Kuenzaniswa kweChiropractic & Hospital Outpatient Care for Back Pain

Kutambudzika shure ndechimwe chezvinhu zvinowanzoita kuti vanhu vashanyire vadzidzisi vavo vehutano hwegore negore. Chiremba mukuru wekuchengetedza kazhinji kacho ndiye chiremba wokutanga anogona kupa chirwere chekukuvara kwakasiyana-siyana uye / kana mamiriro ezvinhu, zvisinei, pakati peavo vari kutsvaka kubatsiridza uye kushandiswa kwezvimwe nzira dzokurapa kwehutano hwemarwadzo, vanhu vazhinji vanosarudza chiropractic kuchengetedza. Chiropractic inotarisa pamusoro pekuongororwa, kurapwa uye kudzivirira kwekutambudzika uye zvirwere zvehutachiona uye hutye hugadziriro, nekugadzirisa zvisiri izvo zvemupenya kuburikidza nekushandura kwemagunha uye nzira dzekushandisa.

 

Anenge 35% yevanhu vanotsvaka chiropractic kurapwa kwemarwadzo kumashure anokonzerwa nematambudziko emotokari, kukuvara kwemitambo, uye zvakasiyana-siyana zvemasimba. Apo vanhu vanotambura nekushungurudzika kana kukuvadzwa semugumisiro wenjodzi, zvisinei, vangave vatanga kugamuchira kurapwa kwezviratidzo zvekurwadziwa shure mushure mezvipatara. Chipatara chiri kunze kwekuchengetedzwa kunorondedzera kurapwa kusingadi kuti usiku hwose hugare pane chimwe chiremba. Imwe tsvakurudzo yakaongororwa yakaronga kuenzanisa kuenzanisa nemigumisiro yechiropractic kuchengetedza uye chipatara chekurapa kurapwa kwepfungwa nokuda kwekutambudzika kweperi. Zvigumisiro zvinotsanangurwa zvakadarika pasi apa.

 

ngovepo

 

Chinangwa: Kufananidza kubudirira kwemakore matatu echiropractic uye chipatara chekuchengetedzwa kwepachipatara chekutapukira kwepamusoro.

 

Design: Randomized kugoverwa kwevarwere kuchiropractic kana kuchipatara chirwere chekurapa kunze.

 

Kuisa: Chiropractic makliniki uye chipatara chiri kunze kwemashami mukati memaitiro ekufamba-famba mune zveimwe II nzvimbo.

 

Zvidzidzo: 741 varume nevakadzi vane makore gumi nemana anopfuura 18-64 makore ane kurwadziwa kwakanyanya kumashure umo kushandiswa kusina kupesana.

 

Migumisiro miitiro: Shanduko yose ye0swestry mubvunzo wemibvunzo uye muchikamu chekurwadziwa uye kugutsikana kwechigarire nekupiwa kurapwa.

 

Results: Maererano nehuwandu hwe0swestry scores kukurudzira kune varwere vose vari mumakore matatu yaiva ne291 / 6 yakawanda kune avo vanorapwa nechiropractors kupfuura kune avo vanorapwa nezvipatara. Iyo inobatsira ye chiropractic pamarwadzo yainyanya kujeka. Vaya vanorapwa nechiropractors vaiva nemishonga yakawanda yekurwadziwa shure shure kwekupedzwa kwekuedzwa kwekuedzwa. Pakati peavo vekutanga vakatumidzwa kubva kuchiropractors uye kubva kuchipatara zvakarongwa kuti chiropractic inobatsira mumakore matatu kupfuura kutarisira kuchipatara.

 

Mhedziso: Kwemakore mitatu zvigumisiro zvinotsigira zvakagadziriswa mushumo wepakutanga apo apo chiropractic kana chipatara maharapa vanoporesa varwere vane kurwadziwa kwakanyanya kwepamusoro sezvavanokwanisa kuita zuva rimwe nerimwe avo vanobatwa nechiropractic vanowana mamwe mararamiro uye kugutsikana kwenguva refu kune avo vanorapwa nezvipatara.

