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Gwajin Sarrafa Bazuwar

Ƙwararren Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru da Ƙwararrun Magunguna Nazarin da mahalarta suka raba kwatsam zuwa ƙungiyoyi daban-daban waɗanda ke kwatanta jiyya daban-daban ko wasu tsoma baki. Yin amfani da damar raba mutane zuwa rukuni yana nufin cewa ƙungiyoyi za su kasance iri ɗaya kuma ana iya kwatanta tasirin jiyya da suke samu cikin adalci.

A lokacin gwaji, ba a san wane magani ya fi kyau ba. A Gwajin Sarrafa Bazuwar ko (RCT) ƙira ba da gangan ba ya sanya mahalarta cikin ƙungiyar gwaji ko ƙungiyar kulawa. Yayin da ake gudanar da binciken, kawai bambancin da ake tsammani daga sarrafawa da ƙungiyoyin gwaji a cikin gwajin gwagwarmayar da ba a sani ba (RCT) shine canjin sakamako da ake nazari.

Abũbuwan amfãni

  • Mafi sauki ga makanta/mask fiye daga nazarin lura
  • Kyakkyawan bazuwar yana wanke duk wani son zuciya
  • An gano adadin mutanen da suka shiga fili
  • Ana iya nazarin sakamako tare da sanannun kayan aikin ƙididdiga

disadvantages

  • Ba ya bayyana dalili
  • Tsada a lokaci da kudi
  • Asara don bin diddigin jiyya
  • Rashin son kai na sa kai: yawan al'ummar da ke shiga ba zai zama wakilci na gaba daya ba

Don amsoshin tambayoyin da za ku iya samu don Allah a kira Dr. Jimenez a 915-850-0900

Sharuɗɗan Lafiya na Rauni na Rauni don Ƙarƙashin Ciwon Baya a El Paso, TX

Sharuɗɗan Lafiya na Rauni na Rauni don Ƙarƙashin Ciwon Baya a El Paso, TX

by | Back Pain, Chiropractic, kullum Pain, Gwajin Sarrafa Bazuwar

Ƙananan ciwon baya yana wakiltar ɗaya daga cikin gunaguni na yau da kullum a cikin saitunan kiwon lafiya. Duk da yake raunuka daban-daban da yanayin da ke hade da musculoskeletal da tsarin juyayi na iya haifar da ƙananan ciwon baya, yawancin masu sana'a na kiwon lafiya sun yi imanin cewa raunin aiki na iya samun haɗin gwiwa mai yawa zuwa ƙananan ciwon baya. Misali, matsayi mara kyau da maimaita motsi na iya haifar da raunin da ya shafi aiki. A wasu lokuta, haɗarin muhalli a wurin aiki na iya haifar da raunin aiki. A kowane hali, bincikar tushen rashin ciwon baya na majiyyaci don tantance daidai wanne zai zama mafi kyawun hanyar magani don dawo da asalin lafiyar mutum da lafiyar gabaɗaya yana da ƙalubale.

 

Da farko dai, samun likitocin da suka dace don takamaiman tushen ku na ƙananan ciwon baya yana da mahimmanci don samun sauƙi daga alamun ku. Yawancin ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun aiki, gami da likitocin chiropractic ko chiropractors. A sakamakon haka, an kafa jagororin jiyya na raunin aiki da yawa don sarrafa ƙananan ciwon baya a cikin saitunan kiwon lafiya. Maganin chiropractic mayar da hankali kan bincike, magani, da kuma hana cututtuka daban-daban da yanayi, irin su LBP, da ke hade da musculoskeletal da tsarin juyayi. Ta hanyar gyaran gyare-gyare a hankali na kashin baya, kulawar chiropractic zai iya taimakawa wajen inganta bayyanar cututtuka na ƙananan ciwon baya, a tsakanin sauran alamun. Manufar labarin mai zuwa shine don tattauna jagororin kiwon lafiya na sana'a don kula da ƙananan ciwon baya.

 

Sharuɗɗan Lafiya na Sana'a don Gudanar da Ƙarƙashin Ciwon Baya: Kwatancen Ƙasashen Duniya

 

Abstract

 

  • Bayan Fage: Babban nauyin zamantakewar tattalin arziki na ƙananan ciwon baya yana jaddada buƙatar sarrafa wannan matsala, musamman a cikin yanayin aiki yadda ya kamata. Don magance wannan, an fitar da jagororin sana'a a ƙasashe daban-daban.
  • Neman: Don kwatanta jagororin ƙasashen duniya da aka samo don sarrafa ƙananan ciwon baya a cikin tsarin kula da lafiya na sana'a.
  • Hanyar: An kwatanta jagororin game da ka'idodin ingancin da aka yarda da su gabaɗaya ta amfani da kayan aikin AGREE kuma an taƙaita game da kwamitin jagora, gabatarwa, ƙungiyar da aka yi niyya, da shawarwarin ƙima da gudanarwa (wato, shawara, komawa dabarun aiki, da magani).
  • Sakamako da Karshe: Sakamakon ya nuna cewa jagororin sun cika ka'idojin inganci daban-daban. Matsalolin gama gari sun shafi rashin ingantaccen bita na waje a cikin tsarin ci gaba, rashin kulawa ga shingen ƙungiyoyi da abubuwan farashi, da rashin cikakken bayani kan gwargwadon yadda masu gyara da masu haɓaka suka kasance masu zaman kansu. Akwai yarjejeniya ta gaba ɗaya akan batutuwa masu yawa na asali don kula da lafiyar sana'a na ciwon baya. Shawarwari na kimantawa sun haɗa da tantancewar ganowa, bincikar tutoci masu ja da matsalolin jijiya, da gano yuwuwar matsalolin zamantakewa da wuraren aiki don murmurewa. Sharuɗɗa kuma sun yarda da shawara cewa ƙananan ciwon baya shine yanayin da ya dace da kai da kuma cewa zama a wurin aiki ko kuma da wuri (a hankali) komawa aiki, idan ya cancanta tare da gyare-gyaren ayyuka, ya kamata a karfafa da goyon baya.

 

Dr. Alex Jimenez's Insight

Ƙananan ciwon baya yana daya daga cikin batutuwan kiwon lafiya da suka fi dacewa da aka bi da su a ofisoshin chiropractic. Kodayake labarin da ke gaba ya kwatanta ƙananan ciwon baya a matsayin yanayin iyakance kansa, dalilin LBP na mutum kuma zai iya haifar da ciwo mai raɗaɗi da ciwo mai tsanani da rashin jin daɗi na hagu ba tare da magani ba. Yana da mahimmanci ga mutumin da ke da alamun ƙananan ciwon baya don neman magani mai kyau tare da chiropractor don bincikar lafiya da kyau da kuma kula da al'amuran kiwon lafiyar su da kuma hana su dawowa a nan gaba. Marasa lafiya da ke fama da ƙananan ciwon baya fiye da watanni 3 sun kasance ƙasa da kashi 3 na iya komawa aiki. Kulawa na chiropractic wani zaɓi ne mai aminci da inganci wanda zai iya taimakawa wajen mayar da ainihin aikin kashin baya. Bugu da ƙari kuma, likita na chiropractic, ko chiropractor, na iya ba da gyare-gyaren salon rayuwa, irin su shawarwarin abinci mai gina jiki da dacewa, don hanzarta aikin dawo da marasa lafiya. Waraka ta hanyar motsi yana da mahimmanci don dawo da LBP.

 

Ƙananan ciwon baya (LBP) ɗaya ne daga cikin ƙasashen masana'antu mafi yawan matsalolin kiwon lafiya. Duk da yanayinsa mai kyau da yanayin sauti, LBP yana da alaƙa da rashin ƙarfi, asarar yawan aiki saboda izinin rashin lafiya, da tsadar al'umma.[1]

 

Saboda wannan tasirin, akwai buƙatu a fili don ingantattun dabarun gudanarwa bisa ga shaidar kimiyya da aka samo daga nazarin ingancin ingantacciyar hanya. Yawancin lokaci, waɗannan gwaje-gwajen da aka sarrafa bazuwar (RCTs) ne akan tasiri na hanyoyin warkewa, nazarin bincike, ko nazarin abubuwan da za a iya gani a kan abubuwan haɗari ko illa. Shaidar kimiyya, wanda aka taƙaita a cikin sake dubawa na tsari da ƙididdigar meta, yana ba da ingantaccen tushe don jagororin sarrafa LBP. A cikin takarda da ta gabata, Koes et al. idan aka kwatanta jagororin asibiti daban-daban don sarrafa LBP da aka yi niyya ga ƙwararrun kiwon lafiya na farko, suna nuna babban abin gama gari.[2]

 

Matsalolin kiwon lafiya na sana'a sun bambanta. Gudanarwa ya fi mayar da hankali kan ba da shawara ga ma'aikaci tare da LBP da kuma magance matsalolin taimaka musu su ci gaba da aiki ko komawa aiki (RTW) bayan jerin marasa lafiya. Duk da haka, LBP kuma wani muhimmin al'amari ne a cikin kula da lafiyar sana'a saboda rashin iya aiki na haɗin gwiwa, asarar yawan aiki, da kuma rashin lafiya. Jagorori da yawa, ko sassan jagororin, an buga yanzu suna ma'amala da takamaiman batutuwan gudanarwa a cikin yanayin kula da lafiya na sana'a. Tun da shaida ta kasa da kasa, za a sa ran cewa shawarwarin jagororin sana'a daban-daban na LBP zasu kasance fiye ko žasa. Duk da haka, ba a bayyana ko jagororin sun cika ka'idojin inganci da aka yarda da su a halin yanzu ba.

 

Wannan takarda tana kimanta jagororin sana'a da ake da su akan sarrafa LBP kuma tana kwatanta kima da shawarwarin gudanarwa.

 

Babban Saƙonni

 

  • A cikin ƙasashe daban-daban, ana ba da jagororin kiwon lafiya na sana'a don inganta kula da ƙananan ciwon baya a cikin yanayin aiki.
  • Matsalolin gama gari na waɗannan jagororin sun shafi rashin ingantaccen bita na waje a cikin tsarin haɓakawa, rashin kulawa ga shingen ƙungiyoyi da abubuwan farashi, da ƙarancin bayanai kan 'yancin kai na masu gyara da masu haɓakawa.
  • Gabaɗaya, shawarwarin kima a cikin jagororin sun ƙunshi nau'ikan bincike, yin gwajin jajayen tutoci da matsalolin jijiya, da gano yuwuwar matsalolin zamantakewa da wuraren aiki don murmurewa.
  • Akwai yarjejeniya ta gaba ɗaya game da shawara cewa ƙananan ciwon baya shine yanayin da ya dace da kai da kuma cewa sauran aiki a wurin aiki ko kuma da wuri (a hankali) komawa aiki, idan ya cancanta tare da ayyukan da aka gyara, ya kamata a karfafa da goyon baya.

 

Hanyar

 

An dawo da jagororin kan kula da lafiyar sana'a na LBP daga fayilolin sirri na marubuta. An duba sake dawowa ta hanyar bincike na Medline ta amfani da maƙallan ƙananan ciwon baya, jagorori, da sana'a har zuwa Oktoba 2001, da sadarwar sirri tare da masana a cikin filin. Manufofin dole ne su cika ka'idojin haɗawa masu zuwa:

 

  • Sharuɗɗan da ke nufin sarrafa ma'aikata tare da LBP (a cikin saitunan kiwon lafiya na sana'a ko magance matsalolin sana'a) ko sassa daban-daban na manufofin da suka shafi waɗannan batutuwa.
  • Ana samun jagororin cikin Ingilishi ko Yaren mutanen Holland (ko kuma an fassara su cikin waɗannan harsuna).

 

Sharuɗɗan keɓancewa sune:

 

  • Sharuɗɗa akan rigakafin farko (wato, rigakafi kafin fara bayyanar cututtuka) na LBP masu aiki (misali, umarnin ɗagawa ga ma'aikata).
  • Jagororin asibiti don gudanar da LBP a cikin kulawa na farko.[2]

 

An kimanta ingancin jagororin da aka haɗa ta amfani da kayan aikin AGREE, kayan aikin gama gari da aka tsara da farko don taimakawa masu haɓakawa da masu amfani da su tantance ingancin tsarin jagororin aikin asibiti.[3]

 

Kayan aikin AGREE yana ba da tsari don tantance ingancin akan abubuwa 24 (tebur 1), kowannensu da aka ƙididdige shi akan ma'auni huɗu. Ana samun cikakken aikin aiki akan www.agreecollaboration.org.

 

Masu bita guda biyu (BS da HH) sun ƙididdige ingancin jagororin da kansu sannan su hadu don tattauna rashin jituwa da kuma cimma matsaya kan ƙimar. Lokacin da suka kasa yarda, mai bita na uku (MvT) ya daidaita sauran bambance-bambancen kuma ya yanke shawara akan ƙimar. Don sauƙaƙe bincike a cikin wannan bita, an canza ƙididdiga zuwa ma'auni daban-daban na ko kowane abu mai inganci ya kasance ko bai cika ba.

 

An taƙaita shawarwarin kima kuma idan aka kwatanta da shawarwari akan shawarwari, jiyya, da komawa dabarun aiki. An kara kwatanta jagororin da aka zaɓa kuma an kai su game da kwamitin jagora, gabatar da tsarin, ƙungiyar da aka yi niyya, da kuma gwargwadon shawarwarin da aka dogara akan shaidar kimiyya. Duk waɗannan bayanan an ciro su kai tsaye daga jagororin da aka buga.

 

Tasirin Siyasa

 

  • Gudanar da ƙananan ciwon baya a cikin kula da lafiyar sana'a ya kamata ya bi ka'idodin tushen shaida.
  • Sharuɗɗan sana'a na gaba don kula da ƙananan ciwon baya da sabuntawa na waɗannan jagororin ya kamata suyi la'akari da ma'auni don ingantaccen ci gaba, aiwatarwa, da kuma kimanta hanyoyin da aka ba da shawara ta hanyar haɗin gwiwar AGREE.

 

results

 

Zaɓin Nazari

 

Bincikenmu ya samo jagororin goma, amma an cire hudu saboda sun yi hulɗa da gudanarwa na LBP a cikin kulawa na farko, [15] an yi nufin jagorancin ma'aikatan da aka jera marasa lafiya gabaɗaya (ba musamman LBP ba), [16] an yi niyya don rigakafin farko na LBP a wurin aiki, [17] ko ba a samuwa a cikin Ingilishi ko Yaren mutanen Holland.[18] Zaɓin ƙarshe, don haka, ya ƙunshi jagororin guda shida masu zuwa, waɗanda aka jera ta kwanan wata:

 

(1) Kanada (Quebec). Hanyar kimiyya don kimantawa da kula da cututtuka na kashin baya da ke da alaka da aiki. A monograph ga likitoci. Rahoton Ƙungiyar Task Force na Quebec akan Cututtukan Spinal. Quebec Kanada (1987).[4]

 

(2) Australia (Victoria). Sharuɗɗa don kula da ma'aikata tare da ƙananan ƙananan ciwon baya. Hukumar Kula da Ayyukan Aikin Victoria, Ostiraliya (1996).[5] (Wannan sigar jagororin da South Australian WorkCover Corporation suka haɓaka a cikin Oktoba 1993.)

 

(3) Amurka. Jagororin Ayyukan Magungunan Ma'aikata. Kwalejin Amirka na Ma'aikata da Magungunan Muhalli. Amurka (1997).[6]

 

(4) New Zealand

 

(a) Aiki da aiki! Sarrafa m ƙananan ciwon baya a wurin aiki. Kamfanin Diyya na Hatsari da Kwamitin Lafiya na Kasa. New Zealand (2000).[7]

 

(b) Jagoran haƙuri don kula da ƙananan ciwon baya. Kamfanin Diyya na Hatsari da Kwamitin Lafiya na Kasa. New Zealand (1998).[8]

 

(c) Yi la'akari da tutoci masu launin rawaya na psychosocial a cikin ƙananan ƙananan ciwon baya. Kamfanin Diyya na Hatsari da Kwamitin Lafiya na Kasa. New Zealand (1997).[9]

(5) Netherlands. Jagoran Yaren mutanen Holland don kula da likitocin sana'a na ma'aikata tare da ƙananan ciwon baya. Ƙungiyar Magungunan Ma'aikata ta Holland (NVAB). Netherlands (1999).[10]

 

(6) UK

 

(a) Jagororin kiwon lafiya na sana'a don sarrafa ƙananan ciwon baya a manyan shawarwarin aiki. Makarantar Magungunan Ma'aikata. Birtaniya (2000).[11]

 

(b) Jagororin kiwon lafiya na sana'a don sarrafa ƙananan ciwon baya a takardar aiki don masu aiki. Makarantar Magungunan Ma'aikata. Birtaniya (2000).[12]

 

(c) Jagororin kiwon lafiya na sana'a don sarrafa ƙananan ciwon baya a nazarin shaidar aikin. Makarantar Magungunan Ma'aikata. Birtaniya (2000).[13]

 

(d) Littafin Baya, Ofishin Kayan Aiki. Birtaniya (1996).[14]

Ba za a iya kimanta jagororin biyu (4 da 6) ba daban-daban daga ƙarin takaddun da suke magana akai (4bc, 6bd), don haka waɗannan takaddun an haɗa su cikin bita.

 

Kima na Ingancin Jagororin

 

Da farko, an yi yarjejeniya tsakanin masu bitar biyu game da 106 (77%) na ƙimar abubuwa 138. Bayan tarurrukan biyu, an cimma matsaya akan dukkan abubuwa in ban da abubuwa hudu, wadanda suka bukaci yanke hukunci daga mai nazari na uku. Table 1 yana gabatar da ƙimar ƙarshe.

 

Dukkan jagororin da aka haɗa sun gabatar da zaɓuɓɓuka daban-daban don sarrafa LBP a cikin lafiyar sana'a. A cikin biyar daga cikin manufofin shida, an bayyana maƙasudin tsarin gaba ɗaya a sarari, [46, 1014] an bayyana masu amfani da tsarin a sarari, [514] an haɗa mahimman shawarwarin da za a iya ganewa cikin sauƙi, [4, 614] ko nazari mai mahimmanci. an gabatar da ma'auni don sa ido da dalilai na tantancewa.[49, 1114].

 

Sakamakon kimar AGREE ya nuna cewa babu ɗaya daga cikin ƙa'idodin da ya ba da isasshiyar kulawa ga yuwuwar shingen ƙungiyoyi da abubuwan farashi wajen aiwatar da shawarwarin. Har ila yau, ba a sani ba ga duk ƙa'idodin da aka haɗa ko sun kasance masu zaman kansu a edita ko a'a ba tare da hukumar ba da kudade ba kuma ko akwai rikice-rikice na sha'awa ga mambobin kwamitocin ci gaban jagora. Bugu da ƙari, babu tabbas ga duk ƙa'idodin ko ƙwararrun sun sake nazarin manufofin a waje kafin bugawa. Jagoran Burtaniya kawai ya bayyana a sarari hanyar da aka yi amfani da ita don tsara shawarwari da kuma tanadar don sabunta tsarin.[11]

 

Tebur 1 Mahimman Bayanan Jagororin Lafiya na Sana'a

 

Haɓaka Sharuɗɗa

 

Tebur na 2 yana gabatar da bayanan baya akan tsarin ci gaba na jagororin.

 

Masu amfani da aka yi niyya don jagororin sun kasance likitoci da sauran masu ba da lafiya a fagen kiwon lafiya na sana'a. An kuma ba da umarni da yawa manufofi don sanar da ma'aikata, ma'aikata [68, 11, 14], ko membobin kungiyoyi masu sha'awar lafiyar sana'a.[4] Jagoran Yaren mutanen Holland an yi niyya ne kawai ga likitan lafiyar sana'a.[10]

 

Kwamitocin jagororin da ke da alhakin haɓaka jagororin gabaɗaya sun kasance nau'i-nau'i iri-iri, gami da fannonin ilimi kamar su annoba, ergonomics, physiotherapy, aikin gama-gari, likitancin sana'a, likitancin sana'a, likitocin kashi, da wakilan ƙungiyoyin ma'aikata da ƙungiyoyin kasuwanci. Wakilan Chiropractic da osteopathic sun kasance a cikin kwamitin jagora na jagororin New Zealand.[79] Rundunar aikin Quebec (Kanada) ta kuma haɗa da wakilan likitancin gyarawa, rheumatology, tattalin arziki na kiwon lafiya, doka, neurosurgery, injiniyan biomechanical, da kimiyyar ɗakin karatu. Sabanin haka, kwamitin jagora na jagorar Dutch ya ƙunshi likitocin sana'a kawai.[10]

 

An ba da jagororin a matsayin takarda dabam, [4, 5, 10] a matsayin babi a cikin littafi, [6] ko kuma a matsayin wasu takardu masu alaƙa.[79, 1114].

 

Birtaniya, [13] Amurka, [6] da Kanada [4] jagororin sun ba da bayani game da dabarun binciken da aka yi amfani da su don gano wallafe-wallafen da suka dace da kuma auna shaidar. A gefe guda, ƙa'idodin Dutch[10] da jagororin Ostiraliya [5] sun goyi bayan shawarwarin su ta hanyar nassoshi kawai. Jagororin New Zealand ba su nuna alaƙa kai tsaye tsakanin shawarwari da damuwa [79]. An tura mai karatu zuwa wasu wallafe-wallafen don bayanin asali.

 

Tebur 2 Bayanin Bayanan Jagororin

 

Shawarwari na 3 Jagororin Sana'a

 

Shawarwari na 4 Jagororin Sana'a

 

Yawan Jama'a da Shawarwari na Bincike

 

Kodayake duk jagororin sun mayar da hankali ga ma'aikata tare da LBP, sau da yawa ba a sani ba ko sun yi maganin LBP mai tsanani ko na kullum ko duka biyu. LBP mai tsanani da na yau da kullum ba a bayyana su ba, kuma an ba da maki yanke (misali, <3 watanni). Yawancin lokaci ba a sani ba ko waɗannan suna nufin farkon alamun ko rashin aiki. Duk da haka, ka'idar Kanada ta gabatar da tsarin rarrabawa (mai tsanani / subacute / na kullum) bisa ga rarraba da'awar cututtuka na kashin baya ta lokaci tun lokacin da ba a aiki.[4]

 

Duk jagororin sun bambanta takamammen ƙayyadaddun LBP. Musamman LBP ya shafi yiwuwar mummunan yanayin alamar ja kamar karaya, ciwace-ciwacen ƙwayoyi, ko cututtuka, da ka'idodin Dutch da na Birtaniya kuma sun bambanta ciwon radicular ko ciwon tushen jijiya.[1013] Dukkanin hanyoyin sun kasance daidai a cikin shawarwarin su don ɗaukar tarihin asibiti da kuma gudanar da gwajin jiki, ciki har da gwajin jini. A lokuta da ake zargin takamaiman cututtukan cututtuka (jajayen tutoci), yawancin jagororin sun ba da shawarar gwajin x-ray. Bugu da ƙari, New Zealand da jagororin Amurka sun kuma ba da shawarar gwajin x-ray lokacin da bayyanar cututtuka ba su inganta ba bayan makonni hudu. mai haƙuri tare da LBP (bambanta daga kowane alamun asibiti).[6]

 

Yawancin jagororin sunyi la'akari da abubuwan zamantakewa a matsayin tutocin rawaya a matsayin cikas ga farfadowa da masu samar da lafiya ya kamata su magance. New Zealand [9] da jagororin Burtaniya [11, 12] a bayyane abubuwan da aka jera su da tambayoyin da aka ba da shawarar don gano waɗancan tutocin launin rawaya na psychosocial.

 

Dukkan jagororin sun yi magana game da mahimmancin tarihin asibiti wanda ke gano abubuwan da ke tattare da yanayin aiki na jiki da na psychosocial da suka dace da LBP, gami da buƙatun jiki na aiki (harɓar hannu, ɗagawa, lanƙwasa, karkatarwa, da fallasa ga rawar jiki gaba ɗaya), hatsarori ko raunin da ya faru, da matsalolin da aka gane. a komawa aiki ko dangantaka a wurin aiki. Jagororin Dutch da na Kanada sun ƙunshi shawarwari don gudanar da binciken wurin aiki[10] ko kimanta ƙwarewar sana'a idan ya cancanta.[4]

 

Takaitacciyar Shawarwari don Ƙimar LBP

 

  • Ƙididdigar bincike (wanda ba takamaiman LBP ba, ciwo na radicular, takamaiman LBP).
  • Banda jajayen tutoci da duban jijiya.
  • Gano abubuwan da suka shafi tunanin mutum da kuma abubuwan da za su iya kawo cikas ga farfadowa.
  • Gano abubuwan wurin aiki (na jiki da na psychosocial) waɗanda zasu iya alaƙa da matsalar LBP kuma komawa aiki.
  • Gwajin X-ray an iyakance shi ga wasu lokuta da ake zargi da cutar ta musamman.

 

Shawarwari Game da Bayani da Nasiha, Jiyya, da Komawa Dabarun Aiki

 

Yawancin jagororin sun ba da shawarar ƙarfafa ma'aikaci da kuma samar da bayanai game da yanayin ƙayyadaddun kai na LBP da kyakkyawan hasashen. An sha ba da shawarar ƙarfafa komawa ga ayyukan yau da kullun gabaɗaya gwargwadon yiwuwa.

 

A cikin layi tare da shawarwarin don komawa aiki na yau da kullum, duk jagororin kuma sun jaddada mahimmancin komawa aiki da sauri kamar yadda zai yiwu, koda kuwa har yanzu akwai wasu LBP kuma, idan ya cancanta, farawa tare da gyare-gyaren ayyuka a cikin mafi tsanani lokuta. Za a iya ƙara ayyukan aiki a hankali (awanni da ayyuka) har sai an kai ga koma baya ga aiki. Jagororin Amurka da Dutch sun ba da cikakken jadawalin lokaci don dawowa aiki. Hanyar Dutch ta ba da shawarar komawa aiki a cikin makonni biyu tare da daidaita ayyukan aiki idan ya cancanta.[10] Har ila yau, tsarin Yaren mutanen Holland ya jaddada mahimmancin kulawar lokaci-lokaci game da komawa aiki.[10] Jagoran Amurka ya ba da shawarar kowane ƙoƙari na kula da majiyyaci a mafi girman matakan aiki, gami da ayyukan aiki; An ba da maƙasudin tsawon lokacin nakasa dangane da komawa aiki a matsayin kwanakin 02 tare da gyare-gyaren ayyuka da kwanakin 714 idan ba a yi amfani da ayyukan da aka gyara ba.[6] Ya bambanta da sauran, ka'idar Kanada ta ba da shawarar komawa aiki kawai lokacin da alamun cututtuka da ƙuntatawa na aiki suka inganta.[4]

 

Zaɓuɓɓukan jiyya da aka fi ba da shawarar akai-akai a cikin duk jagororin da aka haɗa sune: magani don jin zafi, [5, 7, 8] shirye-shiryen motsa jiki na ci gaba a hankali, [6, 10] da gyare-gyare na multidisciplinary.[1013] Jagoran Amurka ya ba da shawarar turawa cikin makonni biyu zuwa shirin motsa jiki wanda ya ƙunshi motsa jiki na motsa jiki, motsa jiki na motsa jiki don tsokoki, da adadin motsa jiki.[6] Jagoran Yaren mutanen Holland ya ba da shawarar cewa idan babu ci gaba a cikin makonni biyu na rashin aiki, ya kamata a mayar da ma'aikata zuwa tsarin aiki mai daraja (yawan motsa jiki a hankali) kuma, idan ba a inganta ta makonni hudu ba, zuwa shirin gyaran gyare-gyare na multidisciplinary.[10] ] Jagoran Burtaniya ya ba da shawarar cewa ma'aikatan da ke da wahalar komawa ayyukan sana'a na yau da kullun da makonni 412 ya kamata a mayar da su zuwa wani shiri na farfadowa. Wannan shirin gyarawa ya kamata ya haɗa da ilimi, tabbatarwa da shawara, ci gaba da motsa jiki mai karfi da shirin motsa jiki, da kuma kula da ciwo bisa ga ka'idodin hali; ya kamata a saka shi a cikin wani wuri na sana'a kuma a kai tsaye zuwa ga komawa zuwa aiki. akan shaidar kimiyya.

 

Takaitacciyar Shawarwari Game da Bayani, Shawara, Komawa Ma'aunin Aiki, da Jiyya a Ma'aikata tare da LBP

 

  • Tabbatar da ma'aikaci kuma ya ba da isassun bayanai game da yanayin ƙayyadaddun kai na LBP da kyakkyawan hasashe.
  • Shawarci ma'aikaci don ci gaba da ayyukan yau da kullun ko komawa motsa jiki na yau da kullun da aiki da wuri-wuri, koda kuwa akwai sauran ciwo.
  • Yawancin ma'aikata tare da LBP suna komawa zuwa fiye ko žasa ayyuka na yau da kullum da sauri. Yi la'akari da daidaitawa na wucin gadi na ayyukan aiki (awanni / ayyuka) kawai idan ya cancanta.
  • Lokacin da ma'aikaci ya kasa komawa aiki a cikin makonni na 212 (akwai bambanci mai yawa a cikin ma'auni na lokaci a cikin jagororin daban-daban), mayar da su zuwa shirin motsa jiki na karuwa a hankali, ko gyaran gyare-gyare na multidisciplinary (ayyukan motsa jiki, ilimi, tabbatarwa, da kuma kula da jin zafi bin ka'idodin hali. ). Waɗannan shirye-shiryen gyarawa
    ya kamata a sanya shi a cikin yanayin aiki.

 

tattaunawa

 

Gudanar da LBP a cikin yanayin kiwon lafiya na sana'a dole ne ya magance alakar da ke tsakanin ƙananan gunaguni da aiki da kuma samar da dabarun da ake nufi don dawowa aiki lafiya. Wannan bita ya kwatanta jagororin kiwon lafiyar sana'a daga ƙasashe daban-daban. Ba a cika lissafin manufofi a cikin Medline ba, don haka lokacin neman jagororin, dole ne mu dogara da farko ga fayilolin sirri da sadarwar sirri.

 

Halayen Inganci da Tsarin Ci gaba na Jagororin

 

Ƙimar da kayan aikin AGREE[3] ya nuna ya nuna wasu bambance-bambance a cikin ingancin jagororin da aka duba, wanda zai iya nuna wani ɓangare na bambancin kwanakin ci gaba da buga jagororin. Jagoran Kanada, alal misali, an buga shi a cikin 1987 da ƙa'idodin Australiya a cikin 1996.

 

Yawancin kuskuren gama gari da suka danganci tsarin ci gaba na jagororin an nuna su ta hanyar kima ta kayan aikin AGREE. Da fari dai, yana da mahimmanci a bayyana ko jagorar ta kasance mai zaman kanta ta edita daga ƙungiyar masu ba da kuɗi, da kuma ko akwai rikice-rikice na sha'awa ga membobin kwamitin jagora. Babu ɗaya daga cikin ƙa'idodin da aka haɗa da ya ba da rahoton waɗannan batutuwa a sarari. Bugu da ari, rahoton binciken waje na jagorar ta kwararrun likitocin asibiti da hanyoyin kafin a buga su ma sun rasa duk jagororin da aka haɗa cikin wannan bita.

 

Sharuɗɗa da yawa sun ba da cikakkun bayanai game da yadda aka bincika wallafe-wallafen da suka dace da kuma fassara su zuwa shawarwari. ƙarfin jagororin ko shawarwarin su.

 

Sharuɗɗa sun dogara da shaidar kimiyya, waɗanda ke canzawa akan lokaci, kuma yana da ban mamaki cewa jagora guda ɗaya kawai aka bayar don sabuntawa nan gaba. zai zama sabuntawa na gaba ba yana nufin zai faru a zahiri ba). Wannan rashin rahoton na iya kasancewa gaskiya ga sauran ka'idojin AGREE waɗanda muka ƙididdige su mara kyau. Yin amfani da tsarin AGREE a matsayin jagora don haɓakawa da kuma bayar da rahoto na jagororin ya kamata ya taimaka wajen inganta ingantaccen jagororin gaba.

 

Ƙimar da Gudanar da LBP

 

Hanyoyin bincike da aka ba da shawarar a cikin jagororin kiwon lafiya na sana'a sun fi kama da shawarwarin jagororin asibiti, [2] kuma, a ma'ana, babban bambanci shine mahimmancin magance matsalolin sana'a. Hanyoyin da aka ruwaito don magance abubuwan wuraren aiki a cikin kima na LBP na kowane ma'aikaci ya shafi gano ayyuka masu wuyar gaske, abubuwan haɗari, da kuma cikas don komawa aiki ta tarihin sana'a. Babu shakka, waɗannan cikas don komawa aiki ba kawai sun shafi abubuwan nauyin jiki ba ne kawai, har ma suna aiki da matsalolin zamantakewar zamantakewa game da nauyi, haɗin gwiwa tare da abokan aiki, da yanayin zamantakewa a wurin aiki.[10] Nunawa ga tutoci masu launin rawaya masu alaƙa da aiki na iya taimakawa wajen gano waɗancan ma'aikatan da ke cikin haɗari don ciwo mai tsanani da nakasa.[1113]

 

Wata mahimmanci mai mahimmanci na jagororin shine cewa sun kasance daidai game da shawarwarin su don tabbatar da ma'aikaci tare da LBP, kuma don ƙarfafawa da goyan bayan komawa aiki har ma da wasu alamun ci gaba. Akwai yarjejeniya gaba ɗaya cewa yawancin ma'aikata ba dole ba ne su jira har sai sun sami cikakkiyar jin daɗi kafin su dawo bakin aiki. Lissafin zaɓuɓɓukan magani da jagororin Kanada da Ostiraliya suka bayar na iya nuna rashin shaida a wancan lokacin, [4, 5] barin masu amfani da jagororin don zaɓar wa kansu. Yana da, duk da haka, abin tambaya ko irin waɗannan lissafin suna ba da gudummawa ga ingantacciyar kulawa, kuma a ra'ayinmu shawarwarin jagororin ya kamata su kasance bisa ingantacciyar shaidar kimiyya.

 

Jagororin sana'a na Amurka, Dutch, da Burtaniya [6, 1013] sun ba da shawarar cewa jiyya mai aiki na multidisciplinary shine mafi kyawun sa baki don komawa aiki, kuma wannan yana da goyan bayan shaida mai ƙarfi daga RCTs.[19, 20] Duk da haka, ƙarin bincike yana har yanzu. da ake buƙata don gano mafi kyawun abun ciki da ƙarfin waɗannan fakitin jiyya.[13, 21]

 

Duk da wasu shaidun gudummawar abubuwan da ke cikin wurin aiki a cikin aetiology na LBP, [22] hanyoyin da aka tsara don daidaitawa wurin aiki sun rasa, kuma ba a ba da su azaman shawarwari a cikin jagororin ba. Wataƙila wannan yana wakiltar rashin amincewa da shaida kan tasirin tasirin abubuwan wuraren aiki gabaɗaya, wahalar fassara zuwa jagora mai amfani, ko kuma saboda waɗannan batutuwan sun ruɗe da dokokin gida (wanda aka nuna a cikin jagororin Burtaniya[11]). Yana iya zama cewa shiga tsakani ergonomics, wanda ke ba da shawarwari tare da ma'aikaci, ma'aikaci, da ergonomist, zai zama mai amfani da komawa ga aikin sa baki. 23] an jaddada shi a cikin jagororin Dutch da UK, [24] amma ana buƙatar ƙarin kimantawa game da wannan tsarin da aiwatar da shi.

 

Haɓaka Jagororin gaba a cikin Kula da Lafiyar Sana'a

 

Manufar wannan bita shine don ba da taƙaitaccen bayani da ƙima mai mahimmanci na jagororin sana'a don gudanar da LBP. Mahimman ƙima na jagororin ana nufin taimakawa ci gaban gaba kai tsaye da sabunta sabbin jagororin. A cikin fage na tsarin jagora wanda har yanzu ya kunno kai muna ɗaukar duk abubuwan da suka gabata a matsayin abin yabawa; mun fahimci buƙatar jagorar asibiti, kuma mun yaba da cewa jagororin masu haɓakawa ba za su iya jira bincike don samar da duk hanyoyin da shaida da ake buƙata ba. Koyaya, akwai ɗaki don haɓakawa kuma jagororin gaba da sabuntawa yakamata suyi la'akari da ma'auni don ingantaccen haɓakawa, aiwatarwa, da kimanta jagororin kamar yadda haɗin gwiwar AGREE ya ba da shawara.

 

Aiwatar da ka'idodin ya wuce iyakar wannan bita, amma an lura cewa babu ɗaya daga cikin takaddun jagororin da ya bayyana dabarun aiwatarwa musamman, don haka ba a da tabbas ko menene aka cimma ƙungiyoyin da aka yi niyya, da kuma irin tasirin da ka iya haifarwa. . Wannan yana iya zama yanki mai fa'ida don ƙarin bincike.

 

Kasancewar waɗannan jagororin kiwon lafiya na sana'a sun nuna cewa ƙa'idodin kulawa na farko na LBP2 ana ɗaukar su bai dace ba ko kuma bai isa ba don kula da lafiyar sana'a. Akwai bayyananniyar fahimta a duniya cewa bukatun ma'aikacin da ke fama da ciwon baya yana da alaƙa da alaƙa da al'amuran sana'a iri-iri waɗanda ba a rufe su ta hanyar jagorar kulawa ta farko da aka saba kuma, saboda haka, aiki. Abin da ke fitowa shi ne, duk da kurakuran hanyoyin, yarjejeniya mai yawa ta bayyana akan yawancin dabarun kiwon lafiya na sana'a don kula da ma'aikaci tare da ciwon baya, wasu daga cikinsu suna da ƙwarewa da ƙalubalanci ra'ayoyin da aka yi a baya. Akwai yarjejeniya a kan ainihin saƙon cewa tsawaita asarar aiki na da lahani, kuma ya kamata a ƙarfafa da kuma sauƙaƙa dawowa aiki da wuri; babu buƙatar jira cikakken ƙudurin alamar. Kodayake dabarun da aka ba da shawarar sun bambanta da ɗan kaɗan, akwai yarjejeniya mai yawa akan ƙimar tabbataccen tabbaci da nasiha, samuwar (na ɗan lokaci) gyare-gyaren aiki, magance matsalolin wurin aiki (samun duk 'yan wasa a waje), da kuma gyara ga ma'aikatan da ke da wahalar komawa bakin aiki.

 

Godiya

 

Wannan binciken ya sami goyan bayan Hukumar Inshorar Kula da Lafiya ta Dutch (CVZ), ba da DPZ no. 169/0, Amstelveen, Netherlands. JB Staal a halin yanzu yana aiki a Sashen Nazarin Cututtuka, Jami'ar Maastricht, PO Box 616 6200 MD Maastricht, Netherlands. W van Mechelen kuma wani ɓangare ne na Cibiyar Bincike akan Ayyukan Jiki, Aiki da Lafiya, Jiki @ aiki TNO-VUmc.

