora kwekutanga kunosanganisira kuenzanisa kwemapoka maviri, isu tinoseta yakakosha nhanho pa0.025. Muenzaniso wekukura wevarwere makumi maviri unodiwa muchikwata chega chega kuti vaone musiyano wakakura musiyano mukuderedzwa kwe20% ine 25% simba. Kuti vabvumire kusiira chikoro panzira, vaongorori vanoronga kutora vechikamu zana nemakumi maviri.

 

Dr. Alex Jimenez's Insight

“Ndakakurudzirwa kutsvaga kurapwa kwechiropractic yemusoro wangu werudzi rwemigraine. Chiropractic spinal manipulative therapy inoshanda kune migraine here? " Mhando dzakasiyana dzakasiyana dzesarudzo dzekurapa dzinogona kushandiswa kunyatso kurapa migraine, zvisinei, chiropractic kuchengetedza ndiyo imwe yenzira dzakakurumbira dzekurapa nzira dzekurapa zvakasikwa migraine. Chiropractic spinal manipulative therapy iyo yechinyakare yakakwira-velocity yakaderera-amplitude (HVLA) kukanda. Iyo inozivikanwawo sekugunun'una kwepamuviri, chiropractor inoita iyi chiropractic maitiro nekushandisa inodzorwa kamwe kamwe simba kune mubatanidzwa apo muviri wakamira mune imwe nzira. Zvinoenderana nechinyorwa chinotevera, chiropractic spinal manipulative Therapy inogona kubatsira kubata migraine.

 

hurukuro

 

Mhedziso dzeMitemo

 

Ikozvino SMT RCTs pane migraine inoratidza kurapa kubudirira pamusoro pemagraine nguva, nguva uye simba. Kunyange zvakadaro, mhedziso yakasimba inoda kliniki isina kuporeswa iyo-placebo-inodzorwa RCTs nemitemo shoma shomanana. [30] Kudzidza kwakadaro kunofanira kutevedzera kune yakakurudzirwa yeHS clinical trial mirayiridzo ne migraine nguva yakawanda sepokupedzisira kuguma uye migraine nguva, migraine simba, headache index uye kushandiswa kwemishonga sechipiri kumagumo. [32, 33] Musoro wemusoro, uyewo kusanganiswa kwemaitiro, nguva uye simba, inopa chiratidzo chehuwandu hwekutambudzika. Pasinei nekushaikwa kwekubvumirana, nhungamiro yemusoro yakakurudzirwa seyakagamuchirwa yepamusoro-soro yekuguma. [33, 52, 53] Pfungwa dzekutanga uye dzekupedzisira dzichaunganidzwa zvichibudirira mune kugadziriswa kuongororwa musoro wezvinyorwa zvekare kune vose vatori vechikamu kuitira kuti vaderedze yeuka hukama. [47, 48] Pakukwanisa kweruzivo rwedu, iyi ndiyo yekutanga inotarisirwa nzira yekurapa mune imwe nhatu-yakashongedzwa-yakasungwa nzvimbo ye-placebo-inodzorwa RCT inofanira kuitwa nekuda kwemigraine. Dzidziso yekugadzirisa inoteerera kune mazano ekurapa maRTMs zvakanyanya. RCTs dzinosanganisira boka re placebo uye boka rinodzora zvinobatsira kuvargmatic RCTs iyo inofanidza maitiro maviri anoshandiswa ekurapwa. RCTs inopawo nzira yakanakisisa yekuunza kuchengetedzwa pamwe chete nedhiyabhorosi yedhesi.

 

 

Kusapofumadza kupofumadza ingangove njodzi yeRCT. Kupofumadza kunowanzooma sezvo pasina imwe yakagadziriswa yakagadzirwa chiropractic sham inopindira iyo inogona kushandiswa seboka rinodzora rezuva rino. Izvozvi, zvisinei, zvakakosha kuisanganisira boka re placebo kuitira kuti rive nehutano hwechokwadi hwekuita kupindira. Kubvumirana nezvenzvimbo yakakodzera yekuchengetedza kliniki ye SMT pakati pezvenyanzvi dzinomiririra vanachiremba nevadzidzisi, zvisinei, hazvina kuwanikwa. [54] Hapana zvidzidzo zvekare zvakapfuura, kune zvakanakisisa zvezivo yedu, yakagadziriswa kubudirira kwekuporesa kwechirongwa chechipatara cheCSMT ne multiple sessions treatment. Tine chinangwa chokuderedza dambudziko iri nekutevera purogiramu yakarongwa yeboka re placebo.