 

ziviso

 

Muna 1990 takataura nezvekuvandudza kwakakura kune varwere vane marwadzo ekurwadziwa kwakaderedzwa nechiropractic vachienzaniswa nevaya vanowana chipatara chekuchengetedzwa kwepachipatara. Mhosva yacho yaiva "pragmatic" mukubvumira vanachiremba kuti vabate varwere sezvavaizoita zuva nezuva. Panguva yechipupuriro chedu chekutanga havasi varwere vose vakange vari mukutongwa kwemwedzi inopfuura mitanhatu. Iyi pepa inopa zvizere zvizere kusvika kumakore matatu kuvarwere vose avo vanozotevera mashoko kubva kuWorwestry mibvunzo uye zvimwe zviitiko zvaivepo zvekuongorora. Isu tinopawo dambudziko pamusoro pekutambudzika kubva mubhuku remibvunzo, iro rinoreva tsanangudzo huru yekunyunyuta kukurudzira kutumira kana kuzvitumira.

 

 

nzira

 

Nzira dzaive dzakatsanangurwa zvizere mumushumo wekutanga. Varwere pakutanga vanotumidzwa kana kuendesa kuchipatara chechiropractic kana muchipatara zvakangoerekana zvapiwa kuti zvibatwe kana chiropractic kana muchipatara. Zvose zvevarwere ve741 vakatanga chirwere. Kufambira mberi kwakaenzaniswa nemibvunzo yeOswestry pamusoro pemarwadzo ekudzokera shure, iyo inopa zvakawanda zve I 0 zvinyorwa, muenzaniso wekutambudzika uye kuoma nekusimudza, kufamba, nekufamba. Chigumisiro chacho chinoratidzwa pamwero kubva ku0 (hapana marwadzo kana matambudziko) ku100 (chikwata chapamusoro chekurwadziwa uye kuoma kukuru pane zvinhu zvose). Kune chimwe chinhu, zvakadai sekurwadziwa, marefu kubva ku0 kusvika ku10. Iyo huru yekugadzirisa matanho ndeye kuchinja muOswestry mapeji kubva mushure mekurapa kune umwe neumwe kutevera. Pane imwe, maviri, nemakore matatu varwere vakabvunzwawo nezvekuwedzera kurapwa kubvira pakupera kwekutongwa kwavo kwechirwere kana kubva mugore rekutanga remibvunzo. Panguva yemakore matatu kutevera varwere vakabvunzwa kana vakafunga kuti avo vakanzi chirongwa chekurapa chakanga chabatsira kurwadziwa kwavo shure.

 

Mukugoverwa kusarongeka kwekuderedzwa kwekurapa kwakashandiswa mukati meimwe nzvimbo kuumba mapoka ekuongororwa kwemhedzisiro zvichienderana nekiriniki yekutanga yekuendesa, kureba kwechino chiitiko (zvakapfuura kana zvishoma pane 'mwedzi), kuvapo kana kusavapo kwenhoroondo yekurwadziwa shure, uye mamaki eOswestry pakupinda kwe> 40 kana <= 40%.

 

Zvigumisiro zvakaongororwa pane chinangwa chekutora hwaro (zvichienderana nekuwanikwa kwemashoko ekutevedza pamwe nekupinda kune mumwe munhu anorwara). Kusiyanana pakati pekureva kuchinja kwakaongororwa kusina kubhadhara t miedzo, uye zviratidzo zve X2 zvakashandiswa kuedza kusiyana kwekuenzanisa pakati pemapoka maviri ekurapwa.

 

Dr. Alex Jimenez's Insight

Chiropractic inzira yehupenyu yehutano iyo chinangwa chekudzorera uye kuchengetedza basa rehutachiona uye hutsinye hurumende, hunosimudzira hutano hwepamuviri uye huchibvumira muviri kuti uzviporese pachawo. Huzivo hwedu hunosimbisa pakurapa kwemuviri wemunhu wose, panzvimbo pekurapwa kwekukuvara kamwe uye / kana mamiriro. Sezvo chiropractor ine ruzivo, chinangwa changu ndechokuongorora zvakanaka varwere kuitira kuti vaone kuti rudzi rwepi rushonga ruchabudirira kuporesa rudzi rwavo rwehutano hwehutano. Kubva kumagadzirirwo emusana uye maitiro ezvinyorwa kumabasa ekuita, chiropractic kuchengetedza kunogona kubatsira kukodzera kwepasipinal misalignments inokonzera kurwadziwa shure.