 

A ƙarshe, bayyanar cututtuka na ƙananan ciwon baya shine daya daga cikin al'amuran kiwon lafiya na yau da kullum da ke hade da raunin aiki. Saboda haka, an kafa jagororin kiwon lafiyar sana'a da yawa don kula da ƙananan ciwon baya. Kulawar chiropractic, a tsakanin sauran hanyoyin magani, ana iya amfani da su don taimakawa mai haƙuri ya sami taimako daga LBP. Bugu da ƙari kuma, labarin da ke sama ya nuna aminci da tasiri na al'ada iri-iri da kuma madadin hanyoyin magance cututtuka a cikin ganewar asali, jiyya da kuma rigakafi da dama na ƙananan ciwon baya. Duk da haka, ana buƙatar ƙarin nazarin bincike don ƙayyade yadda ya dace na kowane hanyar magani. Bayanin da aka ambata daga Cibiyar Bayanan Kimiyyar Halittu ta Ƙasa (NCBI). Matsakaicin bayanin mu yana iyakance ga chiropractic da kuma raunin da ya faru da kashin baya. Don tattauna batun batun, don Allah jin daɗin tambayar Dr. Jimenez ko tuntuɓe mu a 915-850-0900 .

 

Dr. Alex Jimenez ne ya shirya shi

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Ƙarin Maudu'i: Ciwon Baya

 

Bisa ga kididdigar, kimanin 80% na mutane za su fuskanci alamun ciwon baya a kalla sau ɗaya a duk rayuwarsu. Binciken baya koke ne na gama-gari wanda zai iya haifar da rauni da/ko yanayi iri-iri. Sau da yawa lokuta, lalacewar dabi'a na kashin baya tare da shekaru na iya haifar da ciwon baya. Harsiated fayafai faruwa a lokacin da taushi, gel-kamar cibiyar intervertebral disc ta tura ta cikin hawaye a kewaye da shi, waje zobe na guringuntsi, matsawa da kuma fusatar da jijiya tushen. Abubuwan da aka fi sani da diski suna faruwa tare da ƙananan baya, ko kashin baya na lumbar, amma kuma suna iya faruwa tare da kashin mahaifa, ko wuyansa. Ƙunƙarar jijiyoyi da aka samo a cikin ƙananan baya saboda rauni da / ko mummunan yanayin zai iya haifar da bayyanar cututtuka na sciatica.

 

 

hoton blog na zane mai ban dariya paperboy babban labarai

 

MAFI MUHIMMAN BUDURWA: Maganin Ciwon Migraine

 

 

KARATUN BATUN: EXTRA EXTRA: El Paso, Tx | 'Yan wasa

 

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kima da kuma kula da cututtuka na kashin baya da ke da alaka da aiki. A monograph ga likitoci. Rahoton Ƙungiyar Task Force na Quebec akan Cututtukan Spinal. Kashin baya 1987; 12 (kayyade 7S): 1�59.
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12. Jagororin kiwon lafiya na sana'a don kula da ƙananan ciwon baya a takardar aiki don masu aiki. London: Makarantar Magungunan Ma'aikata, 2000 (www.facoccmed.ac.uk).
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14. Roland M, da dai sauransu. Littafin baya. Norwich: Ofishin Kayan Aiki, 1996.
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Rufe Accordion
Magani na Spinal vs. Tattara don Ciwon Ciwon Cervicogenic a El Paso, TX

Magani na Spinal vs. Tattara don Ciwon Ciwon Cervicogenic a El Paso, TX

by | Chiropractic, Neck Pain, Gwajin Sarrafa Bazuwar

Babban ciwon kai yana da alaƙa da ciwon kai wanda ciwon kai ya haifar da kansa. Nau'u uku na ciwon kai na farko sun haɗa da, migraine, ciwon kai irin na tashin hankali da ciwon kai. Ciwon kai alama ce mai raɗaɗi kuma mai raɗaɗi wanda kuma zai iya faruwa a sakamakon wani dalili na asali. An kwatanta ciwon kai na biyu a matsayin ciwon kai wanda ke faruwa saboda rauni da / ko yanayi. Ƙaƙƙarfan ƙashin baya, ko subluxation, tare da kashin mahaifa, ko wuyansa, yawanci yana hade da nau'in alamun ciwon kai.

 

Ciwon kai na Cervicogenic shine ciwon kai na biyu wanda ya haifar da rauni da / ko yanayin da ke shafar tsarin kewaye na kashin mahaifa, ko wuyansa. Yawancin masu sana'a na kiwon lafiya za su ba da shawarar yin amfani da kwayoyi / magunguna don taimakawa wajen inganta ciwon kai, duk da haka, wasu zaɓuɓɓukan magani da yawa za a iya amfani da su cikin aminci da inganci don magance ciwon kai na biyu. Manufar labarin mai zuwa shine don nuna tasiri na ƙwayar mahaifa da babba na thoracic tare da haɗuwa da motsa jiki a cikin marasa lafiya da ciwon kai na cervicogenic.

 

Babba na ƙwayar cuta na cervicated da babba m mangeus tattara da motsa jiki a cikin marasa lafiya tare da ciwon kai na Cervicogenic: fitina mai yawa

 

Abstract

 

  • Bayan Fage: Kodayake abubuwan da ake amfani da su na yau da kullum, babu wani binciken da ya kwatanta tasiri na ƙwayar mahaifa da thoracic don tattarawa da motsa jiki a cikin mutane masu ciwon kai na cervicogenic (CH). Makasudin wannan binciken shine kwatanta tasirin magudi da tattarawa da motsa jiki a cikin mutane tare da CH.
  • Hanyar: Mahalarta ɗari da goma (n?=?110) tare da CH sun kasance bazuwar don karɓar magudin mahaifa da na thoracic (n?=?58) ko tattarawa da motsa jiki (n?=?52). Sakamakon farko shine ƙarfin ciwon kai kamar yadda aka auna ta Ƙididdigar Ƙwararrun Ƙwararru (NPRS). Sakamakon na biyu ya haɗa da mitar ciwon kai, tsawon lokacin ciwon kai, nakasa kamar yadda aka auna ta Neck Disability Index (NDI), shan magani, da Global Rating of Change (GRC). Lokacin jiyya shine makonni 4 tare da kima mai biyo baya a mako 1, makonni 4, da watanni 3 bayan zaman jiyya na farko. An yi nazarin manufar farko tare da nazarin nau'in nau'i-nau'i na 2-hanyar bambance-bambance (ANOVA), tare da rukunin jiyya (masu amfani da motsa jiki da motsa jiki) a matsayin tsakanin batutuwa masu mahimmanci da lokaci (tushen, 1 mako, 4 makonni da 3 watanni) kamar yadda abubuwan da ke cikin batutuwa masu canzawa.
  • results: 2X4 ANOVA ya nuna cewa mutanen da ke tare da CH waɗanda suka karɓi maganin mahaifa da na thoracic sun sami raguwa sosai a cikin tsananin ciwon kai (p?
  • Ƙarshe: An nuna zaman shida zuwa takwas na babba na mahaifa da babba na thoracic manipulation sun fi tasiri fiye da motsa jiki da motsa jiki a cikin marasa lafiya tare da CH, kuma an kiyaye tasirin a cikin watanni 3.
  • Rijistar gwaji: NCT01580280 Afrilu 16, 2012.
  • keywords: Cervicogenic ciwon kai, Gyaran kashin baya, Ƙarfafawa, Ƙarƙashin ƙarfin ƙarfin ƙarfi.

 

Dr Jimenez White Coat

Dr. Alex Jimenez's Insight

Idan aka kwatanta da ciwon kai na farko, kamar migraine, cluster ciwon kai da tashin hankali-nau'in ciwon kai, na biyu ciwon kai ne halin da ciwon kai lalacewa ta hanyar wani rashin lafiya ko jiki batun. A cikin yanayin ciwon kai na cervicogenic, dalilin ciwon kai shine saboda rauni da / ko yanayin tare da kashin mahaifa da kuma tsarin da ke kewaye da shi, ciki har da vertebrae, fayafai na intervertebral da laushi mai laushi. Bugu da ƙari, yawancin masu sana'a na kiwon lafiya sunyi imanin cewa ciwon kai na farko zai iya haɗuwa da al'amurran kiwon lafiya a cikin kashin mahaifa, ko wuyansa. Maganin ciwon kai na Cervicogenic ya kamata ya kai hari ga tushen alamun kuma zai iya bambanta dangane da mai haƙuri. Kulawa na chiropractic yana amfani da gyare-gyare na kashin baya da gyare-gyare na hannu don mayar da hankali na asali da aikin kashin baya, yana taimakawa wajen rage damuwa da matsa lamba don inganta alamun ciwon kai na cervicogenic, a tsakanin sauran nau'in ciwon kai. Hakanan za'a iya amfani da kulawar chiropractic don taimakawa wajen magance ciwon kai na farko, irin su migraines.

 

Tarihi

 

Ƙididdigar Ƙasashen Duniya na Ciwon Ciwon kai yana bayyana ciwon kai na cervicogenic (CH) a matsayin, ciwon kai wanda ya haifar da rashin lafiya na kashin mahaifa da kuma abin da ke tattare da kashi, diski, da / ko abubuwa masu laushi, yawanci amma ba tare da kullun ba tare da ciwon wuyansa. [1] ] (p.760) An ba da rahoton yawancin CH tsakanin 0.4 da 20% na yawan ciwon kai [2, 3], kuma har zuwa 53% a cikin marasa lafiya da ciwon kai bayan rauni na whiplash [4]. Babban fasali na CH yawanci sun haɗa da: rashin daidaituwa na ciwon kai ba tare da jujjuyawar gefe ba, haɓakar zafi tare da matsa lamba na waje akan wuyan ipsilateral, iyakance kewayon motsi na mahaifa, da haifar da hare-hare ta hanyoyi daban-daban masu banƙyama ko ci gaba da motsin wuyansa [4, 5].

 

Mutanen da ke tare da CH ana yawan bi da su tare da maganin manipulative na kashin baya ciki har da haɗuwa da magudi [6]. Ƙunƙarar kashin baya ya ƙunshi sannu-sannu, rhythmical, dabarun oscillating yayin da magudi ya ƙunshi fasaha mai ƙananan hanzari mai sauri. [7] A cikin bita na yau da kullun na yau da kullun, Bronfort da abokan aiki sun ba da rahoton cewa maganin manipulative na kashin baya (duka motsi da magudi) sun kasance masu tasiri a cikin kula da manya tare da CH [8]. Duk da haka, ba su bayar da rahoto ba idan magudi ya haifar da sakamako mafi girma idan aka kwatanta da tattarawa don gudanar da wannan yawan jama'a.

 

Yawancin karatu sun bincika sakamakon magudi na kashin baya a cikin gudanarwa na CH [9�13]. Hasa et al. [10] ya bincika tasirin magudin mahaifa a cikin batutuwa tare da CH. Jull et al. [11] ya nuna ingancin magani don maganin manipulative da / ko motsa jiki a cikin gudanarwa na CH. Duk da haka ƙungiyar maganin manipulative ta haɗa da magudi da ƙaddamarwa don haka ba za a iya ƙayyade idan tasiri mai amfani ya kasance sakamakon magudi, ƙaddamarwa ko haɗuwa.

 

Wasu 'yan nazarin sunyi nazarin fa'idodin magudi tare da tattarawa don gudanar da ciwon wuyan wuyansa tare da ko ba tare da motsa jiki ba [14�16]. Duk da haka, babu wani binciken da ya kwatanta kai tsaye sakamakon magudi tare da tattarawa da motsa jiki a cikin marasa lafiya tare da CH. Idan akai la'akari da haɗarin magudi [17], yana da mahimmanci don ƙayyade idan magudi ya haifar da ingantattun sakamako idan aka kwatanta da haɗuwa don kula da marasa lafiya tare da CH. Sabili da haka, makasudin wannan gwaji na asibiti bazuwar shine don kwatanta tasirin magudi tare da motsa jiki da motsa jiki a cikin marasa lafiya tare da CH. Mun yi la'akari da cewa marasa lafiya da ke karɓar magudi a kan lokacin jiyya na 4-mako za su sami raguwa mafi girma a cikin tsanani ciwon kai, yawan ciwon kai, tsawon lokaci na ciwon kai, rashin lafiya, da kuma shan magani a cikin watanni 3 fiye da marasa lafiya da ke karɓar ƙwayar mahaifa da thoracic haɗuwa tare da motsa jiki. .

 

Hanyar

 

Wanda su ka Halarta

 

A cikin wannan gwajin gwaji na asibiti da yawa, marasa lafiya a jere tare da CH suna gabatar da 1 na 8 asibitocin motsa jiki na marasa lafiya daga wurare daban-daban (Arizona, Georgia, New York, Ohio, Pennsylvania, South Carolina) an ɗauke su sama da wata 29 lokaci (daga Afrilu 2012 zuwa Agusta 2014). Don marasa lafiya su cancanci, dole ne su gabatar da ganewar asali na CH bisa ga ka'idojin bincike da aka bita [5] wanda Cervicogenic Headache International Study Group (CHISG) ya haɓaka [5, 18, 19]. An rarraba CH bisa ga manyan sharuɗɗa� (ba tare da haɗa da shaidar tabbatarwa ta hanyar toshewar cutar ba) da kuma halayen ciwon kai na CHISG. Sabili da haka, domin a haɗa su a cikin binciken, marasa lafiya dole ne su nuna duk waɗannan sharuɗɗa: (1) rashin daidaituwa na ciwon kai ba tare da gefe ba, farawa a cikin wuyansa na baya ko yankin occipital, ƙarshe ya yada zuwa yankin oculofrontotemporal akan Siffar alama, (2) jin zafi da ke haifar da motsin wuyansa da / ko ci gaba da matsayi mara kyau, (3) rage yawan motsi a cikin kashin mahaifa [20] (watau ƙasa da ko daidai da 32 � na dama ko hagu na jujjuyawar motsi a kan Gwajin Juyawa Juyawa [21�23], (4) jin zafi ya haifar da matsa lamba na waje akan aƙalla ɗaya daga cikin haɗin gwiwar mahaifa na sama (C0-3), da (5) matsakaita zuwa mai tsanani, rashin bugun jini da zafi mara lahani. Bugu da ƙari, mahalarta dole ne su sami ciwon kai na akalla 1 a kowane mako don akalla watanni 3, mafi ƙarancin ciwon ciwon kai na maki biyu (0�10 akan sikelin NPRS), ƙarancin nakasa na 20% ko mafi girma (watau maki 10 ko mafi girma akan sikelin 0�50 NDI), kuma ku kasance tsakanin 18 da 65 yea rs shekaru.

 

An cire marasa lafiya idan sun nuna wasu ciwon kai na farko (watau migraine, TTH), suna fama da ciwon kai na biyu, ko kuma sun nuna alamun ja (watau ƙari, karaya, cututtuka na rayuwa, rheumatoid arthritis, osteoporosis, hutawa hawan jini fiye da 140/90). mmHg, tsawon tarihin amfani da steroid, da dai sauransu), an gabatar da su tare da alamun neurologic guda biyu ko fiye masu dacewa daidai da matsawa tushen jijiya (rauni na tsoka wanda ya shafi babban ƙungiyar tsoka na babba, raguwar ƙwayar tsoka mai zurfi mai zurfi, ko raguwa ko rashin jin daɗi. zuwa pinprick a cikin kowane dermatome na sama), wanda aka gabatar tare da ganewar asali na jijiyar mahaifa, bayyanar cututtuka na sama na biyu, yana da shaidar shigar da tsarin juyayi na tsakiya (hyperreflexia, damuwa a cikin hannu, ƙwayar tsoka na ciki na hannu, rashin kwanciyar hankali yayin tafiya). , nystagmus, asarar hangen nesa, rashin jin daɗi na fuska, canza dandano, kasancewar bayyanar cututtuka); yana da tarihin rauni na whiplash a cikin makonni na 6 da suka gabata, yana da kafin tiyata a kai ko wuyansa, ya karbi magani don ciwon kai ko wuyansa daga kowane mai aiki a cikin watan da ya gabata, ya sami farfadowa na jiki ko maganin chiropractic don ciwon kai ko wuyansa a ciki. watanni 3 da suka gabata, ko kuma suna da matakin shari'a da ke jira game da ciwon kai ko wuyansu.

 

Littattafai na baya-bayan nan sun nuna cewa gwajin gwajin jini na pre-manipulative ba zai iya tantance waɗancan mutanen da ke cikin haɗarin rikice-rikice na jijiyoyin jini daga magudin mahaifa [24, 25], kuma duk wani alamun da aka gano yayin gwajin riga-kafi na iya zama ba shi da alaƙa da canje-canje a cikin jini a cikin jini. jijiyoyin kashin baya [26, 27]. Don haka, ba a yi gwajin maganin jijiya na mahaifa a cikin wannan binciken ba; duk da haka, tambayoyin da ake nunawa game da cutar sankarar mahaifa dole ne su kasance marasa kyau [24, 28, 29]. Hukumar Binciken Cibiyoyi ta amince da wannan binciken a Jami'ar Long Island, Brooklyn, NY. An yi rajistar binciken a www.clinicaltrials.gov tare da mai gano gwaji NCT01580280. An sanar da duk marasa lafiya cewa za su sami ko dai magudi ko motsa jiki da motsa jiki sannan kuma sun ba da izini da aka sani kafin shiga cikin binciken.

 

Maganin Magunguna

 

Masu kwantar da hankali na jiki goma sha biyu (ma'anar shekaru 36.6, SD 5.62) sun shiga cikin isar da jiyya ga marasa lafiya a cikin wannan binciken. Suna da matsakaicin 10.3 (SD 5.66, kewayon shekaru 3 zuwa 20) na shekaru na ƙwarewar asibiti, kuma duk sun kammala shirin ba da takardar shaidar kammala karatun digiri na 60 h wanda ya haɗa da horo mai amfani a cikin dabarun hannu gami da yin amfani da ƙwayar mahaifa da magudin thoracic. Don tabbatar da duk gwaje-gwaje, ƙididdigar sakamako, da hanyoyin magani sun daidaita, duk masu aikin kwantar da hankali na jiki suna buƙatar yin nazarin littafin ƙayyadaddun tsarin aiki da kuma shiga cikin horo na 4 h tare da babban mai binciken.

 

Hanyoyin jarrabawa

 

Duk marasa lafiya sun ba da bayanan alƙaluma, sun kammala tambayoyin Neck Pain Medical Screening Questionnaire, kuma sun kammala matakan da yawa na rahoton kai, tare da daidaitaccen tarihin tarihi da jarrabawar jiki a asali. Matakan rahoton kai sun haɗa da ƙarfin ciwon kai kamar yadda aka auna ta NPRS (0�10), NDI (0�50), yawan ciwon kai (yawan kwanaki tare da ciwon kai a cikin makon da ya gabata), tsawon ciwon kai (jimlar sa'o'i na ciwon kai a ƙarshe. mako), da kuma shan magani (yawan lokutan da majiyyaci ya sha narcotic ko kan-kan-counter maganin ciwo a cikin makon da ya gabata).

 

Daidaitaccen jarrabawar jiki ba'a iyakance ga, amma ya haɗa da ma'auni na C1-2 (atlanto-axial haɗin gwiwa) ROM mai jujjuya dama da hagu ta amfani da Gwajin Flexion-Rotation (FRT). An gano amincin tsaka-tsaki na FRT yana da kyau sosai (ICC: 0.93; 95% CI: 0.87, 0.96) [30].

 

Matakan Sakamako

 

Ma'aunin sakamako na farko da aka yi amfani da shi a cikin wannan binciken shine ƙarfin ciwon kai na mai haƙuri kamar yadda NPRS ta auna. An tambayi marasa lafiya don nuna matsakaicin matsanancin ciwon ciwon kai a cikin makon da ya gabata ta amfani da ma'auni na 11 wanda ya fito daga 0 (babu zafi) zuwa 10 (mafi munin zafi da za a iya tsammani) a asali, 1-mako, 1-watanni, da kuma watanni 3 bayan zaman jiyya na farko [31]. NPRS abin dogara ne kuma ingantaccen kayan aiki don tantance tsananin zafi [32�34]. Kodayake babu bayanan da ke cikin marasa lafiya tare da CH, an nuna MCID na NPRS a matsayin 1.3 a cikin marasa lafiya da ciwon wuyan wuyansa [32] da 1.74 a cikin marasa lafiya tare da nau'in ciwo mai tsanani [34]. Don haka, mun zaɓi kawai haɗa marasa lafiya da maki NPRS na maki 2 (20%) ko mafi girma.

 

Matakan sakamako na biyu sun haɗa da NDI, Global Rating of Change (GRC), mita ciwon kai, tsawon ciwon kai, da shan magani. NDI ita ce kayan aikin da aka fi amfani da su don tantance rashin lafiyar da aka yi amfani da su a cikin marasa lafiya da ciwon wuyansa [35�37]. NDI tambayoyin rahoton kai ne tare da abubuwa 10 da aka ƙididdige su daga 0 (babu nakasa) zuwa biyar (cikakken nakasu) [38]. An tattara martanin lamba na kowane abu don jimlar maki tsakanin 0 da 50; duk da haka, wasu masu kimantawa sun zaɓi su ninka ɗanyen maki biyu, sannan su ba da rahoton NDI akan sikelin 0�100% [36, 39]. Maki mafi girma yana wakiltar ƙarin matakan nakasa. An gano NDI don samun ingantaccen gwajin gwaji-gwaji, ingantaccen ingantaccen ingantaccen aiki, daidaituwa mai ƙarfi na ciki da kyakkyawar amsawa a cikin kimanta nakasuwa a cikin marasa lafiya tare da ciwon wuyan inji [36], radiculopathy na mahaifa [33, 40], cuta mai alaƙa da whiplash [38, 41, 42], da kuma gauraye marasa ƙayyadaddun wuyan wuyansa [43, 44]. Ko da yake babu wani binciken da ya yi nazarin kaddarorin ilimin halin dan Adam na NDI a cikin marasa lafiya tare da CH, mun zaɓi kawai haɗa marasa lafiya tare da maki NDI na maki goma (20%) ko mafi girma, saboda wannan yanke yanke ya ɗauki MCID ga NDI, wanda An ba da rahoton zuwa kimanin maki hudu, takwas, da tara (0 50) a cikin marasa lafiya tare da ciwon wuyan wuyansa na musamman [44], ciwon wuyan wuyansa [45], da radiculopathy na mahaifa [33], bi da bi. An auna yawan ciwon kai azaman adadin kwanakin da ciwon kai a cikin makon da ya gabata, daga kwanaki 0 ​​zuwa 7. An auna tsawon lokacin ciwon kai azaman jimlar sa'o'in ciwon kai a cikin makon da ya gabata, tare da jeri shida masu yiwuwa: (1) 0�5 h, (2) 6�10 h, (3) 11�15 h, (4) 16�20 h, (5) 21�25h, ko (6) 26 ko fiye da awanni. An auna shan magani a matsayin adadin lokutan da majiyyaci ya sha takardar sayan magani ko magungunan kashe kwayoyin cuta ko maganin kumburi a cikin makon da ya gabata don ciwon kai, tare da zaɓuɓɓuka biyar: (1) ba kwata-kwata, (2) sau ɗaya a mako, (3) sau daya kowane kwana biyu, (4) sau daya ko sau biyu a rana, ko (5) sau uku ko fiye a rana.

 

Marasa lafiya sun dawo don makonni 1, 4-makonni, da bibiyar watanni 3 inda aka sake tattara matakan sakamakon da aka ambata. Bugu da ƙari, a cikin 1-mako, 4-makonni da kuma watanni 3, marasa lafiya sun kammala tambayoyin GRC na 15-point bisa ma'auni da Jaeschke et al ya bayyana. [46] <> don kimanta fahimtar kansu game da ingantaccen aiki. Ma'auni ya tashi daga -7 (mafi girman muni) zuwa sifili (kimanin iri ɗaya) zuwa +7 (mafi kyau sosai). Ana sanya masu siffantawa na wucin gadi na tabarbarewa ko haɓakawa ƙima daga -1 zuwa -6 da +1 zuwa +6, bi da bi. Ba a ba da rahoton MCID na GRC musamman ba amma yawancin +4 da +5 sun kasance suna nuni da matsakaicin canje-canje a matsayin haƙuri [46]. Duk da haka, ya kamata a lura cewa kwanan nan Schmitt da Abbott sun ruwaito cewa GRC ba zai iya daidaitawa da canje-canje a cikin aiki a cikin yawan mutanen da ke da raunin hip da idon sawu [47]. Duk matakan sakamako an tattara su ta hanyar mai tantance makaho zuwa aikin rukuni.

 

A ziyarar farko marasa lafiya sun kammala duk matakan sakamako sannan sun sami zaman jiyya na farko. Marasa lafiya sun kammala zaman jiyya guda 6 zuwa 8 na ko dai magudi ko motsi tare da motsa jiki sama da makonni 4. Bugu da ƙari, an tambayi batutuwa idan sun fuskanci wasu manyan abubuwan da ba su da kyau [48, 49] (bugun jini ko nakasar jijiya ta dindindin) a kowane lokaci na gaba.

 

Randomization

 

Bayan jarrabawar asali, an ba da marasa lafiya ba da izini don karɓar ko dai magudi ko motsi da motsa jiki. An yi ɓoyayyiyar ɓoyayyiya ta hanyar amfani da tebur ɗin da aka ƙirƙira na kwamfuta da aka ƙirƙira wanda mutum bai da hannu tare da ɗaukar marasa lafiya kafin farkon binciken. Kowane mutum, katunan fihirisa masu ƙididdigewa tare da aikin bazuwar an shirya su don kowane rukunin yanar gizon tattara bayanai guda 8. An ninke katunan fihirisar kuma an sanya su a cikin ambulan da aka rufe. Makanta ga gwajin asali, mai ilimin hanyoyin kwantar da hankali ya buɗe ambulaf kuma ya ci gaba da jiyya bisa ga aikin ƙungiyar. An umurci marasa lafiya da kada su tattauna tsarin kulawa na musamman da aka karɓa tare da likitan ilimin likita. Mai ilimin hanyoyin kwantar da hankali ya kasance makaho ga aikin ƙungiyar majiyyaci a kowane lokaci; duk da haka, dangane da yanayin ayyukan ba zai yiwu a makantar da marasa lafiya ba ko kuma kula da masu kwantar da hankali.

 

Rukunin magudi

 

An yi amfani da gyare-gyaren da aka yi amfani da dama da hagu na C1-2 articulations da T1-2 articulations a kan akalla daya daga cikin 6-8 zaman jiyya (Figs. 1 da ?da2).2). A wasu zaman jiyya, masu ilimin hanyoyin kwantar da hankali ko dai sun sake maimaita C1-2 da / ko T1-2 manipulations ko kuma sun yi niyya ga wasu maganganun kashin baya (watau C0-1, C2-3, C3-7, T2-9, hakarkarinsa 1�9) ta amfani da magudi. . Zaɓin sassan kashin baya da aka yi niyya an bar shi ga mai ilimin hanyoyin kwantar da hankali kuma ya dogara ne akan haɗuwa da rahotannin haƙuri da jarrabawar hannu. Don duka manipulations na sama da na thoracic na sama, idan ba a ji sautin murya ko fashewa ba a kan ƙoƙari na farko, mai ilimin hanyoyin kwantar da hankali ya sake mayar da majiyyaci kuma ya yi magudi na biyu. Matsakaicin ƙoƙari na 2 an yi shi akan kowane majiyyaci kama da sauran karatun [14, 50�53]. An umurci likitocin cewa magudin zai iya kasancewa tare da sautuka masu yawan sauti [54�58]. An ƙarfafa marasa lafiya don kula da ayyukan yau da kullum a cikin iyakokin zafi; duk da haka, ba a bayar da tattarawa da kuma takardar izinin motsa jiki, ko duk wani amfani da wasu hanyoyin ba, ga wannan rukunin.

 

Hoto 1 HVLA Ƙaƙƙarfan Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙaƙwalwar C1-2 na Dama | El Paso, TX Chiropractor

 

Hoto na 2 HVLA Manipulations Manipulation Wanda Aka Jagoranci Bilaterally zuwa Saman Ƙwayoyin Ƙwayoyin Ƙwaƙwalwa | El Paso, TX Chiropractor

 

An yi amfani da magudin da aka yi niyya C1-2 tare da mai haƙuri a kwance. Don wannan dabarar, an tuntuɓi majinyacin hagu na baya na atlas tare da gefen gefe na kusa da phalanx na mai ilimin hanyoyin kwantar da hankali yatsa na biyu na hagu ta amfani da riƙon shimfiɗar jariri. Don ƙaddamar da rundunonin zuwa hagu na C1-2 na hagu, an sanya mai haƙuri ta hanyar amfani da tsawo, motsi na baya-baya (PA), ipsilateral side-lankwasa da kuma sabani gefe-motsi. Yayin da yake riƙe da wannan matsayi, mai ilimin hanyoyin kwantar da hankali ya yi wani nau'i mai girma guda ɗaya, ƙaddamar da ƙananan ƙananan haɓaka zuwa haɗin gwiwar atlanto-axial na hagu ta hanyar yin amfani da madaidaicin juyawa a cikin baka zuwa idon ido da fassarar zuwa tebur (Fig. 1). An maimaita wannan ta amfani da wannan hanya amma an umurce shi zuwa madaidaicin C1-2.

 

An yi amfani da magudin da aka yi niyya T1-2 tare da mai haƙuri a kwance. Don wannan dabarar, majiyyacin ya riƙe hannayenta/hannunsa da gaɓoɓinsa a fadin ƙirjin tare da gwiwar gwiwar da aka jera a cikin wata hanya mafi girma. Mai ilimin hanyoyin kwantar da hankali ya tuntuɓi hanyoyin juzu'i na ƙananan kashin baya na ɓangaren motsi na manufa tare da ficewar lokacin da tsakiyar phalanx na lambobi na uku. An keɓanta lever na sama zuwa ɓangaren motsi na niyya ta ƙara jujjuya baya da lanƙwasa gefe zuwa ga mai ilimin hanyoyin kwantar da hankali yayin da hannun ƙasa ya yi amfani da juzu'i da radial don cimma jujjuyawar gaba da lanƙwasa gefe, bi da bi. An yi amfani da sararin da ya fi ƙasa da tsarin xiphoid da kuma gefen costochondral na mai ilimin hanyoyin kwantar da hankali a matsayin wurin tuntuɓar majiyyaci don sadar da magudi a gaba zuwa ta baya wanda ke niyya T1-2 bilaterally (Fig. 2).

 

Ƙungiyar Motsi da Motsa jiki

 

Tattaunawar da aka yi niyya ta hannun dama da hagu na C1-2 da maganganun T1-2 na biyu an yi su akan aƙalla ɗaya daga cikin zaman jiyya na 6–8. A wasu zaman jiyya, masu ilimin hanyoyin kwantar da hankali ko dai sun sake maimaita motsin C1-2 da/ko T1-2 ko kuma sun yi niyya ga wasu maganganun kashin baya (watau C0-1, C2/3, C3-7, T2-9, ribs 1�9) ta amfani da tattarawa. . Zaɓin sassan kashin baya da aka yi niyya an bar shi ga mai ilimin hanyoyin kwantar da hankali kuma ya dogara ne akan haɗuwa da rahotannin haƙuri da jarrabawar hannu. Koyaya, don guje wa tasirin tuntuɓar ko ��� idan aka kwatanta da ƙungiyar magudin, an umurci masu ilimin hanyoyin kwantar da hankali da su tattara ɓangaren mahaifa ɗaya (watau dama da hagu) da kashi ɗaya na thoracic ko ƙwanƙwasa haƙarƙari akan kowane zaman jiyya.

 

An ƙaddamar da ƙaddamar da ƙaddamarwar C1-2 a cikin sauƙi. Don wannan dabarar, mai ilimin hanyoyin kwantar da hankali ya yi wasan motsa jiki na 30s na gefen hagu na aji ɗaya na IV PA zuwa sashin motsi na C1-2 kamar yadda Maitland [7] ya bayyana. An sake maimaita wannan hanya guda ɗaya na tsawon 30s zuwa ga haɗin gwiwa na atlanto-axial dama. Bugu da ƙari, kuma aƙalla zaman ɗaya, ƙaddamar da ƙaddamarwa da aka yi wa kashin baya na thoracic na sama (T1-2) tare da mai haƙuri an yi. Don wannan dabarar, mai ilimin hanyoyin kwantar da hankali ya yi wasan motsa jiki na 30s na tsakiyar aji IV PA zuwa sashin motsi na T1-2 kamar yadda Maitland [7] ya bayyana. Sabili da haka, mun yi amfani da 180 (watau 30 s bouts a kusan 2 Hz) jujjuyawar zangon ƙarshen gabaɗaya akan kowane batu don maganin tattarawa. Musamman ma, babu wata shaida mai inganci har zuwa yau don bayar da shawarar cewa tsayin daka na tattarawa yana haifar da raguwar zafi fiye da guntuwar lokaci ko ƙididdiga na motsi [59, 60].

 

Cranio-cervical flexion exercises [11, 61�63] an yi tare da mai haƙuri a kwance, tare da gwiwoyi sun durƙusa da matsayi na kai da aka daidaita ta hanyar sanya craniocervical da spines na mahaifa a tsakiyar matsayi, kamar layi tsakanin Taken goshinsa da haɓoɓinsa ya kasance a kwance, kuma wani layi a kwance daga tragus na kunne ya bige wuyan a tsaye. Naúrar biofeedback mai cike da iska (Chattanooga Group, Inc., Hixson, TN) an sanya shi a bayan wuyan mara lafiya kuma an riga an ƙaddamar da shi zuwa tushe na 20 mmHg [63]. Don ayyukan da aka tsara, ana buƙatar marasa lafiya don yin aikin jujjuyawar craniocervical (� nod na kai, mai kama da nuna i�) [63] da ƙoƙari na matsi na gani na 22, 24, 26, 28, da 30 mmHg daga madaidaicin tushe na 20 mmHg kuma don riƙe matsayi a tsaye don 10 s [61, 62]. An yi aikin nodding a hankali da hankali. An ba da izinin hutu na 10 s tsakanin gwaji. Idan matsa lamba ya karkata a ƙasa da maƙasudin maƙasudin, matsa lamba ba a ci gaba da tsayawa ba, maye gurbin tare da gyare-gyare na sama (sternocleidomastoid ko na baya scalene) ya faru, ko kuma an lura da wuyan wuyansa kafin kammala 10 s isometric riƙe, an dauke shi a matsayin kasawa. [63] An yi amfani da matsa lamba mai nasara na ƙarshe don tantance matakin motsa jiki na kowane majiyyaci inda aka yi saiti 3 na maimaitawa 10 tare da riƙe isometric na tsawon sa'o'i 10. Bugu da ƙari, ƙungiyoyi da motsa jiki na cranio-cervical flexion, ana buƙatar marasa lafiya don yin 10 min na ayyukan juriya na ci gaba (watau ta amfani da Therabands ko ma'auni kyauta) zuwa tsokoki na kafada a yayin kowane zaman jiyya, a cikin nasu haƙuri, kuma musamman mayar da hankali kan ƙananan trapezius da serratus na gaba [11].

 

Samfurin Sample

 

An yi girman samfurin da lissafin wutar lantarki ta amfani da software na kan layi daga MGH Biostatistics Center (Boston, MA). Lissafin sun dogara ne akan gano bambancin maki 2 (ko 20%) a cikin NPRS (ƙarfin ciwon kai) a cikin watanni 3 da suka biyo baya, suna ɗaukar daidaitaccen karkatacciyar maki uku, gwajin wutsiya 2, da matakin alpha daidai. ku 0.05. Wannan ya haifar da girman samfurin marasa lafiya 49 a kowace rukuni. Ba da izinin raguwar raguwar ra'ayin mazan jiya na 10%, mun shirya ɗaukar aƙalla marasa lafiya 108 a cikin binciken. Wannan girman samfurin ya ba da iko sama da 90% don gano wani muhimmin canji a makin NPRS.

 

data Analysis

 

Ƙididdiga masu bayyanawa, gami da ƙididdige mitar don bambance-bambancen ma'auni da ma'auni na ɗabi'a na tsakiya da tarwatsawa don ci gaba da masu canji an ƙididdige su don taƙaita bayanai. Sakamakon jiyya akan tsananin ciwon kai da nakasa kowanne an gwada su tare da 2-by-4 mix-model analysis of bambance-bambancen (ANOVA), tare da ƙungiyar jiyya (manipulation da motsa jiki da motsa jiki) a matsayin tsaka-tsakin tsaka-tsaki da lokaci (tushe, 1 mako, 4 makonni, da 3 watanni bi-bi-bi) a matsayin tsaka-tsaki m. An yi daban-daban ANOVAs tare da NPRS (ƙarfin ciwon kai) da NDI (nakasa) a matsayin abin dogaro. Ga kowane ANOVA, hasashe na sha'awa shine hulɗar hanya biyu (rukuni ta lokaci).

 

An yi amfani da t-gwajin mai zaman kanta don ƙayyade tsakanin bambance-bambancen rukuni don canjin kashi daga asali zuwa 3-watanni mai biyo baya a cikin tsananin ciwon kai da nakasa. An yi gwaje-gwaje daban-daban na Mann�Whitney U tare da mitar ciwon kai, GRC, tsawon lokacin ciwon kai da shan magani azaman mai dogaro. Mun yi ƙaramin abu ne kawai a lokacin da bazuwar (64] don sanin idan abubuwan da suka ɓace sun ɓace tare da zaɓin data da ke hade da bazuwar ko ɓacewa don dalilai masu tsari. An gudanar da bincike na niyya ta hanyar amfani da Tsammani-Maximization inda aka ƙididdige bayanan da suka ɓace ta amfani da ma'auni na koma baya. An gudanar da kwatancen da aka tsara ta hanyar nazarin bambanci tsakanin asali da lokutan biyo baya tsakanin ƙungiyoyi ta amfani da gyaran Bonferroni a matakin alpha na .05.

 

Mun dichotomized marasa lafiya a matsayin masu amsawa a bin 3-watanni ta hanyar amfani da raguwar maki na 2 ci gaba don ƙarfin ciwon kai kamar yadda NPRS ta auna. Lambobin da ake buƙata don bi da (NNT) da 95% tazarar amincewa (CI) kuma an ƙididdige su a cikin watanni na 3 masu biyo baya ta amfani da kowane ɗayan waɗannan ma'anar don sakamako mai nasara. An yi nazarin bayanai ta amfani da SPSS 21.0.

 

results

 

An bincika marasa lafiya ɗari biyu da hamsin da ɗaya tare da ƙarar ƙarar ciwon kai don yuwuwar cancanta. Ana iya samun dalilai na rashin cancanta a cikin siffa 3, zane-zane na gudana na daukar ma'aikata da kuma riƙewa. Daga cikin marasa lafiya na 251 da aka bincika, marasa lafiya 110, tare da matsakaicin shekaru 35.16 (SD 11.48) da kuma tsawon lokacin bayyanar cututtuka na shekaru 4.56 (SD 6.27), sun gamsu da ka'idodin cancanta, sun yarda su shiga, kuma an bazu su cikin magudi (n) ?=?58) da ƙungiyoyin motsa jiki da motsa jiki (n?=?52). Za'a iya samun ma'auni na asali ga kowane rukuni a cikin Table 1. Masu kwantar da hankali goma sha biyu daga 8 dakunan shan magani na jiki kowannensu ya bi da 25, 23, 20, 14, 13, 7, 6 ko 2 marasa lafiya, bi da bi; haka kuma, kowane daga cikin masu kwantar da hankali na 12 sun bi da kusan daidai gwargwado na marasa lafiya a kowane rukuni. Babu wani bambanci mai mahimmanci (p? =? 0.227) tsakanin ma'anar adadin da aka kammala jiyya ga ƙungiyar magudi (7.17, SD 0.96) da ƙungiyar motsa jiki da motsa jiki (6.90, SD 1.35). Bugu da ƙari, ma'anar adadin zaman jiyya da aka yi niyya ga C1-2 articulation shine 6.41 (SD 1.63) don ƙungiyar magudi da 6.52 (SD 2.01) don ƙungiyar motsa jiki da motsa jiki, kuma wannan bai bambanta ba (p? =? 0.762). ɗari bakwai na marasa lafiya 110 sun kammala duk matakan sakamako ta hanyar watanni 3 (97 % bibi). Ƙananan Rasa Gabaɗaya a gwajin bazuwar (MCAR) ba shi da mahimmancin ƙididdiga (p?=?0.281); saboda haka, mun yi amfani da dabarar ƙima-Maximization don maye gurbin ƙimar da aka ɓace tare da ƙimar da aka annabta don ɓacewar sakamakon watanni 3.