 

Nzvimbo yebhenekeri inowedzera zvakare mune zvepamusoro pemasvomhu uye inofungidzirwa zvakadai semasvomhu ekuongorora zvipatara; zvisinei, zvingatove zvakakwirira mumabhuku ekurapa RCTs zvakanyatsotarisirwa uye kubatana kwepanyama kunobatanidzwa. [55] Saizvozvowo, kunetseka kwepanyama pamusoro pekufungisisa kunenge kuchibatanidzwa kuboka rekutonga sezvo risingaonekwe nemunhu kana kuti risingaoneki zvakanyanya nechechipatori anoongorora semamwe mapoka maviri.

 

Iko kunogara kune njodzi dzekudonha nekuda kwezvikonzero zvakasiyana. Sezvo nguva yekuyedzwa iri 17? Mwedzi iine gumi nemaviri-mwedzi yekutevera-nguva, njodzi yekurasikirwa nekutevera inowedzerwa. Kubatanidzwazve kwekumwe kupindira kwebhuku panguva yekutongwa ndiyo imwe njodzi inogona kuitika, nekuti avo vanogamuchira kumanikidza kana mamwe marapirwo emuviri kumwe kunhu mukati menguva yekutongwa vachabviswa kubva muchidzidzo uye voonekwa sevanosiiwa panguva yekutyorwa.

 

Izvo zvekunze kwekodzero yeRCT inogona kunge iine utera sezvo kune mumwe chete anoongorora. Zvisinei, takaona kuti zvinobatsira kune vatsvakurudzi vakawanda, kuitira kupa ruzivo rwakafanana kune vatori vechikamu mumapoka ose matatu uye kupindira kwebhuku muna CSMT uye mapoka e placebo. Nokudaro, isu tinoda kupedza kuparadzanisa kwemukati-mutsva unogona kuvapo kana kune vaviri kana vanopfuura vapfuri. Kunyange zvazvo nzira yeGonstead ndiyo yechipiri inowanzoshandiswa netsika pakati pechiropractors, hationi nyaya yekutinhira kana ine chokuita nekugadzirisa uye kunze kwekuita. Uyezve, iyo nhamba ye randomisation ichapa shanduro yakafanana mumapoka matatu.

 

Iko mukati maitiro, zvisinei, yakasimba kuburikidza nekuva nechiremba mumwe chete wokurapa. Iyo inoderedza ngozi yekusarudzwa kusarudzwa, ruzivo uye kuedza kushandiswa. Uyezve, kuongororwa kwevadzidzi vose kunoitwa nevanoziva nezvemagetsi uye kwete nemibvunzo. Kubvunzurudzwa kwakananga kune huwandu hwekunzwisisa uye huwandu hwakaenzaniswa nekuenzanisa nemibvunzo yemibvunzo. [27] Zvimwe zvinokurudzira zvinokonzera zvinogona kuita kuti munhu anenge aine chikamu aone uye zvaanofarira paanenge achitarisa zvose zviri kuderedzwa nokuva nemutsvaga mumwe. Mukuwedzera, kubvumirana kwemukati kunowedzera kusimbiswa nevanenge vakavanzwa vachigadziriswa nzira. Sezvo makore nemakore evanhu vangave nechinzvimbo mukugadzirisa migwagwa, kuvharidzira randomisation kwakawanikwa zvakakosha kuenzanisa zvombo nezera uye hutano kuitira kuti kuderedze kukwanisika kwepabonde uye / kana yehutano hwakabatana.