 

Results

 

Kutevedzera Oswestry mibvunzo yakadzorerwa nehuwandu hwepamusoro hwevarwere vakagoverwa chiropractic kupfuura kuchipatara. Pamasvondo matanhatu, somuenzaniso, vakadzorerwa ne95% uye 89% yechiropractic nevarwere vechipatara, pamwe uye pamakore matatu ne 77% uye 70%.

 

Zvichireva (SD) zvikwata zvisati zvarapwa kwaiva 29-8 (14-2) uye 28-5 (14-1) mumapoka ekurapa echipatractic uye muchipatara, zvichienderana. Dhiyabhorosi ini ndinoratidza kusiyana pakati pezvinoreva kushanduka muOustwestry scores zvese maererano nemaitiro akapiwa boka rekurapa. Kusiyana pane imwe neimwe kutevera ndiko kushanduka kunoreva kwechiropractic boka kuderedza kuchinja kunoreva kweboka rechipatara.

 

 

Kusiyana kwakasiyana naizvozvo kunoratidza humwe huri nani (zvichienderana nekuchinja kukuru kwezvikamu) kune avo vanorapwa nechiropractic kupfuura muchipatara (kusawirirana kwakasiyana nechekare). I3-18 kugoverwa kwepakati pepakati pamakore matatu ari patafura ini ndinomiririra 29% kukurudzira kukuru kune varwere vanobatwa nechiropractic vachienzaniswa nekurapwa kwechipatara, kushandiswa kwakakwana mumapoka maviri panguva ino iri 14-1 uye 10-9 muzana, maererano. Sezvakataurwa mumushumo wekutanga avo vane nguva shomanana dzemazuva ano, nhoroondo yemarwadzo ekudzokera shure, uye pakutanga yakakwirira Oswestry scores yakada kuwana zvakanyanya kubatsirwa nechiropractic. Izvo zvinoshandiswa nechiropractors nguva dzose zvakagamuchira ruzivo rwechiropractic kupfuura iyo inoshandiswa nezvipatara.

 

Itafura II inoratidza kushanduka pakati pezvikamu pahutano hwakanyanya kusati kwaitwa uye kuenzanisa kunowanikwa panguva dzakasiyana-siyana dzinotevera. Zvose izvi zvaive zvakanaka, izvo, kuratidzirwa kunoratidzirwa asi zvose zvaikosha zvikuru kune avo vaibatwa nechiropractic, kusanganisira kuchinja kare kare, ndiko kwemavhiki masere nemwedzi mitanhatu, apo mhinduro dzemibvunzo yakadzoka dzakanga dzakakwirira. Sezvo nemigumisiro inobva paAustwestry yose yakazara huri nani huripo nokuda kwechiropractic hwakanga hukuru kune avo pakutanga vakatumidzwa nechiropractors, kunyange zvazvo pakange panewo kusakosha kunoshandiswa (kubva pa 9% pamwedzi mitanhatu kusvika ku34% mumakore matatu) chiropractic pane imwe neimwe kutevera nguva mukati meavo inoshandiswa nezvipatara.

 

 

Zvimwe zvikamu zvezvimwe zvinhu pa Oswestry index kuratidza kuwedzera kukuru kunokonzerwa nechiropractic vaikwanisa kugara kwechinguva chiduku uye kurara (P = 0'004 uye 0 03, maererano nemakore matatu), kunyange zvazvo kusiyana kwakange kusiri sezvakafanana nekurwadziwa. Zvimwe zvikwereti (kutarisirwa kwevanhu, kusimudzira, kufamba, kumira, hutano hwepabonde, hupenyu hwehupenyu, uye kufamba) uye zvinenge zvose zvakagadziridzwa zvikuru kune varwere vanobatwa nechiropractic, kunyange zvazvo kuwanda kwekusiyana kwakanga kuchienzanisa nekusiyana kwekutambudzika.