 

Hoto na 3 Tsarin Tafiya na Ma'aikata da Riƙewa | El Paso, TX Chiropractor

 

Tebur 1 Matsalolin Tushe, Ƙididdigar Alƙaluma da Matakan Sakamako | El Paso, TX Chiropractor

 

Ƙungiya ta gaba ɗaya ta hanyar hulɗar lokaci don sakamakon farko na ƙarfin ciwon kai yana da mahimmanci ga NPRS (F(3,106)?=?11.196; p?

 

Table 2 Canje-canje a cikin Ƙarfin Ciwon Kai da Nakasa | El Paso, TX Chiropractor

 

Tebur 3 Kashi na Abubuwan da ke Samun 50, 75, da Rage Kashi 100 | El Paso, TX Chiropractor

 

Don sakamako na biyu babban rukuni ta hanyar hulɗar lokaci ya wanzu don NDI (F(3,106)?=?8.57; p?

 

Gwajin Mann�Whitney U ya nuna cewa marasa lafiya a cikin babban mahaifa da ƙungiyar magudin thoracic sun sami ƙarancin ciwon kai akai-akai a mako 1 (p?

 

Ba mu tattara wani bayani game da faruwar ƙananan ƙananan abubuwan da suka faru ba [48, 49] (alamun cututtuka na wucin gadi, ƙãra taurin kai, raɗaɗi mai zafi, gajiya ko wasu); duk da haka, ba a ba da rahoton wani mummunan al'amuran [48, 49] (bugun jini ko raunin jijiya na dindindin) ga kowane rukuni.

 

tattaunawa

 

Bayanin Babban Bincike

 

Don iliminmu, wannan binciken shine farkon gwajin gwaji na asibiti don kwatanta tasirin maganin mahaifa da na thoracic don tattarawa da motsa jiki a cikin marasa lafiya tare da CH. Sakamakon ya nuna zaman 6-8 na magudi a cikin makonni 4, wanda aka fi dacewa ga duka biyu na mahaifa (C1-2) da babba na thoracic (T1-2), ya haifar da haɓaka mafi girma a cikin tsanani ciwon kai, nakasa, mita ciwon kai, tsawon ciwon kai. , da kuma shan magunguna fiye da motsa jiki tare da motsa jiki. Ƙididdigar maƙasudin don canje-canje tsakanin rukuni a cikin ƙarfin ciwon kai (maki 2.1) da nakasa (maki 6.0 ko 12.0%) sun wuce rahoton MCIDs na matakan biyu. Kodayake MCID na NDI a cikin marasa lafiya tare da CH ba a bincika ba tukuna, duk da haka ya kamata a lura cewa ƙananan iyaka na 95 % CI don nakasa (maki 3.5) ya kasance ƙasa kaɗan (ko kimanin a lokuta biyu) MCID cewa an samo shi a matsayin 3.5 [65], 5 [66], da 7.5 [45] a cikin marasa lafiya da ciwon wuyan wuyansa, 8.5 [33] maki a cikin marasa lafiya tare da radiculopathy na mahaifa, da kuma 3.5 [44] a cikin marasa lafiya tare da gauraye, ciwon wuya mara takamaiman. Duk da haka, ya kamata a gane cewa ƙungiyoyin biyu sun inganta asibiti. Bugu da ƙari, NNT yana ba da shawara ga kowane marasa lafiya hudu da aka bi da su tare da magudi, maimakon ƙaddamarwa, wani ƙarin mai haƙuri ya sami raguwa mai mahimmanci na asibiti a cikin watanni 3.

 

Karfi da raunin Nazari

 

Haɗin 12 masu warkarwa na jiki daga asibitoci masu zaman kansu guda 8 a cikin jihohi daban-daban na 6 suna haɓaka gabaɗayan bincikenmu. Kodayake an gane bambance-bambance masu mahimmanci har zuwa watanni 3, ba a sani ba idan waɗannan fa'idodin za su dore a cikin dogon lokaci. Bugu da kari, mun yi amfani da dabaru masu saurin-sauri, masu karamin girman girman da suka yi amfani da karfin juzu'i zuwa juyi da fassarar lokaci guda da dabarun tattara dabaru na tushen maitland IV PA; Don haka, ba za mu iya tabbatar da cewa waɗannan sakamakon sun zama gama gari ga sauran nau'ikan dabarun aikin jiyya na hannu ba. Wasu na iya yin gardama cewa ƙungiyar kwatancen ƙila ba ta sami isasshen sa hannun ba. Mun nemi daidaita ingancin ciki da waje don haka daidaitaccen jiyya ga ƙungiyoyin biyu kuma mun ba da cikakken bayanin dabarun da aka yi amfani da su wanda kuma zai ba da damar yin kwafi. Bugu da ƙari, ba mu auna ƙananan abubuwan da suka faru ba kuma mun yi tambaya ne kawai game da manyan abubuwa biyu masu haɗari. Wani iyakance shine mun haɗa da sakamako na biyu da yawa. Ba a tattara abubuwan da masu ilimin hanyoyin kwantar da hankali ba game da wace dabarar da suke tunanin za ta fi kyau ba a tattara ba kuma suna iya yin tasiri ga sakamakon.

 

Ƙarfi da Ƙarfi dangane da Sauran Nazarin: Muhimman Bambance-bambance a Sakamako

 

Jull et al. [11] ya nuna tasirin magani don maganin manipulative da motsa jiki a cikin kulawar CH; duk da haka, wannan kunshin jiyya ya haɗa da haɗuwa da magudi. Binciken na yanzu na iya ba da shaida cewa kula da marasa lafiya tare da CH ya kamata ya haɗa da wani nau'i na magudi duk da cewa sau da yawa ana ba da shawarar cewa ya kamata a kauce wa magudi na mahaifa saboda hadarin mummunar mummunan al'amura [67, 68]. Bugu da ƙari kuma, an nuna cewa mutanen da ke karɓar maganin kashin baya don ciwon wuyan wuyansa da ciwon kai ba za su iya samun bugun jini na vertebrobasilar ba fiye da idan sun sami magani daga likitan su [69]. Bugu da ƙari, bayan nazarin rahotanni na 134, Puentedu et al. ya kammala da cewa tare da zaɓin da ya dace na marasa lafiya ta hanyar yin nazari a hankali na jajayen tutoci da contraindications, yawancin munanan abubuwan da ke da alaƙa da magudin mahaifa za a iya hana [70].

 

Ma'anar Nazarin: Mahimman Bayani da Tasiri ga Likitoci da Masu Tsara Tsara

 

Dangane da sakamakon binciken likitocin na yanzu ya kamata suyi la'akari da haɗawa da magudi na kashin baya ga mutanen da ke da CH. Wani bita na yau da kullun ya gano duka tattarawa da magudi don yin tasiri ga kula da marasa lafiya tare da CH amma ya kasa tantance wace dabara ce ta fi [8]. Bugu da ƙari, jagororin asibiti sun ba da rahoton cewa magudi, tattarawa da motsa jiki duk sun kasance masu tasiri ga kula da marasa lafiya tare da CH; duk da haka, jagorar ba ta bayar da shawarwari game da fifikon ko wace fasaha ba. [71] Sakamakon na yanzu na iya taimaka wa marubutan sake dubawa na yau da kullum da jagororin asibiti a cikin samar da ƙarin takamaiman shawarwari game da yin amfani da magudi na kashin baya a cikin wannan yawan.

 

Tambayoyin da ba a Amsa ba da Bincike na gaba

 

Hanyoyin da ake amfani da su na dalilin da yasa magudin zai iya haifar da ƙarin cigaba. An ba da shawarar cewa ƙaura mai saurin gudu na kashin baya tare da tsawon lokacin da bai wuce 200 ms ba na iya canza ƙimar fitarwa mai ƙarfi [72] ta hanyar ƙarfafa injiniyoyi da masu haɓakawa, ta haka canza matakan haɓakar alpha motorneuron da aikin tsoka na gaba [72�74]. Manipulation na iya kuma tada masu karɓa a cikin musculature mai zurfi na paraspinal, kuma ƙungiyoyi na iya zama mafi kusantar sauƙaƙe masu karɓa a cikin tsokoki na sama [75]. Biomechanical [76, 77], kashin baya ko yanki [78, 79] da kuma tsakiyar gangara inhibitory hanyar zafi [80�83] samfura ne masu ma'ana don tasirin hypoalgesic da aka lura bayan magudi. Kwanan nan, abubuwan da ke tattare da kwayoyin halitta na magudi sun kasance a karkashin binciken kimiyya [84], kuma yana da kyau cewa amfanin asibiti da aka samu a cikin bincikenmu yana da alaƙa da amsawar neurophysiological wanda ya haɗa da taƙaitaccen lokaci a cikin ƙaho na dorsal na kashin baya [78]; duk da haka, wannan samfurin da aka tsara a halin yanzu yana tallafawa ne kawai akan binciken daga wucin gadi, jin zafi na gwaji a cikin batutuwa masu lafiya [85, 86], ba marasa lafiya tare da CH ba. Ya kamata karatun gaba ya bincika dabaru daban-daban na jiyya na hannu tare da ma'auni daban-daban kuma ya haɗa da bibiyar shekara 1. Bugu da ƙari kuma, nazarin gaba na nazarin abubuwan da ke tattare da neurophysiological na duka magudi da ƙaddamarwa zai zama mahimmanci don ƙayyade dalilin da yasa za'a iya ko a'a akwai bambanci a cikin tasirin asibiti tsakanin waɗannan jiyya guda biyu.

 

Kammalawa

 

Sakamakon binciken na yanzu ya nuna cewa marasa lafiya tare da CH wadanda suka karbi maganin mahaifa da thoracic sun sami raguwa da yawa a cikin ciwon ciwon kai, rashin lafiya, yawan ciwon kai, tsawon lokacin ciwon kai, da kuma shan magani idan aka kwatanta da kungiyar da ta karbi motsi da motsa jiki; haka kuma, an kiyaye tasirin a cikin watanni 3 masu biyo baya. Nazarin gaba ya kamata yayi nazarin tasirin nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan magudi daban-daban kuma ya haɗa da bin diddigin dogon lokaci.

 

Godiya

 

Babu ɗaya daga cikin marubutan da ya sami wani kuɗi don wannan binciken. Marubutan suna son gode wa duk mahalarta binciken.

 

Bayanan kalmomi

 

  • Gudanar da bukatun: Dokta James Dunning shi ne Shugaban Cibiyar Nazarin Manipulative Therapy ta Amurka (AAMT). AAMT yana ba da shirye-shiryen horarwa na digiri na biyu a cikin magudi na kashin baya, motsa jiki na kashin baya, buƙatun busassun bushewa, yin amfani da ƙwayar cuta, ƙaddamar da ƙwayar cuta, kayan aiki mai laushi mai laushi da motsa jiki na motsa jiki ga masu kwantar da hankali na jiki masu lasisi, osteopaths da likitocin likita. Drs. James Dunning, Raymond Butts, Thomas Perreault, da Firas Mourad manyan malamai ne na AAMT. Sauran marubutan sun bayyana cewa ba su da wani buri mai gasa.
  • Marubuta� gudunmawa: JRD ya shiga cikin tunani, ƙira, samun bayanai, ƙididdigar ƙididdiga da tsara rubutun. RB da IY sun shiga cikin ƙira, tattara bayanai, ƙididdigar ƙididdiga da sake duba rubutun. FM ta shiga cikin ƙira, ƙididdigar ƙididdiga, fassarar bayanai da sake fasalin rubutun. MH ya shiga cikin tunani, tsarawa da sake fasalin rubutun. CF da JC sun shiga cikin ƙididdigar ƙididdiga, fassarar bayanai, da kuma mahimmancin bita na rubutun don mahimman abun ciki na hankali. TS, JD, DB, da TH sun shiga cikin tattara bayanai da sake duba rubutun. Duk marubutan sun karanta kuma sun amince da rubutun ƙarshe.

 

Bayanin Mai Bayarwa

 

Ncbi.nlm.nih.gov/pmc/articles/PMC4744384/

 

A ƙarshe,Ciwon kai wanda ciwon kai na biyu ya haifar saboda batun kiwon lafiya tare da tsarin kewaye na kashin mahaifa, ko wuyansa, na iya haifar da alamu masu raɗaɗi da raɗaɗi waɗanda zasu iya shafar ingancin rayuwar mai haƙuri. Ana iya amfani da magudi na kashin baya da motsi a cikin aminci kuma yadda ya kamata don taimakawa wajen inganta alamun ciwon kai na cervicogenic. Bayanin da aka ambata daga Cibiyar Bayanan Kimiyyar Halittu ta Ƙasa (NCBI). Matsakaicin bayanin mu yana iyakance ga chiropractic da kuma raunin da ya faru da kashin baya. Don tattauna batun batun, don Allah jin daɗin tambayar Dr. Jimenez ko tuntuɓe mu a 915-850-0900 .

 

Dr. Alex Jimenez ne ya shirya shi

 

 

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Ƙarin Maudu'i: Ciwon Baya

 

Bisa ga kididdigar, kimanin 80% na mutane za su fuskanci alamun ciwon baya a kalla sau ɗaya a duk rayuwarsu. Binciken baya koke ne na gama-gari wanda zai iya haifar da rauni da/ko yanayi iri-iri. Sau da yawa lokuta, lalacewar dabi'a na kashin baya tare da shekaru na iya haifar da ciwon baya. Harsiated fayafai faruwa a lokacin da taushi, gel-kamar cibiyar intervertebral disc ta tura ta cikin hawaye a kewaye da shi, waje zobe na guringuntsi, matsawa da kuma fusatar da jijiya tushen. Abubuwan da aka fi sani da diski suna faruwa tare da ƙananan baya, ko kashin baya na lumbar, amma kuma suna iya faruwa tare da kashin mahaifa, ko wuyansa. Ƙunƙarar jijiyoyi da aka samo a cikin ƙananan baya saboda rauni da / ko mummunan yanayin zai iya haifar da bayyanar cututtuka na sciatica.

 

hoton blog na zane mai ban dariya paperboy babban labarai

 

MAFI MUHIMMAN BUDURWA: Maganin Ciwon Migraine

 

 

KARATUN BATUN: EXTRA EXTRA: El Paso, Tx | 'Yan wasa

 

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Rufe Accordion
Jagoran Maganin Ciwon Ciwon Chiropractic a El Paso, TX

Jagoran Maganin Ciwon Ciwon Chiropractic a El Paso, TX

by | Chiropractic, Gwajin Sarrafa Bazuwar

Ciwon kai yana daya daga cikin dalilan da suka fi yawa na ziyarar ofishin likitoci. Yawancin mutane suna fuskantar su a wani lokaci a rayuwarsu kuma suna iya shafar kowa, ba tare da la'akari da shekaru, launin fata da jinsi ba. Ƙungiyar Ciwon Kai ta Duniya, ko IHS, ta rarraba ciwon kai a matsayin na farko, lokacin da ba a haifar da su ta hanyar wani rauni da / ko yanayin ba, ko na sakandare, lokacin da akwai wani dalili a bayan su. Daga migraines don tattara ciwon kai da ciwon kai na tashin hankali, mutanen da ke fama da ciwon kai akai-akai na iya samun wahalar shiga cikin ayyukansu na yau da kullun. Yawancin masu sana'a na kiwon lafiya suna kula da ciwon kai, duk da haka, kula da chiropractic ya zama sanannen zaɓin magani na daban don al'amuran kiwon lafiya. Manufar labarin mai zuwa shine don nuna ka'idodin tushen shaida don maganin chiropractic na manya da ciwon kai.

 

Shaidu-Tsarin Shaida don Maganin Chiropractic na Manya tare da Ciwon Kai

 

Abstract

 

  • Manufa: Manufar wannan rubutun shine don samar da shawarwarin aikin da aka ba da shaida don maganin chiropractic da ciwon kai a cikin manya.
  • Hanyar: Binciken wallafe-wallafen na yau da kullum na gwaje-gwaje na asibiti da aka buga ta hanyar Agusta 2009 da suka dace da aikin chiropractic da aka gudanar ta amfani da bayanan bayanan MEDLINE; EMBASE; Hadin gwiwa da Magungunan Ƙarfafawa; Ƙididdigar Taɗi zuwa Ma'aikatan Jiyya da Adabin Kiwon Lafiyar Ƙungiyoyin Ƙungiyoyi; Manual, Madadin, da Tsarin Fihirisar Jiyya na Halitta; Alt HealthWatch; Fihirisar zuwa Adabin Chiropractic; da kuma Cochrane Library. An yi la'akari da lambar, inganci, da daidaiton binciken don sanya cikakken ƙarfin shaida (ƙarfi, matsakaici, iyakance, ko rikice-rikice) da kuma tsara shawarwarin aiki.
  • results: Labari XNUMX sun cika ka'idojin haɗawa kuma an yi amfani da su don haɓaka shawarwari. Shaida ba ta wuce matsakaicin matsayi ba. Don ƙaura, magudi na kashin baya da kuma multimodal multidisciplinary tsoma baki ciki har da tausa ana bada shawarar don kula da marasa lafiya da episodic ko na kullum migraine. Don nau'in ciwon kai na tashin hankali, ba za a iya ba da shawarar yin amfani da kashin baya ba don gudanar da nau'in ciwon kai na episodic tashin hankali. Ba za a iya ba da shawara don ko a kan yin amfani da magudi na kashin baya ga marasa lafiya da ciwon kai na yau da kullum. Ƙunƙashin ɗaukar nauyi na craniocervical na iya zama da fa'ida don gudanar da dogon lokaci na marasa lafiya tare da ciwon kai na episodic ko na yau da kullun. Don ciwon kai na cervicogenic, ana ba da shawarar yin amfani da kashin baya. Ƙaddamar da haɗin gwiwa ko zurfin wuyansa na motsa jiki na motsa jiki na iya inganta bayyanar cututtuka. Babu wani fa'ida ta yau da kullun na haɗa haɗin haɗin gwiwa da motsa jiki mai zurfi na wuyansa ga marasa lafiya da ciwon kai na cervicogenic. Ba a magance abubuwan da ba su da kyau a yawancin gwaji na asibiti; kuma idan sun kasance, babu ko sun kasance kanana.
  • Ƙarshe: Shaida ta nuna cewa kulawar chiropractic, ciki har da magudi na kashin baya, yana inganta migraine
    da ciwon kai na cervicogenic. Nau'in, mita, sashi, da tsawon lokacin jiyya (s) yakamata su dogara ne akan shawarwarin jagora, ƙwarewar asibiti, da binciken. Shaida don amfani da magudi na kashin baya azaman keɓewar saƙo ga marasa lafiya da ciwon kai irin na tashin hankali ya kasance daidai. (J Manipulative Physiol Ther 2011; 34: 274-289)
  • Mabuɗin Sharuɗɗan Fihirisa: Gyaran kashin baya; Ciwon kai na Migraine; Tashin hankali-Nau'in ciwon kai; Ciwon kai bayan tashin hankali; Jagoran Ayyuka; Chiropractic

 

Dr Jimenez White Coat

Dr. Alex Jimenez's Insight

Ciwon kai, ko ciwon kai, ciki har da migraines da sauran nau'in ciwon kai, yana daya daga cikin mafi yawan nau'in ciwon da aka ruwaito a tsakanin yawan jama'a. Wadannan na iya faruwa a daya ko bangarorin biyu na kai, ana iya keɓance su zuwa wani takamaiman wuri ko kuma suna iya haskakawa a kan kai daga aya ɗaya. Yayin da alamun ciwon kai na iya bambanta dangane da nau'in ciwon kai da kuma saboda tushen matsalar kiwon lafiya, ciwon kai ana daukarsa a matsayin babban gunaguni ba tare da la'akari da girmansa da siffarsa ba. Ciwon kai, ko ciwon kai, na iya faruwa a sakamakon rashin daidaituwa na kashin baya, ko subluxation, tare da tsawon kashin baya. Ta hanyar yin amfani da gyare-gyare na kashin baya da kuma manipulations na hannu, kulawar chiropractic zai iya zama lafiya da kuma daidaita yanayin kashin baya, rage danniya da matsa lamba a kan sassan da ke kewaye da kashin baya, don taimakawa wajen taimakawa wajen inganta ciwon ciwon ciwon kai da kuma lafiyar lafiya da lafiya.

 

Ciwon kai wani abu ne na kowa a cikin manya. Ciwon kai mai maimaitawa yana haifar da mummunar tasiri ga rayuwar iyali, zamantakewar zamantakewa, da kuma iya aiki.[1,2] A duk duniya, bisa ga Hukumar Lafiya ta Duniya, migraine kadai shine 19th a cikin dukan abubuwan da suka faru na shekaru da suka rayu tare da nakasa. Ciwon kai shine na uku a cikin dalilan neman kulawar chiropractic a Arewacin Amirka.[3]

 

Madaidaicin ganewar asali shine mabuɗin don gudanarwa da magani, kuma an kwatanta nau'in nau'in ciwon kai mai yawa a cikin Ƙwararren Ƙwararrun Ƙwararrun Ciwon Kai 2 (International Headache Society [IHS]).[4] An yi nufin rukunan don asibiti da kuma amfani da bincike. Mafi yawan ciwon kai na yau da kullum, nau'in tashin hankali da ƙaura, ana la'akari da ciwon kai na farko wanda ke da episodic ko na yau da kullum a cikin yanayi. Ciwon kai na Episodic ko tashin hankali-nau'in ciwon kai yana faruwa ƙasa da kwanaki 15 a kowane wata, yayin da ciwon kai na yau da kullun yana faruwa fiye da kwanaki 15 a kowane wata na akalla 3 (migraine) ko watanni 6 (nau'in ciwon kai).[4] Ana danganta ciwon kai na biyu zuwa matsalolin asibiti a cikin kai ko wuyansa wanda kuma yana iya zama na al'ada ko na yau da kullun. Ciwon kai na Cervicogenic sune ciwon kai na biyu wanda masu chiropractors ke bi da su kuma sun haɗa da ciwo da ake magana a kai daga wani tushe a cikin wuyansa da kuma fahimta a cikin 1 ko fiye da yankuna na kai. IHS ta gane ciwon kai na cervicogenic a matsayin cuta mai banƙyama, [4] da kuma shaida cewa ciwon kai za a iya danganta shi da ciwon wuyan wuyansa ko raunin da ya danganci tarihin da kuma siffofin asibiti (tarihin ciwon wuyan wuyansa, ciwon inji na ciwo, rage yawan motsi na mahaifa, da kuma Ƙunƙarar wuyan wuyansa, ban da ciwon myofascial kadai) ya dace da ganewar asali amma ba tare da jayayya a cikin wallafe-wallafe ba.

 

Hanyoyin jiyya da aka saba amfani da su ta hanyar chiropractors don kula da marasa lafiya da ciwon kai sun hada da magudi na kashin baya, ƙaddamarwa, na'urar da ke taimaka wa kashin baya, ilimi game da abubuwan da za a iya canza salon rayuwa, hanyoyin kwantar da hankali na jiki, zafi / kankara, tausa, ci-gaba mai laushi nama hanyoyin kwantar da hankali irin su faɗakar da batu far. da motsa jiki da ƙarfafawa. Akwai tsammanin ci gaba ga sana'o'in kiwon lafiya, ciki har da chiropractic, don ɗauka da kuma amfani da ilimin bincike na bincike, yin la'akari da isasshen adadin shaidar bincike don sanar da aikin asibiti. A sakamakon haka, manufar ƙungiyar Chosan Choropractic (CCA) da Kanada na Kanada na gudanar da tsarin gudanarwa na ilimi shine inganta jagororin aiki dangane da shaidar. Manufar wannan rubutun shine don samar da shawarwarin aikin da aka ba da shaida don maganin chiropractic da ciwon kai a cikin manya.

 

Hanyar

 

Kwamitin Haɓaka Jagororin (GDC) ya tsara da daidaita tsarin tsari don bincike, dubawa, bita, bincike, da fassarar. Hanyoyin sun yi daidai da sharuɗɗan da �Kimanin Jagororin Bincike da Ƙimar Haɗin gwiwawww.agreecollaboration.org). Wannan jagorar kayan aiki ne mai goyan baya ga masu aiki. Ba a yi nufin shi azaman ma'auni na kulawa ba. Jagoran ya haɗu da samuwan shaidar da aka buga zuwa aikin asibiti kuma shine kawai 1 ɓangaren hanyar da aka ba da shaida ga kulawar haƙuri.

 

Tushen Bayanai da Bincike

 

An gudanar da bincike na tsari da kimantawa na wallafe-wallafen magani ta hanyar amfani da hanyoyin da Cochrane Collaboration Back Review Group [6] da Oxman da Guyatt suka ba da shawarar. An ƙaddamar da dabarun bincike a cikin MEDLINE ta hanyar bincika kalmomin MeSH da suka danganci chiropractic da ƙayyadaddun ayyuka kuma daga baya an gyara su don wasu bayanan bayanai. Dabarun binciken adabi sun kasance da niyya mai faɗi. An bayyana maganin chiropractic kamar yadda ya haɗa da mafi yawan hanyoyin kwantar da hankali da masu yin amfani da su ke amfani da su kuma ba a iyakance ga hanyoyin magani ba kawai ta hanyar chiropractors. An jefa babbar hanyar sadarwa don haɗawa da jiyya waɗanda za a iya gudanar da su a cikin kulawar chiropractic da kuma waɗanda za a iya ba da su a cikin yanayin kulawa da wasu masu sana'a na kiwon lafiya a cikin wani bincike na musamman (Shafi A). An bayyana magudin kashin baya a matsayin babban matsananciyar ƙarfi mai ƙarfi da aka kai ga kashin baya. Magungunan da aka keɓance sun haɗa da hanyoyin analgesic masu ɓarna ko hanyoyin neurostimulation, magunguna, alluran toxin botulinum, hanyoyin kwantar da hankali ko halayen halayen, da acupuncture.

 

An kammala binciken wallafe-wallafe daga Afrilu zuwa Mayu 2006, an sabunta shi a cikin 2007 (lokaci na 1), kuma an sake sabunta shi a cikin Agusta 2009 (phase 2). Bayanan bayanan da aka bincika sun haɗa da MEDLINE; EMBASE; Hadin gwiwa da Magungunan Ƙarfafawa; Ƙididdigar Taɗi zuwa Ma'aikatan Jiyya da Adabin Kiwon Lafiyar Ƙungiyoyin Ƙungiyoyi; Manual, Madadin, da Tsarin Fihirisar Jiyya na Halitta; Alt HealthWatch; Fihirisar zuwa Adabin Chiropractic; da ɗakin karatu na Cochrane (Shafi A). Bincike ya haɗa da labaran da aka buga a cikin Turanci ko tare da rubutun Ingilishi. Dabarar bincike ta iyakance ga manya (? 18 shekaru); ko da yake an sake dawo da binciken bincike tare da ma'auni na haɗa abubuwa da ke tattare da shekaru masu yawa, kamar manya da matasa, ta hanyar amfani da dabarun bincike. Jerin abubuwan da aka bayar a cikin sake dubawa na tsari (SRs) kuma GDC sun sake duba su don rage abubuwan da suka dace daga rasa su.

 

Sharuɗɗan Zaɓin Shaida

 

An tantance sakamakon binciken ta hanyar lantarki, kuma an yi amfani da gwajin matakai da yawa (Shafi B): mataki 1A ( take), 1B (abstract); mataki 2A (cikakken rubutu), 2B (cikakkiyar hanyar rubutu, dacewa); da mataki na 3 (cikakken rubutu-karshe GDC nunawa a matsayin ƙwararrun abun ciki na asibiti). An cire kwafin kwafi, kuma an dawo da abubuwan da suka dace azaman na lantarki da/ko kwafi mai ƙarfi don cikakken bincike. Masu tantancewa daban-daban, ta yin amfani da ma'auni iri ɗaya, sun kammala allon wallafe-wallafe a cikin 2007 da 2009 saboda tsawon lokaci tsakanin bincike.

 

Gwajin gwaji na asibiti kawai (CCTs); bazuwar, gwaji masu sarrafawa (RCTs); da kuma sake dubawa na tsari (SRs) an zaba a matsayin tushen shaida don wannan jagorar daidai da ka'idodin halin yanzu don fassarar binciken asibiti. GDC ba ta ƙididdige nazarin binciken ba, jerin shari'o'i, ko rahotannin shari'o'i saboda yanayin rashin kulawa da yuwuwar ƙarancin ingancin tsari vs CCTs. Wannan tsarin ya yi daidai da sabunta hanyoyin don SRs wanda Cochrane Back Review Group ya buga.[8] Idan mawallafa iri ɗaya ne suka buga SRs da yawa akan wani batu da aka bayar, kawai an ƙidaya bugu na baya-bayan nan kuma an yi amfani da shi don haɗin shaida. An kuma cire bita-da-kulli na SRs don gujewa kirga sakamakon bincike sau biyu.

 

Tantance Adabi da Tafsiri

 

Ƙididdiga masu inganci na CCTs ko RCTs sun haɗa da ma'auni 11 da aka amsa ta �e (maki 1)� ko �a (maki 0)/ba su sani ba (maki 0) GDC ta rubuta ƙarin sharuɗɗan sha'awa guda 1: (2) amfani da masu bincike na ƙa'idodin bincike na IHS don yin rajistar batutuwa da (1) kimanta tasirin sakamako (Table 2, ginshiƙan L da M). Amfani da sharuɗɗan IHS[1] ya dace da wannan tsarin Jagoran Ayyukan Clinical (CPG) don tabbatar da ƙayyadaddun bincike a ciki da kuma cikin nazarin bincike. An cire karatun idan masu bincike ba su yi amfani da ka'idojin bincike na IHS ba don shigar da batun cikin binciken (Shafi C); kuma idan kafin 4, kafin ciwon kai na cervicogenic an haɗa shi a cikin rarrabuwa na IHS, ba a yi amfani da ka'idojin bincike na Cervicogenic Headache International Study Group[2004] ba. An sake duba illolin a matsayin wakili don yuwuwar haɗarin(s) tare da jiyya. Ba a yi amfani da ma'aunin nauyi (s) ga ma'auni na mutum ɗaya ba, kuma yiwuwar ƙimar inganci ya kasance daga 9 zuwa 0. Dukansu makantar batutuwa da masu ba da kulawa an ƙididdige su a cikin labaran bincike ta GDC, tun da an jera waɗannan abubuwa a cikin kayan aikin ƙima. [11] Hanyoyin GDC ba su daidaita ko canza kayan aikin ƙima ba. Dalilin wannan hanya shine cewa wasu hanyoyin magani (misali, motsa jiki na jijiyar lantarki ta hanyar transcutaneous [TENS], duban dan tayi) da kuma ƙirar gwaji na iya cimma makanta mai haƙuri da / ko mai aiki.[6] GDC bai iyakance kimanta waɗannan ma'auni na inganci ba idan da gaske an ruwaito su a cikin binciken asibiti don maganin cututtukan ciwon kai. GDC kuma sun yi la'akari da shi a waje da ƙwarewar su don gyara, ba tare da tabbatarwa ba, kayan aikin ƙididdiga da aka yi amfani da su da yawa da ake amfani da su don tantance wallafe-wallafen asibiti.[10] Sabbin kayan aikin bincike don ƙididdigewa da ƙididdigewa na wallafe-wallafen jiyya na hannu, duk da haka, ana buƙatar gaggawa kuma an lura da su azaman yanki don bincike na gaba a cikin sashin tattaunawa da ke ƙasa.

 

Tebu 1 Ƙididdiga masu ƙima na Gudanar da Gwajin Jiyya na Jiki don Gudanar da Ciwon Kai

 

Masu tantance adabi sun kasance masu ba da gudummawar ayyuka dabam da GDC kuma ba su makance game da nazarin marubuta, cibiyoyi, da mujallu na tushe. Membobi uku na GDC (MD, RR, da LS) sun tabbatar da hanyoyin ƙididdiga masu inganci ta hanyar kammala ƙididdiga masu inganci a kan bazuwar ɓangarorin 10. [11-20] An tabbatar da babban matakin yarjejeniya a duk ƙimar ƙimar inganci. An cimma cikakkiyar yarjejeniya akan duk abubuwa don karatun 5: a cikin 10 na abubuwa 11 don karatun 4 da 8 na abubuwa 11 don karatun 1 da ya rage. An warware duk bambance-bambance cikin sauƙi ta hanyar tattaunawa da yarjejeniya ta GDC (Table 1). Saboda bambancin hanyoyin bincike a cikin gwaje-gwaje, ba a yi nazarin meta ko tattara sakamakon gwaji ba. Gwaje-gwajen da suka sami sama da rabin jimillar kima mai yuwuwa (watau?6) an yi la'akari da inganci. Gwaje-gwajen da suka ci 0 zuwa 5 an yi la'akari da ƙarancin inganci. Nazarin tare da manyan lahani na hanyoyin ko binciken dabarun jiyya na musamman an cire su (misali, jiyya da GDC bai yi la'akari da shi ba don kula da chiropractic marasa lafiya da ciwon kai; Shafi Table 3).

 

Ingancin ƙimar SRs ya haɗa da ma'auni 9 da aka amsa da e (maki 1) ko a'a (maki 0)/ba su sani ba (maki 0) da kuma ingantaccen amsa ga abu J ba aibi, �ƙananan aibi, ko �manyan lahani (Table 2). Mahimman ƙididdiga masu yiwuwa sun kasance daga 0 zuwa 9. Ƙayyadaddun ƙayyadaddun ingancin kimiyya na SRs tare da manyan lahani, ƙananan lahani, ko rashin lahani, kamar yadda aka jera a shafi na J (Table 2), ya dogara ne akan amsoshin masu lissafin adabi ga abubuwan 9 da suka gabata. . An yi amfani da sigogi masu zuwa don samun cikakkiyar ingancin kimiyyar SR: idan babu/ba a san an yi amfani da amsa ba, mai yuwuwa SR ya sami ƙananan lahani a mafi kyau. Koyaya, idan an yi amfani da �A'a akan abubuwa B, D, F, ko H, bita na iya samun babban lahani.[21] Bita na yau da kullun waɗanda ke da sama da rabin jimillar ƙima mai yuwuwa (watau?5) ba tare da ƙarami ko ƙarami ba an ƙididdige su azaman inganci. An keɓe bita na tsari mai ƙima 4 ko ƙasa da / ko tare da manyan lahani.

 

Tebu 2 Mahimman ƙididdiga na Tsare-tsare na Bita na Jiyya na Jiki don Gudanar da Ciwon Kai

 

An bayyana sake dubawa a matsayin tsari idan sun haɗa da wata hanya madaidaiciya kuma mai maimaitawa don bincike da nazarin wallafe-wallafen kuma idan an kwatanta ma'auni da ƙaddamarwa don nazarin. Hanyoyi, ma'auni na haɗawa, hanyoyin ƙididdige ingancin binciken, halayen binciken da aka haɗa, hanyoyin haɗa bayanai, da sakamako an kimanta su. Raters sun cimma cikakkiyar yarjejeniya don duk abubuwan ƙima don 7 SRs [22-28] da kuma na 7 na 9 abubuwa don ƙarin SRs 2. [29,30] An yi la'akari da bambance-bambancen ƙananan kuma an warware su cikin sauƙi ta hanyar nazarin GDC da yarjejeniya (Table 2). ).

 

Haɓaka Shawarwari don Ayyuka

 

GDC ta fassara shaidar da ta dace da maganin chiropractic na marasa lafiya na ciwon kai. Za a buga cikakken taƙaitaccen labaran abubuwan da suka dace zuwa gidan yanar gizon CCA/Tarayya na Ayyukan Ayyukan Clinical.

 

An ƙididdige gwaje-gwajen da bazuwar, sarrafawa da binciken su don sanar da shawarwarin jiyya. Don ba da cikakkiyar ƙarfin shaida (ƙarfi, matsakaici, iyakance, rikice-rikice, ko babu shaida), [6] GDC yayi la'akari da lambar, inganci, da daidaiton sakamakon bincike (Table 3). An yi la'akari da shaida mai ƙarfi kawai lokacin da yawancin RCTs masu inganci suka tabbatar da binciken wasu masu bincike a wasu saitunan. SRs masu inganci ne kawai aka kimanta dangane da jikin shaida da kuma sanar da shawarwarin jiyya. GDC ta yi la'akari da hanyoyin jiyya don samun ingantacciyar fa'ida (s) lokacin da goyan bayan mafi ƙarancin matsakaicin matakin shaida.

 

Tebur 3 Ƙarfin Shaida

 

An ɓullo da shawarwarin aiki a cikin taron ƙungiyar aiki na haɗin gwiwa.

 

results

 

Tebu 4 Takaitaccen Adabin Adabi na !huality na Shaida don Matsalolin Ciwon Ciwon Kai na Migraine tare da ko ba tare da Aura ba.

 

Takaitacciyar Adabi na 5 da Ƙididdiga masu Inganci na Shaida don Matsalolin Tashin Hankali-Nau'in ciwon kai.

 

Tebura 6 Takaitaccen Adabin Adabi da Ƙididdiga Masu Inganci na Shaida don Matsalolin Ciwon Ciwon Cervicogenic

 

Takaitacciyar Adabi na 7 da Ƙididdiga masu Inganci na Tsare-tsare na Bita na Jiyya na Jiki don Gudanar da Ciwon Kai

 

Wallafe-wallafe

 

Daga binciken wallafe-wallafen, da farko an gano ƙididdiga 6206. Labari ashirin da ɗaya sun haɗu da ma'auni na ƙarshe don haɗawa kuma an yi la'akari da su a cikin haɓaka shawarwarin aiki (16 CCTs / RCTs [11-20,31-36] da 5 SRs [24-27,29]). An bayar da ƙimar ingancin abubuwan da aka haɗa a cikin Tebura 1 da 2. Shafi na 3 ya lissafa abubuwan da aka ware a cikin tantancewar ƙarshe ta GDC da dalilai (s) don keɓe su. Rashin batun batun da makanta da ma'aikaci da kuma bayanan da ba su gamsarwa game da tsaka-tsakin tsaka-tsaki an gano iyakokin hanyoyin gwaji na sarrafawa. Nau'in ciwon kai da aka kimanta a cikin waɗannan gwaje-gwajen sun haɗa da migraine (Table 4), ciwon kai na nau'in tashin hankali (Table 5), da ciwon kai na cervicogenic (Table 6). Saboda haka, kawai waɗannan nau'ikan ciwon kai kawai ana wakilta ta hanyar shaida da shawarwarin aiki a cikin wannan CPG. An bayar da taƙaitaccen bayani na SRs a cikin Tebur 7.

