Gudanar da Maganin Chiropractic na Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙafafun Ƙafafun Ƙafafun Ƙafafun baya: Ƙaƙwalwar Adabi

 

Taimakon Chiropractic sanannen ƙarin zaɓi ne kuma madadin magani akai-akai da ake amfani da shi don tantancewa, jiyya da hana raunin da ya faru da yanayin musculoskeletal da tsarin juyayi. Al'amurran kiwon lafiya na kashin baya suna cikin wasu dalilai na yau da kullum da mutane ke neman kulawar chiropractic, musamman ga ƙananan ciwon baya da kuma gunaguni na sciatica. Duk da yake akwai nau'o'in jiyya daban-daban da ke samuwa don taimakawa wajen inganta ƙananan ciwon baya da kuma alamun sciatica, mutane da yawa za su fi son zaɓin jiyya na halitta fiye da amfani da kwayoyi / magunguna ko aikin tiyata. Binciken bincike na gaba yana nuna jerin hanyoyin hanyoyin maganin chiropractic da ke da alaƙa da shaida da kuma tasirin su don inganta al'amuran kiwon lafiya iri-iri.

 

Abstract

 

• Manufofin: Manufar wannan aikin shine don nazarin wallafe-wallafen don yin amfani da magudi na kashin baya don ƙananan ciwon baya (LBP).
• Hanyar: Dabarun bincike da aka gyara daga bitar Haɗin gwiwar Cochrane na LBP an gudanar da su ta hanyar bayanan bayanai masu zuwa: PubMed, Mantis, da Cochrane Database. An ba da gayyata don ƙaddamar da labaran da suka dace ga sana'a ta hanyar watsa labarai na ƙwararru da kafofin watsa labarai na ƙungiyoyi. Kwamitin Kimiyya na Majalisar kan Sharuɗɗa na Chiropractic and Practice Parameters (CCGPP) an caje shi tare da haɓaka wallafe-wallafen wallafe-wallafen, wanda yankin anatomical ya tsara, don kimantawa da bayar da rahoto game da tushen shaida don kula da chiropractic. Wannan labarin shine sakamakon wannan cajin. A matsayin wani ɓangare na tsarin CCGPP, an buga daftarin farko na waɗannan labaran akan gidan yanar gizon CCGPP www.ccgpp.org (2006-8) don ba da damar buɗe tsari da mafi fa'ida mai yuwuwar hanyar shigar da masu ruwa da tsaki.
• results: An samu jimillar takardun tushe guda 887. An rarraba sakamakon binciken zuwa ƙungiyoyin batutuwa masu alaƙa kamar haka: gwaje-gwaje masu sarrafawa (RCTs) na LBP da magudi; gwaje-gwajen da aka bazu na sauran ayyukan don LBP; jagororin; sake dubawa na yau da kullun da meta-bincike; ilimin asali; labaran da ke da alaƙa da bincike, hanya; ilimin halayyar kwakwalwa da al'amurran da suka shafi psychosocial; ƙungiyar ƙungiya da nazarin sakamakon; da sauransu. An rarraba kowace ƙungiya ta jigo ta yadda membobin ƙungiyar za su sami kusan daidai adadin labarai daga kowace ƙungiya, waɗanda aka zaɓa ba da gangan don rarrabawa. Ƙungiyar da aka zaɓa don iyakance la'akari a cikin wannan ƙaddamarwa ta farko zuwa jagorori, nazari na yau da kullum, nazarin-meta, RCTs, da kuma nazarin haɗin gwiwa. Wannan ya ba da jimillar jagororin 12, 64 RCTs, 13 nazari na yau da kullun / nazarin meta-bincike, da kuma nazarin ƙungiyar 11.
• Ƙarshe: Kamar yadda yawa ko fiye da shaida akwai don amfani da magudi na kashin baya don rage alamun bayyanar cututtuka da inganta aiki a cikin marasa lafiya tare da LBP na yau da kullum kamar yadda ake amfani da su a cikin LBP mai tsanani da ƙananan. Yin amfani da motsa jiki tare da magudi na iya yin saurin sauri da inganta sakamako tare da rage yawan sake dawowa. Akwai ƙarancin shaida don yin amfani da magudi ga marasa lafiya tare da LBP da radiating ciwo na ƙafafu, sciatica, ko radiculopathy. (J Manipulative Physiol Ther 2008; 31: 659-674)
• Mabuɗin Sharuɗɗan Fihirisa: Ƙananan Ciwon Baya; Yin magudi; Chiropractic; Kashin baya; Sciatica; Radiculopathy; Bita, Tsari