 

Nhamba dzakakwirira dzevarwere dzakapiwa chiropractic dzaida kutsvaga kurapwa (chero ipi zvayo) kumarwadzo ekurwa shure mushure mekupedzwa kwehutano kurapwa kune avo vakachengetwa muchipatara. Somuenzaniso, pakati pemakore maviri nemakore mushure mokuedzwa muedzo 122 / 292 (42%) varwere vakabata nechiropractic vachienzaniswa ne80 / 258 (3 1%) yechipatara vakabata varwere vakaita saizvozvo (Xl = 6 8, P = 0 0 1) .

 

Tetatu III inoratidza kuenzana kwevarwere mumakore matatu avo vaifunga kuti avo vakapa chirongwa chekuedzwa kwakabatsira kurwadziwa kwavo kumashure. Pakati peavo vanotanga kutumirwa nezvipatara uye pakati peavo vanotanga kutaura nezvechiropractors zvakakwirira zvakarapwa nechiropractic vakaona kuti kurapwa kwave kwakabatsira kufanana nevaya vakarapwa muchipatara.

 

 

Mharidzo yeChinyorwa

 

• Kurwadziwa kumashure kunowanzotora zvishoma
• Kurapa kunobudirira kwekusati kuri kukonzera zvikamu zvinoda kujekeswa zvakajeka
• Chiropractic inoita seinobudirira kupfuura kutarisira kuchipatara, zvichida nokuti mamwe marapirwo akapararira kwenguva yakareba
• Nhamba iri kukura yeVATS vanotenga vari kuwedzera kurapa kwakakwana, kusanganisira chiropractic, inowanikwa
• Mamwe mimwe miedzo yekuziva kuti zvikamu zvinoshanda zvechiropractic zvinodiwa

 

hurukuro

 

Zvinoguma pamavhiki masere nemwedzi mitanhatu zvakaratidzwa patafura ini zvakafanana neavo mushumo yedu yekutanga, sezvo varwere vose vakange vakateverwa kwemwedzi mitanhatu. Zvakawanikwa kune rimwe gore zvakangofanana nevarwere vakawanda vakange vanyatsoteverawo. Nhamba dzakawanda dzevarwere vane deta zvino inowanikwa pamakore maviri nemitatu vanoratidzira zviduku zvishoma pane izvi zvakapfuura kupfuura kare, kunyange izvozvi zvichiri kuwedzerwa chiropractic. Kubatsira kukuru kwechiropractic pamusana pekurwadziwa kunoratidzika kare uye zvinoramba zvichiripo. Iyo yakawanda yakakura zvikuru yakawanda yakarashika kutevera muhutachidzo iyo kune avo vanorapwa muchipatara pane kune avo vanorapwa nechiropractic inoratidza kugutsikana kukuru nechiropractic. Izvi zvinotsigirwa (tafura III) nehupamhi hwepamusoro muboka rekutumira rimwe nerimwe rinofunga nezvechiropractic rinobatsira nekuenzanisa nekurapa kuchipatara.

 

 

Kunyanya kutsoropodza kwekutongwa mushure mokunge mharidzo yedu yekutanga ichitaura nezve "pragmatic" yayo, kunyanya chiverengero chikuru chechiropractic kupfuura kurapwa kwezvipatara uye nguva yakareba iyo maitiro echiropractic akapararira uye ayo akabvumirwa nemaune. Izvi zvinofanirwa uye nemigumisiro yakawanda yehuwandu hwevarwere vakagoverwa chiropractic avo vakagamuchira kurapwazve mune zvikamu zvekupedzisira zvekutevera, zvisinei, hazvirevi kumigumisiro mumavhiki matanhatu uye zvinoshandiswa kune zvishoma pamwedzi mitanhatu, apo zviyero zvakatevera zvakange zvakakwirira uye kuwedzerwa kwehuwandu hazvina kumboitika zvachose kana kuti zvisati zvanyanyisa. Makomborero anokonzerwa nechiropractic akanga atooneka (zvikurukuru pamarwadzo, tafura II) panguva idzi shomanana.