 

Shawarwari na Ayyuka: Maganin Migraine

 

  • Ana ba da shawarar yin amfani da kashin baya don kula da marasa lafiya tare da episodic ko migraine na yau da kullum tare da ko ba tare da aura ba. Wannan shawarar ta dogara ne akan nazarin da suka yi amfani da mitar magani 1 zuwa sau 2 a kowane mako don makonni 8 (matakin shaida, matsakaici). Ɗaya daga cikin RCT mai mahimmanci, [20] 1 ƙananan RCT, [17] da 1 high quality SR [24] suna goyan bayan yin amfani da magudi na kashin baya ga marasa lafiya da episodic ko migraine na kullum (Tables 4 da 7).
  • Ana ba da shawarar maganin tausa na mako-mako don rage mitar ƙaura na episodic kuma don inganta alamun bayyanar da ke da alaƙa da ciwon kai (matakin shaida, matsakaici). Ɗayan ingantaccen RCT[16] yana goyan bayan wannan shawarar aikin (Table 4). Masu bincike sun yi amfani da tausa na minti 45 tare da mayar da hankali kan tsarin neuromuscular da kuma haifar da yanayin baya, kafada, wuyansa, da kai.
  • Multimodal multidisciplinary kulawa (motsa jiki, shakatawa, danniya da kuma shawarwarin abinci mai gina jiki, maganin tausa) an bada shawarar don kula da marasa lafiya tare da episodic ko migraine na kullum. Koma yadda ya dace (matakin shaida, matsakaici). Ɗaya daga cikin RCT mai mahimmanci [32] yana goyan bayan tasiri na Multi-modal multidisciplinary intervention for migraine (Table 4). Shisshigin yana ba da fifiko ga tsarin gudanarwa na gaba ɗaya wanda ya ƙunshi motsa jiki, ilimi, canjin rayuwa, da sarrafa kai.
  • Akwai ƙarancin bayanan asibiti don bayar da shawarar don ko a kan yin amfani da motsa jiki kadai ko motsa jiki tare da hanyoyin kwantar da hankali na jiki don kula da marasa lafiya tare da episodic ko migraine na yau da kullum ( motsa jiki na motsa jiki, motsi na mahaifa [cROM], ko dukan jiki mikewa). Ƙananan CCTs guda uku [13,33,34] suna ba da gudummawa ga wannan ƙarshe (Table 4).

 

Shawarwari na Ayyuka: Nau'in Tashin Kai

 

  • Ƙunƙarar ɗaukar nauyi na craniocervical (misali, Thera-Band, Resistive Exercise Systems; Hygenic Corporation, Akron, OH) ana ba da shawarar na tsawon lokaci (misali, watanni 6) kulawa da marasa lafiya tare da ciwon kai na episodic ko na yau da kullun (matakin shaida, matsakaici). Ɗaya daga cikin RCT mai mahimmanci [36] ya nuna cewa ƙaddamar da ƙananan kayan aiki ya rage yawan alamun tashin hankali-nau'in ciwon kai ga marasa lafiya a lokacin dogon lokaci (Table 5).
  • Ba za a iya ba da shawarar yin amfani da kashin baya don kula da marasa lafiya tare da ciwon kai na episodic tashin hankali (matakin shaida, matsakaici). Akwai shaidun matsakaicin matsakaicin cewa magudi na kashin baya bayan maganin nama mai laushi na farko yana ba da ƙarin fa'ida ga marasa lafiya da ciwon kai irin na tashin hankali. Ɗaya daga cikin RCT mai inganci [12] (Table 5) da kuma lura da aka ruwaito a cikin 4 SRs [24-27] (Table 7) ba da shawarar yin amfani da magudi na kashin baya ga marasa lafiya da ciwon kai na episodic tashin hankali.
  • Ba za a iya ba da shawara don ko a kan yin amfani da magudi na kashin baya (sau 2 a kowane mako don makonni 6) ga marasa lafiya da ciwon kai na yau da kullum. Mawallafa na 1 RCT [11] an ƙididdige su a matsayin babban inganci ta hanyar kayan aikin ƙima mai inganci [6] (Table 1), da taƙaitaccen binciken wannan binciken a cikin 2 SRs [24,26] ya nuna cewa magudi na kashin baya na iya zama tasiri ga ciwon kai na kullum. . Koyaya, GDC yayi la'akari da RCT[11] yana da wahala a fassara da rashin daidaituwa (Table 5). Jarabawar ba ta da isasshen sarrafawa tare da rashin daidaituwa a cikin adadin batutuwa-maganin likitanci tsakanin ƙungiyoyin nazarin (misali, 12 ziyara ga batutuwa a cikin jiyya mai laushi da ƙungiyar magudi na kashin baya vs 2 ziyara ga batutuwa a cikin rukunin amitriptyline). Babu wata hanyar sanin ko kwatankwacin matakin kulawa na mutum don batutuwa a cikin rukunin amitriptyline na iya tasiri sakamakon binciken. Waɗannan la'akari da fassarori daga 2 wasu SRs [25,27] suna ba da gudummawa ga wannan ƙarshe (Table 7).
  • Babu isassun shedar da za ta ba da shawarar don ko adawa da amfani da jan hankali na hannu, sarrafa nama mai haɗawa, haɗawar Cyriax, ko motsa jiki/ horo na jiki ga marasa lafiya tare da ciwon kai na episodic ko na yau da kullun na tashin hankali. Ƙididdigar ƙananan ƙananan ƙananan ƙananan binciken [19,31,35] (Table 5), 1 ƙananan RCT mara kyau, [14] da 1 SR [25] suna ba da gudummawa ga wannan ƙaddamarwa (Table 7).

 

Shawarwari na Ayyuka: Ciwon kai na Cervicogenic

 

  • Ana ba da shawarar yin amfani da kashin baya don kula da marasa lafiya da ciwon kai na cervicogenic. Wannan shawarar ta dogara ne akan binciken 1 wanda yayi amfani da mitar magani na sau 2 a kowane mako don makonni 3 (matakin shaida, matsakaici). A cikin RCT mai mahimmanci, Nilsson et al [18] (Table 6) ya nuna tasiri mai mahimmanci na babban saurin gudu, ƙananan ƙananan ƙwayar cuta ga marasa lafiya da ciwon kai na cervicogenic. Haɗin shaida daga 2 SRs[24,29] (Table 7) yana goyan bayan wannan shawarar aikin.
  • Ana ba da shawarar haɗin gwiwa don kula da marasa lafiya da ciwon kai na cervicogenic (matakin shaida, matsakaici). Jull et al [15] yayi nazarin tasirin haɗin gwiwar Maitland 8 zuwa jiyya na 12 don makonni 6 a cikin RCT mai inganci (Table 6). Ƙaddamarwa ya biyo bayan al'ada na asibiti na al'ada, wanda zaɓi na ƙananan sauri da fasaha mai tsayi ya dogara ne akan ƙididdigar farko da ci gaba na rashin aikin haɗin gwiwa na mahaifa na marasa lafiya. An ba da rahoton sakamako masu amfani don mitar ciwon kai, ƙarfi, da ciwon wuyansa da nakasa. Haɗin shaida daga 2 SRs[24,29] (Table 7) yana goyan bayan wannan shawarar aikin.
  • Ana ba da shawarar motsa jiki mai zurfi mai zurfi don kula da marasa lafiya da ciwon kai na cervicogenic (matakin shaida, matsakaici). Wannan shawarar ta dogara ne akan binciken sau 2 kowace rana don makonni 6. Babu wani fa'ida mai ɗorewa na haɗuwa da motsa jiki mai zurfi na wuyansa da haɗin gwiwa don ciwon kai na cervicogenic. Ɗaya daga cikin RCT mai inganci [15] (Table 6) da kuma abubuwan lura da aka bayar a cikin 2 SRs [24,29] (Table 7) suna goyan bayan wannan shawarar aikin.

 

Safety

 

Masu aiki suna zaɓar hanyoyin jiyya tare da duk bayanan asibiti da ake samu don wani majiyyaci. Daga cikin 16 CCTs / RCTS [11-20,31-36] da aka haɗa a cikin jiki na shaida don wannan CPG, kawai nazarin 6 [11,12,15,20,32,36] da aka kimanta ko tattauna tasirin haƙuri ko aminci. sigogi (Table 1, shafi na M). Gabaɗaya, haɗarin da aka ruwaito sun yi ƙasa kaɗan. Uku daga cikin gwaje-gwajen sun ba da rahoton bayanan aminci don magudi na kashin baya.[11,12,20] Boline et al [11] ya ruwaito cewa 4.3% na batutuwa sun sami wuyan wuyansa bayan magudi na farko wanda ya ɓace ga duk lokuta bayan makonni 2 na farko na jiyya. Ciwo ko karuwa a cikin ciwon kai bayan magudi na kashin baya (n = 2) sune dalilai na dakatar da jiyya da Tuchin et al.[20] ya ambata. Babu wani illa da aka samu ta kowane batutuwa da Bove et al[12] suka yi ta yin amfani da magudin kashin baya don maganin tashin hankali-nau'in ciwon kai. Gwaje-gwajen jiyya don kimanta sakamako masu inganci bazai iya yin rajista da isassun lambobi na batutuwa don tantance abubuwan da ba a saba gani ba. Ana buƙatar wasu hanyoyin bincike don haɓaka cikakkiyar fahimtar daidaito tsakanin fa'idodi da kasada.

 

tattaunawa

 

An yi nazarin magudi na kashin baya da sauran hanyoyin kwantar da hankali da aka saba amfani da su a cikin chiropractic a cikin CCT da yawa waɗanda ke da bambanci a cikin rajistar batutuwa, ƙira, da ingancin gabaɗaya. Nau'in marasa lafiya da ciwon kai da aka wakilta a cikin tsarin shaida sune ƙaura, nau'in ciwon kai, da ciwon kai na cervicogenic. Sakamakon matsayin kiwon lafiya na farko da aka ruwaito shine yawanci yawan ciwon kai, ƙarfi, tsawon lokaci, da matakan ingancin rayuwa. Shaidar ba ta fi matsakaicin matsayi ba a wannan lokacin.

 

Shaidar ta goyi bayan yin amfani da magudi na kashin baya don kula da chiropractic marasa lafiya tare da ciwon kai ko ciwon kai na cervicogenic amma ba nau'in ciwon kai ba. Don migraine, kulawa da yawa ta yin amfani da maganin tausa na mako-mako na 45-minti da kulawa da yawa (motsa jiki, shakatawa, da damuwa da shawarwarin abinci mai gina jiki) na iya zama tasiri. A madadin haka, ana ba da shawarar haɗakar haɗin gwiwa ko zurfin wuyan motsa jiki na motsa jiki don inganta alamun ciwon kai na cervicogenic. Ya bayyana babu wani fa'ida ta yau da kullun na haɗa haɗin haɗin gwiwa da motsa jiki mai zurfi na wuyansa ga marasa lafiya da ciwon kai na cervicogenic. Matsakaicin shaida na goyan bayan yin amfani da ƙananan kayan aiki na craniocervical motsi don kulawa na tsawon lokaci na nau'in ciwon kai.

 

gazawar

 

Rashin gazawar wannan jagorar sun haɗa da yawa da ingancin shaida masu goyan baya da aka samu yayin bincike. Babu wani binciken bincike mai inganci mai inganci na kwanan nan da aka buga tare da sake fasalin binciken asibiti da aka buga don kula da chiropractic na marasa lafiya na ciwon kai. Ana buƙatar nazarin don ƙara fahimtar takamaiman hanyoyin kwantar da hankali na hannu a cikin keɓe ko a cikin haɗin kai mai kyau don maganin ciwon kai, nau'in ciwon kai, ciwon kai na cervicogenic, ko wasu nau'in ciwon kai da ke nunawa ga likitoci (misali, tari, ciwon kai na posttraumatic) . Wani gazawar wannan haɗin gwiwar wallafe-wallafen shine dogara ga binciken bincike da aka buga tare da ƙananan samfurori (Tables 4-6), ƙayyadaddun jiyya na gajeren lokaci, da kuma lokuta masu biyo baya. Gwajin gwaje-gwajen da aka tsara da kyau tare da isassun batutuwa na batutuwa, jiyya na tsawon lokaci, da kuma lokuta masu biyo baya suna buƙatar samun kuɗi don ci gaba da kula da chiropractic, da magudi na kashin baya musamman, don kula da marasa lafiya da ciwon kai. Kamar yadda yake tare da kowane bita na wallafe-wallafe da jagororin aikin asibiti, bayanan tushe da wallafe-wallafen da aka buga suna haɓakawa. Binciken da watakila ya sanar da wannan aikin yana iya yiwuwa an buga shi bayan kammala wannan binciken.[37-39]

 

La'akari don Bincike na gaba

 

Yarjejeniyar GDC ita ce cewa akwai buƙatar ƙarin nazarin chiropractic tare da marasa lafiya da ciwon kai.

 

  • Ana buƙatar ƙarin ingantaccen bincike na asibiti. Bincike na gaba yana buƙatar ƙirar binciken ta amfani da masu kwatanta aiki da marasa magani da / ko ƙungiyar placebo don haɓaka tushen shaida don kulawa da haƙuri. Ana buƙatar makantar haƙuri ga tsoma baki na jiki don gudanar da sakamakon tsammanin da ake bukata kuma masu bincike sun bincikar su a cikin chiropractic don sauran yanayin zafi.[10] Rashin binciken da aka ba da rahoto na tsari yana ba da ƙalubale mai amfani don samar da shawarwarin jiyya na tushen shaida. Ya kamata a tsara duk karatun nan gaba ta amfani da ingantattun hanyoyi (misali, Ƙarfafa Ma'auni na Gwaje-gwajen Rahoto [CONSORT] da Bayar da Rahoton Ƙimar Ƙirarriya tare da Tsare-tsare marasa tsari [TREND]).
  • Ana buƙatar rahoto na tsari na bayanan aminci a cikin binciken chiropractic. Duk gwaje-gwajen asibiti dole ne su tattara da bayar da rahoto kan yuwuwar illolin ko lahani ko da ba a lura da su ba.
  • Ƙirƙirar sabbin kayan aikin ƙididdigewa don kimanta binciken aikin jiyya na hannu. Makanta yana aiki don sarrafa tasirin tsammanin da kuma abubuwan da ba su da takamaiman tasiri na hulɗar masu ba da labari a cikin ƙungiyoyin bincike. Yawanci ba zai yiwu a makantar da batutuwa da masu samarwa a cikin ingantaccen nazarin hanyoyin kwantar da hankali na hannu ba. Duk da ƙayyadaddun ƙayyadaddun ƙididdiga, duka makantar batutuwa da masu ba da kulawa an ƙididdige su a cikin labaran bincike ta GDC, tun da waɗannan abubuwa an haɗa su a cikin kayan kima masu inganci.[6] Ana buƙatar manyan kayan aikin bincike don nazari da ƙididdige ƙima na wallafe-wallafen jiyya na hannu cikin gaggawa.
  • Don ci gaba da bincike kan sakamakon aiki a cikin kulawar chiropractic na ciwon kai. Wannan jagorar ya gano cewa nazarin ciwon kai yana amfani da ma'auni mai mahimmanci wajen kimanta tasirin jiyya akan sakamakon lafiya. Mitar ciwon kai, ƙarfi, da tsawon lokaci sune sakamakon da aka fi amfani da su akai-akai (Tables 4-6). Ana buƙatar ƙoƙari mai tsanani don haɗawa da ingantattun matakan sakamako na masu haƙuri a cikin binciken chiropractic wanda ya dace da ingantawa a cikin rayuwar yau da kullum da kuma sake dawowa da ayyuka masu ma'ana.
  • Tasirin farashi. Babu wani binciken bincike da aka dawo da shi akan ƙimar farashi na magudi na kashin baya don maganin ciwon kai. Gwajin gwaji na asibiti na gaba na magudi na kashin baya ya kamata yayi la'akari da ƙimar farashi.

 

Ana buƙatar wasu hanyoyin bincike don haɓaka cikakkiyar fahimtar daidaito tsakanin fa'idodi da haɗari. Wannan CPG baya bayar da bita na duk jiyya na chiropractic. Duk wani ƙetare yana nuna gibi a cikin wallafe-wallafen asibiti. Nau'in, mita, sashi, da tsawon lokaci na jiyya (s) ya kamata a dogara ne akan shawarwarin jagora, kwarewa na asibiti, da sanin mai haƙuri har sai an sami manyan matakan shaida.

 

karshe

 

Akwai tushe na shaida don tallafawa kulawar chiropractic, ciki har da magudi na kashin baya, don kula da ciwon kai da ciwon kai na cervicogenic. Nau'in, mita, sashi, da tsawon lokacin jiyya (s) ya kamata a dogara ne akan shawarwarin jagora, gwaninta na asibiti, da sanin mai haƙuri. Shaida don amfani da magudi na kashin baya azaman keɓewar saƙo ga marasa lafiya da ciwon kai irin na tashin hankali ya kasance daidai. Ana buƙatar ƙarin bincike.
Sharuɗɗan ayyuka sun haɗa mafi kyawun shaidar da aka samu zuwa kyakkyawan aikin asibiti kuma su ne kawai 1 ɓangaren hanyar da aka ba da shaida don ba da kulawa mai kyau. An yi nufin wannan jagorar don zama hanya don isar da kulawar chiropractic ga marasa lafiya da ciwon kai. Daftarin aiki ne mai rai kuma batun sake dubawa tare da bullar sabbin bayanai. Bugu da ƙari, ba maye gurbin gwaninta na asibiti da gwaninta ba. Ba a yi nufin wannan takaddar don zama ma'aunin kulawa ba. Maimakon haka, ƙa'idar ta tabbatar da ƙaddamar da sana'a don ci gaba da aikin tushen shaida ta hanyar yin musayar ilimi da tsarin canja wuri don tallafawa motsi na ilimin bincike a aikace.

 

Practical aikace-aikacen kwamfuta

 

  • Wannan jagorar ita ce hanya don isar da kulawar chiropractic ga marasa lafiya da ciwon kai.
  • Ana ba da shawarar yin amfani da kashin baya don kula da marasa lafiya da ciwon kai ko ciwon kai na cervicogenic.
  • Hanyoyin multidisciplinary multimodal ciki har da tausa na iya amfanar marasa lafiya tare da migraine.
  • Ƙaddamar da haɗin gwiwa ko zurfin wuyansa masu sassaucin ra'ayi na iya inganta alamun ciwon kai na cervicogenic.
  • Ƙunƙashin ɗaukar nauyi na craniocervical na iya inganta ciwon kai irin na tashin hankali.

 

Godiya

 

Marubutan sun gode wa waɗannan abubuwan don shigarwa akan wannan jagorar: Ron Brady, DC; Gadar Grayden, DC; H James Duncan; Wanda Lee MacPhee, DC; Keith Thomson, DC, ND; Dean Wright, DC; da Peter Waite (Mambobin Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru). Marubutan sun gode wa masu zuwa don taimako tare da ƙididdigar binciken wallafe-wallafen Mataki na I: Simon Dagenais, DC, PhD; da Thor Eglinton, MSc, RN. Marubutan sun gode wa waɗannan abubuwan don taimako tare da ƙarin binciken wallafe-wallafen Phase II da ƙimar shaida: Seema Bhatt, PhD; Mary-Doug Wright, MLS. Marubutan sun gode wa Karin Sorra, PhD don taimako tare da binciken wallafe-wallafe, ƙimar shaida, da tallafin edita.

 

Tushen Ba da Tallafin Kuɗi da Rikicin Mahimmanci

 

CCA, Ƙungiyar Kariyar Chiropractic ta Kanada, da kuma gudunmawar lardi na lardi daga duk lardunan banda British Columbia ne suka ba da kuɗi. CCA da Tarayya ne suka dauki nauyin wannan aikin. Ba a sami rahoton sabani na sha'awa don wannan binciken ba.

 

A ƙarshe, ciwon kai na daya daga cikin dalilan da ya sa mutane ke neman kulawar likita. Kodayake yawancin masu sana'a na kiwon lafiya na iya magance ciwon kai, kulawar chiropractic shine sanannen zaɓin magani wanda aka saba amfani dashi don magance matsalolin kiwon lafiya da dama, ciki har da nau'in ciwon kai. Bisa ga labarin da ke sama, shaidu sun nuna cewa kulawar chiropractic, ciki har da gyare-gyare na kashin baya da kuma manipulations na hannu, na iya inganta ciwon kai da ƙaura. Bayanin da aka ambata daga Cibiyar Bayanan Kimiyyar Halittu ta Ƙasa (NCBI). Matsakaicin bayanin mu yana iyakance ga chiropractic da kuma raunin da ya faru da kashin baya. Don tattauna batun batun, don Allah jin daɗin tambayar Dr. Jimenez ko tuntuɓe mu a 915-850-0900 .

 

Dr. Alex Jimenez ne ya shirya shi

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Ƙarin Maudu'i: Ciwon Baya

 

Bisa ga kididdigar, kimanin 80% na mutane za su fuskanci alamun ciwon baya a kalla sau ɗaya a duk rayuwarsu. Binciken baya koke ne na gama-gari wanda zai iya haifar da rauni da/ko yanayi iri-iri. Sau da yawa lokuta, lalacewar dabi'a na kashin baya tare da shekaru na iya haifar da ciwon baya. Harsiated fayafai faruwa a lokacin da taushi, gel-kamar cibiyar intervertebral disc ta tura ta cikin hawaye a kewaye da shi, waje zobe na guringuntsi, matsawa da kuma fusatar da jijiya tushen. Abubuwan da aka fi sani da diski suna faruwa tare da ƙananan baya, ko kashin baya na lumbar, amma kuma suna iya faruwa tare da kashin mahaifa, ko wuyansa. Ƙunƙarar jijiyoyi da aka samo a cikin ƙananan baya saboda rauni da / ko mummunan yanayin zai iya haifar da bayyanar cututtuka na sciatica.

 

hoton blog na zane mai ban dariya paperboy babban labarai

 

MAFI MUHIMMAN BUDURWA: �Maganin Ciwon Wuya El Paso, TX Chiropractor

 

 

KARATUN BATUN: EXTRA EXTRA: El Paso, Tx | 'Yan wasa

 

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51. Sjogren T, Nissinen KJ, Jarvenpaa SK, Ojanen MT, Vanharanta H, Malkia EA. Sakamakon aikin motsa jiki na motsa jiki na wurin aiki akan tsananin ciwon kai da wuyansa da alamun kafada da ƙarfin tsokar tsoka na ma'aikatan ofis: wani gungu mai ba da izini ga gwaji na giciye. Ciwon 2005;116:119-28.
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59. Fernandez-de-las-Penas C, Alonso-Blanco C, San-Roman J, Miangolarra-Page JC. Ingantattun hanyoyin da aka bazuwar gwajin gwaji na magudin kashin baya da tattarawa a cikin nau'in ciwon kai na tashin hankali, migraine, da ciwon kai na cervicogenic. J Orthop Wasanni Phys Ther 2006;36:160-9.
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Rufe Accordion
Ciwon kai na Migraine Ciwon Maganin Maganin Chiropractic a El Paso, TX

Ciwon kai na Migraine Ciwon Maganin Maganin Chiropractic a El Paso, TX

by | Chiropractic, Gwajin Sarrafa Bazuwar

An yi la'akari da ciwon kai na Migraine a matsayin daya daga cikin cututtuka mafi ban takaici idan aka kwatanta da sauran al'amurran kiwon lafiya na kowa. Gabaɗaya yana haifar da damuwa, alamun ƙaura, gami da ciwon kai mai raɗaɗi, hankali ga haske da sauti gami da tashin zuciya, na iya yin tasiri sosai ga ingancin rayuwar migraineur. Duk da haka, binciken bincike ya gano cewa kulawar chiropractic zai iya taimakawa wajen rage yawan mita da kuma tsananin ciwon kai. Yawancin masu sana'a na kiwon lafiya sun nuna cewa rashin daidaituwa na kashin baya, ko subluxation, na iya zama tushen ciwon ciwon kai na migraine. Manufar labarin da ke ƙasa shine don nuna matakan sakamako na maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin cutar da laguna.

 

Maganin Maganin Manipulative na Chiropractic don Migraine: Uku?Makamai, Single? Makafi, Placebo, Gwajin Sarrafa Bazuwar

 

Abstract

 

  • Bayani da manufar: Don bincika tasirin maganin manipulative na chiropractic (CSMT) don migraineurs.
  • Hanyar: Wannan shi ne mai yiwuwa uku-makamai, guda ɗaya?makafi, placebo, bazuwar gwajin gwaji (RCT) na tsawon watanni 17 ciki har da 104 migraineurs tare da akalla daya migraine harin kowane wata. An gudanar da RCT a Asibitin Jami'ar Akershus, Oslo, Norway. Magani mai aiki ya ƙunshi CSMT, yayin da placebo wani motsi ne na motsa jiki na gefen scapula da / ko yankin gluteal. Ƙungiyar kulawa ta ci gaba da sarrafa magungunan da suka saba. RCT ta ƙunshi tafiyar watanni 1, watanni 3 da matakan sakamako a ƙarshen sa baki da kuma a 3, 6 da 12 watanni masu biyo baya. Ƙarshen farko? Ma'anar ita ce adadin kwanakin ƙaura a kowace wata, yayin da na biyu na ƙarshe? Matsaloli sun kasance tsawon lokacin ƙaura, ƙarfin ƙaura da ciwon kai, da kuma amfani da magani.
  • results: Kwanakin Migraine sun ragu sosai a cikin dukkanin kungiyoyi uku daga asali zuwa jiyya (P <0.001). Tasirin ya ci gaba a cikin CSMT da ƙungiyar placebo a duk lokacin biyo baya, yayin da ƙungiyar kulawa ta koma tushe. Ragewar kwanakin migraine ba su bambanta sosai tsakanin ƙungiyoyi (P> 0.025 don hulɗar juna). An rage tsawon lokacin migraine da ma'anar ciwon kai da yawa a cikin CSMT fiye da ƙungiyar kulawa zuwa ƙarshen bi? (P = 0.02 da P = 0.04 don hulɗar, bi da bi). Mummunan al'amuran sun kasance kaɗan, masu sauƙi kuma masu wucewa. An kiyaye makanta da ƙarfi a cikin RCT.
  • Ƙarshe: Yana yiwuwa a gudanar da wani manual?therapy RCT tare da boye placebo. Tasirin CSMT da aka lura a cikin bincikenmu mai yiwuwa ne saboda amsawar placebo.
  • keywords: chiropractic, ciwon kai, migraine, bazuwar gwajin gwaji, maganin manipulative na kashin baya

 

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Dr. Alex Jimenez's Insight

Ciwon wuyan wuya da ciwon kai shine dalili na uku mafi yawan dalilin da mutane ke neman kulawar chiropractic. Yawancin binciken bincike sun nuna cewa maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin ƙwayar cuta. Kulawa na chiropractic zai iya gyara duk wani kuskuren kashin baya, ko subluxation, wanda aka samo tare da tsawon kashin baya, wanda aka nuna ya zama tushen ciwon ciwon kai. Bugu da ƙari, gyare-gyare na kashin baya da gyare-gyare na hannu na iya taimakawa wajen rage danniya da ƙwayar tsoka ta hanyar rage yawan matsa lamba da ake sanyawa a kan hadaddun sifofi na kashin baya sakamakon rashin daidaituwa na kashin baya, ko subluxation. Ta hanyar daidaita kashin baya da kuma rage danniya da tashin hankali na tsoka, kulawar chiropractic zai iya inganta bayyanar cututtuka na migraine kuma rage yawan su.

 

Gabatarwa

 

Hanyoyin zamantakewar tattalin arziki na ƙaura suna da yawa saboda yawan yaduwa da nakasa yayin hare-hare [1, 2, 3]. Maganin magunguna mai tsanani yawanci shine zaɓi na farko na magani don ƙaura a cikin manya. Migraineurs tare da hare-hare akai-akai, rashin isasshen tasiri da / ko ƙin yarda da magani mai tsanani sune masu yuwuwar 'yan takara don maganin rigakafi. Maganin rigakafi na Migraine sau da yawa yakan zama ilimin harhada magunguna, amma maganin hannu ba sabon abu bane, musamman idan maganin pharmacological ya gaza ko kuma idan mai haƙuri yana son guje wa magani [4]. Bincike ya nuna cewa maganin manipulative na kashin baya na iya tayar da tsarin hanawa na jijiyoyi a matakan kashin baya daban-daban saboda yana iya kunna hanyoyi daban-daban na saukowa na tsakiya [5, 6, 7, 8, 9, 10].

 

Gwaje-gwajen da aka sarrafa bazuwar magunguna (RCTs) yawanci sau biyu ne?makafi, amma wannan ba zai yiwu ba a cikin RCTs na manual? A halin yanzu babu wata yarjejeniya kan hanyar sham a cikin manual?therapy RCTs waɗanda ke kwaikwayon placebo a cikin RCTs na magunguna [11]. Rashin ingantaccen tsarin sham shine babban iyakancewa a cikin duk RCTs na baya-bayan nan? Kwanan nan, mun ci gaba da tsarin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin maganin .

 

Manufar farko na wannan binciken shine don gudanar da wani manual?therapy uku?makamai, single?makafi, placebo RCT ga migraineurs tare da ma'auni na hanya mai kama da na RCTs na pharmacological.

 

Manufar ta biyu ita ce tantance ingancin CSMT da magudin magudi (placebo) da CSMT tare da sarrafawa, watau mahalarta waɗanda suka ci gaba da sarrafa magunguna na yau da kullun.

 

Hanyar

 

Nazarin Zane

 

Nazarin ya kasance uku?makamai, guda?makafi, placebo RCT sama da watanni 17. RCT ya ƙunshi tushen 1? watan, 12 zaman jiyya a kan watanni 3 tare da matakan biyo baya a ƙarshen sa baki, 3, 6 da 12 watanni daga baya.

 

Mahalarta sun kasance, kafin tushe, bazuwar daidai gwargwado zuwa ƙungiyoyi uku: CSMT, placebo (mai amfani da sham) da sarrafawa (ci gaba da gudanar da sarrafa magunguna na yau da kullun).

 

Tsarin binciken ya dace da shawarwarin Ƙungiyar Ciwon Kai ta Duniya (IHS) da CONSORT (Shafi S1) [1, 15, 16]. Kwamitin Yanki na Yaren mutanen Norway don La'akarin Bincike na Likita da Sabis na Bayanan Kimiyyar Kimiyya na Norwegian sun amince da aikin. An yi rajistar RCT a ClinicalTrials.gov (ID no: NCT01741714). An buga cikakken ka'idar gwaji a baya [17].

 

Wanda su ka Halarta

 

An dauki mahalarta daga Janairu zuwa Satumba 2013 da farko ta Sashen Nazarin Jiki, Asibitin Jami'ar Akershus. An kuma dauki wasu mahalarta aikin ta hanyar Manyan Kwararru daga Gundumar Akershus da Oslo ko tallan kafofin watsa labarai. Duk mahalarta sun sami bayanan da aka buga game da aikin tare da hira ta wayar tarho.

 

Mahalarta da suka cancanta sun kasance masu ƙaura daga shekaru 18 zuwa 70 tare da aƙalla harin ƙaura guda ɗaya a kowane wata kuma an ba su izinin samun tashin hankali?Nau'in ciwon kai amma babu wani ciwon kai na farko. Dukkan mahalarta an gano su ta hanyar chiropractor tare da kwarewa a cikin ciwon kai a lokacin hira da kuma bisa ga Ƙungiyar Ƙasa ta Duniya na Ciwon Ciwon Kai? II (ICHD?II) 2. Masanin ilimin likitanci ya gano duk migraineurs daga Asibitin Jami'ar Akershus.

 

Sharuɗɗan keɓancewa sun kasance haƙiƙa ga maganin manipulative na kashin baya, radiculopathy na kashin baya, ciki, damuwa da CSMT a cikin watanni 12 da suka gabata. Mahalarta da suka karɓi maganin hannu [18], sun canza maganin ƙaura na prophylactic ko kuma sun kasance masu juna biyu a lokacin RCT an sanar da su cewa za a janye su daga binciken a wancan lokacin kuma an dauke su a matsayin saukewa. An ba wa mahalarta damar ci gaba da canza magungunan ƙaura mai tsanani a duk lokacin nazarin.

 

An gayyaci mahalarta masu cancanta zuwa hira da kima na jiki ciki har da bincike mai zurfi na kashin baya ta hanyar chiropractor (AC). Mahalarta bazuwar zuwa CSMT ko rukunin placebo sun sami cikakken gwajin rediyo na kashin baya.

 

Randomization da Masking

 

Bayan an sami izini a rubuce, mahalarta sun kasance daidai da bazuwar zuwa ɗaya daga cikin makaman binciken guda uku ta hanyar zana kuri'a ɗaya. Kuri'a masu ƙididdigewa tare da makaman binciken guda uku an raba kowannensu zuwa ƙungiyoyi huɗu ta shekaru da jinsi, watau 18 zuwa 39 ko 40�70, da maza ko mata.

 

Bayan kowane zaman jiyya, mahalarta a cikin CSMT da ƙungiyar placebo sun kammala tambayoyin kan ko sun yi imani cewa an karɓi maganin CSMT, da kuma yadda suke da tabbacin cewa an karɓi magani mai aiki akan ma'aunin ƙima na lambobi 0 - 10, inda 10 ya wakilci cikakkiyar tabbaci. [14].

 

Duka bazuwar toshewa da kuma tambayoyin makanta an gudanar da su ne kawai daga wata ƙungiya ta waje.

 

shisshigi

 

Ƙungiyar CSMT ta sami maganin manipulative na kashin baya ta hanyar amfani da hanyar Gonstead, takamaiman lamba, high?guri, low?amplitude, short?lever spinal ba tare da wani post?daidaitawar recoil wanda aka directed zuwa kashin baya biomechanical dysfunction (cikakken tsarin kula da kashin baya) kamar yadda aka gano ta misali. Gwajin chiropractic a kowane zaman jiyya na mutum [19].

 

Ƙungiyar placebo ta sami magudi na sham, ƙayyadaddun hulɗar da ba ta dace ba, ƙananan sauri, ƙananan ƙanƙara? ]. Dukkanin lambobin da ba na jiyya ba an yi su a waje da ginshiƙin kashin baya tare da isassun ƙarancin haɗin gwiwa kuma ba tare da zafin nama mai laushi ba don haka babu cavitations haɗin gwiwa ya faru. An riga an saita hanyoyin maye gurbin sham kuma an canza su daidai tsakanin mahalarta placebo bisa ga ka'ida yayin lokacin jiyya na mako 14 don ƙarfafa ingancin binciken. An kwatanta hanyar placebo daki-daki a cikin ka'idar gwaji da ke akwai [12].

 

Kowane zaman tsaka-tsakin ya kasance na tsawon mintuna 15 kuma duka ƙungiyoyin biyu sun yi ƙayyadaddun tsari da ƙima iri ɗaya kafin da bayan kowane saƙo. Ba a ba da wani sa baki ko shawara ga mahalarta ba yayin lokacin gwaji. Dukansu ƙungiyoyin sun sami shiga tsakani a Asibitin Jami'ar Akershus ta hanyar gogaggen chiropractor (AC).

 

Ƙungiyar kulawa ta ci gaba da gudanar da aikin da suka saba yi ba tare da samun sa hannun mai binciken asibiti ba.

 

sakamakon

 

Mahalarta sun cika ingantacciyar diary na ciwon kai a duk tsawon binciken kuma suna mayar da su kowane wata [20]. Game da littafin tarihin da ba a dawo ba ko bayanan da ba a dawo ba, an tuntuɓi mahalarta ta waya don tabbatar da bin doka.

 

Ƙarshen farko?Batun shine adadin kwanakin ƙaura a kowane wata (kwanaki 30 / wata). Akalla 25% rage yawan kwanakin ƙaura daga asali zuwa ƙarshen sa baki, tare da irin wannan matakin da aka kiyaye a 3, 6 da 12 watanni bi? Ana sa ran a cikin kungiyar CSMT.

 

Ƙarshen na biyu?Maki sun kasance tsawon lokacin ƙaura, ƙarfin ƙaura da ciwon kai (HI), da shan magani. Aƙalla 25% raguwa a cikin tsawon lokaci, ƙarfi da HI, kuma aƙalla 50% rage yawan amfani da magani ana sa ran daga tushe zuwa ƙarshen sa baki, tare da irin wannan matakin da aka kiyaye a 3, 6 da 12 watanni masu biyo baya a cikin ƙungiyar CSMT.

 

Babu wani canji da aka yi tsammanin ƙarshen firamare da na biyu? aya a cikin placebo da ƙungiyar kulawa.

 

An bayyana ranar migraine a matsayin ranar da migraine tare da aura, migraine ba tare da aura ko yiwuwar ƙaura ba ya faru. An ƙididdige harin Migraine na tsawon sa'o'i 24 a matsayin harin guda ɗaya sai dai idan an sami tazara na kyauta na ?48 hours [21]. Idan mai haƙuri ya yi barci a lokacin harin ƙaura kuma ya farka ba tare da ƙaura ba, daidai da ICHD?III?, an rubuta tsawon lokacin harin a matsayin ci gaba har zuwa lokacin farkawa [22]. Matsakaicin lokacin harin ƙaura shine sa'o'i 4 sai dai idan an yi amfani da triptan ko magungunan da ke ɗauke da ergotamine, a cikin wannan yanayin ba mu ayyana mafi ƙarancin lokaci ba. An ƙididdige HI a matsayin ma'anar migraine kwanaki a kowane wata (kwanaki 30) - ma'anar ƙaura (h / day) ma'anar ƙarfin (0-10 ma'auni na ƙima).

 

An zaɓi maƙasudi na farko da na sakandare? bisa ga Task Force of the IHS Clinical Trial Jagororin gwaji na asibiti [1, 15]. Dangane da sake dubawa na baya game da ƙaura, an yi la'akari da raguwar 25% a matsayin ƙididdigar ra'ayin mazan jiya [12, 13].

 

An ƙididdige ƙididdigar sakamakon a cikin kwanaki 30 bayan zaman tsaka-tsaki na ƙarshe da kwanaki 30 bayan abubuwan da aka biyo baya, watau watanni 3, 6 da 12, bi da bi.

 

An rubuta duk abubuwan da ba su da kyau (AEs) bayan kowane shiga tsakani bisa ga shawarwarin CONSORT da Ƙungiyar Task Force na IHS akan AEs a cikin gwaji na migraine [16].

 

ilimin kididdiga Analysis

 

Mun kafa lissafin wutar lantarki akan binciken kwanan nan na topiramate a cikin migraineurs [24]. Mun yi la'akari da matsakaicin bambanci a rage yawan adadin kwanakin migraine a kowace wata tsakanin masu aiki da placebo, da kuma tsakanin masu aiki da ƙungiyoyi masu kula da kwanaki 2.5, tare da SD na 2.5 don ragewa a kowane rukuni. Kamar yadda bincike na farko ya ƙunshi kwatancen rukuni biyu, an saita matakin mahimmanci a 0.025. Don ikon 80%, ana buƙatar samfurin samfurin marasa lafiya 20 a cikin kowane rukuni don gano babban bambanci a raguwa na kwanaki 2.5.

 

An gabatar da halayen marasa lafiya a asali azaman ma'ana da SD ko mitoci da kaso a cikin kowace ƙungiya kuma idan aka kwatanta da samfuran masu zaman kansu t? gwaji da? 2 gwaji.