 

An kafa Majalisar kan Sharuɗɗan Sharuɗɗa da Ayyukan Ayyuka (CCGPP) a cikin 1995 ta hanyar Congress of Chiropractic State Associations tare da taimako daga Ƙungiyar Chiropractic ta Amirka, Ƙungiyar Kwalejojin Chiropractic, Majalisar kan Ilimin Chiropractic, Federation of Chiropractic Licensing �Boards, Foundation for the Chiropractic Association. Ci gaban Kimiyyar Chiropractic, Foundation for Chiropractic Education and Research, International Chiropractors Association, National Association of Chiropractic Attorneys, da Cibiyar Nazarin Chiropractic ta Kasa. Cajin ga CCGPP shine ƙirƙirar takaddun mafi kyawun ayyuka na chiropractic. An ba da wakilcin Majalisar kan Jagororin Chiropractic da Ma'auni don bincika duk jagororin da ke akwai, sigogi, ka'idoji, da ayyuka mafi kyau a Amurka da sauran ƙasashe a cikin ginin wannan takaddar.

 

A karshen wannan, an caje Hukumar Kimiyya ta CCGPP tare da haɓaka wallafe-wallafen wallafe-wallafen, wanda yanki ya tsara (wuyansa, ƙananan baya, thoracic, babba da ƙananan ƙwanƙwasa, nama mai laushi) da kuma nau'o'in da ba na yanki ba na musculoskeletal, rigakafi / inganta kiwon lafiya, jama'a na musamman, subluxation, da kuma ganewar asali.

 

Manufar wannan aikin shine don samar da daidaitattun fassarar wallafe-wallafen don gano hanyoyin lafiya da tasiri a cikin kula da marasa lafiya da ƙananan ciwon baya (LBP) da kuma cututtuka masu dangantaka. Wannan taƙaitaccen bayanin an yi niyya ne don zama tushen albarkatu ga masu yin aiki don taimaka musu cikin la'akari da zaɓuɓɓukan kulawa daban-daban don irin waɗannan marasa lafiya. Ba maye gurbin hukumcin asibiti ba ne ko ƙa'idar kulawar marasa lafiya ɗaya.

 

 

Hanyar

 

An gudanar da ci gaba da ci gaba ta hanyar ƙwarewar mambobin kwamitin tare da tsarin ra'ayi na RAND, haɗin gwiwar Cochrane, Hukumar Kula da Lafiya da Nazarin Manufofin, da kuma buga shawarwarin da aka gyara ga bukatun majalisa.

 

Ganewa da Maidowa

 

Yankin don wannan rahoto shine na LBP da ƙananan alamun ƙafafu na baya. Ta yin amfani da safiyo na sana'a da wallafe-wallafe kan tantancewa na aiki, ƙungiyar ta zaɓi batutuwan da za a bita ta wannan maimaitawar.

 

An zaɓi batutuwa bisa ga yawancin cututtuka da aka gani da kuma mafi yawan nau'o'in jiyya da aka yi amfani da su ta hanyar chiropractors bisa ga wallafe-wallafe. An samo kayan don bita ta hanyar binciken hannu na yau da kullun na wallafe-wallafen da aka buga da na bayanan lantarki, tare da taimako daga ƙwararren ƙwararren laburare na kwalejin chiropractic. An ƙirƙiri dabarun bincike, bisa ƙungiyar CochraneWorking don Ƙananan Ciwo. Gwaje-gwajen da aka bazu (RCTs), sake dubawa na yau da kullun / nazarin meta, da jagororin da aka buga ta 2006 sun haɗa; duk sauran nau'o'in karatu sun haɗa ta hanyar 2004. An ba da gayyata don ƙaddamar da labaran da suka dace ga sana'a ta hanyar watsa labaran sana'a da kafofin watsa labaru na ƙungiyoyi. Binciken da aka mayar da hankali kan jagorori, nazarin meta-nazari, bita na tsari, gwaje-gwaje na asibiti bazuwar, nazarin ƙungiyar, da jerin shari'o'i.

 

Evaluation

 

An yi amfani da ƙayyadaddun ƙayyadaddun kayan aiki da ingantattun kayan aikin da Cibiyar Sadarwar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru ta Scotland ta yi amfani da su don kimanta RCTs da sake dubawa na tsari. Don jagororin, an yi amfani da Ƙimar Jagororin don Bincike da Kayan Aiki. An yi amfani da hanyar da aka daidaita don ƙididdige ƙarfin shaidar, kamar yadda aka taƙaita a cikin Hoto 1. Kowane kwamiti na multidisciplinary na kowane ƙungiya ya gudanar da nazari da kimanta shaidar.