 

 

Kuitisa maX-ray pamberi peanoshanda uye ekuisa placebo akawanikwa achishandiswa kuitira kuona mamiriro, kubatana uye disc kuvimbika. [56, 57] Sezvo iyo yakazara X-ray radiation mwero ichisiyana kubva pa0.2-0.8? MSv, mwaranzi kuratidzwa kwaifungidzirwa kuve kwakaderera. [58, 59] X-ray kuongororwa kwakawanikwawo kuve kwakakosha kuitira kuti uone kana izere musana X-rays inobatsira muzvidzidzo zvenguva yemberi kana kwete.

 

Sezvo isu tisingazivi nzira dzekugona kushanda zvakanaka, uye zvose zviri mumutsipa wepelinha uye pakati nepakati pakadzika nzira dzisina kudzivirirwa dzakagadziriswa, hationi zvikonzero zvekusiya kusungirirwa kwepine mushonga wekupindira kweboka rinopindira. Izvi zvakaratidza zvakare kuti marwadzo akasiyana-siyana mumasipireti haafaniri kuonekwa sematambudziko akasiyana asi asi senhengo imwe chete. [60] Saizvozvowo, kusanganisira zvizere zvepfungwa zvinokonzera kukanganisa pakati peCSMT nemapoka e placebo. Nokudaro, inogona kusimbisa mikana yekubudirira kupofumadza muboka re-placebo riri kuwanikwa. Mukuwedzera, mahofisi ese e-placebo achaitwa kunze kwemukona wepelinha, nokudaro kuderedza kunogona kweropa rwonzivo rwemagetsi.

 

Innovative uye Scientific Value

 

Iyi RCT ichasimbisa nekusimbisa Gonstead CSMT ye migraineurs, iyo isina kumbobvunzwa. Kana CSMT ichiratidza kuti inoshanda, inopa hutachiona hwekurapa. Izvi zvinonyanya kukosha sevamwe vashandisi vasina hutano hwezvinyorwa zvakajeka uye / kana prophylactic mishonga, asi vamwe vane zvisingagoneki zvinokonzerwa nemigumisiro kana kukanganiswa kwevamwe zvirwere zvinopesana nemishonga apo vamwe vanoda kuvhara mishonga nokuda kwezvikonzero zvakasiyana-siyana. Nokudaro, kana CSMT inoshanda, inogona kuva nemigumisiro yekurapa kwemigraine. Chidzidzo chacho chinokonzerawo kubatana pakati pechiropractors uye vanachiremba, izvo zvinokosha kuitira kuti utano hwehutano huve hunobudirira. Pakupedzisira, nzira yedu inogona kushandiswa mune ramangwana chiropractic uye mamwe mabhuku eRCTs pamusoro wemusoro.

 

Maitiro uye Kuparadzirwa

 

Ethics

 

Chidzidzo chakabvumidzwa neNorway Regional Committee yeMedical Research Ethics (REK) (2010/1639 / REK) neNorway Social Science Data Services (11-77). Kuzivisa kwaHelsinki kunoteverwa neimwe nzira. Yese data ichave isingazivikanwe nepo vatori vechikamu vachifanira kupa nemuromo uye nekunyora zivo ruzivo. Inishuwarenzi inopihwa kuburikidza neNorway System yeCompensation to Patients (NPE), inova nyika yakazvimiririra yenyika yakagadzirirwa kugadzirisa zvichemo kubva kuvarwere vakakuvara nekuda kwekurapwa pasi pebasa rezvehutano reNorway. Mutemo wekumisa wakatsanangurwa wekubvisa vatori vechikamu kubva muchidzidzo ichi zvinoenderana nezvakakurudzirwa muCONSORT yekuwedzera kweKunaka Kuzivisa kweHarms. [61] Kana mukwikwidzi akamhan'arira kuchiropractor kana kune vanotsvaga chiitiko chakakomba, anozobviswa pachidzidzo oendeswa kunavanachiremba vese kana dhipatimendi rekukurumidzira kuchipatara zvichienderana nemamiriro echiitiko ichi. Yekupedzisira data seti ichave ichiwanikwa kune wekiriniki muongorori (AC), akazvimiririra uye akapofomadzwa statistician (JSB) uye Study Director (MBR). Dhata richachengetwa mukabati rakavharirwa kuResearch Center, Akershus University Hospital, Norway, kwemakore mashanu?