 

Bayanan lokaci na duk ƙarshen?An kwatanta maki tsakanin ƙungiyoyi. Saboda maimaita ma'auni ga kowane majiyyaci, misalan gauraye masu gauraya na layi wanda ke lissafin bambance-bambancen mutum-mutumi an ƙiyasta su ga duk ƙarshen maki. Kafaffen tasiri don lokacin (ba na layi ba), rabon rukuni da hulɗar tsakanin su biyun an haɗa su. An shigar da tasirin bazuwar ga marasa lafiya da gangara cikin ƙirar. Kamar yadda ragowar abubuwan suka karkata, an yi amfani da ƙimar bootstrap bisa samfuran gungu 1000. An yi kwatancen nau'i-nau'i ta hanyar samun bambance-bambancen lokaci guda ɗaya a cikin kowane rukuni a kowane lokaci tare da daidaitattun ƙimar P? da tazarar amincewa 95%. An ba da rahoton amfani da magani a cikin ƙungiyoyi ta matsakaiciyar allurai tare da SD, kuma an kwatanta ƙungiyoyi ta hanyar gwajin tsaka-tsaki na samfurori masu zaman kansu. An bayyana kashi a matsayin gudanarwa guda ɗaya na triptan ko ergotamine; paracetamol 1000 MG � codeine; magungunan anti-inflammatory marasa steroidal (tolfenamic acid, 200 MG; diclofenac, 50 MG; aspirin, 1000 MG; ibuprofen, 600 MG; naproxen, 500 MG); da kuma morphinometics (tramadol, 50 MG). Babu wani daga cikin marasa lafiya da ya canza hannun nazarin kuma babu ɗaya daga cikin drop?outs da ke cike da littattafan ciwon kai bayan janyewa daga binciken. Don haka, kowane bincike na yarjejeniya kawai ya dace.

 

An makantar da nazarin don rarraba jiyya kuma an gudanar da su a cikin SPSS v22 (IBM Corporation, Armonk, NY, Amurka) da STATA v14 (JSB) (StataCorp LP, Kwalejin Kwalejin, TX, Amurka). An yi amfani da matakin mahimmanci na 0.025 don ƙarshen farko? aya, yayin da sauran wurare an yi amfani da matakin 0.05.

 

Ethics

 

An bi ka'idodin aikin asibiti mai kyau [25]. An ba da bayanan baka da rubuce-rubuce game da aikin a gaba da haɗawa da rarraba rukuni. An sami izini a rubuce daga duk mahalarta. Mahalarta a cikin placebo da ƙungiyar kulawa an yi musu alkawarin CSMT magani bayan RCT, idan an gano aikin aiki yana da tasiri. An ba da inshora ta hanyar tsarin biyan kuɗi na Norwegian ga marasa lafiya (Rauni na Rauni), wata ƙungiya ta ƙasa mai zaman kanta wadda ke biyan marasa lafiya da suka ji rauni ta hanyar jiyya da sabis na kiwon lafiya na Norwegian ya bayar. An ayyana dokar dakatarwa don janye mahalarta daga wannan binciken daidai da shawarwarin da ke cikin tsawaitawar CONSORT don Ingantacciyar Rahoto na Harms [26]. An kula da duk AEs a lokacin lokacin shiga tsakani kuma sun yi aiki kamar yadda suka faru bisa ga shawarwarin CONSORT da Ƙungiyar Task Force na IHS akan AEs a cikin gwaji na migraine [16, 23]. Idan akwai mai tsanani AE, za a janye mahalarta daga binciken kuma a koma ga Babban Kwararren ko Sashin gaggawa na asibiti dangane da taron. Ana samun mai binciken (AC) ta wayar hannu a kowane lokaci a tsawon lokacin jiyya na binciken.

 

results

 

Hoto ?1 yana nuna ginshiƙi mai gudana na 104 migraineurs da aka haɗa a cikin binciken. Siffofin asali da halayen alƙaluma sun kasance iri ɗaya a cikin ƙungiyoyi uku (Table 1).

 

Hoto 1 Jadawalin Tafiyar Karatu

Hoto 1: Jadawalin kwararar karatu.

 

Tebur 1 Baseline Demographic and Clinical Halayen

 

Matakan Sakamako

 

Sakamako a kan dukkan ƙarshen?Ana gabatar da maki a cikin siffa ?2a�d da Tables 2, 3, 4.

 

Figure 2

Hoto 2: (a) Ranakun ciwon kai; (b) tsawon ciwon kai; (c) tsananin ciwon kai; (d) ma'anar ciwon kai. Bayanan martaba na lokaci a ƙarshen firamare da sakandare?maki, hanyoyi da sandunan kuskure suna wakiltar tazarar amincewa 95%. BL, asali; sarrafawa, ƙungiyar kulawa (�); CSMT, maganin manipulative na kashin baya na chiropractic (?); placebo, sham magudi (?); PT, bayan jiyya; 3 m, 3?wata-wata? 6 m, 6?wata-wata? 12 m, 12?wata-wata? VAS, sikelin analog na gani.

 

Table 2 Regression Coefficients da SE

 

Table 3 Ma'anar da SD

 

Tebur na 4 Ma'anar Ma'aunin Magani na SD

 

Ƙarshen farko? aya. Kwanakin ƙaura sun ragu sosai a cikin duk ƙungiyoyi daga tushe zuwa jiyya (P <0.001). Sakamakon ya ci gaba a cikin CSMT da ƙungiyoyin placebo a 3, 6 da 12 watanni masu biyo baya, yayin da kwanakin migraine suka koma matakin asali a cikin ƙungiyar kulawa (Fig.? 2a). Tsarin haɗin linzamin linzamin kwamfuta bai nuna babban bambance-bambance a cikin canji a cikin kwanakin ƙaura tsakanin CSMT da ƙungiyoyin placebo (P = 0.04) ko tsakanin CSMT da ƙungiyar kulawa (P = 0.06; Table 2). Koyaya, kwatancen da aka kwatanta a wuraren lokaci ɗaya sun nuna bambance-bambance masu mahimmanci tsakanin CSMT da ƙungiyar kulawa a kowane lokaci da suka fara a bayan jiyya (Table 3).

 

Ƙarshen sakandare?maki. An sami raguwa mai mahimmanci daga asali zuwa matsayi? 0.003, bi da bi) ƙungiyoyi, kuma tasirin ya ci gaba a cikin watanni 0.002, 0.001 da 0.001 bi?

 

Babban bambance-bambancen da ke tsakanin CSMT da ƙungiyoyi masu kulawa sun canza a tsawon lokacin ƙaura (P = 0.02) da kuma a cikin HI (P = 0.04; Table 2).

 

A cikin watanni 12 masu biyo baya, canjin amfani da paracetamol ya ragu sosai a cikin ƙungiyar CSMT idan aka kwatanta da placebo (P = 0.04) da ƙungiyoyi (P = 0.03) (Table 4).

 

Makanta. Bayan kowane zaman 12 na shiga tsakani,> 80% na mahalarta sun yi imanin sun karbi CSMT ba tare da la'akari da rabon rukuni ba. Matsakaicin rashin daidaituwa don gaskata cewa an karɓi maganin CSMT shine> 10 a duk zaman jiyya a cikin ƙungiyoyin biyu (duk P <0.001).

 

Tasiri mara kyau. An ƙididdige jimlar 703 na yuwuwar zaman shiga tsakani na 770 don AEs (355 a cikin ƙungiyar CSMT da 348 a cikin rukunin placebo). Dalilan rashin tantancewar AE da aka rasa sun kasance sun fita?ko kuma an rasa zaman shiga tsakani. AEs sun kasance da yawa akai-akai a cikin CSMT fiye da zaman tsaka-tsakin wuribo (83/355 vs. 32/348; P <0.001). Tausayi na gida shine mafi yawan AE da aka ruwaito ta hanyar 11.3% (95% CI, 8.4�15.0) a cikin rukunin CSMT da 6.9% (95% CI, 4.7-10.1) a cikin rukunin placebo, yayin da gajiya a ranar shiga tsakani da wuyan wuyansa. An ruwaito ta 8.5% da 2.0% (95% CI, 6.0�11.8 da 1.0�4.0), da 1.4% da 0.3% (95% CI, 0.6�3.3 da 0.1�1.9), bi da bi. Duk sauran AEs (ƙananan ciwon baya, fuskar fuska, tashin zuciya, tsokanar ciwon kai da gajiya a cikin makamai) ba su da yawa (<1%). Ba a sami rahoton AE mai tsanani ko mai tsanani ba.

 

tattaunawa

 

A iya saninmu, wannan shine jagorar jagora na farko RCT tare da rubutaccen nasarar makanta. Mu uku 'makamai, guda ɗaya' makafi, placebo RCT yayi la'akari da ingancin CSMT a cikin maganin migraine tare da placebo (sham chiropractic) da sarrafawa (maganin magunguna na yau da kullum). Sakamakon ya nuna cewa kwanakin migraine sun ragu sosai a cikin dukkanin kungiyoyi uku daga asali zuwa post?magani. Tasirin ya ci gaba a cikin CSMT da ƙungiyoyin placebo a duk lokacin biyo baya, yayin da ƙungiyar kulawa ta koma tushe. AEs sun kasance masu sauƙi kuma masu wucewa, wanda ya dace da binciken da ya gabata.

 

Tsarin binciken ya bi shawarwarin RCTs na magunguna kamar yadda IHS da CONSORT [1, 15, 16] suka bayar. Manual?therapy RCTs suna da manyan cikas guda uku idan aka kwatanta da RCTs na magunguna. Na farko, ba shi yiwuwa a makantar da mai binciken dangane da maganin da aka yi amfani da shi. Na biyu, ijma'i a kan wani inert placebo magani ya rasa [11]. Na uku, yunƙurin da aka yi a baya don haɗa ƙungiyar placebo sun tsallake tabbatar da makanta, don haka, har yanzu ba a sani ba ko an ɓoye maganin aiki da placebo [27]. Saboda waɗannan ƙalubalen mun yanke shawarar gudanar da RCT masu makafi guda uku, masu makafi, wanda kuma ya haɗa da ƙungiyar kulawa da ta ci gaba da maganin magunguna na yau da kullun don samun alamar girman amsawar placebo.

 

An ba da shawarar cewa, a cikin magungunan magunguna biyu? Makafi placebo RCTs, kawai 50% za su yi imani da cewa suna karɓar magani mai aiki a kowace ƙungiya, idan makanta ya kasance cikakke. Koyaya, wannan bazai zama gaskiya ba a cikin RCTs na farfesa na hannu, saboda kuzarin motsa jiki da placebo na iya zama mai gamsarwa fiye da kwamfutar hannu [28]. Mai bincike guda ɗaya yana rage bambance-bambancen masu bincike ta hanyar samar da irin wannan bayanin ga duk mahalarta kuma ana ba da shawarar cewa aikin placebo ya kamata ya yi kama da magani mai aiki dangane da hanya, mitan jiyya da lokacin da aka kashe tare da mai binciken don ba da damar irin wannan tsammanin a cikin ƙungiyoyin biyu. [28]. Muhimmancin nasarar makantarmu an jaddada ta gaskiyar cewa duk littafin da ya gabata?farayin RCTs akan ciwon kai rashin placebo. Don haka, mun yi imanin cewa sakamakonmu da aka tattauna a ƙasa yana da inganci a daidai matakin da RCT pharmacological [14].

 

Bayanan da ake tsammani sun fi dogara fiye da bayanan da aka dawo da su dangane da ƙiyayyar tunawa; duk da haka, rashin bin bin doka zai iya zama ƙalubale, musamman a ƙarshen binciken. Mun yi imanin yawan hulɗar tsakanin mahalarta da mai binciken, gami da tuntuɓar kowane wata a cikin lokacin biyo baya, mai yiwuwa ya kiyaye babban yarda a duk lokacin bincikenmu.

 

Kodayake samfurin bincikenmu ya ƙare tare da mahalarta 104 a cikin ƙungiyoyin uku, ƙididdigar ƙididdigar wutar lantarki da babban adadin ƙimar da aka samu yana goyan bayan bayanan da aka samu yana da inganci ga yawan mutanen da aka bincika. Ana amfani da hanyar Gonstead ta hanyar 59% na chiropractors [19] kuma, don haka, sakamakon ya zama cikakke ga sana'a. Tabbatar da ganewar asali yana ɗaya daga cikin manyan ƙarfinmu kamar yadda kusan dukkanin mahalartan likitocin ne suka gano su bisa ga ICHD?II [2]. Ya bambanta da RCTs na migraine migraine na baya wanda ya dauki nauyin mahalarta ta hanyar kafofin watsa labaru irin su jaridu da tallace-tallace na rediyo [12], yawancin mahalartanmu an dauki su daga Sashen Neurology, Asibitin Jami'ar Akershus, yana nuna cewa migraineurs na iya samun karin hare-hare / tsanani. Wannan yana da wuyar bi da yawan jama'a, kamar yadda babban aikinsu da / ko aikata likitan ƙwayoyin cuta. Don haka, bincikenmu shine wakilin farko na yawan jama'ar asibitoci, kuma sakamakon zai iya bambanta idan an dauki mahalarta daga yawan jama'a. An gano yawan ciwon wuyan wuyansa a cikin marasa lafiya da migraines [29] kuma, don haka, yawan adadin wadanda ba?

 

Uku pragmatic chiropractic manual?therapy RCTs ta yin amfani da fasaha daban-daban an gudanar da su a baya don migraineurs [12, 30, 31, 32]. Wani RCT na Australiya ya nuna a cikin? Ƙungiya ta raguwa a cikin mitar ƙaura, tsawon lokaci da ƙarfin 40%, 43% da 36%, bi da bi, a watanni 2 bi?up [30]. Wani binciken Amurka ya gano mitar ƙaura da ƙarfi don ragewa cikin rukuni ta 33% da 42%, bi da bi, a bibiyar wata 1 [31]. Wani binciken Ostiraliya, wanda shine kawai RCT don haɗawa da ƙungiyar kulawa, watau duban dan tayi, ya sami raguwa a cikin rukuni na raguwar ƙaura da tsawon lokaci na 35% da 40%, bi da bi, a cikin watanni 2 a cikin ƙungiyar CSMT, idan aka kwatanta da raguwar rukuni na 17% da 20% a cikin rukunin kulawa, bi da bi [32]. Rage raguwa a cikin kwanakin ƙaura ya kasance kama da namu (40%) a cikin ƙungiyar CSMT daga asali zuwa watanni na 3?up, yayin da tsawon lokacin migraine da tsanani ya ragu a cikin watanni 3, watau 21% da 14%, bi da bi. Kwatancen bin dogon lokaci ba zai yuwu ba saboda ba a cikin binciken da ya gabata ya haɗa da isasshen lokacin bibiyar. Tsarin bincikenmu wanda ya haɗa da ingantaccen inganci na ciki yana ba mu damar fassara tasirin da ake gani azaman amsawar placebo.

 

RCT ɗinmu yana da ƙarancin AEs idan aka kwatanta da karatun jagora na baya? Koyaya, ba a isasshe ƙarfin ikon gano manyan AEs ba. A kwatankwacin, AEs a cikin pharmacological migraine prophylactic placebo RCTs sun kasance na kowa ciki har da wadanda ba m da kuma marasa wucewa AEs [33, 34].

 

Kammalawa

 

An ci gaba da makanta da ƙarfi a cikin RCT, AEs sun kasance kaɗan kuma masu laushi, kuma tasirin da ke cikin CSMT da ƙungiyar placebo shine yiwuwar amsawar wuribo. Saboda wasu migraineurs ba su yarda da magani ba saboda AEs ko rashin lafiya, ana iya la'akari da CSMT a cikin yanayi inda wasu zaɓuɓɓukan magani ba su da tasiri ko rashin haƙuri.

 

Bayyana Rigingimun Sha'awa

 

Duk mawallafa sun kammala fom ɗin bayyana rigar Kwamitin Editocin Jarida na Duniya na Likita kuma sun bayyana rashin kuɗi ko wasu rikice-rikice na sha'awa.

 

Goyan bayan Bayanan

 

Ncbi.nlm.nih.gov/pmc/articles/PMC5214068/#ene13166-tbl-0001

 

Godiya

 

Mawallafa suna so su nuna godiya ta gaske ga Asibitin Jami'ar Akershus, wanda ya ba da kyauta ga wuraren bincike, da Chiropractor Clinic 1, Oslo, Norway, wanda ya yi duk nazarin x?ray. Wannan binciken ya sami goyan bayan tallafi daga Extrastiftelsen, Ƙungiyar Chiropractic ta Norwegian, Asibitin Jami'ar Akershus da Jami'ar Oslo a Norway.

 

A ƙarshe, bayyanar cututtuka masu lalacewa na migraines, ciki har da ciwon kai mai tsanani da kuma jin dadi ga haske da sauti da kuma tashin hankali, na iya rinjayar yanayin rayuwar mutum, sa'a, an nuna kulawar chiropractic a matsayin wani zaɓi mai aminci da tasiri don maganin ciwon kai. zafi. Bugu da ƙari kuma, labarin da ke sama ya nuna cewa migraineurs sun sami raguwar bayyanar cututtuka da kwanakin migraine sakamakon sakamakon kulawar chiropractic. Matsakaicin bayanin mu yana iyakance ga chiropractic da kuma raunin da ya faru da kashin baya. Don tattauna batun batun, don Allah jin daɗin tambayar Dr. Jimenez ko tuntuɓe mu a 915-850-0900 .

 

Dr. Alex Jimenez ne ya shirya shi

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Ƙarin Maudu'i: Ciwon Baya

 

Bisa ga kididdigar, kimanin 80% na mutane za su fuskanci alamun ciwon baya a kalla sau ɗaya a duk rayuwarsu. Binciken baya koke ne na gama-gari wanda zai iya haifar da rauni da/ko yanayi iri-iri. Sau da yawa lokuta, lalacewar dabi'a na kashin baya tare da shekaru na iya haifar da ciwon baya. Harsiated fayafai faruwa a lokacin da taushi, gel-kamar cibiyar intervertebral disc ta tura ta cikin hawaye a kewaye da shi, waje zobe na guringuntsi, matsawa da kuma fusatar da jijiya tushen. Abubuwan da aka fi sani da diski suna faruwa tare da ƙananan baya, ko kashin baya na lumbar, amma kuma suna iya faruwa tare da kashin mahaifa, ko wuyansa. Ƙunƙarar jijiyoyi da aka samo a cikin ƙananan baya saboda rauni da / ko mummunan yanayin zai iya haifar da bayyanar cututtuka na sciatica.

 

hoton blog na zane mai ban dariya paperboy babban labarai

 

MAFI MUHIMMAN BUDURWA: �Maganin Ciwon Wuya El Paso, TX Chiropractor

 

 

KARATUN BATUN: EXTRA EXTRA: El Paso, Tx | 'Yan wasa

 

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Rufe Accordion
Ilimin halin dan Adam, Ciwon kai, Ciwon Baya, Ciwo na Zamani da Chiropractic a El Paso, TX

Ilimin halin dan Adam, Ciwon kai, Ciwon Baya, Ciwo na Zamani da Chiropractic a El Paso, TX

by | Back Pain, Chiropractic, kullum Pain, migraine, Gyara jiki, Gwajin Sarrafa Bazuwar, danniya, jiyya

Kowane mutum yana jin zafi lokaci zuwa lokaci. Ciwo shine jin rashin jin daɗi na jiki wanda rauni ko rashin lafiya ya haifar. Lokacin da ka ja tsoka ko yanke yatsa, alal misali, ana aika sigina ta tushen jijiya zuwa kwakwalwa, yana nuna maka cewa wani abu ba daidai ba ne a cikin jiki. Jin zafi na iya bambanta ga kowa da kowa kuma akwai hanyoyi da yawa na ji da kwatanta ciwo. Bayan rauni ko rashin lafiya ya warke, zafin zai ragu, duk da haka, menene zai faru idan ciwon ya ci gaba ko da bayan kun warke?

 

kullum ciwo galibi ana bayyana shi azaman kowane ciwo wanda ya wuce makonni 12. Jin zafi na yau da kullum zai iya kasancewa daga m zuwa mai tsanani kuma zai iya zama sakamakon raunin da ya faru a baya ko tiyata, migraine da ciwon kai, arthritis, lalacewar jijiya, kamuwa da cuta da fibromyalgia. Jin zafi na yau da kullun na iya shafar yanayin tunanin mutum da tunanin mutum, yana sa ya zama da wahala a sauƙaƙe alamun. Nazarin bincike ya nuna cewa maganganun tunani na iya taimakawa tsarin farfadowa na ciwo na kullum. Yawancin masu sana'a na kiwon lafiya, kamar likita na chiropractic, na iya ba da kulawar chiropractic tare da maganganun tunani don taimakawa wajen dawo da lafiyar lafiyar marasa lafiya. Manufar labarin mai zuwa shine don nuna rawar da ke tattare da tunani a cikin kula da marasa lafiya da ciwo mai tsanani, ciki har da ciwon kai da ciwon baya.

 

 

Matsayin Harkokin Ilimin Ilimin Halittu a Gudanar da Marasa lafiya tare da Ciwo na Zamani

 

Abstract

 

Za a iya fahimtar zafi na yau da kullum daga hangen nesa na biopsychosocial ta hanyar da ake kallon zafi a matsayin hadaddun, ƙwarewa mai yawa da ke fitowa daga ma'amala mai ƙarfi na yanayin yanayin yanayin haƙuri, tunani, motsin rai, halaye, da tasirin al'adun zamantakewa. Wani ra'ayi na biopsychosocial yana mayar da hankali kan kallon ciwo na kullum a matsayin rashin lafiya maimakon cuta, don haka sanin cewa yana da kwarewa mai mahimmanci da kuma cewa hanyoyin da za a magance su suna nufin gudanarwa, maimakon magani, na ciwo mai tsanani. Hanyoyin da ake ciki na halin yanzu don kula da ciwo na kullum sun haɗa da ayyukan da ke da nufin cimma nasarar sarrafa kai, canjin hali, da canji na fahimta maimakon kai tsaye kawar da wurin jin zafi. Amfanin haɗawa da jiyya na tunani a cikin hanyoyin da yawa don kula da ciwo mai tsanani sun haɗa da, amma ba'a iyakance su ba, ƙara yawan kulawa da jin zafi, ingantattun hanyoyin magance ciwo, rage raunin da ke da alaka da ciwo, da kuma rage damuwa na zuciya � ingantattu da aka samu. ta hanyar dabarun sarrafa kai iri-iri masu inganci, ɗabi'a, da dabarun fahimi. Ta hanyar aiwatar da waɗannan canje-canje, masu ilimin halayyar ɗan adam na iya taimaka wa marasa lafiya yadda yakamata su ji daɗin kulawa da jin zafi kuma su ba su damar rayuwa ta al'ada kamar yadda zai yiwu duk da ciwo. Bugu da ƙari, ƙwarewar da aka koya ta hanyar shiga tsakani na tunanin mutum yana ƙarfafawa da ba da damar marasa lafiya su zama masu shiga tsakani a cikin kula da rashin lafiyar su da kuma haifar da kwarewa masu mahimmanci waɗanda marasa lafiya za su iya amfani da su a duk rayuwarsu.

 

keywords: Gudanar da ciwo na yau da kullum, ilimin halin dan Adam, maganin jin zafi na multidisciplinary, ilimin halin kirki don jin zafi

 

Dr Jimenez White Coat

Dr. Alex Jimenez's Insight

An riga an ƙaddara zafi na yau da kullum don rinjayar lafiyar tunanin mutum na waɗanda ke da alamun bayyanar cututtuka, a ƙarshe ya canza yanayin tunaninsu da tunanin su gaba ɗaya. Bugu da ƙari, marasa lafiya tare da yanayi masu haɗuwa, ciki har da damuwa, damuwa da damuwa, na iya sa jiyya ya zama kalubale. Matsayin kulawar chiropractic shine don sake dawowa da kuma kula da kuma inganta ainihin asali na kashin baya ta hanyar yin amfani da gyare-gyare na kashin baya da kuma manipulations na hannu. Kulawa na chiropractic yana ba da damar jiki don warkar da kansa ta dabi'a ba tare da buƙatar magunguna / magunguna da kuma aikin tiyata ba, kodayake ana iya kiran su ta hanyar chiropractor idan an buƙata. Duk da haka, kulawar chiropractic yana mayar da hankali ga jiki gaba ɗaya, maimakon a kan rauni guda ɗaya da / ko yanayin da alamunsa. gyare-gyare na kashin baya da manipulations na hannu, a tsakanin sauran hanyoyin jiyya da dabarun da ake amfani da su ta hanyar chiropractor, suna buƙatar wayar da kan mai haƙuri game da tunanin tunanin mutum da tunanin tunanin mutum don samar da su da lafiya da lafiya gaba ɗaya. Marasa lafiya da suka ziyarci asibitina tare da damuwa na zuciya daga ciwo mai tsanani sun fi dacewa su fuskanci matsalolin tunani a sakamakon haka. Sabili da haka, kulawar chiropractic zai iya zama mahimmancin shiga tsakani na tunani don kula da ciwo na kullum, tare da waɗanda aka nuna a kasa.

 

Gabatarwa

 

Ciwo shine kwarewar ɗan adam a ko'ina. An kiyasta cewa kusan 20% ~ 35% na manya suna fama da ciwo mai tsanani. An ambaci zafi a matsayin dalilin farko na neman magani a Amurka.[1,2] Bugu da ƙari, masu rage radadi sune magunguna na biyu da aka fi rubutawa a ofisoshin likitoci da dakunan gaggawa.[3] Bugu da ƙari da ƙarfafa mahimmancin isasshen kima na ciwo, Hukumar Haɗin gwiwa a kan Amincewa da Ƙungiyoyin Kiwon Lafiyar Jama'a sun ba da umarni da ke buƙatar a kimanta ciwo a matsayin alama ta biyar mai mahimmanci a lokacin ziyarar likita.[4]

 

Ƙungiyar Ƙasa ta Duniya don Nazarin Raɗaɗi (IASP) ta bayyana ciwo a matsayin �wani yanayi mara daɗi da jin daɗi da ke da alaƙa da lalacewa ta zahiri ko yuwuwar lalacewar nama, ko kuma aka kwatanta cikin irin wannan lalacewar[7]. Ma'anar IASP tana ba da haske game da nau'in nau'i-nau'i da nau'i na jin zafi, ƙwarewa mai mahimmanci wanda ke da mahimmanci ga kowane mutum. Ciwo na yau da kullun yana bambanta da matsananciyar zafi dangane da tsawon lokaci ko tsayin daka, hanyoyin kiyaye lafiyar jiki, da/ko tasirin sa akan rayuwar mutum. Gabaɗaya, an yarda cewa ciwon da ya ci gaba fiye da lokacin da aka sa ran don warkar da nama bayan rauni ko tiyata ana la'akari da ciwo mai tsanani. Koyaya, ƙayyadaddun ƙayyadaddun lokacin da ke ƙunshe da lokacin warkarwa da ake tsammanin yana canzawa kuma galibi yana da wahala a tantancewa. Don sauƙi na rarrabuwa, wasu jagororin suna ba da shawarar cewa ciwon da ke ci gaba da kasancewa bayan taga lokaci na wata 3�6 ana ɗaukar ciwo mai tsanani.[7] Duk da haka, rarrabuwa na ciwo bisa tsawon lokaci kawai aiki ne mai mahimmanci kuma, a wasu lokuta, ma'auni na sabani. Fiye da yawa, ƙarin abubuwa irin su etiology, tsananin zafi, da tasiri ana la'akari da su tare da tsawon lokaci lokacin rarraba ciwo mai tsanani. Wata hanyar da za a iya kwatanta ciwo na yau da kullum ya dogara ne akan tsarin kula da ilimin lissafi; wato, ciwon da ake tunanin zai iya fitowa a sakamakon gyara na gefe da na tsakiya. Yanayin zafi na yau da kullum sun hada da cututtuka na musculoskeletal, yanayin ciwon neuropathic, ciwon kai, ciwon daji, da ciwon visceral. Fiye da yawa, yanayin zafi na iya zama da farko nociceptive (samar da inji ko ciwon sinadarai), neuropathic (sakamakon lalacewar jijiya), ko tsakiya (sakamakon rashin aiki a cikin ƙananan ƙwayoyin cuta na tsarin kulawa na tsakiya).[8]

 

Abin takaici, ƙwarewar ciwo akai-akai ana nuna shi ta hanyar rashin lafiyar jiki, tunani, zamantakewa, da kuma kudi. An gane ciwo na yau da kullum a matsayin babban dalilin rashin nakasa na dogon lokaci a cikin yawan jama'ar Amirka.[9] Saboda ciwo mai tsanani yana shafar mutum a wurare da yawa na kasancewarsa kuma ya zama babban nauyin kudi ga al'ummarmu. Haɗaɗɗen farashin kai tsaye da kai tsaye na ciwo an kiyasta su kasance daga dala biliyan 125 zuwa dala biliyan 215, kowace shekara. karuwar yawan nakasa da ke da alaka da ciwo, gyare-gyaren da ke da alaka da ciwo a cikin cognition, da kuma rage yawan rayuwa. Don haka, za a iya fahimtar ciwo na yau da kullum daga hangen nesa na biopsychosocial ta hanyar da ake kallon ciwo a matsayin hadaddun, ƙwarewa mai yawa da ke fitowa daga ma'amala mai ƙarfi na yanayin yanayin yanayin haƙuri, tunani, motsin rai, halaye, da tasirin al'adun zamantakewa.

 

Pain Management

 

Idan aka ba da yaduwar ciwon zafi da yanayinsa mai yawa, tsarin kula da ciwo mai kyau zai zama cikakke, haɗin kai, da kuma tsaka-tsaki. Hanyoyin da ake amfani da su na yau da kullum don kula da ciwo na kullum sun kara karuwa da raguwa da kuma tsarin aikin tiyata, jiki, ko magungunan magani. Hanyoyi na yau da kullum sun gane darajar tsarin tsarin kulawa da yawa wanda ke yin hari ba kawai abubuwan nociceptive na ciwo ba amma har ma da fahimi-ƙimantawa, da kuma abubuwan da suka dace da motsa jiki tare da daidai da rashin jin daɗi da tasiri. Gudanar da tsaka-tsakin tsaka-tsaki na ciwo mai tsanani yawanci ya haɗa da jiyya na multimodal kamar haɗuwa da analgesics, jiyya na jiki, ilimin halin mutum, da kuma ilimin halin mutum. Hanyar multimodal ta fi dacewa da kuma cikakkiyar magana game da kula da ciwo a cikin kwayoyin halitta, hali, fahimta-tasiri, da matakan aiki. An nuna waɗannan hanyoyin da za su haifar da mafi girma da kuma dogon lokaci na ainihi da kuma sakamako na haƙiƙa ciki har da rahotanni na ciwo, yanayi, maido da aikin yau da kullum, matsayi na aiki, da magani ko amfani da kiwon lafiya; Hanyoyin multimodal kuma an nuna su sun fi tsada fiye da hanyoyin unimodal.[12,13] Mayar da hankali na wannan bita zai kasance musamman akan bayyana fa'idodin ilimin halin dan Adam a cikin kula da ciwo mai tsanani.

 

Dr. Jimenez yana yin aikin jiyya na jiki akan mai haƙuri.

 

Da farko majiyyata za su fara gabatar da su ga ofishin likita don neman magani ko jinyar ciwon su. Ga marasa lafiya da yawa, dangane da ilimin cututtuka da ilimin cututtuka na ciwon su tare da tasirin biopsychosocial akan jin zafi, ciwo mai tsanani zai warware tare da wucewar lokaci, ko bin hanyoyin da aka yi amfani da su don ƙaddamar da abin da ake tsammani na ciwo ko watsawa. Duk da haka, wasu marasa lafiya ba za su cimma matsaya game da ciwon su ba duk da yawancin magungunan likita da haɗin kai kuma za su canza daga yanayin ciwo mai tsanani zuwa yanayin ciwo mai tsanani, mai tsanani. Alal misali, bincike ya nuna cewa kimanin 30% na marasa lafiya da ke gabatarwa ga likitan su na farko don gunaguni da suka shafi ciwon baya mai tsanani za su ci gaba da jin zafi kuma, ga wasu da yawa, ƙayyadaddun ayyuka masu tsanani da wahala watanni 12 daga baya.[14]. Yayin da ciwo da sakamakonsa ke ci gaba da tasowa da kuma bayyana a cikin bangarori daban-daban na rayuwa, ciwo mai tsanani zai iya zama matsala ta farko ta biopsychosocial, wanda yawancin al'amuran biopsychosocial zasu iya ci gaba da ci gaba da ci gaba da ciwo, don haka ci gaba da mummunar tasiri ga rayuwar mutum. A wannan lokaci ne tsarin tsarin jiyya na asali zai iya bambanta don haɗawa da sauran kayan aikin warkewa, ciki har da hanyoyin tunani don kula da ciwo.

 

Hanyoyi na ilimin halin dan adam don kula da ciwo mai tsanani da farko sun sami shahara a ƙarshen 1960 tare da bayyanar Melzack da Wall�s ka'idar kula da ƙofa na zafi[15] da ka'idar neuromatrix na gaba.[16] A taƙaice, waɗannan ka'idodin sun nuna cewa tsarin ilimin zamantakewa da ilimin lissafi yana hulɗa da su don rinjayar fahimta, watsawa, da kimantawa na ciwo, kuma sun gane tasirin waɗannan matakai a matsayin abubuwan kiyayewa da ke cikin jihohi na ciwo mai tsanani ko na tsawon lokaci. Wato, waɗannan ra'ayoyin sun kasance masu haɓakawa don ƙaddamar da canji a cikin tsari mai mahimmanci da haɗin kai don maganin ciwo, wanda ya mamaye ainihin yanayin nazarin halittu. Ma'aikatan asibiti da marasa lafiya sun sami karuwa da kuma godiya ga rikitarwa na sarrafa ciwo da kulawa; sabili da haka, an kafa yarda da fifiko don ra'ayi mai yawa na ciwo. A halin yanzu, samfurin biopsychosocial na ciwo shine, watakila, mafi yawan yarda da tsarin heuristic don fahimtar ciwo.[17] Wani ra'ayi na biopsychosocial yana mayar da hankali kan kallon ciwo mai tsanani a matsayin rashin lafiya maimakon cuta, don haka sanin cewa yana da kwarewa na ainihi da kuma cewa hanyoyin da za a magance su suna nufin gudanarwa, maimakon magani, na ciwo mai tsanani.[17]. Kamar yadda amfani da fa'ida mafi fa'ida kuma mafi mahimmanci ga kula da ciwo na yau da kullun ya zama bayyananne, abubuwan da suka shafi tunanin mutum sun shaida haɓakar haɓakar shaharar da kuma yarda da su azaman jiyya. Nau'o'in ayyukan tunani da aka yi amfani da su a matsayin wani ɓangare na shirin kula da ciwo mai yawa ya bambanta bisa ga tsarin ilimin likitanci, ilimin jin zafi, da halayen haƙuri. Hakazalika, bincike game da tasiri na abubuwan da suka shafi tunanin mutum don ciwo na kullum ya nuna m, ko da yake alƙawarin, sakamakon da aka yi a kan mahimman abubuwan da aka yi nazari. Wannan bayyani zai ɗan bayyana zaɓuɓɓukan jiyya da aka yi amfani da su akai-akai da tasirin su akan mahimman sakamako.

 

Hanyoyin da ake ciki na halin yanzu don kula da ciwo mai tsanani sun haɗa da ayyukan da ke da nufin cimma nasarar sarrafa kai, canjin hali, da canji na fahimta maimakon kai tsaye kawar da wurin jin zafi. Don haka, suna yin la'akari da halayen halayen da ba a kula da su akai-akai, motsin rai, da fahimi na ciwo na yau da kullun da abubuwan da ke ba da gudummawa ga kiyaye shi. An sanar da shi ta tsarin da Hoffman et al[18] da Kerns et al suka bayar, [19] ana yin nazari akai-akai akai-akai ana yin amfani da yankunan jiyya na tushen tunani: dabarun ilimin halin dan Adam, hanyoyin halayyar jiyya, farfagandar halayen halayen, da kuma shigar da tushen yarda.

 

Dabarun Ilimin Halitta

 

Biofeedback

 

Biofeedback fasaha ce ta koyo ta hanyar da majiyyata ke koyon fassara ra'ayi (a cikin nau'in bayanan ilimin lissafi) game da wasu ayyukan ilimin lissafi. Misali, majiyyaci na iya amfani da kayan aikin biofeedback don koyan gane wuraren tashin hankali a jikinsu sannan kuma ya koyi shaƙata waɗancan wuraren don rage tashin hankali na tsoka. Ana ba da amsa ta kayan aikin auna iri-iri waɗanda zasu iya ba da bayanai game da ayyukan lantarki na kwakwalwa, hawan jini, kwararar jini, sautin tsoka, aikin lantarki, bugun zuciya, da zafin fata, tsakanin sauran ayyukan ilimin lissafi cikin sauri. Manufar hanyoyin biofeedback shine majiyyaci ya koyi yadda za a fara aiwatar da tsarin sarrafa kansa ta hanyar samun iko na son rai akan wasu martanin ilimin lissafin jiki don haɓaka sassaucin ilimin lissafi ta hanyar ƙarin sani da takamaiman horo. Don haka majiyyaci zai yi amfani da ƙayyadaddun ƙwarewar sarrafa kansa a cikin ƙoƙari na rage abin da ba a so (misali, zafi) ko halayen halayen ilimin lissafi marasa kyau ga wani abin da ba a so (misali, amsa damuwa). Yawancin masana ilimin halayyar dan adam an horar da su a dabarun biofeedback kuma suna ba da waɗannan ayyuka azaman ɓangaren jiyya. An ayyana Biofeedback a matsayin ingantaccen magani don jin zafi da ke hade da ciwon kai da rikice-rikice na ɗan lokaci (TMD).[20] Wani bincike-bincike na binciken 55 ya nuna cewa ayyukan biofeedback (ciki har da nau'o'in biofeedback daban-daban) ya haifar da ci gaba mai mahimmanci game da yawan hare-haren migraine da kuma fahimtar yadda ake gudanar da ciwon kai da kai idan aka kwatanta da yanayin sarrafawa.[21] Nazarin ya ba da goyon baya mai ma'ana don biofeedback don TMD, kodayake ƙarin ingantaccen haɓakawa game da ciwo da nakasa da ke da alaƙa an samo su don ka'idoji waɗanda ke haɗa biofeedback tare da horar da ƙwarewar halayyar fahimta, a ƙarƙashin tsammanin cewa tsarin haɗin gwiwar haɗin gwiwa yana magance gamut sosai. na matsalolin biopsychosocial da za a iya fuskanta a sakamakon TMD.[22]

 

Hanyoyi na Halaye

 

Horon shakatawa

 

An yarda da shi gabaɗaya cewa damuwa shine muhimmin mahimmancin da ke tattare da haɓakawa da kuma kula da ciwo mai tsanani. Mayar da hankali na horar da shakatawa shine don rage matakan tashin hankali (na jiki da tunani) ta hanyar kunna tsarin juyayi na parasympathetic kuma ta hanyar samun fahimtar mafi girma game da ilimin lissafin jiki da kuma yanayin tunani, don haka samun raguwa a cikin ciwo da kuma ƙara iko akan ciwo. Ana iya koya wa marasa lafiya dabarun shakatawa da yawa kuma a yi su a ɗaiɗaiku ko a haɗin gwiwa tare da juna, da kuma abubuwan haɗin gwiwa zuwa wasu dabaru da dabarun kula da jin zafi. Wadannan su ne taƙaitaccen bayanin dabarun shakatawa da masana ilimin halayyar dan adam ke koyar da su a cikin kula da ciwo mai tsanani.