 

Tinotenda kuti pane ikozvino kutsigirwa kwekudiwa kwe "miedzo" yepamusoro inotarisa pane zvimwe zvikamu zvehutungamiri uye pamusoro pezvinoita. Munguva iyi, migumisiro yechiratidzo chedu inoratidza kuti chiropractic ine chikamu chakakosha chekutamba mukutungamira kwekutambudzika kwepamusoro.

 

Tinoonga Dr. Iain Chalmers kuti ataure nezvekumbwa kwepapepa. Tinoonga vaongorori vashandi, vanachiremba, physiotherapists, uye chiropractors muZ11 nzvimbo dzebasa ravo, uye Dr Alan Breen weBritish Chiropractic Association kuti abatsirwe. Iyi nzvimbo yaiva muHarrow Taunton, Plymouth, Bournemouth naPoole, Oswestry, Chertsey, Liverpool, Chelmsford, Birmingham, Exeter, uye Leeds. Pasina rubatsiro rwevashandi vazhinji mune imwe neimwe kutongwa kwaisagona kupera.

 

Mariro: Medical Research Council, National Back Pain Association, European Chiropractors Union, uye King Edward's Hospital Fund yeLondon.

 

Kupesana kwechido: Hapana.

 

Mukupedzisa,Years mushure memakore matatu, mhedzisiro yechidzidzo chekutsvagisa ichienzanisa kuchengetwa kwechiropractic uye chipatara chekurapa varwere kwekutambudzika kwepashure kwakaratidza kuti vanhu vanorapwa nechiropractic vakawana mamwe mabhenefiti pamwe nekugutsikana kwenguva refu kupfuura avo vanorapwa nezvipatara. Nekuti kurwadziwa musana ndechimwe chezvinhu zvakajairika zvinoita kuti vanhu vashanyire nyanzvi yavo yehutano gore rega rega, zvakakosha kuti utsvage mhando yehutano hwakanyanya. Ruzivo rwunotsanangurwa kubva kuNational Center yeBiotechnology Ruzivo (NCBI). Chiyero cheruzivo rwedu chinogumira kuchiropractic pamwe nekukuvara kwepamuviri nemamiriro. Kuti ukurukure nyaya yacho, ndapota inzwa wakasununguka kubvunza Dr. Jimenez kana kutibata nesu pa 915-850-0900 .

 

Yakarongedzwa naDkt Alex Jimenez

 

References

 

1. Meade TW, Dyer S, Browne W, Townsend J, Frank AO. Kutambudzika kwekudzokera kumashure kwema mechanical mavambo: kuenzanisa kusarongeka kwechiropractic uye chipatara kunze kwekurapwaBMJ. 1990 Jun 2;300(6737): 1431-1437. [PMC free article] [PubMed]
2. Fairbank JC, Couper J, Davies JB, O'Brien JP. Iyo Oswestry yakaderera musana marwadzo hurema remibvunzoPhysiotherapy. 1980 Aug;66(8): 271-273. [PubMed]
3. Pocock SJ, Simon R. Sequential kurapwa basa pamwe nekuenzanisa zvinhu zvekufungidzira mune inodzorwa kiriniki kutongwaBiometrics. 1975 Mar;31(1): 103-115. [PubMed]

 

 

Mimwe Misoro: Sciatica

 

Sciatica inotumidzwa sekusanganiswa kwezviratidzo kwete pane imwe rudzi rwekukuvara kana mamiriro. Zviratidzo izvi zvinoratidzika sehupenzi huri kurwadza, kupera uye kurira kwekunzwa kubva mumusana wakagadzika mumucheto wakadzika, pasi pamakumbo nemahudyu uye kuburikidza nemumwe kana makumbo maviri nemakumbo. Sciatica inowanzokonzera kutsamwa, kuvhiringidzika kana kuwedzerwa kwechiremera chikuru mumutumbi wemunhu, kazhinji zvichienderana nekodhi kana kuti bone spur.

 

 

NHAURWA INOKOSHA: KUDZIDZISA KWENYAYA: Kurapa Sciatica Pain