 

Kuparadzirwa

 

Iyi purojekiti inofanirwa kupedzwa 3? Makore mushure mekutanga. Mhedzisiro ichave yakaburitswa mune vezera-vakaongorora epasi rese esainzi magazini zvinoenderana neCONSORT 2010 Chirevo. Mhedzisiro yakanaka, yakaipa, pamwe neyakajeka ichaburitswa. Uye zvakare, pfupiso yakanyorwa yakaiswa yemhedzisiro ichave iripo yekudzidza vatori vechikamu pachikumbiro. Vanyori vese vanofanirwa kukodzera kunyorwa zvinoenderana neInternational Committee yeMedical Journal Editors, 1997. Munyori wega wega aifanirwa kutora chikamu chakaringana pabasa rekutora ruzhinji kuita zvemukati. Sarudzo yekupedzisira pakurongeka kwemunyori ichagadziriswa kana chirongwa chapera. Mhedzisiro kubva mukudzidza inogona, zvakare, kuunzwa semaposta kana mutauri mutaurwo kumusangano wenyika uye / kana wepasi rese.

 

Kutenda

 

Akershus University Hospital nemutsa vakapa zvivako zvekutsvakurudza. Chiropractor Clinic1, Oslo, Norway, yakaita X-ray kuongorora.

 

Mashoko Omuzasi

 

Vabatsiri: AC uye PJT vaiva nemuongorori wekutanga wekudzidza. AC uye MBR yakawana mari. MBR yakaronga huwandu hwekugadzira. AC yakagadzirira kutanga kwepurogiramu uye PJT yakataura pamusoro pekupedzisira shanduro yechirongwa. JSB yakaita nhamba dzose dzinoongorora. AC, JSB, PJT uye MBR vakapindira mukududzirwa uye vakabatsirwa mukugadzirisa nekugadzirisa kwemavara. Vose vanyori vakaverenga uye vakabvuma magwaro ekupedzisira.

 

Mariro: Chidzidzo chacho chakagamuchira mari kubva kuAddstiftelsen (nhamba yekupa: 2829002), chiNorwegian Chiropractic Association (nhamba yepaeni: 2829001), Akershus University Hospital (nhamba yekupa: N / A) uye Yunivhesiti yeOslo kuNorway (nhamba yekupa: N / A) .

 

Kukwikwidzana: Hapana chakaziviswa.

 

Kubvumirwa nemwoyo murefu: Akawanikwa.

 

Kugamuchirwa kwemitemo: Dare reNorway Regional Committee reMitambo yekutsvakurudza yezvokurapa rakagamuchira basa (ID yekubvumirwa: 2010 / 1639 / REK).

 

Provenance uye peer review: Haana kutumirwa; kunze kwezera rekuongorora.

 

A Randomized Controlled Trial of Chiropractic Spinal Manipulative Therapy for Migraine

 

ngovepo

 

Chinangwa: Kuongorora kubatsira kwechiropractic spinal manipulative therapy (SMT) mukurapa migraine.

 

Design: Muedzo unongorongedzwa usinganzwisisiki wemwedzi we6. Chiyero chacho chaive nematanho e3: mwedzi 2 yekuunganidza deta (musati watapwa), mwedzi 2 yekurapa, uye mamwe mwedzi 2 yekuunganidza data (mushure mekurapa). Kuenzaniswa kwemigumisiro kune zvisikwa zvekutanga zvekutanga zvakagadzirwa pamagumo emwedzi ye6 kune boka re SMT uye boka rekutonga.

 

Kuisa: Chiropractic Research Center yeMacquarie University.

 

Vadzidzi: Vane zana makumi maviri nemanomwe vanozvipira pakati pemakore e10 nemakore 70 vakanyoreswa kuburikidza nekutengeswa kwemashizha. Kuongororwa kwemigraine kwakagadzirwa pamusana peStendered Headache International Society, ine uwandu hwekunge imwechete migraine pamwedzi.