 

Diaphragmatic numfashi. Numfashin diaphragmatic wata hanya ce ta shakatawa ta asali inda aka umurci marasa lafiya da su yi amfani da tsokoki na diaphragm sabanin tsokar ƙirjin su don yin aikin motsa jiki mai zurfi. Numfasawa ta hanyar ɗaukar diaphragm yana ba huhu damar faɗaɗa ƙasa (alama ta faɗaɗa cikin ciki yayin shaƙa) don haka ƙara yawan iskar oxygen.[24]

 

Progressive tsoka shakatawa (PMR). PMR yana da alaƙa ta hanyar shiga cikin haɗuwa da tashin hankali na tsoka da motsa jiki na musamman na tsoka ko ƙungiyoyin tsoka a cikin jiki.[25] An umurci majiyyaci da yawa don shiga cikin motsa jiki / shakatawa a cikin layi daya har sai an magance duk sassan jiki.

 

Autogenic horo (AT). AT wata dabara ce ta shakatawa mai sarrafa kansa wacce majiyyaci ke maimaita jumla tare da hangen nesa don haifar da yanayin shakatawa.

 

Kallon gani/Hoto mai jagora. Wannan dabarar tana ƙarfafa marasa lafiya su yi amfani da dukkan hankulansu wajen yin tunanin yanayi mai haske, kwanciyar hankali, da aminci don cimma ma'anar annashuwa da shagaltuwa daga raɗaɗin raɗaɗi da tunani da jin zafi.[27]

 

Gabaɗaya, an gano fasahohin shakatawa gabaɗaya suna da fa'ida a cikin sarrafa nau'ikan nau'ikan nau'ikan yanayin zafi mai ƙarfi da na yau da kullun da kuma kula da mahimman abubuwan jin zafi (misali, ingancin rayuwa mai alaƙa da lafiya).[28�31] ] Yawancin fasaha na shakatawa ana yin su tare da sauran hanyoyin kula da ciwo, kuma akwai babban rikici a cikin hanyoyin da ake zaton na shakatawa da biofeedback, alal misali.

 

Aiki Halayen Therapy

 

Maganin halayyar aiki don ciwo mai tsanani yana jagorancin ka'idodin gyaran gyare-gyare na asali na Skinner [32] da kuma mai ladabi ta Fordyce [33] don dacewa da kula da ciwo. Babban ka'idoji na tsarin gyaran gyare-gyare na aiki kamar yadda yake da alaka da jin zafi yana riƙe da cewa halin jin zafi zai iya tasowa a ƙarshe kuma a kiyaye shi azaman bayyanar cututtuka na ciwo mai tsanani sakamakon sakamako mai kyau ko mara kyau na ƙarfafa halin da aka ba da ciwo da kuma azabtar da ƙarin daidaitawa, ba tare da izini ba. -ciwo hali. Idan ƙarfafawa da sakamakon da ya biyo baya ya faru tare da isasshen mita, za su iya yin aiki don daidaita halin, don haka ƙara yiwuwar maimaita halin a gaba. Don haka, halayen sharadi suna faruwa azaman samfurin koyan sakamakon (ainihin ko tsammanin) shiga cikin halin da aka bayar. Misalin hali shine ci gaba da amfani da magani � dabi'ar da ta samo asali daga koyo ta hanyar ƙungiyoyi masu maimaitawa cewa shan magani yana biye da kawar da abin sha'awa (zafi). Hakazalika, halayen ciwo (misali, maganganun maganganu na ciwo, ƙananan matakan aiki) na iya zama halayen halayen da ke aiki don ci gaba da ciwo mai tsanani da kuma abubuwan da ke faruwa. Jiyya waɗanda ke ƙarƙashin ƙa'idodin ɗabi'a na aiki suna nufin kashe halayen ɓacin rai ta hanyar ƙa'idodin koyo waɗanda ƙila an kafa su. Gabaɗaya, sassan jiyya na jiyya mai aiki sun haɗa da kunnawa mai ƙima, jadawalin lokaci na magani, da kuma amfani da ƙa'idodin ƙarfafawa don haɓaka ɗabi'a mai kyau da rage halayen raɗaɗi mara kyau.

 

Kunna darajar darajar. Masanan ilimin kimiyya na iya aiwatar da shirye-shiryen ayyuka masu daraja ga marasa lafiya masu fama da ciwo mai tsanani waɗanda suka rage yawan matakan ayyukan su (ƙaramar yiwuwar lalata jiki) kuma daga bisani sun fuskanci matsanancin zafi a kan yin aiki. An umurci marasa lafiya da su karya zagayowar rashin aiki da yankewa cikin aminci ta hanyar yin aiki cikin tsari da iyakataccen lokaci. Ta wannan hanyar, marasa lafiya na iya ƙara tsawon lokaci da ƙarfin aiki a hankali don inganta aiki. Masanan ilimin kimiyya zasu iya kula da ci gaba da kuma samar da ƙarfafawa mai dacewa don yarda, gyaran gyare-gyare na rashin fahimta ko rashin fahimta na ciwo da ke haifar da aiki, inda ya dace, da kuma magance matsalolin matsalolin da za a bi. Wannan tsarin yawanci yana haɗawa a cikin jiyya na kula da jin zafi na fahimi.

 

Jadawalin magunguna na lokaci-lokaci. Masanin ilimin halayyar dan adam zai iya zama mai bada sabis na kiwon lafiya mai mahimmanci a kula da kula da magungunan ciwo. A wasu lokuta, masu ilimin halin dan Adam suna da damar da za su iya yin hulɗa tare da marasa lafiya akai-akai da zurfi fiye da likitoci kuma don haka zasu iya zama masu haɗin gwiwa masu mahimmanci na tsarin kulawa na multidisciplinary. Masanan ilimin halayyar dan adam na iya kafa jadawalin magunguna na lokaci-lokaci don rage yuwuwar dogaro ga magungunan jin zafi don samun isasshen iko akan zafi. Bugu da ƙari kuma, masu ilimin halin ɗan adam suna da ingantattun shirye-shiryen shiga marasa lafiya a cikin tattaunawa mai mahimmanci game da mahimmancin riko da kyau ga magunguna da shawarwarin likita da magance matsalolin da aka tsinkaya don kiyaye aminci.

 

Guji tsoro. Samfurin guje wa jin tsoro na ciwo mai tsanani shine heuristic da aka fi amfani da shi akai-akai a cikin mahallin ƙananan ciwon baya (LBP).[34] Wannan samfurin ya zana da yawa daga ƙa'idodin ɗabi'a masu aiki da aka kwatanta a baya. Ainihin, samfurin guje wa tsoro yana nuna cewa lokacin da aka yi wa jihohi ciwo mai tsanani akai-akai a matsayin alamun haɗari ko alamun rauni mai tsanani, marasa lafiya na iya fuskantar haɗarin shiga cikin halayen gujewa da tsoro da kuma fahimtar da ke kara ƙarfafa imani cewa zafi shine siginar haɗari da ci gaba da lalatawar jiki. Yayin da zagayowar ta ci gaba, nisantar na iya zama gama gari zuwa nau'ikan ayyuka da yawa kuma ya haifar da farfaɗowar ji na zahiri da ke tattare da kuskuren fassarorin bala'i na ji na zahiri. Bincike ya nuna cewa babban mataki na bala'in ciwo yana hade da kiyaye sake zagayowar.[35] Magani da nufin karya zagayowar gujewa tsoro suna amfani da tsarin bayyanuwa ga al'amuran tsoro don tabbatar da abin tsoro, galibin bala'i, sakamakon shiga ayyukan. Mahimman bayanai yawanci ana ƙara haɓakawa tare da ilimin halayyar ɗan adam game da ciwo da abubuwan gyare-gyaren fahimi waɗanda ke da alaƙa da fahimi marasa ƙarfi da tsammanin game da aiki da zafi. Masanan ilimin halayyar dan adam suna cikin kyakkyawan matsayi don aiwatar da waɗannan nau'ikan tsoma baki waɗanda ke kwaikwayi jiyya da aka saba amfani da su a al'ada wajen magance wasu matsalolin tashin hankali.

 

Ko da yake an nuna ƙayyadaddun jiyya na bayyanar da ƙima don yin tasiri a cikin jiyya na nau'in ciwon ciwo na yanki mai rikitarwa I (CRPS-1) [36] da LBP [37] a cikin ƙira guda ɗaya, babban gwaji mai sarrafawa wanda ya fi girma wanda ya kwatanta daidaitaccen tsari. jiyya na bayyanar cututtuka da aka haɗa tare da tsarin jin zafi na multidisciplinary magani tare da shirye-shiryen jin zafi na multidisciplinary kawai kuma tare da ƙungiyar kula da jerin jirage sun gano cewa jiyya guda biyu masu aiki sun haifar da gagarumin ci gaba a kan matakan sakamako na ciwo mai tsanani, tsoron motsi / rauni, jin zafi mai tasiri, bakin ciki, da matakin aiki[38]. Sakamako daga wannan gwaji ya nuna cewa duka ayyukan biyu suna da alaƙa da tasiri mai mahimmanci kamar yadda maganin bayyanar da darajar ba ya bayyana ya haifar da ƙarin ribar jiyya ba.[38] Bayanan kulawa a cikin fassarar waɗannan sakamakon ya nuna cewa gwajin gwagwarmayar da aka bazu (RCT) ya haɗa da nau'o'in nau'i na ciwo mai tsanani wanda ya wuce LBP da CRPS-1 kuma ba kawai ya haɗa da marasa lafiya tare da manyan matakan jin tsoro na jin zafi ba; Har ila yau, an ba da shisshigin a cikin tsarin rukuni maimakon nau'i na mutum ɗaya. Ko da yake in-vivo jiyya sun fi girma a rage raɗaɗin bala'i da kuma hasashe na cutarwa na ayyuka, jiyya na fallasa da alama suna da tasiri kamar yadda aka ƙididdige ayyukan ayyukan inganta nakasa aiki da manyan gunaguni.[39] Wani gwaji na asibiti idan aka kwatanta da tasiri na rarrabuwa na tushen jiyya (TBC) jiyya na jiki kadai zuwa TBC wanda aka haɓaka tare da aikin da aka ƙididdigewa ko bayyanar da darajar ga marasa lafiya tare da LBP mai tsanani da ƙananan ƙananan.[40]. Sakamakon ya nuna cewa babu bambance-bambance a cikin sakamakon 4-mako da 6-watanni don rage nakasa, tsananin zafi, ciwo mai zafi, da kuma rashin lafiyar jiki a tsakanin kungiyoyin jiyya, kodayake bayyanar da darajar da TBC ya haifar da raguwa mafi girma a cikin gaskatawar tsoron tsoro a watanni 6. [40] Abubuwan da aka samo daga wannan gwaji na asibiti sun nuna cewa inganta TBC tare da aikin da aka yi da ma'auni ko ƙaddamarwa ba zai haifar da ingantaccen sakamako ba game da matakan da ke hade da ci gaban LBP na yau da kullum fiye da ingantawa da aka samu tare da TBC kadai.[40].

 

Hanyoyi na Fahimta-Halayyar Hannu

 

Rashin daidaituwa na halayyar kwamfuta (CBT) ayyukan shiga na zamani suna amfani da canje-canjen masu daidaitawa a halayyar marasa lafiya, da fifiko ko kimantawa, da motsin rai, da motsin rai. Waɗannan ayyukan gabaɗaya sun ƙunshi ilimin ilimin halayyar ɗan adam game da ciwo da ciwon ciwo na musamman na majiyyaci, abubuwan ɗabi'a da yawa, horar da dabarun shawo kan matsalolin, hanyoyin warware matsalolin, da ɓangaren sake fasalin fahimi, kodayake ainihin abubuwan jiyya sun bambanta bisa ga likitan. Abubuwan halayen halayen na iya haɗawa da ƙwarewar shakatawa iri-iri (kamar yadda aka yi nazari a cikin sashin hanyoyin ɗabi'a), umarnin motsa jiki / kunnawa mai daraja, dabarun kunna ɗabi'a, da haɓaka haɓakar motsa jiki na jiki idan akwai gagarumin tarihin gujewa ayyuka da ƙaddamarwa na gaba. Babban makasudin tunkarar horon ƙwarewa shine gano dabarun shawo kan matsalolin halin yanzu (misali, bala'i, gujewa) waɗanda majiyyaci ke shiga ciki tare da amfani da dabarun shawo kan su (misali, amfani da ingantattun maganganun kai, goyon bayan zamantakewa). A matsayin bayanin kula, matakin da dabarun ke daidaitawa ko rashin daidaituwa da kuma fahimtar tasirin takamaiman dabarun magance ya bambanta daga mutum zuwa mutum.[41] A duk lokacin jiyya, ana amfani da dabarun magance matsalolin don taimaka wa marasa lafiya a ƙoƙarin da suke yi da kuma taimaka musu su ƙara ƙarfin kansu. Sake fasalin fahimi ya haɗa da sanin fahimi mara kyau na halin yanzu da majiyyaci ke shiga ciki, ƙalubalantar fahimi mara kyau da aka gano, da sake fasalin tunani don samar da daidaitattun tunani, madadin tunani. Ta hanyar motsa jiki na sake fasalin tunani, marasa lafiya suna ƙara haɓaka fahimtar yadda motsin zuciyar su, fahimta, da fassarorin ke daidaita ciwon su a cikin hanyoyi masu kyau da mara kyau. A sakamakon haka, ana tsammanin cewa marasa lafiya za su sami fahimtar kulawa da jin zafi, mafi kyawun iya sarrafa halinsu da tunanin su yayin da suke da alaka da ciwo, kuma su iya daidaitawa da ma'anar da suke ba da jin zafi. . Ƙarin abubuwan da aka haɗa wani lokaci a cikin sa baki na CBT sun haɗa da horar da ƙwarewar zamantakewa, horar da sadarwa, da kuma faffadar hanyoyin sarrafa damuwa. Ta hanyar shiga tsakani na CBT mai raɗaɗi, yawancin marasa lafiya suna samun fa'ida daga haɓakawa game da jin daɗin tunanin su da aikin su, kuma a ƙarshe fahimtar yanayin rayuwarsu mai alaƙa da lafiya.

 

Dr. Alex Jimenez yana shiga cikin motsa jiki da motsa jiki.

 

Ana ba da ayyukan CBT a cikin yanayi mai tallafi da tausayi wanda ke ƙoƙarin fahimtar ciwon mai haƙuri daga hangen nesa na biopsychosocial kuma a cikin hanyar haɗin gwiwa. Masu ilimin hanyoyin kwantar da hankali suna ganin matsayinsu na malamai ko �masu koyarwa� kuma saƙon da ake isar wa majiyyata shi ne na koyon yadda za su iya sarrafa radadin da suke ciki da inganta ayyukansu na yau da kullum da ingancin rayuwarsu sabanin nufin warkarwa ko kawar da ciwon. Babban makasudin shine ƙara majiyyata� fahimtar zafin su da ƙoƙarin da suke yi na sarrafa ciwo da abubuwan da ke biyo bayan sa cikin aminci da daidaitawa; sabili da haka, koyar da marasa lafiya don kula da kansu, tunaninsu, da motsin zuciyar su shine wani abu mai mahimmanci na jiyya da kuma dabarun da ke da amfani don haɓaka haɓakar kai. Bugu da ƙari, mai ilimin hanyoyin kwantar da hankali yana ƙoƙarin haɓaka kyakkyawan fata, tabbatacce, da yanayi mai ƙarfafawa wanda majiyyaci zai iya ƙara ƙwarewa wajen ganewa da koyo daga nasarorin da suka samu da koyo daga da ingantawa akan yunƙurin da ba su yi nasara ba. Ta wannan hanyar, masu ilimin hanyoyin kwantar da hankali da marasa lafiya suna aiki tare don gano nasarorin haƙuri, matsalolin da za a bi, da kuma haɓaka tsare-tsaren tsare-tsare da sake dawowa a cikin yanayi mai mahimmanci, haɗin kai, da amintacce. Wani fasali mai ban sha'awa na tsarin halayyar tunani shine amincewa da majiyyaci a matsayin mai shiga tsakani na gyaran ciwo ko shirin gudanarwa.

 

Bincike ya gano CBT ya zama magani mai mahimmanci don ciwo mai tsanani da kuma abubuwan da ke biyo baya kamar yadda aka yi la'akari da canje-canje masu mahimmanci a cikin yankuna daban-daban (watau matakan jin zafi, yanayi / tasiri, daidaitawa da ƙima da ƙima, halayyar ciwo da matakin aiki, da kuma aikin zamantakewar zamantakewa. ) idan aka kwatanta da yanayin kula da lissafin jira[42]. Lokacin da aka kwatanta da sauran jiyya masu aiki ko yanayin sarrafawa, CBT ya haifar da ingantaccen haɓaka, ko da yake ƙananan sakamako (girman sakamako ~ 0.50), game da jin zafi, juriya da ƙima, da aikin zamantakewa.[42] Wani ƙarin bincike-bincike na kwanan nan na binciken 52 da aka buga idan aka kwatanta da yanayin farfaɗo (BT) da CBT akan jiyya kamar yanayin sarrafawa na yau da kullun da yanayin kulawa mai aiki a lokuta daban-daban.[43] Wannan meta-bincike ya kammala cewa bayanan su ba su ba da tallafi ga BT ba fiye da ingantawa a cikin jin zafi nan da nan bayan jiyya idan aka kwatanta da jiyya kamar yadda yanayin sarrafawa na yau da kullum.[43] Game da CBT, sun yanke shawarar cewa CBT yana da iyakacin tasiri mai kyau don rashin ciwo, da yanayi; duk da haka, akwai rashin isassun bayanai don bincika takamaiman tasirin abun cikin jiyya akan sakamakon da aka zaɓa.[43] Gabaɗaya, ya bayyana cewa CBT da BT sune hanyoyin magancewa masu tasiri don inganta yanayi; sakamakon da ya kasance mai ƙarfi a wuraren bayanan biyo baya. Duk da haka, kamar yadda aka nuna ta hanyar bita da yawa da nazarin meta-bincike, wani muhimmin mahimmanci don yin la'akari da yin la'akari da tasiri na CBT don kula da ciwo mai tsanani yana dogara ne akan al'amurran da suka shafi isarwa mai mahimmanci, rashin kayan aikin jiyya na yau da kullum, bambance-bambance a cikin bayarwa a fadin likitoci da magani. yawan jama'a, da kuma sauye-sauye a cikin sauye-sauyen sakamako na sha'awa a cikin gwaje-gwajen bincike.[13] Ƙarin rikitarwa fassarar binciken tasiri shine halaye masu haƙuri da ƙarin masu canji waɗanda zasu iya rinjayar sakamakon magani da kansa.

 

Hanyoyi bisa Yarda

 

Hanyoyi na tushen yarda akai-akai ana gano su azaman hanyoyin kwantar da hankali-halayen raƙuman ruwa na uku. Yarda da jiyya na sadaukarwa (ACT) shine mafi yawan na yau da kullun na tushen yarda da ilimin halin dan adam. ACT yana jaddada mahimmancin sauƙaƙe ci gaban abokin ciniki don samun rayuwa mai ƙima da cikar rayuwa ta hanyar haɓaka sassaucin ra'ayi maimakon mayar da hankali sosai kan sake fasalin fahimi.[44] A cikin mahallin ciwo na kullum, ACT yana ƙaddamar da dabarun sarrafawa marasa tasiri da kuma guje wa kwarewa ta hanyar haɓaka dabarun da ke kafa sassaucin ra'ayi. Mahimman matakai guda shida na ACT sun haɗa da: yarda, rashin fahimta, kasancewa, kai a matsayin mahallin, dabi'u, da aiwatar da ayyuka.[45] A taƙaice, karɓa yana ƙarfafa marasa lafiya masu fama da ciwo mai tsanani don yin raƙuman raɗaɗi da jin zafi da abubuwan da suka biyo baya maimakon ƙoƙarin canza shi, ta yin haka yana ƙarfafa majiyyaci don dakatar da yakin da ba shi da amfani wanda aka tsara don kawar da ciwon su. Ana amfani da dabarun rugujewar fahimta (deliteralization) don gyara aikin tunani maimakon rage yawan su ko sake fasalin abun cikin su. Ta wannan hanyar, rashin fahimta na iya canza ma'ana ko aiki mara kyau na tunani mara kyau kuma don haka rage abin da aka makala da martanin motsin rai da hali na gaba ga irin waɗannan tunanin. Babban tsari na kasancewa yana jaddada hulɗar da ba ta yanke hukunci ba tsakanin tunanin kai da na sirri da abubuwan da suka faru. Ana amfani da dabi'u azaman jagora don zabar ɗabi'a da fassarorin da ke da alaƙa da waɗannan dabi'un da mutum ke ƙoƙarin aiwatarwa a rayuwar yau da kullun. A ƙarshe, ta hanyar aiwatar da ayyuka, marasa lafiya na iya gane sauye-sauyen ɗabi'a masu dacewa da ƙimar mutum ɗaya. Don haka, ACT tana amfani da mahimman ka'idoji guda shida tare da haɗin gwiwa tare da juna don ɗaukar cikakkiyar hanya don haɓaka sassaucin tunani da rage wahala. Ana ƙarfafa marasa lafiya su kalli ciwo a matsayin makawa kuma su yarda da shi a cikin hanyar da ba ta dace ba don su ci gaba da samun ma'ana daga rayuwa duk da kasancewar ciwo. Mahimman hanyoyin da ke da alaƙa suna misalta tunani da hanyoyin karɓuwa da sadaukarwa da aiwatar da canjin hali.[45]

 

Sakamakon bincike game da tasiri na hanyoyin da ake amfani da su na ACT don kula da ciwo na kullum yana da alamar alkawari, kodayake har yanzu yana ba da tabbacin ƙarin ƙima. A RCT kwatanta ACT tare da yanayin kula da jirage ya ba da rahoton ci gaba mai mahimmanci a cikin bala'in ciwo, nakasa da ke da alaka da ciwo, gamsuwar rayuwa, tsoron motsi, da damuwa na tunanin mutum wanda aka kiyaye a cikin watanni na 7.[46]. Gwajin da ya fi girma ya ba da rahoton ci gaba mai mahimmanci don ciwo, damuwa, damuwa da ke da alaka da jin zafi, rashin lafiya, ziyarar likita, matsayi na aiki, da aikin jiki.[47] Wani bincike-bincike na baya-bayan nan wanda ke kimanta abubuwan da aka yarda da su (ACT da rage yawan damuwa na hankali) a cikin marasa lafiya da ciwo mai tsanani sun gano cewa, a gaba ɗaya, hanyoyin da aka yarda da su suna haifar da sakamako mai kyau ga marasa lafiya da ciwo mai tsanani.[48] Musamman, ƙididdigar meta-bincike ya nuna ƙananan ƙananan sakamako masu girma don tsananin zafi, damuwa, damuwa, jin dadin jiki, da kuma rayuwa mai kyau, tare da ƙananan tasirin da aka samu lokacin da aka cire gwajin gwaji na asibiti kuma kawai RCTs sun haɗa a cikin nazarin.[48]. Sauran hanyoyin da aka yarda da su sun haɗa da yanayin haɓaka-halayen halayen yanayi da kuma tsarin kulawa da hankali, kodayake bincike mai zurfi game da tasirin waɗannan hanyoyin kwantar da hankali don kula da ciwo mai tsanani har yanzu yana cikin jariri.

 

tsammanin

 

Wani muhimmin abu mai mahimmanci kuma wanda ba a manta da shi na gama gari na duk hanyoyin magani shine la'akari da tsammanin majiyyaci don samun nasarar jiyya. Duk da ci gaba da yawa a cikin ƙirƙira da isar da ingantattun jiyya na multidisciplinary don ciwo mai tsanani, an ba da fifiko kaɗan kan fahimtar mahimmancin tsammanin samun nasara da kuma mayar da hankali kan ƙoƙarin inganta majiyyata. Sanin cewa placebo don jin zafi yana da alaƙa da kaddarorin masu aiki waɗanda ke haifar da abin dogaro, abubuwan gani, da sauye-sauye masu ƙima tare da abubuwan da ke tattare da neurobiological a halin yanzu a cikin binciken bincike na ciwo. Yawancin karatu sun tabbatar da cewa, lokacin da aka jawo shi ta hanyar da ta dace da tsammanin (ta hanyar yin amfani da tsammanin tsammanin da / ko daidaitawa), placebos na analgesic na iya haifar da canje-canje masu iya gani da ma'auni a cikin tsinkayen jin zafi a matakin da ya dace da kai da kuma neurological. matakin sarrafa zafi.[49,50] An bayyana ma'anar analgesic placebos a matsayin jiyya ko hanyoyin da ke faruwa a cikin mahallin zamantakewa da kuma yin tasiri akan kwarewar mutum da/ko ilimin lissafi.[51]. Halin fahimtar placebo na yanzu yana jaddada mahimmancin mahallin psychosocial a cikin abin da aka saka placebos. Ƙarƙashin yanayin mahallin psychosocial da al'ada na jiyya shine tsammanin marasa lafiya. Saboda haka, ba abin mamaki ba ne cewa tasirin placebo yana da zurfi a cikin kusan kowane magani; kamar haka, likitoci da marasa lafiya za su iya amfana daga sanin cewa a ciki akwai ƙarin hanyar da za a iya inganta hanyoyin magance ciwo na yanzu.

 

An ba da shawarar cewa tsammanin sakamako shine ainihin tasirin haifar da ingantattun sauye-sauye da aka samu ta hanyoyi daban-daban na horarwar annashuwa, hypnosis, jiyya na fallasa, da kuma hanyoyin warkewa da yawa masu dogaro da kai. Don haka, hanyar da ta dace don kula da ciwo mai tsanani yana ba da ƙarfin ƙarfin tsammanin marasa lafiya don samun nasara. Abin baƙin ciki, sau da yawa, ma'aikatan kiwon lafiya suna sakaci don magance kai tsaye da kuma jaddada mahimmancin tsammanin marasa lafiya a matsayin abubuwan da ke ba da gudummawa ga nasarar sarrafa ciwo mai tsanani. Zeitgeist a cikin al'ummarmu shine haɓaka maganin cututtuka da ke haifar da tsammanin gaba ɗaya cewa ciwo (har ma da ciwo mai tsanani) ya kamata a kawar da shi ta hanyar ci gaban likita. Waɗannan duk tsammanin tsammanin da aka saba yi suna barin marasa lafiya da yawa cikin ɓacin rai game da sakamakon jiyya na yanzu kuma suna ba da gudummawa ga neman maganin. Neman maganin � shine keɓancewar maimakon ka'ida dangane da yanayin zafi na yau da kullun. A cikin yanayin mu na yanzu, inda ciwo mai tsanani ya addabi miliyoyin jama'ar Amirka a kowace shekara, yana da kyau a cikin sha'awar mu don ci gaba da ci gaba da ba da shawarar sauyin ra'ayi wanda a maimakon haka ya mayar da hankali kan kulawa mai kyau na ciwo mai tsanani. Hanya mai dacewa kuma mai ban sha'awa don cimma wannan ita ce yin amfani da mafi yawan majinyata (na zahiri) tsammanin da kuma ilmantar da marasa lafiya da kuma sauran jama'a (20% wanda a wani lokaci na gaba za su zama masu jin zafi) akan abin da ke haifar da tsammanin gaske. game da kula da ciwo. Wataƙila, wannan na iya faruwa da farko ta hanyar ilimin halin yanzu, tushen shaidar shaida game da placebo da takamaiman tasirin jiyya kamar yadda marasa lafiya zasu iya gyara gaskatawar da ba a sani ba waɗanda wataƙila suka yi a baya. Bayan haka, likitocin na iya yin niyyar haɓaka tsammanin marasa lafiya a cikin mahallin jiyya (a zahirin yanayin) da kuma rage tsammanin tsammanin da zai hana samun nasarar jiyya, sabili da haka, koyo don haɓaka jiyya na yau da kullun ta hanyar ƙoƙarin da aka jagoranta don haɓaka haɓakar placebo na iya samarwa, ko da a cikin magani mai aiki �. Masana ilimin halayyar dan adam za su iya magance waɗannan batutuwa cikin hanzari tare da majiyyatan su kuma taimaka musu su zama masu ba da shawara ga nasarar maganin kansu.

 

Ƙaunar Ƙaunar Ciwo

 

Wani lamari mai kalubalanci sau da yawa na kula da ciwo mai tsanani shine rashin daidaituwa mai yawa na rashin tausayi na damuwa. Bincike ya nuna cewa damuwa da damuwa sun haura zuwa sau uku a cikin marasa lafiya masu ciwo na kullum fiye da na yawan jama'a. ingancin kulawar da za su samu. Marasa lafiya da bacin rai suna da sakamako mafi ƙasƙanci ga duka ɓacin rai da jiyya na jin zafi, idan aka kwatanta da marasa lafiya da ke da cututtukan guda ɗaya na ciwo ko baƙin ciki. sakamakon jiyya da rage yawan wahalar tunanin marasa lafiya. Masanan ilimin halayyar dan adam na iya magance mahimman alamun bayyanar cututtuka (misali, anhedonia, ƙarancin motsa jiki, shingen warware matsala) na baƙin ciki wanda ke tsoma baki tare da halartar jiyya da damuwa na tunani. Bugu da ƙari, ba tare da la'akari da ciwon hauka ba, masu ilimin halin dan Adam na iya taimakawa marasa lafiya masu ciwo mai tsanani su aiwatar da muhimmiyar rawar da za su iya fuskanta (misali, asarar aiki, nakasa), matsalolin tsaka-tsakin da za su iya fuskanta (misali, ma'anar keɓancewa da ciwo ya kawo), da kuma Wahalhalun zuciya (misali, damuwa, fushi, bakin ciki, rashin jin daɗi) abin da ke tattare da gogewarsu. Don haka, masu ilimin halayyar ɗan adam na iya yin tasiri ga tsarin jiyya ta hanyar rage tasirin abubuwan da ke tattare da motsin rai waɗanda ake magana da su azaman ɓangaren jiyya.

 

Kammalawa

 

Amfanin haɗawa da jiyya na tunani a cikin hanyoyin da yawa don kula da ciwo mai tsanani suna da yawa. Waɗannan sun haɗa da, amma ba'a iyakance su ba, ƙara yawan kula da kai na ciwo, inganta kayan aikin jin zafi, rage raunin da ke da alaka da ciwo, da kuma rage yawan damuwa-haɓaka motsin zuciyar da ke faruwa ta hanyar tasiri daban-daban na tsarin kai, halayya, da fahimta. dabaru. Ta hanyar aiwatar da waɗannan canje-canje, masanin ilimin halayyar ɗan adam zai iya taimaka wa marasa lafiya yadda ya kamata su ji daɗin kulawa da jin zafi kuma ya ba su damar rayuwa a matsayin al'ada kamar yadda zai yiwu duk da ciwo. Bugu da ƙari, ƙwarewar da aka koya ta hanyar shiga tsakani na tunanin mutum yana ƙarfafawa da ba da damar marasa lafiya su zama masu shiga tsakani a cikin kula da rashin lafiyar su da kuma haifar da kwarewa masu mahimmanci waɗanda marasa lafiya za su iya amfani da su a duk rayuwarsu. Ƙarin fa'idodi na haɗakarwa da cikakkiyar tsarin kula da ciwo mai tsanani na iya haɗawa da ƙara yawan komawa zuwa aiki, raguwa a farashin kula da lafiya, da kuma ƙara yawan lafiyar lafiyar lafiyar miliyoyin marasa lafiya a duk faɗin duniya.

 

Hoton mai koyarwa yana ba da shawarar horo ga majiyyaci.

 

Bayanan kalmomi

 

ƙwaƙƙwafi: Ba a ayyana sabani na maslaha dangane da wannan takarda ba.

 

A ƙarshe, Za a iya amfani da hanyoyin da za a iya amfani da su da kyau don taimakawa wajen taimakawa bayyanar cututtuka na ciwo mai tsanani tare da yin amfani da wasu hanyoyin magani, irin su kulawar chiropractic. Bugu da ƙari kuma, binciken binciken da ke sama ya nuna yadda ƙayyadaddun maganganun tunani zasu iya inganta matakan sakamako na kula da ciwo na kullum. Bayanin da aka ambata daga Cibiyar Bayanan Kimiyyar Halittu ta Ƙasa (NCBI). Matsakaicin bayanin mu yana iyakance ga chiropractic da kuma raunin da ya faru da kashin baya. Don tattauna batun batun, don Allah jin daɗin tambayar Dr. Jimenez ko tuntuɓe mu a 915-850-0900 .

 

Dr. Alex Jimenez ne ya shirya shi

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Ƙarin Maudu'i: Ciwon Baya

 

Bisa ga kididdigar, kimanin 80% na mutane za su fuskanci alamun ciwon baya a kalla sau ɗaya a duk rayuwarsu. Binciken baya koke ne na gama-gari wanda zai iya haifar da rauni da/ko yanayi iri-iri. Sau da yawa lokuta, lalacewar dabi'a na kashin baya tare da shekaru na iya haifar da ciwon baya. Harsiated fayafai faruwa a lokacin da taushi, gel-kamar cibiyar intervertebral disc ta tura ta cikin hawaye a kewaye da shi, waje zobe na guringuntsi, matsawa da kuma fusatar da jijiya tushen. Abubuwan da aka fi sani da diski suna faruwa tare da ƙananan baya, ko kashin baya na lumbar, amma kuma suna iya faruwa tare da kashin mahaifa, ko wuyansa. Ƙunƙarar jijiyoyi da aka samo a cikin ƙananan baya saboda rauni da / ko mummunan yanayin zai iya haifar da bayyanar cututtuka na sciatica.

 

hoton blog na zane mai ban dariya paperboy babban labarai

 

MAFI MUHIMMAN BATUN: Sarrafar da damuwa a wurin Aiki

 

 

MASU MUHIMMAN BUDURWA: KARIN KARAWA: Maganin Rauni na Mota El Paso, TX Chiropractor

 

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Rufe Accordion
Matsalolin Tunani don Ciwon Ciwon Jiki a cikin El Paso, TX

Matsalolin Tunani don Ciwon Ciwon Jiki a cikin El Paso, TX

by | Chiropractic, Yanayi Karɓa, Gyara jiki, Gwajin Sarrafa Bazuwar, danniya, jiyya

Idan kun sami ciwon kai, ba kai kaɗai ba. Kimanin mutane 9 cikin 10 a Amurka suna fama da ciwon kai. Yayin da wasu ke dawwama, wasu kuma akai-akai, wasu kuma suna buguwa da buguwa, wasu kuma suna haifar da raɗaɗi da tashin zuciya, kawar da ciwon kai wani martani ne ga mutane da yawa nan take. Amma, ta yaya za ku iya magance ciwon kai sosai?

 

Nazarin bincike ya nuna cewa kulawar chiropractic wani zaɓi ne mai mahimmanci na magani don yawancin ciwon kai. Rahoton 2014 a cikin Jarida na Manipulative and Physiological Therapeutics (JMPT) ya gano cewa gyare-gyare na kashin baya da kuma manipulations na hannu da aka yi amfani da su a cikin kulawar chiropractic sun inganta matakan sakamako don maganin ciwon wuyan wuyansa na yau da kullum da kuma inganta amfani da hanyoyi daban-daban na magani. ciwon wuya. Bugu da ƙari kuma, binciken 2011 JMPT ya gano cewa kulawar chiropractic zai iya ingantawa da rage yawan adadin migraine da ciwon kai na cervicogenic.

 

Ta yaya Kulawar Chiropractic ke Magance Ciwon Kai?

 

Kulawa na chiropractic yana mayar da hankali kan maganin raunin da dama da / ko yanayi na musculoskeletal da tsarin juyayi, ciki har da ciwon kai. Mai chiropractor yana amfani da gyare-gyare na kashin baya da kuma manipulations na hannu don gyara daidaitattun kashin baya a hankali. An nuna alamar subluxation, ko rashin daidaituwa na kashin baya, don haifar da bayyanar cututtuka, irin su wuyansa da ciwon baya, da ciwon kai da migraine. Daidaitaccen kashin baya na iya inganta aikin kashin baya da kuma rage damuwa na tsari. Bugu da ƙari, likita na chiropractic zai iya taimakawa wajen magance ciwon kai da sauran cututtuka masu raɗaɗi ta hanyar samar da shawarwarin abinci mai gina jiki, bayar da shawarwarin matsayi da ergonomics da bada shawarar kula da damuwa da shawarwarin motsa jiki. Kulawa na chiropractic zai iya ƙarshe sauƙaƙe tashin hankali na tsoka tare da kewayen sifofin kashin baya, maido da aikin asali na kashin baya.

 

Dokta Alex Jimenez yana yin gyaran gyare-gyare na chiropractic akan mai haƙuri.

 

Dokta Alex Jimenez yana ba da shawarar dacewa ga mai haƙuri.

 

Bugu da ƙari kuma, kulawar chiropractic zai iya zama lafiya da kuma yadda ya kamata ya bi da sauran al'amurran kiwon lafiya na kashin baya, ciki har da alamun wuyansa da ƙananan ciwon baya saboda ƙwayar mahaifa da lumbar herniated discs, a tsakanin sauran raunuka da / ko yanayi. Mai chiropractor ya fahimci yadda rashin daidaituwa na kashin baya, ko subluxation, zai iya rinjayar sassa daban-daban na jiki kuma za su bi da jiki gaba ɗaya maimakon mayar da hankali kan alamar kawai. Maganin chiropractic zai iya taimakawa jikin mutum ta dabi'a ya dawo da lafiyarsa da lafiyarsa ta asali.

 

Mai horo da hulɗar haƙuri a cibiyar gyarawa.

 

An san cewa kulawar chiropractic yana da tasiri ga nau'o'in raunuka da / ko yanayi, duk da haka, a cikin 'yan shekarun nan, binciken bincike ya gano cewa chiropractic zai iya inganta lafiyar mu ta hanyar sarrafa damuwa. Yawancin waɗannan binciken bincike na baya-bayan nan sun nuna cewa kulawar chiropractic zai iya canza aikin rigakafi, ya shafi yanayin zuciya, da kuma rage karfin jini. Wani bincike na 2011 daga Japan ya nuna cewa chiropractic na iya samun tasiri mai girma a jikinka fiye da yadda kuka yi imani.

 

Damuwa shine muhimmiyar alamar lafiya, kuma alamun ciwo na yau da kullum na iya rinjayar lafiya sosai. Masu bincike a Japan sun nemi bincika ko chiropractic zai iya canza matakan damuwa a cikin maza da mata na 12 da ciwon wuyansa da ciwon kai. Amma masana kimiyya a Japan sun so su sami ƙarin haƙiƙa hoto na yadda gyare-gyare na kashin baya na chiropractic da manipulations na hannu ke shafar tsarin mai juyayi, don haka sun yi amfani da binciken PET don saka idanu akan ayyukan kwakwalwa da gwajin salvia don lura da canje-canje na hormone.

 

Bayan kulawar chiropractic, marasa lafiya sun canza aikin kwakwalwa a cikin sassan kwakwalwa da ke da alhakin sarrafa ciwo da halayen damuwa. Hakanan sun rage matakan cortisol sosai, yana nuna raguwar damuwa. Mahalarta kuma sun ba da rahoton ƙananan ƙananan ciwon da kuma mafi kyawun rayuwa bayan jiyya. Hanyoyin tunani, irin su kulawar chiropractic, su ne mahimman hanyoyin sarrafa damuwa da dabaru. Damuwa na yau da kullum zai iya haifar da al'amurran kiwon lafiya iri-iri, ciki har da wuyansa da ciwon baya da ciwon kai da ciwon kai. Sauran matakan kulawa na iya kuma amintacce da ingantaccen taimako inganta alamun bayyanar. Manufar labarin mai zuwa shine don nuna tasiri na wani tunani mai mahimmanci, wanda aka sani da raguwar damuwa na tushen tunani, akan jin zafi mai tsanani da ingancin rayuwa a cikin marasa lafiya da aka gano a baya tare da ciwon kai na kullum.

 

Ingantacciyar Rage Danniya-Tsarin Hankali akan Ƙarfin Raɗaɗi da Ingancin Rayuwa a cikin Marasa lafiya da Ciwon Kai

 

Abstract

 

Manufar wannan binciken ya kasance don sanin tasirin saurin matsawa na hankali (MBSR) akan tsinkayen zafi da ingancin rayuwa a cikin marasa lafiya da ciwon kai na ciwon kai. Don haka, marasa lafiya arba'in bisa ga ganewar asali na likitan ilimin likitancin jiki da kuma ka'idojin bincike na Ƙungiyar Ciwon Kai ta Duniya (IHS) don ƙaura da ciwon kai na ciwon kai na yau da kullum da aka zaba da kuma ba da izini ga ƙungiyar shiga tsakani da ƙungiyar kulawa, bi da bi. Mahalarta sun kammala tambayoyin Pain da ingancin rayuwa (SF-36). Ƙungiyar shiga tsakani ta shiga cikin shirin MBSR na mako takwas wanda ya haɗa da tunani da aikin gida na yau da kullum, kowane mako, zaman 90-mintuna. Sakamakon bincike na covariance tare da kawar da gwajin gwaji ya nuna mahimmancin inganta jin zafi da ingancin rayuwa a cikin ƙungiyar sa baki idan aka kwatanta da ƙungiyar kulawa. Binciken da aka yi daga wannan binciken ya nuna cewa MBSR za a iya amfani da shi ba tare da maganin magunguna ba don inganta yanayin rayuwa da kuma ci gaba da hanyoyin da za a magance ciwo ga marasa lafiya da ciwon kai na kullum. Kuma ana iya amfani dashi a hade tare da wasu hanyoyin kwantar da hankali irin su pharmacotherapy.

 

keywords: ciwo na kullum, ciwon kai na migraine, tunani, ingancin rayuwa, tashin hankali ciwon kai

 

Dr Jimenez White Coat

Dr. Alex Jimenez's Insight

Ciwon kai na yau da kullun alama ce mai rauni wanda ke shafar mutane da yawa. Akwai nau'ikan ciwon kai daban-daban, duk da haka, yawancinsu sau da yawa suna raba abin faɗa. Damuwa na yau da kullun na iya haifar da al'amuran kiwon lafiya iri-iri waɗanda ba a sarrafa su yadda ya kamata, gami da tashin hankali na tsoka, wanda zai iya haifar da rashin daidaituwa na kashin baya, ko subluxation, da sauran alamun bayyanar cututtuka, irin su wuyansa da ciwon baya, ciwon kai da migraines. Hanyoyin sarrafa damuwa da dabaru na iya taimakawa a ƙarshe don ingantawa da sarrafa alamun da ke tattare da damuwa. Ayyukan tunani kamar kulawar chiropractic da rage yawan damuwa na tushen tunani an ƙaddara don taimakawa wajen rage damuwa da kuma rage alamun ciwon kai na yau da kullum.

 

Gabatarwa

 

Ciwon kai yana ɗaya daga cikin korafe-korafen da aka fi bincikawa a asibitocin manya da na yara. Yawancin waɗannan ciwon kai sune ƙaura da ciwon kai irin na tashin hankali (Kurt & Kaplan, 2008). An rarraba ciwon kai zuwa kashi biyu na ciwon kai na babba ko na farko da na sakandare. Kashi 2013 cikin 4 na ciwon kai sune ciwon kai na farko, daga cikinsu akwai ciwon kai da tashin hankali sune nau'ikan da suka fi yawa (International Headache Society [IHS], 72). Bisa ga ma'anar, ciwon kai na migraine yawanci yakan kasance ɗaya ne kuma yana jin dadi a cikin yanayi kuma yana daga 2013 zuwa XNUMX hours. Alamomin da ke da alaƙa sun haɗa da tashin zuciya, amai, haɓakar hankali ga haske, sauti da zafi, kuma yana ƙaruwa gabaɗaya tare da haɓaka aikin jiki. Har ila yau, ciwon kai na tashin hankali yana da alaƙa da haɗin kai, rashin jin zafi, matsa lamba ko matsawa, zafi mai zafi, kamar bandeji ko hula, da ci gaba da ciwo mai sauƙi zuwa matsakaici, hana ayyukan rayuwar yau da kullum (IHS, XNUMX).

 

Stovner et al. (2007). Wannan yana nuna cewa abubuwan da suka faru da kuma yawan ciwon kai irin na tashin hankali sun fi yadda aka yi hasashe. An kiyasta cewa kimanin kashi 46 zuwa 42 cikin dari na mutanen suna da ciwon kai (Stovner & Andree, 12). Mata suna iya fuskantar ƙaura idan aka kwatanta da maza, ƙaurawar ƙaura yana kusan 18% ga maza da 2010% ga mata (Tozer et al., 6).

 

Migraine da ciwon kai irin na tashin hankali sune na gama-gari kuma rubuce-rubucen martani ga matsalolin tunani da na jiki (Menken, Munsat, & Toole, 2000). Migraine wani ciwo ne na lokaci-lokaci kuma mai lalacewa kuma yana da mummunar tasiri akan ingancin rayuwa, dangantaka da yawan aiki. Hukumar Lafiya ta Duniya (WHO) ta sanar da mummunan ciwon kai a matsayin daya daga cikin cututtuka mafi lalacewa tare da matsayi na goma sha tara (IHS, 2013; Menken et al., 2000).

 

Duk da ci gaban magunguna da yawa don magancewa da rigakafin hare-haren ƙaura, yawancin marasa lafiya suna ganin ba su da tasiri kuma wasu suna ganin ba su dace ba saboda illar da ke tattare da su kuma sau da yawa sau da yawa yakan haifar da dakatar da magani da wuri. A sakamakon haka, ana iya lura da babban sha'awar ci gaban jiyya ba tare da magunguna ba (Mulleners, Haan, Dekker, & Ferrari, 2010).

 

Abubuwan da ke tattare da kwayoyin halitta kadai ba za su iya bayyana rashin lafiya ga kwarewar ciwon kai ba, farkon harin da yanayinsa, hare-haren ciwon kai, rashin ciwon kai da kuma yanayin rayuwa a cikin marasa lafiya da ciwon kai na yau da kullum. Abubuwan da ba su da kyau a rayuwa sune (kamar yadda yanayin psychosocial) sau da yawa aka sani da mahimmanci a cikin ci gaba da haɓaka ciwon kai (Nash & Thebarge, 2006).

 

Shirin Rage Ƙwararrun Ƙwararrun Ƙwararru (MBSR) yana cikin jiyya, wanda aka yi nazari a cikin shekaru ashirin da suka gabata akan nau'in ciwo mai tsanani. MBSR ya haɓaka ta Kabat-Zinn kuma an yi amfani da shi a cikin yawan jama'a tare da matsalolin damuwa da ciwo mai tsanani (Kabat-Zinn, 1990). Musamman a cikin 'yan shekarun nan, an gudanar da bincike da yawa don nazarin tasirin maganin MBSR. Yawancin karatu sun nuna mahimmancin tasirin MBSR akan yanayi daban-daban na tunani ciki har da rage yawan alamun tunani na damuwa, damuwa, rumination, damuwa da damuwa (Bohlmeijer, Prenger, Taal, & Cuijpers, 2010; Carlson, Speca, Patel, & Goodey, 2003; Grossman, Niemann, Schmidt, & Walach, 2004; Jain et al., 2007; Kabat-Zinn, 1982; Kabat-Zinn, Lipworth, & Burney, 1985; Kabat-Zinn et al., 1992; Teasdale et al. , 2002), zafi (Flugel et al., 2010; Kabat-Zinn, 1982; Kabat-Zinn et al., 1985; La Cour & Petersen, 2015; Rosenzweig et al., 2010; Zeidan, Gordon, Merchant, & Goolkasian , 2010) da ingancin rayuwa (Brown & Ryan, 2003; Carlson et al., 2003; Flugel et al., 2010; Kabat-Zinn, 1982; La Cour & Petersen, 2015; Morgan, Ransford, Morgan, Driban, & Wang, 2013; Rosenzweig et al., 2010).

 

Bohlmeijer et al. (2010) ya gudanar da bincike-bincike na binciken bincike guda takwas da aka bazu a kan tasirin shirin MBSR, ya kammala cewa MBSR yana da ƙananan tasiri akan ciki, damuwa da damuwa na tunani a cikin mutanen da ke fama da cututtuka na kullum. Hakanan Grossman et al. (2004) a cikin bincike-bincike na 20 da aka sarrafa da kuma binciken da ba a kula da shi ba game da tasirin shirin MBSR akan lafiyar jiki da tunani na likita da samfurori marasa lafiya, sun sami sakamako mai girma na matsakaici don nazarin bincike akan lafiyar kwakwalwa. Babu wani sakamako masu girma ga takamaiman alamun alamun kamar baƙin ciki da damuwa da aka ruwaito. Binciken da aka yi kwanan nan ya hada da nazarin 16 da aka sarrafa da kuma rashin kulawa, Wannan bita ya ba da rahoton cewa shiga tsakani na MBSR ya rage yawan zafin ciwo, kuma mafi yawan nazarin gwaji (6 na 8) yana nuna raguwa mafi girma a cikin ciwo mai tsanani ga ƙungiyar shiga idan aka kwatanta da ƙungiyar kulawa (Reiner, Tibi, & Lipsitz, 2013).

 

A cikin wani binciken, masu bincike sun sami babban tasiri masu girma dabam ga wasu ƙananan sikelin ingancin rayuwa misali ma'auni mai mahimmanci da ciwo na jiki, ƙananan sakamako masu mahimmanci don ciwo da kuma mahimmancin matsakaici zuwa babban girman girman girman damuwa da damuwa (La Cour & Petersen, 2015) . Hakanan a cikin binciken Rosenzweig et al. (2010) a kan marasa lafiya da ciwo mai tsanani ciki har da wadanda ke fama da migraines, akwai bambance-bambance masu mahimmanci a cikin tsananin zafi, ƙananan ayyuka masu alaƙa da ciwo tsakanin marasa lafiya. Duk da haka, waɗanda ke fama da ciwon kai sun sami mafi ƙasƙanci mafi ƙasƙanci a cikin ciwo da kuma nau'o'i daban-daban na ingancin rayuwa. Gabaɗaya, ƙungiyoyi daban-daban na ciwo na yau da kullun sun nuna ci gaba mai mahimmanci a cikin tsananin zafi da ƙayyadaddun ayyuka masu alaƙa da ciwo a cikin wannan binciken. Kabat-Zinn ya gudanar da wasu nazarin guda biyu da kuma amfani da hanyoyin MBSR don magance marasa lafiya da ciwo mai tsanani, ciki har da yawan marasa lafiya da ciwon kai. Ƙididdigar ƙididdiga ta nuna raguwa mai yawa a cikin ciwo, tsoma baki tare da ayyukan yau da kullum, alamun likitanci da cututtuka da alamun cututtuka, damuwa da damuwa, mummunan yanayin jiki, tsoma baki tare da ayyukan yau da kullum, amfani da miyagun ƙwayoyi da kuma karuwa a cikin amincewa (Kabat-Zinn, 1982; Kabat-Zinn et al., 1985).

 

Saboda ciwo da asarar aiki da rage yawan aiki da kuma ƙara yawan amfani da kiwon lafiya, ciwon kai na yau da kullum yana haifar da farashi ga mutum da al'umma, da alama cewa ciwon kai na yau da kullum shine babban matsalar kiwon lafiya da kuma gano hanyoyin da za a iya sarrafawa da magance wannan matsala zai iya zama na muhimmancin gaske. Babban makasudin wannan binciken shine don kimanta tasiri na MBSR ban da magungunan magunguna na al'ada a cikin samfurin asibiti na marasa lafiya da ciwon kai na yau da kullum don nuna tasirin wannan fasaha a matsayin hanyar magance ciwo da inganta yanayin rayuwa a cikin marasa lafiya. tare da ciwon kai na kullum.

 

Hanyar

 

Mahalarta da Shirin

 

Wannan gwaji ne da aka sarrafa bazuwar rukuni-biyu �pretest-posttest� ƙirar binciken. Hakanan an samu izini daga Kwamitin Da'a na Jami'ar Zahedan na Kimiyyar Likita. Mahalarta sun zaɓa ta hanyar samfurin samfurin dacewa daga marasa lafiya da ciwon kai na yau da kullum da ciwon kai-nau'in tashin hankali, wanda likitan neurologist da likitan kwakwalwa suka gano ta amfani da ka'idojin bincike na IHS-wanda ake nufi da asibitocin jami'a na Jami'ar Zahedan na Kimiyyar Kiwon Lafiya, Zahedan-Iran.

 

Bayan yin la'akari da kowane mai haƙuri don saduwa da ƙayyadaddun haɗawa da ƙaddamarwa da kuma yin hira na farko, 40 daga cikin marasa lafiya na farko tamanin da bakwai da ciwon kai na yau da kullum da aka zaba kuma an ba da su a cikin ƙungiyoyi guda biyu masu daidaitawa da kulawa. Dukansu ƙungiyoyin kulawa da masu shiga tsakani sun sami maganin pharmacotherapy na yau da kullun a ƙarƙashin kulawar likitan jijiyoyi. A lokacin zaman jiyya batutuwa guda uku, saboda rashin daidaituwa na yau da kullum ko ka'idojin keɓancewa, an cire ko an cire su daga binciken.

 

Abinda ya haɗa

 

  • (1) Sanarwa izinin shiga cikin zaman.
  • (2) Mafi qarancin shekaru 18.
  • (3) Ƙananan cancantar ilimi na digiri na tsakiya.
  • (4) Sakamakon ganewar ciwon kai na yau da kullum (nau'in ciwon kai na farko da tashin hankali-nau'in ciwon kai) ta likitan neurologist kuma bisa ga ka'idojin bincike na IHS.
  • (5) 15 ko fiye da kwanaki a kowace wata don fiye da watanni 3 da akalla watanni shida tarihin migraines da tashin hankali-nau'in ciwon kai.

 

Criteria mara inganci

 

  • (1) Batutuwan da ba su son ci gaba da shiga cikin binciken ko barin binciken don kowane dalili.
  • (2) Wasu matsalolin ciwo na kullum.
  • (3) Ciwon Hankali, Haushi da rashin fahimta.
  • (4) Abubuwan da ke tattare da matsalolin tsaka-tsaki na tsaka-tsakin aiki tare.
  • (5) Shaye-shaye da shaye-shaye.
  • (6) Rashin hankali

 

Ƙungiyoyi masu aiki

 

An gudanar da zaman jiyya (MBSR) don 1.5 zuwa 2 hours a mako don mambobin kungiyar masu shiga tsakani (magunguna da MBSR); Duk da yake babu MBSR da aka yi don ƙungiyar kulawa (kawai magungunan da aka yi amfani da su) har zuwa ƙarshen binciken. An gudanar da MBSR na makonni 8. A cikin wannan binciken, an yi amfani da shirin MBSR na 8 (Chaskalon, 2011). Don yin aikin gida na tunani yayin horar da mahalarta a zaman, an samar da matakan da suka dace a cikin CD da ɗan littafin. Idan daya daga cikin batutuwa bai shiga wani zama ko zama ba, a farkon zama na gaba mai ilimin hanyoyin kwantar da hankali zai ba da rubutattun bayanan zaman ga batutuwa, ban da maimaita taƙaitaccen zaman da ya gabata. An gabatar da shirin MBSR da tattaunawa ga marasa lafiya a cikin zaman takwas da suka hada da: fahimtar ciwo da kuma aetiology, tattauna game da danniya na dangantaka, fushi da motsin rai tare da ciwo, Fahimtar tunani mara kyau na atomatik, gano tunani da ji, gabatar da ra'ayi na Yarda, sararin samaniya. , sararin numfashi na minti uku, motsa jiki mayar da hankali motsa jiki, abubuwan ban sha'awa da ban sha'awa yau da kullum, kunna hali, kula da ayyukan yau da kullum, aikin duban jiki, gani da jin motsa jiki, tunani na zama, tafiya mai hankali, karanta wakoki masu alaka da tunani da kuma tattauna yadda za a yi. ci gaba da abin da aka inganta a cikin dukan karatun, tattauna tsare-tsare da dalilai masu kyau na kiyaye aikin. Har ila yau, marasa lafiya sun sami bayanai game da koyan yadda za a gano duk wani sake dawowa na gaba da kuma dabaru da tsare-tsaren da za a samo asali da wuri na hare-haren ciwo da kuma kai kai ga sababbin yanayi.

 

Ƙungiyar Kulawa

 

Marasa lafiya waɗanda aka bazu a cikin ƙungiyar kulawa sun ci gaba da ci gaba da maganin pharmacotherapy na yau da kullun (ciki har da takamaiman magunguna da marasa ƙayyadaddun ƙwayoyi) ta likitan jijiyoyin su har zuwa ƙarshen binciken.

 

Instruments

 

An yi amfani da manyan kayan aiki guda biyu a cikin kafin gwajin da kuma bayan gwaji don tattara bayanai, baya ga tsarin bayanan alƙaluma. An yi amfani da log ɗin ciwon kai don sanin girman jin zafi ta amfani da sassa uku: (1) 10-point likert-ma'auni, (2) adadin sa'o'i na zafi a kowace rana da (3) yawan jin zafi a cikin wata. An zana kowane sashi daga 0 zuwa 100, matakin mafi girma shine 100. Tun da kowane mai haƙuri ya ƙididdige yawan zafin da aka samu a cikin tambayoyin, inganci da aminci ba a la'akari da su ba. Kuma ɗayan shine ɗan gajeren tsari na 36 (SF-36). Tambayoyin suna aiki a cikin ƙungiyoyin shekaru daban-daban da cututtuka daban-daban. Ware et al (Ware, Osinski, Dewey, & Gandek, 2000) sun amince da amincin da ingancin takardar. SF-36 yayi la'akari da fahimtar ingancin rayuwa a cikin 8 subscales sun hada da: aikin jiki (PF), iyakokin rawar jiki saboda lafiyar jiki (RP), ciwo na jiki (PB), lafiyar jiki (GH), makamashi da mahimmanci (VT). ), Ayyukan zamantakewa (SF), gazawar rawar aiki saboda matsalolin motsin rai (RE) kuma yana shafar lafiya (AH). Kayan aikin yana da ma'auni na taƙaitaccen ma'auni guda biyu don Takaitaccen Abubuwan Abubuwan Jiki (PCS) da Takaitaccen Abubuwan Abubuwan Hankali (MCS). Ana ƙididdige kowane ma'auni daga 0 zuwa 100, mafi girman matakin aiki shine 100. An gwada inganci da amincin SF-36 a cikin al'ummar Iran. Ƙididdigar daidaito na ciki sun kasance tsakanin 0.70 da 0.85 don ƙananan ma'auni na 8 da gwajin gwajin gwaji tsakanin 0.49 da 0.79 tare da tazara na mako guda (Montazeri, Goshtasebi, Vahdaninia, & Gandek, 2005).

 

data Analysis

 

Don nazarin bayanan, ban da yin amfani da alamomi masu bayyanawa, don kwatanta sakamakon sa baki da ƙungiyoyi masu kulawa, an yi amfani da nazarin covariance don ƙayyade tasiri da kuma kawar da sakamakon gwajin da aka rigaya a 95% matakin amincewa.

 

Daina

 

A lokacin zaman jiyya batutuwa guda uku, saboda rashin daidaituwa na yau da kullum ko ka'idojin keɓancewa, an cire ko an cire su daga binciken. Talatin da bakwai daga cikin marasa lafiya 40 sun kammala binciken na yanzu kuma an yi nazarin bayanan da aka tattara.

 

results

 

An yi nazari don kwatanta rarraba alƙaluma tsakanin ƙungiyoyin biyu ta amfani da chi-square da t-test mai zaman kansa. An nuna bayanan alƙaluma na ƙungiyoyin biyu a cikin Tebur 1. Rarraba shekaru, shekarun ilimi, jinsi da matsayin aure sun kasance iri ɗaya a kowace ƙungiya.

 

Tebur 1 Halayen Alƙaluman Mahalarta

Shafin 1: Halayen alƙaluma na mahalarta.

 

Shafin 2 yana nuna sakamakon bincike na covariance (ANCOVA). Gwajin Levene ba shi da mahimmanci, F (1, 35) = 2.78, P = 0.105, yana nuna cewa an amince da zato na bambancin bambancin. Wannan binciken ya nuna cewa bambance-bambancen da ke tsakanin ƙungiyoyi daidai suke kuma ba a sami bambanci tsakanin ƙungiyoyi biyu ba.

 

Tebur 2 Sakamakon Binciken Covarice

Shafin 2: Sakamakon bincike na covariance don tasiri na MBSR akan tsananin zafi.

 

Babban tasiri na shiga tsakani na MBSR yana da mahimmanci, F (1, 34) = 30.68, P = 0.001, partial?2 = 0.47, yana nuna cewa ciwon zafi ya ragu bayan shigar MBSR (Ma'anar = 53.89, SD.E = 2.40) fiye da ƙungiyar kulawa (Ma'anar = 71.94, SD.E = 2.20). Har ila yau, covariate (kafin gwajin zafi) yana da mahimmanci, F (1, 34) = 73.41, P = 0.001, partial?2 = 0.68, yana nuna cewa matakin zafi mai tsanani kafin shigar da MBSR yana da tasiri mai mahimmanci akan matakin zafi mai zafi. . A wasu kalmomi, akwai dangantaka mai kyau a cikin ma'aunin zafi tsakanin gwaji da gwaji. Sabili da haka, an tabbatar da ma'anar bincike na farko kuma magani na MBSR akan fahimtar ƙarfin yana da tasiri a cikin marasa lafiya da ciwon kai na yau da kullum kuma zai iya rage yawan jin zafi a cikin waɗannan marasa lafiya. Ana ba da rahoton duk mahimman ƙima a p<0.05.

 

Magana ta biyu na wannan binciken shine tasirin fasahar MBSR akan ingancin rayuwa a marasa lafiya da ciwon kai na kullum. Don kimanta tasirin fasahar MBSR akan ingancin rayuwa a cikin marasa lafiya da ciwon kai na yau da kullun da kuma kawar da sauye-sauye masu rikicewa da tasirin gwajin da aka riga aka yi, don nazarin bayanan, ana amfani da bincike na covariate multivariate (MANCOVA) na ma'auni na ingancin rayuwa. cewa Table 3 yana nuna sakamakon bincike a cikin ƙungiyar shiga tsakani.

 

Tebur na 3 Sakamakon Bincike na Covariance

Shafin 3: Sakamakon bincike na covariance don tasiri na MBSR akan ingancin rayuwa.

 

Teburin 3 yana nuna sakamakon bincike na covariance (MANCOVA). Ana buƙatar bayanai masu zuwa don fahimtar sakamakon da aka gabatar a cikin Tebu 3.

 

Jarabawar akwatin ba ta da mahimmanci, F = 1.08, P = 0.320, yana nuna cewa bambance-bambancen matrices iri ɗaya ne a cikin ƙungiyoyi biyu don haka an gamu da zato na kamanni. Hakanan F (10, 16) = 3.153, P = 0.020, Wilks� Lambda = 0.33, partial

 

Gwajin Levene ba shi da mahimmanci a cikin wasu masu canji masu dogaro da suka haɗa da [PF: F (1, 35) = 3.19, P = 0.083; RF: F (1, 35) = 1.92, P = 0.174; BP: F (1, 35) = 0.784, P = 0.382; GH: F (1, 35) = 0.659, P = 0.422; PCS: F (1, 35) = 2.371, P = 0.133; VT: F (1, 35) = 4.52, P = 0.141; AH: F (1, 35) = 1.03, P = 0.318], yana nuna cewa an yarda da zato na bambancin ra'ayi a cikin ma'auni na ingancin rayuwa kuma gwajin Levene yana da mahimmanci a wasu masu canji masu dogara ciki har da [RE: F (1, 35) = 4.27, P = 0.046; SF: F (1, 35) = 4.82, P = 0.035; MCS: F (1, 35) = 11.69, P = 0.002], yana nuna cewa an karya tunanin kamanni na bambance-bambance a cikin ma'auni na ingancin rayuwa.

 

Babban tasiri na shiga tsakani na MBSR yana da mahimmanci ga wasu masu canji masu dogara ciki har da [RP: F (1, 25) = 5.67, P = 0.025, partial ?2 = 0.18; BP: F (1, 25) = 12.62, P = 0.002, m?2 = 0.34; GH: F (1, 25) = 9.44, P = 0.005, m?2 = 0.28; PCS: F (1, 25) = 9.80, P = 0.004, m?2 = 0.28; VT: F (1, 25) = 12.60, P = 0.002, m?2 = 0.34; AH: F (1, 25) = 39.85, P = 0.001, m?2 = 0.61; MCS: F (1, 25) = 12.49, P = 0.002, partial Ma'ana = 2, SD.E = 0.33; BP: Ma'ana = 61.62, SD.E = 6.18; GH: Ma'ana = 48.97, SD.E = 2.98; PCS: Ma'ana = 48.77, SD.E = 2.85; VT: Ma'ana = 58.52, SD.E = 2.72; AH: Ma'ana = 44.99, SD.E = 2.81; MCS: Ma'ana = 52.60, SD.E = 1.97] fiye da ƙungiyar kulawa [RP: Ma'ana = 44.82, SD.E = 2.43; BP: Ma'ana = 40.24, SD.E = 5.62; GH: Ma'ana = 33.58, SD.E = 2.71; PCS: Ma'ana = 36.05, SD.E = 2.59; VT: Ma'ana = 46.13, SD.E = 2.48; AH: Ma'ana = 30.50, SD.E = 2.56; MCS: Ma'ana = 34.49, SD.E = 1.80].

 

Duk da haka, babban sakamako na shiga tsakani na MBSR ba shi da mahimmanci ga wasu masu canji masu dogara ciki har da [PF: F (1, 25) = 1.05, P = 0.314, partial?2 = 0.04; RE: F (1, 25) = 1.74, P = 0.199, m?2 = 0.06; SF: F (1, 25) = 2.35, P = 0.138, m?2 = 0.09]. Wadannan sakamakon suna nuna, kodayake hanyoyin da ke cikin waɗannan ƙananan matakan rayuwa sun kasance mafi girma [PF: Mean = 75.43, SD.E = 1.54; RE: Ma'ana = 29.65, SD.E = 6.02; SF: Ma'ana = 51.96, SD.E = 2.63] fiye da ƙungiyar kulawa [PF: Ma'ana = 73.43, SD.E = 1.40; RE: Ma'ana = 18.08, SD.E = 5.48; SF: Ma'ana = 46.09, SD.E = 2.40], Amma Ma'anar bambanci ba shi da mahimmanci.

 

A taƙaice, sakamakon bincike na Covariance (MANCOVA) a cikin Tebura 3 yana nuna bambanci mai mahimmanci na ƙididdiga a cikin ƙididdiga na ƙayyadaddun ƙayyadaddun matsayi saboda lafiyar jiki (RP), ciwon jiki (BP), kiwon lafiya na gaba (GH), makamashi da kuzari (VT). ), Tasiri lafiya (AH) da jimlar girman lafiyar jiki (PCS) da lafiyar hankali (MCS). Hakanan yana nuna cewa babu wani bambanci mai mahimmanci na ƙididdiga a cikin ƙananan ma'auni na aikin jiki (PF), iyakancewar matsayi saboda matsalolin motsin rai (RE) da aikin zamantakewa (SF) a cikin ƙungiyar sa baki. Ana ba da rahoton duk mahimman ƙima a p<0.05.

 

tattaunawa

 

Wannan binciken ya yi niyya don kimanta tasirin MBSR akan tsinkayen tsananin zafi da ingancin rayuwa a cikin marasa lafiya da ciwon kai na yau da kullun. Sakamakon ya nuna cewa maganin MBSR yana da tasiri mai mahimmanci akan rage ra'ayi mai tsanani. Sakamakon binciken na yanzu ya dace da sakamakon wasu masu bincike da suka yi amfani da wannan hanya don ciwo mai tsanani (misali Flugel et al., 2010; Kabat-Zinn, 1982; Kabat-Zinn et al., 1985; La Cour & Petersen , 2015; Reibel, Greeson, Brainard, & Rosenzweig, 2001; Reiner et al., 2013; Rosenzweig et al., 2010; zeidan et al., 2010). Alal misali, a cikin binciken guda biyu da Kabat-Zinn ya gudanar, inda aka yi amfani da shirin MBSR don magance marasa lafiya da ciwo mai tsanani ta hanyar likitoci, an kuma haɗa da yawan marasa lafiya da ciwon kai. Nazarin farko na binciken biyu, ya nuna raguwa mai yawa a cikin ciwo, tsoma baki tare da ayyukan yau da kullum, alamun likita da cututtuka na kwakwalwa, ciki har da damuwa da damuwa (Kabat-Zinn, 1982). Sakamakon binciken na biyu ya nuna raguwa mai yawa a cikin ciwo, mummunan siffar jiki, damuwa, damuwa, tsoma baki tare da ayyukan yau da kullum, alamun likita, amfani da magani, kuma ya nuna karuwar amincewa da kai (Kabat-Zinn et al., 1985) .

 

Har ila yau, binciken binciken na yanzu ya dace da sakamakon Rosenzweig et al. (2010), sakamakon su ya nuna cewa shirin MBSR yana da tasiri don ragewa, ciwo na jiki, ingancin rayuwa da kuma jin dadin tunanin marasa lafiya da cututtuka daban-daban da kuma tunani yana da tasiri a kan abubuwan da ke tattare da jin dadi da jin dadi na jin zafi ta hanyar kula da hankali. ta hanyar ayyukan tunani. Kodayake sakamakon Rosenzweig et al. (2010) ya nuna cewa a tsakanin marasa lafiya da ciwo mai tsanani da ƙananan tasiri akan rage yawan ciwo na jiki da kuma inganta yanayin rayuwa yana da alaka da marasa lafiya da fibromyalgia, ciwon kai na kullum. A wani binciken da Flugel et al. (2010), ko da yake an lura da canje-canje masu kyau a cikin mita da kuma tsananin zafi, raguwar zafi ba ta da mahimmanci.

 

A cikin wani binciken, tsananin zafi ya ragu sosai bayan sa baki a cikin marasa lafiya da ciwon kai. Bugu da ƙari, ƙungiyar MBSR ta nuna maki mafi girma a cikin fahimtar hankali idan aka kwatanta da ƙungiyar kulawa (Omidi & Zargar, 2014). A cikin binciken matukin jirgi na Wells et al. (2014), sakamakon su ya nuna cewa MBSR tare da maganin magunguna yana yiwuwa ga marasa lafiya da migraines. Kodayake ƙananan samfurin wannan binciken na matukin jirgi bai ba da iko don gano babban bambanci a cikin tsananin zafi da ƙaura ba, sakamakon ya nuna cewa wannan saƙon yana da tasiri mai tasiri akan tsawon ciwon kai, rashin lafiya, rashin amfani da kai.

 

A cikin bayanin sakamakon tasirin hanyoyin kwantar da hankali na tunani don jin zafi ana iya cewa, samfurori na tunani na ciwo mai tsanani irin su tsarin guje wa tsoro ya nuna cewa hanyoyin da mutane ke fassara ra'ayoyinsu na jin zafi da kuma amsa musu su ne masu mahimmanci masu mahimmanci a cikin kwarewa na ciwo (Schutze, Rees, Preece, & Schutze, 2010). Raɗaɗin bala'i yana da alaƙa da tsoro da damuwa da ke haifar da jin zafi, hanyoyin fahimi ta hanyar da za a iya haifar da tsoron jin zafi da kuma nakasa da ke da alaƙa da kuma saboda mummunan kima na jin zafi ya bayyana 7 zuwa 31% na bambancin zafin zafi. Sabili da haka, duk wani tsari wanda zai iya rage ciwo mai zafi ko yin canje-canje a cikin tsarinsa zai iya rage fahimtar zafin ciwo da nakasa wanda hakan ya haifar. Schutz et al. (2010) jayayya cewa ƙananan tunani shine farkon abin da ke haifar da ciwo. A gaskiya ma, da alama dabi'ar mutum ya shiga cikin tsarin sarrafawa ta atomatik maimakon tsarin ilimi tare da kula da rashin isasshen sassauci, da rashin sanin halin yanzu (Kabat-Zinn, 1990), zai sa mutane suyi aiki. Yi tunani game da zafi kuma don haka ƙididdige haɗarin sakamakonsa. Don haka, ƙananan hankali yana ba da damar haɓaka ƙimar ƙima mara kyau na ciwo (Kabat-Zinn, 1990).

 

Wani dalili mai yiwuwa na iya zama cewa yarda da jin zafi da shirye-shiryen canji ya karu da motsin rai mai kyau, yana haifar da raguwa a cikin tsananin zafi ta hanyar tasiri akan tsarin endocrin da kuma samar da opioids na endogenous da raguwa a cikin nakasa da ke da alaka da ciwo ko shirya mutane don amfani da su. ingantattun dabarun magance zafi (Kratz, Davis, & Zautra, 2007). Wani dalili mai yiwuwa don bayyana sakamakon binciken da aka yi a cikin tasirinsa akan rage jin zafi zai iya zama gaskiyar cewa ciwo mai tsanani yana tasowa saboda tsarin amsawa mai tsanani (Chrousos & Gold, 1992). Sakamakon shine damuwa na tsarin jiki da tunani. Hankali na iya ba da damar samun dama ga cortex na gaba da inganta shi, yankunan kwakwalwa da ke haɗa ayyukan jiki da tunani (Shapiro et al., 1995). Sakamakon shine ƙirƙirar ɗan ƙarami wanda zai rage ƙarfin da kuma jin daɗin ciwo na jiki da tunani. Don haka, abubuwan da ke sha'awar jin zafi suna dandana kamar jin zafi na ainihi maimakon ganewa mara kyau. Sakamakon shine rufewar tashoshi masu zafi wanda zai iya rage zafi (Astin, 2004).

 

Tunani mai hankali yana Rage zafi Ta hanyar Hanyoyi da yawa na Brain da hanyoyi daban-daban kamar canza hankali a cikin ayyukan zuzzurfan tunani na iya burge duka abubuwan da ke da hankali da tasiri na tsinkayen jin zafi. A gefe guda, hankali yana rage mayar da martani ga tunani mai raɗaɗi da jin daɗin da ke tare da jin zafi da ƙarfafa jin zafi. Har ila yau, hankali yana rage bayyanar cututtuka na tunanin mutum irin su damuwa da damuwa da damuwa da kuma ƙara yawan aikin parasympathetic, wanda zai iya inganta kwanciyar hankali mai zurfi wanda zai iya rage zafi. A ƙarshe, hankali na iya rage danniya da rashin aikin yanayi mai alaƙa da kunnawa psychophysiologic ta hanyar ƙarfafa sake fasalin mummunan yanayi da ƙwarewar sarrafa kai. Matsayi mafi girma na hankali ya annabta ƙananan matakan damuwa, damuwa, tunanin bala'i da nakasa. Sauran bincike sun nuna cewa tunani yana da muhimmiyar rawa a cikin kulawa da hankali da tunani, kuma yana iya zama da amfani a sake tsara yanayi mara kyau (Zeidan et al., 2011; Zeidan, Grant, Brown, McHaffie, & Coghill, 2012).

 

Manufar na biyu na wannan binciken shine don ƙayyade tasiri na shirin MBSR akan ingancin rayuwa a marasa lafiya da ciwon kai na kullum. Wannan binciken ya nuna cewa wannan magani yana da tasiri mai mahimmanci akan yanayin rayuwa, ciki har da iyakancewar matsayi saboda matsayi na kiwon lafiya, ciwo na jiki, lafiyar jiki, makamashi da mahimmanci, lafiyar tunanin mutum da ma'aunin lafiyar jiki da tunani gaba daya. Duk da haka, shirin MBSR ba zai iya ƙara yawan ingancin rayuwa a cikin aikin jiki ba, iyakancewar matsayi saboda matsalolin motsin rai da aikin zamantakewa. Yana da alama daga binciken da ya gabata da na yanzu da kuma daga binciken da aka yi a yanzu cewa MBSR ba ta da tasiri akan ayyukan jiki da zamantakewa. Wannan yana yiwuwa saboda sakamakon da ke kan matakan zafi a cikin marasa lafiya da ciwon kai kadan ne, kuma wannan canji yana jinkirin. A gefe guda, marasa lafiya da ciwo mai tsanani sun koyi yin watsi da jin zafi don yin aiki akai-akai (La Cour & Petersen, 2015). Ko da yake, canje-canjen sun kasance a cikin hanyar da ake so kuma sun ƙara yawan ma'auni na ƙungiyar sa baki idan aka kwatanta da ƙungiyar kulawa. Waɗannan binciken sun yi daidai da binciken da aka yi a baya (Brown & Ryan, 2003; Carlson et al., 2003; Flugel et al., 2010; Kabat-Zinn, 1982; La Cour & Petersen, 2015; Morgan et al., 2013; Reibel et al. al., 2001; Rosenzweig et al., 2010).

 

Game da abubuwan da ke cikin zaman MBSR, wannan shirin yana jaddada aikace-aikacen fasaha don rage damuwa, magance ciwo da sanin halin da ake ciki. Bayar da yakin da yarda da halin da ake ciki yanzu, ba tare da hukunci ba, shine babban manufar shirin (Flugel et al., 2010). A gaskiya ma, canje-canje a cikin karɓa ba tare da hukunci ba suna da alaƙa da inganta rayuwar rayuwa (Rosenzweig et al., 2010). MBSR na nufin ƙara wayar da kan jama'a game da halin yanzu. Tsarin jiyya wata sabuwar hanya ce ta sirri don magance damuwa ga mutum. Abubuwan damuwa na waje wani ɓangare ne na rayuwa kuma ba za a iya canza su ba, amma ƙwarewar magancewa da kuma yadda za a amsa damuwa za a iya canza (Flugel et al., 2010). McCracken da velleman (2010) sun nuna cewa sassaucin ra'ayi da kuma mafi girman hankali yana hade da rashin wahala da rashin lafiya a cikin marasa lafiya. Marasa lafiya tare da ciwo mai tsanani tare da matakan da suka fi dacewa da hankali sun ba da rahoton ƙarancin damuwa, damuwa, damuwa da zafi da kuma ingantawa a cikin ingancin kai da ingancin rayuwa. Morgan et al. (2013) nazarin marasa lafiya na arthritis sun sami irin wannan sakamakon, don haka marasa lafiya da matakan tunani sun ruwaito ƙananan damuwa, rashin tausayi da girman kai da ingancin rayuwa. Kamar yadda aka gani a sama an sa ran cewa rage jin zafi a cikin marasa lafiya yana haifar da rage tsoro da damuwa da ke hade da ciwo kuma ta haka ne ya rage sakamakon aiki na iyakoki. Hakanan, sakamakon binciken da yawa (Cho, Heiby, McCracken, Lee, & Moon, 2010; McCracken, Gauntlett-Gilbert, & Vowles, 2007; Rosenzweig et al., 2010; Schutz et al., 2010) sun tabbatar da wannan binciken. .