 

Zvinyorwa: Mwedzi miviri ye chiropractic SMT (diversified technique) pamagadzirirwo emagetsi anotsanangurwa nevadzidzisi (huwandu hwehutano hwe16).

 

Mitezo mikuru Mitezo: Vatori vemapurisa vakapedzisa zviyero zvepamusoro zvemashoko munguva yekutongwa kwose kucherechedza nguva, kuwedzerwa (inooneka analogue score), nguva, kuremara, zviratidzo zvinobatana, nekushandiswa kwemishonga kune umwe neumwe migraine episode.

 

Results: Ivhareji yekupindura yeboka rekurapa (n = 83) yakaratidza kuwanda kwakakosha mukuwedzera kwemigraine frequency (P <.005), nguva (P <.01), kuremara (P <.05), uye kushandiswa kwemishonga (P <.001 ) kana ichienzaniswa neboka rinodzora (n = 40). Vanhu vana vakatadza kupedzisa kutongwa nekuda kwezvikonzero zvakasiyana siyana, zvinosanganisira shanduko yekugara, tsaona yemotokari, uye kuwedzerwa kwemigraine kuwanda. Yakatsanangurwa mune mamwe mazwi, 22% yevatori vechikamu vakashuma kudarika 90% kuderedzwa kwemigraines semhedzisiro yemwedzi miviri yeSMT. Vanoda kusvika makumi mashanu kubva muzana vatori vechikamu vakazivisa shanduko yakakosha mukukanganiswa kwechikamu chega chega.

 

mhedziso: Mhedzisiro yeichi chidzidzo inotsigira mhedzisiro yapfuura inoratidza kuti vamwe vanhu vanotaura kuvandudzwa kwakanyanya mumigraines mushure mechiropractic SMT. Chikamu chepamusoro (> 80%) chevatori vechikamu chakaratidza kushushikana sechinhu chakakonzera migraines yavo. Zvinotaridzika sezvingabvira kuti chiropractic kuchengetedza ine zvainoita pamamiriro epanyama ane chekuita nekushushikana uye kuti mune vanhu ava mhedzisiro yemigraine inoderedzwa.

 

Mukupedzisa, chiropractic spinal manipulative therapy inogona kushandiswa zvakajeka kubatsira kubata migraine, maererano nekuongorora kwekuongorora. Uyezve, chiropractic yakagadzirisa hutano hwehutano uye hukama hwakakwana. Utano hwemuviri womunhu wose hutendwa humwe humwe hukuru hwezvikonzero nei chiropractic kutarisira kunobatsira migraine. Mashoko anotsanangurwa kubva kuNational Center for Biotechnology Information (NCBI). Kuwanda kweruzivo rwedu kunogumira kune chiropractic pamwe nekukuvara kwepamuviri nemamiriro. Kuti ukurukure nyaya yacho, ndapota ivai vakasununguka kubvunza Dr. Jimenez kana kuti tibvunzei kwatiri 915-850-0900 .

 

Yakarongedzwa naDkt Alex Jimenez

 

 

Mimwe Misoro: Neck Pain

 

Kutambudzika kwemutsipa ndiko kunyunyuta kunowanzoitika kunogona kuguma nekuda kwekukuvara kwakasiyana siyana uye / kana mamiriro. Maererano nehuwandu, hukuvadza kwemotokari uye kukuvara kweputika ndeimwe yezvikonzero zvinowanzokonzera kurwadziwa kwemutsipa pakati pevanhu vakawanda. Pakaitika pangozi yemotokari, kusvibiswa kwechiitiko ichi kunogona kuita kuti musoro nemutsipa zvive zvishoma nezvishoma zvekare zvichienda mberi, zvichikuvadza zvivako zvakakomba zvakakomberedza mutsara. Kutambudza kumatokoni nemirasi, pamwe chete neyimwe michina mumutsipa, kunogona kukonzera marwadzo emutsipa uye kupenya kwezviratidzo mumuviri womunhu.

 

CHINOKOSHA CHINOKOSHA: KUDZIDZA KUNYANYA: Anokufadza Iwe!