 

An yi nazari da yawa don kimanta tasiri na nau'o'in nau'i-nau'i daban-daban na tunani game da ciwo mai tsanani, ciki har da marasa lafiya da ciwon kai. Ba kamar sauran binciken da suka yi nazarin nau'o'in nau'in marasa lafiya da ciwo mai tsanani ba, amfanin wannan binciken shine, an yi shi ne kawai ga marasa lafiya da ciwon kai na kullum.

 

A ƙarshe, ya kamata a san cewa akwai wasu iyakoki a cikin wannan binciken kamar ƙananan samfurin, rashin tsarin bin diddigin lokaci mai tsawo, mahalarta yin amfani da magunguna da jiyya na sabani; kuma duk da ƙoƙarin masu bincike, rashin cikakkiyar irin wannan magani ga duk mahalarta na iya rikitar da sakamakon gwajin kuma ya sa ya zama da wahala a tantance sakamakon. Tun da binciken da aka yi a halin yanzu shine nau'insa na farko a cikin marasa lafiya da ke fama da ciwon kai a Iran, ana ba da shawarar cewa ya kamata a gudanar da irin wannan binciken a wannan fanni, tare da manyan samfurori kamar yadda zai yiwu. Kuma ƙarin nazarin binciken binciken kwanciyar hankali na sakamakon jiyya a cikin dogon lokaci masu biyo baya.

 

Kammalawa

 

Bisa ga binciken da aka yi na wannan binciken za a iya ƙaddamar da cewa hanyoyin MBSR gabaɗaya suna da tasiri a kan jin daɗin jin zafi da ingancin rayuwar marasa lafiya da ciwon kai na kullum. Ko da yake babu wani bambanci mai mahimmanci a cikin wasu nau'o'in ingancin rayuwa, irin su aikin jiki, iyakancewar matsayi saboda matsalolin motsin rai da aiki na zamantakewa, amma gaba ɗaya canje-canje a cikin ma'ana ana so ga binciken. Don haka ana iya ba da shawarar haɗawa da magani na MBSR tare da maganin likita na al'ada a cikin ka'idar jiyya ga marasa lafiya da ciwon kai na yau da kullum. Har ila yau, mai binciken ya yi imanin cewa, duk da gazawar da kuma gazawar bincike na yanzu, wannan binciken zai iya zama sabuwar hanyar magance ciwon kai mai tsanani kuma zai iya samar da sabon hangen nesa a wannan fanni na jiyya.

 

Godiya

 

Wannan binciken ya sami goyan bayan (a matsayin tassis) a wani bangare ta Jami'ar Zahedan na Kimiyyar Kiwon Lafiya. Muna so mu gode wa dukkan mahalarta binciken, masu warkarwa na gida, ma'aikatan asibitoci - Ali-ebn-abitaleb, Khatam-al-anbia da Ali asghar- don goyon baya da taimako.

 

A ƙarshe,Kulawar chiropractic wani zaɓi ne mai aminci kuma mai inganci wanda aka yi amfani da shi don taimakawa haɓakawa da sarrafa alamun ciwon kai na yau da kullun ta hanyar daidaitawa a hankali da kuma daidaita kashin baya tare da samar da hanyoyin sarrafa damuwa da dabaru. Saboda an haɗa danniya tare da al'amuran kiwon lafiya iri-iri, ciki har da subluxation, ko rashin daidaituwa na kashin baya, da ciwon kai na yau da kullum, abubuwan da suka shafi tunani kamar kulawar chiropractic da damuwa na tushen damuwa (MBSR) suna da mahimmanci ga ciwon kai na kullum. A ƙarshe, labarin da ke sama ya nuna cewa MBSR za a iya amfani da shi yadda ya kamata a matsayin kulawa da hankali don ciwon kai na kullum da kuma inganta lafiyar jiki da lafiya. Bayanin da aka ambata daga Cibiyar Bayanan Kimiyyar Halittu ta Ƙasa (NCBI). Matsakaicin bayanin mu yana iyakance ga chiropractic da kuma raunin da ya faru da kashin baya. Don tattauna batun batun, don Allah jin daɗin tambayar Dr. Jimenez ko tuntuɓe mu a 915-850-0900 .

 

Dr. Alex Jimenez ne ya shirya shi

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Ƙarin Maudu'i: Ciwon Baya

 

Bisa ga kididdigar, kimanin 80% na mutane za su fuskanci alamun ciwon baya a kalla sau ɗaya a duk rayuwarsu. Binciken baya koke ne na gama-gari wanda zai iya haifar da rauni da/ko yanayi iri-iri. Sau da yawa lokuta, lalacewar dabi'a na kashin baya tare da shekaru na iya haifar da ciwon baya. Harsiated fayafai faruwa a lokacin da taushi, gel-kamar cibiyar intervertebral disc ta tura ta cikin hawaye a kewaye da shi, waje zobe na guringuntsi, matsawa da kuma fusatar da jijiya tushen. Abubuwan da aka fi sani da diski suna faruwa tare da ƙananan baya, ko kashin baya na lumbar, amma kuma suna iya faruwa tare da kashin mahaifa, ko wuyansa. Ƙunƙarar jijiyoyi da aka samo a cikin ƙananan baya saboda rauni da / ko mummunan yanayin zai iya haifar da bayyanar cututtuka na sciatica.

 

hoton blog na zane mai ban dariya paperboy babban labarai

 

MAFI MUHIMMAN BATUN: Sarrafar da damuwa a wurin Aiki

 

 

MASU MUHIMMAN BUDURWA: KARIN KARAWA: Maganin Rauni na Mota El Paso, TX Chiropractor

 

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Rufe Accordion
Hankali don Ciwon Kai da Ciwon Jiki a cikin El Paso, TX

Hankali don Ciwon Kai da Ciwon Jiki a cikin El Paso, TX

by | Yanayi Karɓa, Ƙwaƙwalwar Herniated, Gwajin Sarrafa Bazuwar, danniya, jiyya

danniya sakamako ne na martanin “yaki ko jirgin” jikin mutum, tsarin kariya na tarihi wanda ya haifar da tsarin juyayi mai tausayi (SNS). Damuwa muhimmin bangaren rayuwa ne. Lokacin da masu damuwa suka kunna yaƙin ko amsawar jirgin, ana ɓoye cakuda sinadarai da hormones a cikin jini, wanda ke shirya jiki don haɗarin haɗari. Kodayake damuwa na ɗan gajeren lokaci yana taimakawa, duk da haka, damuwa na dogon lokaci zai iya haifar da al'amurran kiwon lafiya iri-iri. Bugu da ƙari, damuwa a cikin al'ummar zamani sun canza kuma ya zama mafi wuya ga mutane su iya sarrafa damuwa da kuma kula da hankali.

 

Yaya Damuwa ke Shafar Jiki?

 

Ana iya fuskantar damuwa ta hanyoyi guda uku: motsin rai; jiki da muhalli. Damuwar motsin rai ya ƙunshi yanayi mara kyau waɗanda ke shafar tunaninmu da yanke shawara. Damuwar jiki ya haɗa da rashin abinci mai gina jiki da rashin barci. Kuma a ƙarshe, damuwa na muhalli yana faruwa bisa ga abubuwan waje. Lokacin da kuka fuskanci kowane irin nau'in damuwa, tsarin juyayi mai tausayi zai haifar da amsawar "yaki ko jirgin", sakin adrenaline da cortisol don ƙara yawan bugun zuciya da haɓaka hankalinmu don sa mu ƙara faɗakarwa don fuskantar halin da ke gabanmu. .

 

Koyaya, idan abubuwan da ake ganin damuwa suna nan koyaushe, yaƙin SNS ko martanin jirgin na iya ci gaba da aiki. Danniya na yau da kullum zai iya haifar da al'amurran kiwon lafiya iri-iri, kamar damuwa, damuwa, tashin hankali na tsoka, wuyansa da ciwon baya, matsalolin narkewa, karuwar nauyi da matsalolin barci da kuma rashin ƙwaƙwalwar ajiya da maida hankali. Bugu da ƙari, tashin hankali na tsoka tare da kashin baya saboda damuwa na iya haifar da rashin daidaituwa na kashin baya, ko subluxation, wanda zai iya haifar da zubar da diski.

 

Ciwon kai da Ciwon faifai daga Damuwa

 

Fayil mai lalacewa yana faruwa a lokacin da taushi, gel-kamar cibiyar cibiyar intervertebral ta tura ta hawaye a cikin waje, zobe na guringuntsi, haushi da matsawa kashin baya da / ko tushen jijiya. Harshen diski yana faruwa a cikin kashin mahaifa, ko wuyansa, da kuma a cikin kashin lumbar, ko ƙananan baya. Alamun fayafai na herniated sun dogara ne akan wurin da ake matsawa tare da kashin baya. Ciwon wuyan wuyansa da ciwon baya tare da rashin jin daɗi, tingling sensations da rauni tare da babba da ƙananan ƙafafu wasu daga cikin alamun da suka fi dacewa da ke hade da labarun diski. Ciwon kai da ciwon kai suma alamun bayyanar cututtuka ne na yau da kullum da ke hade da danniya da kuma diski na herniated tare da kashin mahaifa, sakamakon sakamakon tsoka da rashin daidaituwa na kashin baya.

 

Matsalolin Tunani don Gudanar da Damuwa

 

Gudanar da damuwa yana da mahimmanci don ingantawa tare da kiyaye lafiya da lafiya gaba ɗaya. Bisa ga binciken bincike, ƙaddamar da hankali, irin su kulawar chiropractic da rage yawan damuwa na tushen tunani (MBSR), da sauransu, na iya taimakawa a amince da rage damuwa. Kulawa na chiropractic yana amfani da gyare-gyare na kashin baya da gyare-gyare na hannu don mayar da hankali na asali na kashin baya, yana kawar da ciwo da rashin jin daɗi da kuma sauƙaƙe tashin hankali na tsoka. Bugu da ƙari, mai chiropractor na iya haɗawa da gyare-gyaren salon rayuwa don taimakawa wajen inganta alamun damuwa. MBSR kuma na iya taimakawa rage damuwa, damuwa da damuwa.

 

Saduwa da Mu Yau

 

Idan kuna fuskantar alamun damuwa tare da ciwon kai ko migraine da kuma wuyansa da ciwon baya da ke hade da labarun diski, abubuwan da suka shafi tunani irin su kulawar chiropractic zai iya zama lafiya da tasiri mai mahimmanci ga damuwa. Ayyukan kulawa da damuwa na Dr. Alex Jimenez na iya taimaka maka samun lafiya da lafiya gaba ɗaya. Neman madaidaicin shisshigi na tunani zai iya samun sauƙin da kuka cancanci. Manufar labarin mai zuwa shine don nuna sakamakon raguwar damuwa na tushen tunani a cikin marasa lafiya da ciwon kai. Kada ku magance alamun kawai, je zuwa tushen batun.

 

Tasirin Rage Matsi na Tushen Hankali akan Hakkar Damuwa da Lafiyar Hankali a cikin Marasa lafiya masu Ciwon Tashin Hankali

 

Abstract

 

Bayan Fage: Shirye-shiryen inganta yanayin kiwon lafiya na marasa lafiya da rashin lafiya da ke da alaka da ciwo, irin su ciwon kai, sau da yawa har yanzu suna cikin jariri. Rage damuwa na tushen tunani (MBSR) wani sabon ilimin tunani ne wanda ya bayyana yana da tasiri wajen magance ciwo mai tsanani da damuwa. Wannan binciken ya kimanta ingancin MBSR a cikin kula da damuwa da damuwa da lafiyar tunanin abokin ciniki wanda ke da ciwon kai.

 

Kaya da matakai: Wannan binciken gwaji ne na asibiti bazuwar. Marasa lafiya sittin da ke da nau'in ciwon kai na tashin hankali bisa ga Kwamitin Rarraba Ciwon Ciwon Kai na Duniya an sanya su ba da gangan ga ƙungiyar Jiyya Kamar yadda aka saba (TAU) ko ƙungiyar gwaji (MBSR). Ƙungiyar MBSR ta sami abokan karatun mako takwas tare da zaman 12-minti. Zaman sun dogara ne akan ka'idar MBSR. Ƙididdigar Ƙarfafa Alamar Ƙarfafa (BSI) da Ƙwararren Ƙwararrun Ƙwararrun Ƙwararru (PSS) an gudanar da su a cikin lokacin da aka rigaya da kuma bayan jiyya da kuma a cikin watanni 3 masu biyo baya ga ƙungiyoyin biyu.

 

results: Ma'anar jimillar ma'aunin BSI (ma'auni mai tsanani na duniya; GSI) a cikin rukunin MBSR shine 1.63 � 0.56 kafin shiga tsakani wanda ya ragu sosai zuwa 0.73 � 0.46 da 0.93 � 0.34 bayan sa baki da kuma a zaman da aka biyo baya, bi da bi. P <0.001). Bugu da ƙari, ƙungiyar MBSR ta nuna ƙananan ƙididdiga a cikin fahimtar damuwa idan aka kwatanta da ƙungiyar kulawa a kimantawa bayan gwaji. Ma'anar damuwa da aka fahimta kafin shiga tsakani shine 16.96 � 2.53 kuma an canza shi zuwa 12.7 � 2.69 da 13.5 � 2.33 bayan sa baki da kuma a zaman da aka biyo baya, bi da bi (P <0.001). A gefe guda, ma'anar GSI a cikin ƙungiyar TAU shine 1.77 � 0.50 a pretest wanda ya ragu sosai zuwa 1.59 � 0.52 da 1.78 � 0.47 a bayan gwaji da biyo baya, bi da bi (P <0.001). Hakanan, ma'anar damuwa a cikin ƙungiyar TAU a pretest shine 15.9 � 2.86 kuma an canza wannan zuwa 16.13 � 2.44 da 15.76 � 2.22 a bayan gwaji da biyo baya, bi da bi (P <0.001).

 

Kammalawa: MBSR na iya rage damuwa da inganta lafiyar kwakwalwa gaba ɗaya a cikin marasa lafiya da ciwon kai.

 

keywords: Lafiyar hankali, tashin hankali ciwon kai, rage yawan damuwa na tushen tunani (MBSR), damuwa da damuwa, jiyya kamar yadda aka saba (TAU)

 

Dr Jimenez White Coat

Dr. Alex Jimenez's Insight

Kulawa na chiropractic wani tasiri ne mai kula da damuwa saboda yana mai da hankali kan kashin baya, wanda shine tushen tsarin jin tsoro. Chiropractic yana amfani da gyare-gyare na kashin baya da kuma manipulations na hannu don mayar da daidaitawar kashin baya a hankali don ba da damar jiki ya warkar da kansa. Rashin daidaituwa na kashin baya, ko subluxation, na iya haifar da tashin hankali na tsoka tare da kashin baya kuma ya haifar da al'amurran kiwon lafiya iri-iri, ciki har da ciwon kai da migraines, da kuma diski herniation. sciatica. Kulawar chiropractic kuma na iya haɗawa da gyare-gyaren salon rayuwa, kamar shawarwarin abinci mai gina jiki da shawarwarin motsa jiki, don ƙara haɓaka tasirin sa. Rage damuwa na tushen tunani yana iya taimakawa sosai tare da sarrafa damuwa da alamu.

 

Gabatarwa

 

Tashin ciwon kai ya ƙunshi 90% na jimlar ciwon kai. Kusan kashi 3% na yawan jama'a suna fama da ciwon kai mai tsanani.[1] Yawancin ciwon kai na tashin hankali yana haɗuwa da ƙananan ingancin rayuwa da matakan rashin jin daɗi na tunani.[2] A cikin 'yan shekarun nan, da yawa meta-bincike kimantawa kafa zafi jiyya amfani a yau sun nuna cewa likita jiyya, wanda zai iya zama tasiri a cikin m zafi, ba su da tasiri tare da ciwo mai tsanani kuma yana iya, a gaskiya, yana haifar da ƙarin matsaloli. Yawancin jiyya na jin zafi an tsara su don kuma suna da amfani ga ciwo mai tsanani amma idan aka yi amfani da su a cikin dogon lokaci zai iya haifar da ƙarin matsaloli irin su cin zarafi da kuma guje wa ayyuka masu mahimmanci.[3] Wani abu na yau da kullum a yawancin jiyya na ciwo shine suna jaddada ko dai guje wa ciwo ko yaki don rage ciwo. Jin zafi a cikin tashin hankali ciwon kai na iya zama wanda ba za a iya jurewa ba. Magungunan kashe ciwo da dabarun kula da ciwo na iya kara yawan rashin haƙuri da jin dadi ga ciwo. Sabili da haka, maganin da ke ƙara yarda da haƙuri ga ciwo, musamman ma ciwo mai tsanani, yana da tasiri. Rage yawan damuwa na tushen tunani (MBSR) wani sabon ilimin halin dan Adam ne wanda ya bayyana yana da tasiri wajen inganta aikin jiki da kuma jin dadi a cikin marasa lafiya da ciwo mai tsanani.[4,5,6,7,8] A cikin shekaru ashirin da suka wuce, Kabat -Zin et al. a Amurka sun yi nasarar yin amfani da hankali don jin daɗin ciwo da rashin lafiya da ke da alaƙa da ciwo.[9] Nazarin kwanan nan game da hanyoyin da aka yarda da su, irin su tunani, suna nuna ingantaccen aiki a cikin marasa lafiya da ciwo mai tsanani. Tunani yana daidaita zafi ta amfani da wayar da kan jama'a game da tunani, ji da jin daɗi, da dangantaka mai nisa ta zuciya tare da gogewar ciki da waje.[10] Nazarin ya gano cewa shirin MBSR na iya rage yawan rashin lafiyar likita da ke da alaka da ciwo mai tsanani irin su fibromyalgia, rheumatoid arthritis, ciwo na musculoskeletal na kullum, ƙananan ciwon baya, da kuma sclerosis mai yawa. , damuwa, damuwa, gunaguni na somatic, jin dadi, daidaitawa, ingancin barci, gajiya, da aiki na jiki. irin su tashin hankali ciwon kai, sau da yawa har yanzu a cikin jarirai. Sabili da haka, an gudanar da binciken don tantance sakamakon MBSR akan fahimtar damuwa da lafiyar kwakwalwa gaba ɗaya a cikin marasa lafiya da ciwon kai.

 

Kaya da matakai

 

An yi wannan gwajin gwaji na asibiti a cikin 2012 a Asibitin Shahid Beheshti a cikin birnin Kashan. Kwamitin Da'a na Bincike na Jami'ar Kimiyyar Kiwon Lafiya ta Kashan ta amince da wannan binciken (IRCT No: 2014061618106N1). Mahalarta binciken sun hada da manya masu fama da ciwon kai wadanda likitocin tabin hankali da masu aikin jinya a Kashan suka tura su. Sharuɗɗan haɗaɗɗen sun kasance kamar haka: Samun ciwon kai na tashin hankali bisa ga Kwamitin Rarraba Ciwon Kai na Duniya, yana son shiga cikin binciken, ba tare da ciwon ƙwayar cuta ta ƙwayoyin cuta ko cuta ta hauka ba, kuma ba ta da tarihin jiyya ta hankali yayin 6 da ta gabata. watanni. Marasa lafiya waɗanda ba su kammala aikin ba kuma sun rasa fiye da lokuta biyu an cire su daga binciken. Mahalarta taron, waɗanda suka rattaba hannu kan takardar izini da aka sanar, sun kammala matakan a matsayin shaida. Don ƙididdige girman samfurin, mun yi magana game da wani binciken wanda canje-canjen ma'anar gajiya ya kasance 62 - 9.5 a cikin lokacin pretreatment da 54.5 - 11.5 a cikin lokacin jinya.[18]. Sannan, ta hanyar amfani da lissafin girman samfurin, mahalarta 33 (tare da haɗarin haɗari) a cikin kowace ƙungiya tare da? = 0.95 da 1? = 0.9 an raba su. Bayan lissafin girman samfurin, an zaɓi marasa lafiya 66 da ciwon kai na tashin hankali ta hanyar samfurin dacewa bisa ga ka'idojin haɗawa. Bayan haka, an kira marasa lafiya kuma an gayyaci su shiga cikin binciken. Idan majiyyaci ya yarda ya shiga, to an gayyace shi/ta don halartar zaman taƙaitaccen nazari kuma idan ba wani majiyyaci ba an zaɓi irin wannan. Sannan ta amfani da tebur mai lamba bazuwar, an sanya su ko dai zuwa ƙungiyar gwaji (MBSR) ko zuwa ƙungiyar kulawa waɗanda aka bi da su kamar yadda aka saba. A ƙarshe, an cire marasa lafiya 3 daga kowane rukuni kuma an haɗa marasa lafiya 60 (majiyyata 30 a kowace ƙungiya). Ƙungiyar TAU ta sami magani ne kawai ta hanyar maganin antidepressant da kula da asibiti. Ƙungiyar MBSR ta sami horo na MBSR ban da TAU. An horar da marasa lafiya a cikin ƙungiyar MBSR don makonni 8 ta hanyar likitan ilimin likitancin likita tare da digiri na PhD. Takaitaccen bayanin yanayin alama (BSI) da tsinkayar yanayin damuwa (PSS) kafin zaman jiyya ta farko a cikin rukunin Mbsr, bayan gwajin (bibiya) a cikin kungiyoyi biyu. An gayyaci kungiyar TAU zuwa asibitin Shahid Beheshti don cike tambayoyin. Hoto na 3 yana nuna Haɗin Haɗin Gwaje-gwaje na Rahoto (CONSORT) wanda ke nuna kwararar mahalarta binciken.

 

Hoto na 1 CONSORT zane mai nuna Gudun Mahalarta Nazari

Hoto 1: CONSORT zane mai nuna kwararar mahalarta binciken.

 

Tsakani

 

An horar da ƙungiyar masu shiga tsakani (MBSR) a asibitin Shahid Beheshti. An gudanar da zaman mako guda takwas (minti 120) bisa ga daidaitaccen ka'idar MBSR kamar yadda Kabat-Zinn ya inganta.[11] An gudanar da ƙarin zama ga mahalarta waɗanda suka rasa zama ɗaya ko biyu. A ƙarshen horo da watanni 3 (biyu), duka MBSR da ƙungiyoyin TAU an gayyaci su zuwa asibitin Shahid Beheshti (wurin gwajin MBSR) kuma an umurce su da su kammala tambayoyin. A lokacin zaman MBSR, an horar da mahalarta don sanin tunaninsu, ji, da jin dadin jiki ba tare da hukunci ba. Ana koyar da darussan tunani azaman nau'i biyu na ayyukan zuzzurfan tunani - na yau da kullun da na yau da kullun. Nau'in motsa jiki na yau da kullun sun haɗa da horar da tunani na zama, duban jiki, da yoga mai hankali. A cikin tunani na yau da kullum, hankali da sani suna mayar da hankali ba kawai akan ayyukan yau da kullum ba, har ma a kan tunani, ji, da jin dadi na jiki har ma suna da matsala da zafi. An ambaci jimillar abubuwan da ke cikin zaman a cikin Tebur 1.

 

Tebur 1 Ajanda don Zama na MBSR

Shafin 1: Ajanda don zaman na rage yawan damuwa na tushen tunani.

 

Sakamakon Sanya

 

Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwaƙwalwa na Ƙaƙwalwa na Ƙaƙwalwa na Ciwon ) ya yi don ciwon kai

 

An auna ciwon kai ta sikelin diary don ciwon kai.[19] An tambayi marasa lafiya don yin rikodin tarihin tsananin zafi akan ma'auni na 0-10. Rashin ciwo da ciwon kai mai tsanani na nakasa yana da 0 da 10, bi da bi. An ƙididdige ma'anar tsananin ciwon kai a cikin mako guda ta hanyar rarraba jimillar ma'aunin tsanani ta hanyar 7. Haka kuma, an ƙididdige ma'anar ciwon kai a cikin wata guda ta hanyar rarraba jimillar ma'auni da 30. Matsakaicin matsakaici da matsakaicin maki. tsananin ciwon kai ya kasance 0 da 10, bi da bi. An ba da bayanin kula da ciwon kai ga marasa lafiya biyar da likitan jijiyoyi da likitan hauka ya tabbatar da ingancin kayan aikin.[20] An ƙididdige madaidaicin ƙimar sigar Farisa na wannan sikelin a matsayin 0.88.[20].

 

Taƙaitaccen Alamar Inventory (BSI)

 

An yi la'akari da alamun ilimin tunani tare da BSI.[21] Ƙirar ta ƙunshi abubuwa 53 da ƙananan ma'auni 9 waɗanda ke tantance alamun tunani. Kowane abu yana da maki tsakanin 0 zuwa 4 (misali: Ina da tashin zuciya ko bacin rai a cikina). BSI tana da ma'aunin tsananin tsanani na duniya (GSI) ya sami jimillar maki 53. Amincewar gwajin ya ba da rahoton maki 0.89.[22]. A cikin bincikenmu, ƙididdigar gwajin GSI ta kasance .90 bisa samfurin marasa lafiya 60 masu ciwon kai waɗanda suka kammala BSI.

 

Siffar Matsala (PSS)

 

An yi la'akari da damuwa ta hanyar amfani da PSS, [21,23] wani ma'auni na 10 wanda ke kimanta yanayin yanayin da ba a iya sarrafawa da kuma rashin tabbas a cikin watan da ya gabata (misali: Jin cewa ba za ku iya sarrafa abubuwa masu muhimmanci a rayuwar ku ba. ?). Masu amsa suna ba da rahoton yawaitar abu a cikin watan da ya gabata akan ma'auni 5, kama daga 0 (ba) zuwa 4 (sau da yawa). Ana kammala ƙididdigewa ta hanyar mayar da maki guda huɗu ingantattun kalmomi[4,5,7,8] da taƙaita duk maki. Makin ma'auni yana daga 0-40. Maki mafi girma yana nuna matakan damuwa. Yana ɗauka cewa mutane sun dogara da albarkatun da suke jurewa suna kimanta matakin barazana ko ƙalubale abubuwan da suka faru. Maki mafi girma yana nuna mafi girman matakin da aka gane damuwa. An kuma bayar da rahoton isassun gwaji—amintacce da daidaito da ingancin wariya.[19] A cikin bincikenmu, ƙididdigar alpha na Cronbach don tantance daidaiton wannan sikelin an ƙididdige su zuwa 0.88.

 

An yi nazarin matakan da aka maimaita akai-akai don kwatanta ƙungiyoyin MBSR da TAU akan matakan da aka sani da damuwa da GSI a pretreatment, posttreatment, da 3-watanni masu biyo baya. Hakanan, an yi amfani da gwajin Chi-square don kwatanta ƙididdiga a cikin ƙungiyoyin biyu. An yi la'akari da ƙimar P ƙasa da 0.05 mai mahimmanci a duk gwaje-gwaje.

 

results

 

Daga cikin batutuwa na 66, mahalarta 2 daga ƙungiyar MBSR an cire su saboda rasa fiye da lokutan 2. Har ila yau, an cire mahalarta uku saboda ba su kammala tambayoyin a cikin gwaji ko biyo baya ba wanda daya daga cikinsu ya kasance daga kungiyar MBSR da mahalarta uku daga kungiyar TAU. Table 2 ya nuna halayen alƙaluma na batutuwa da sakamakon binciken bazuwar. Sakamakon t-gwajin don bambance-bambance tsakanin MBSR da kungiyoyin TAU a cikin shekarun shekaru da gwajin Chi-square a cikin wasu masu canji ya nuna cewa babu wani bambanci mai mahimmanci tsakanin ma'auni na alƙaluma a cikin ƙungiyoyi biyu kuma an ba da batutuwa ga ƙungiyoyi biyu.

 

Tebur 2 Halayen Alƙaluman Abubuwan

Shafin 2: Halayen alƙaluma na batutuwa a,b.

 

Shafin 3 yana ba da ma'auni da ma'auni na ma'auni na ma'auni na masu dogara (wanda aka gane danniya da GSI) da kwatanta matakan sakamako a lokacin da aka rigaya, lokacin bayan jiyya, da kuma biyo bayan watanni 3.

 

Tebur na 3 Ma'anar, Madaidaicin Saɓani da Kwatanta Ma'aunin Sakamako

Shafin 3: Ma'anar, daidaitattun sauye-sauye, da kwatanta matakan sakamako a pretreatment, posttreatment, da matakan biyo baya a cikin MBSR da kungiyoyin TAU a,b.

 

Shafin 3 yana nuna ƙarin raguwa da aka samu da kuma GSI a cikin ƙungiyar masu shiga tsakani (MBSR) idan aka kwatanta da ƙungiyar TAU, yayin da rage yawan damuwa da GSI ba a lura da su ba a cikin ƙungiyar TAU. Sakamakon ya bayyana gagarumin tasirin lokaci da hulɗar tsakanin lokaci da nau'in jiyya akan canje-canje na maki (P <0.001).

 

Figures ?2 da 3 suna yanzu suna nufin sun sami damuwa da maki GSI don MBSR da ƙungiyoyin TAU a matakan gwaji da biyo baya.

 

Hoto na 2 CONSORT zane mai nuna Gudun Mahalarta Nazari

Hoto 2: CONSORT zane mai nuna kwararar mahalarta binciken.

 

Hoto na 3 Ma'anar Ƙwararrun Ƙwararru a cikin MBSR da Ƙungiyoyin Sarrafa

Hoto 3: Ma'anar damuwa a cikin MBSR da ƙungiyoyi masu sarrafawa a cikin pretest, posttest, da kuma biyo baya.

 

tattaunawa

 

Wannan binciken ya kwatanta ingancin MBSR da Jiyya Kamar yadda ya saba (TAU) a cikin fahimtar damuwa da lafiyar kwakwalwa na marasa lafiya da ciwon kai. Kodayake an gane MBSR a matsayin magani mai mahimmanci don alamun damuwa da ciwo, akwai buƙatar yin nazarin tasirinsa don magance matsalolin lafiyar kwakwalwa a cikin marasa lafiya da ciwon kai na tashin hankali, wanda shine daya daga cikin gunaguni na kowa a cikin yawan jama'a.

 

Sakamakon bincikenmu ya nuna ingantaccen lafiyar kwakwalwa gabaɗaya a cikin ma'aunin GSI na BSI. A cikin wasu binciken, an ba da rahoton ci gaba mai mahimmanci ta hanyar shiga tsakani na MBSR akan duk ma'auni na 36-item Short Form Health Survey (SF-36). SCL-20,24-R) ƙananan ƙananan kamar damuwa da damuwa ta MBSR bayan sa baki da kuma bibiyar shekara 90.[90] Reibel et al. ya nuna MBSR a cikin marasa lafiya da ciwo mai tsanani sun ba da rahoton raguwa a cikin alamun kiwon lafiya kamar damuwa, damuwa, da zafi.[1] An nuna cewa tashin hankali ciwon kai da damuwa suna tare da kasawa a cikin sarrafa fahimi aiki kamar ci gaba da kulawa da ƙwaƙwalwar aiki.[5] Mummunan motsin rai na iya haɓaka wahala da ke da alaƙa da tsinkayen jin zafi.

 

MBSR yana aiwatar da hanyoyi masu zuwa don inganta yanayin tunanin mai haƙuri: Na farko, hankali yana haifar da ƙara fahimtar abin da ke faruwa a kowane lokaci, tare da halin karɓa, ba tare da shiga cikin tunanin al'ada, motsin zuciyarmu, da dabi'un hali ba. Ƙarfafa wayar da kan jama'a sannan ya haifar da sababbin hanyoyin amsawa da jurewa dangane da kai da kuma duniya.[3] Hankali yana kafa tunanin kai wanda ya fi tunanin mutum, ji, da jin jiki kamar zafi. Motsa hankali, koyan abokan ciniki suna haɓaka �mai kallo�. Tare da wannan ikon, za su iya lura da tunaninsu da yadda suke ji ta hanyar da ba ta da hankali kuma ba ta yanke hukunci a baya ba, wanda a baya aka nisantar da tunani da ji da gani ta hanyar da ba ta da hankali kuma ba ta yanke hukunci ba. Abokan ciniki suna koyon lura da tunani ba tare da yin aiki da su ba, ko sarrafa su, ko gaskata su.[3]

 

Na biyu, hankali yana taimaka wa abokin ciniki haɓaka dagewa wajen ɗaukar matakai a cikin mahimman kwatance masu mahimmanci a gare su. Yawancin abokan ciniki da ke fama da ciwo mai tsanani suna so su zama marasa ciwo maimakon rayuwa masu mahimmancin rayuwar da suka zaɓa. Amma shirin MBSR ya horar da su don yin aiki mai daraja duk da ciwo. Nazarin ya nuna kulawa da jin daɗin jin zafi yana da muhimmiyar rawa wajen zama mai tsayin daka.[26] Abubuwan da ke tattare da motsin rai da fahimi na iya canza hankali ga ciwo da damuwa game da shi wanda zai iya ƙarfafa ciwo da rushe ayyukan marasa lafiya.[27,28]

 

Na uku, binciken da aka yi daga wasu nazarin ya nuna cewa MBSR na iya canza aikin kwakwalwar da ke da alhakin rinjayar ka'idoji da yankunan da ke tafiyar da yadda muke amsawa ga matsalolin damuwa, kuma wannan na iya daidaita ayyukan jiki kamar numfashi, bugun zuciya, da kuma aikin rigakafi.[29,30] Ayyukan tunani yana rage mayar da hankali ga tunani da jin dadi wanda ke haɗuwa da ƙarfafa fahimtar jin zafi.[31] Har ila yau hankali na iya rage kunnawa na psychophysiological da ke da alaƙa da damuwa da rashin aiki na yanayi ta hanyar ƙarfafa ingantaccen kimantawa da ƙwarewar ka'idojin motsin rai.[32]

 

Ƙarfin wannan binciken shine amfani da sabon ingantaccen ilimin halin ɗan adam don rage damuwa akan ƙarar da ba a yi nazari ba, amma matsala ce ta likita. Abubuwan da ke tattare da binciken mu suna amfani da tsarin ilimin halin ɗan adam mai sauƙi wanda baya buƙatar fahimi da yawa kuma ana iya amfani da shi azaman ƙwarewar jurewa ga mai haƙuri tare da ciwon kai. Don haka, ƙwararrun likitocin kiwon lafiya waɗanda ke da alaƙa da wannan korafi da majiyyaci za su iya amfani da wannan magani. Hakanan, MBSR zai canza salon rayuwar majiyyaci wanda matsalarsa/ta zata tsananta. Babban ƙayyadaddun wannan binciken shine rashin kwatanta tsakanin MBSR da ma'auni na zinare na zinari irin su farfaɗowar halayyar hali (CBT). An ba da shawarar cewa karatun nan gaba yana buƙatar kwatanta ingancin MBSR da sauran al'adun gargajiya da sababbin hanyoyin kwantar da hankali a cikin marasa lafiya da ciwon kai.

 

Kammalawa

 

Nazarin mu yana goyan bayan hasashen cewa marasa lafiya da ke fama da ciwon kai na iya haɓaka lafiyar tunanin su gabaɗaya ta hanyar shiga cikin shirin MBSR. A taƙaice, sakamakon binciken da aka yi a yanzu ya nuna cewa MBSR na iya rage damuwa da damuwa da damuwa a cikin ayyukan yau da kullum a cikin gajeren lokaci. Siffofin musamman na motsa jiki na tunani sune horo mai sauƙi kuma babu buƙatar hadaddun iyawar fahimta.

 

Tallafin kuɗi da tallafi: Nil.

 

Rikicin sha'awa: Babu rikice-rikice na sha'awa.

 

Gudunmawar Marubuci

 

AO ya ba da gudummawa a cikin tunanin aikin, gudanar da binciken, kuma ya amince da duk abubuwan da ke cikin aikin. FZ ta ba da gudummawa a cikin tunanin aikin, sake fasalin daftarin, amincewa da sigar ƙarshe na rubutun kuma an yarda da duk abubuwan da ke cikin aikin.

 

Acknowledgments

 

Marubuta suna godiya ga ma'aikatan asibitin Shahid Beheshti da mahalarta. Har ila yau, mawallafa sun nuna godiya ga Kabat-Zinn daga Cibiyar Tunatarwa (CFM) a Jami'ar Massachusetts wanda ya ba da kyautar lantarki na ka'idojin MBSR.

 

A ƙarshe,�Yayin da damuwa na ɗan gajeren lokaci yana da taimako, damuwa na dogon lokaci zai iya haifar da al'amurran kiwon lafiya iri-iri, ciki har da damuwa da damuwa da kuma wuyansa da ciwon baya, ciwon kai da zubar da ciki. Abin farin ciki, ƙaddamar da hankali, irin su kulawar chiropractic da rage yawan damuwa na tushen tunani (MBSR) suna da aminci da tasiri mai sarrafa damuwa na madadin zaɓuɓɓukan magani. A ƙarshe, labarin da ke sama ya nuna sakamakon tushen shaida cewa MBSR zai iya rage damuwa da inganta lafiyar kwakwalwa gaba ɗaya a cikin marasa lafiya da ciwon kai. Bayanin da aka ambata daga Cibiyar Bayanan Kimiyyar Halittu ta Ƙasa (NCBI). Matsakaicin bayanin mu yana iyakance ga chiropractic da kuma raunin kashin baya da yanayi. Don tattauna batun batun, don Allah jin daɗin tambayar Dr. Jimenez ko tuntuɓe mu a 915-850-0900 .

 

Dr. Alex Jimenez ne ya shirya shi

 

Green-Call-Now-Button-24H-150x150-2-3.png

 

Ƙarin Maudu'i: Ciwon Baya

 

Bisa ga kididdigar, kimanin 80% na mutane za su fuskanci alamun ciwon baya a kalla sau ɗaya a duk rayuwarsu. Binciken baya koke ne na gama-gari wanda zai iya haifar da rauni da/ko yanayi iri-iri. Sau da yawa lokuta, lalacewar dabi'a na kashin baya tare da shekaru na iya haifar da ciwon baya. Harsiated fayafai faruwa a lokacin da taushi, gel-kamar cibiyar intervertebral disc ta tura ta cikin hawaye a kewaye da shi, waje zobe na guringuntsi, matsawa da kuma fusatar da jijiya tushen. Abubuwan da aka fi sani da diski suna faruwa tare da ƙananan baya, ko kashin baya na lumbar, amma kuma suna iya faruwa tare da kashin mahaifa, ko wuyansa. Ƙunƙarar jijiyoyi da aka samo a cikin ƙananan baya saboda rauni da / ko mummunan yanayin zai iya haifar da bayyanar cututtuka na sciatica.

 

hoton blog na zane mai ban dariya paperboy babban labarai

 

MAFI MUHIMMAN BATUN: Sarrafar da damuwa a wurin Aiki

 

 

MASU MUHIMMAN BUDURWA: KARIN KARAWA: Maganin Rauni na Mota El Paso, TX Chiropractor

 

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