 

 

An rarraba sakamakon binciken zuwa ƙungiyoyi masu alaƙa kamar haka: RCTs na LBP da magudi; gwaje-gwajen da aka bazu na sauran ayyukan don LBP; jagororin; sake dubawa na yau da kullun da meta-bincike; ilimin asali; labaran da ke da alaƙa; hanya; ilimin halayyar kwakwalwa da al'amurran da suka shafi psychosocial; ƙungiyar ƙungiya da nazarin sakamako; da sauransu. An rarraba kowace ƙungiya ta jigo ta yadda membobin ƙungiyar za su sami kusan daidai adadin labarai daga kowace ƙungiya, waɗanda aka zaɓa ba da gangan don rarrabawa. A kan tushen tsarin CCGPP na tsarin maimaitawa da yawan aikin da ake samu, ƙungiyar ta zaɓa don iyakance la'akari a cikin wannan juzu'i na farko zuwa jagororin, bita na tsari, nazarin-meta, RCTs, da kuma nazarin ƙungiyar.

 

Dr. Alex Jimenez's Insight

Ta yaya kulawar chiropractic ke amfanar mutanen da ke da ƙananan ciwon baya da sciatica?�Kamar yadda wani chiropractor ya samu a gudanar da al'amurran kiwon lafiya da yawa na kashin baya, ciki har da ƙananan ciwon baya da sciatica, gyare-gyare na kashin baya da kuma manipulations na hannu, da sauran hanyoyin da ba su da haɗari, za a iya aiwatar da su cikin aminci da yadda ya kamata don inganta ciwon baya. bayyanar cututtuka. Manufar binciken bincike na gaba shine don nuna alamun shaida na chiropractic a cikin maganin raunin da ya faru da kuma yanayin tsarin musculoskeletal da juyayi. Bayanin da ke cikin wannan labarin zai iya ilmantar da marasa lafiya game da yadda zaɓuɓɓukan magani za su iya taimakawa wajen inganta ƙananan ciwon baya da sciatica. A matsayin chiropractor, ana iya kiran marasa lafiya zuwa wasu masu sana'a na kiwon lafiya, irin su masu kwantar da hankali na jiki, masu aikin likita da likitocin likita, don taimaka musu su ci gaba da sarrafa ƙananan ciwon baya da kuma alamun sciatica. Za a iya amfani da kulawar chiropractic don kauce wa ayyukan tiyata don al'amurran kiwon lafiya na kashin baya.

 

Sakamako da Tattaunawa

 

An fara samun jimillar takardun tushe guda 887. Wannan ya haɗa da jimillar jagororin 12, 64 RCTs, 20 nazari na yau da kullum / meta-bincike, da kuma 12 nazarin ƙungiyoyi. Tebu 1 yana ba da taƙaitaccen taƙaitaccen adadin binciken da aka kimanta.

 

 

Tabbaci da Nasiha

 

Dabarar binciken da ƙungiyar ta yi amfani da ita ita ce ta van Tulder et al, kuma ƙungiyar ta gano gwaji 11. Shaidu masu kyau sun nuna cewa marasa lafiya tare da LBP mai tsanani a kan gadon gado suna da ciwo mai tsanani da kuma rashin aikin dawowa fiye da wadanda ke aiki. Babu wani bambanci a cikin zafi da matsayi na aiki tsakanin hutun gado da motsa jiki. Ga marasa lafiya na sciatica, shaida mai kyau ba ta nuna ainihin bambanci a cikin ciwo da matsayi na aiki tsakanin kwanciyar barci da kasancewa mai aiki. Akwai tabbataccen shaida na babu bambanci a cikin tsananin zafi tsakanin hutun gado da ilimin motsa jiki amma ƙananan haɓakawa a matsayin aiki. A ƙarshe, akwai ɗan bambanci a cikin tsananin zafi ko matsayi na aiki tsakanin ɗan gajeren lokaci ko kwanciyar hankali na tsawon lokaci.

 

Wani bita na Cochrane da Hagen et al ya nuna ƙananan fa'idodi a cikin ɗan gajeren lokaci da kuma dogon lokaci don kasancewa mai aiki a kan hutun gado, kamar yadda wani babban bita na Danish Society of Chiropractic and Clinical Biomechanics ya yi, gami da sake dubawa na tsarin 4, 4 ƙarin RCTS. , da kuma jagororin 6, akan m LBP da sciatica. Binciken Cochrane ta Hilde et al ya haɗa da gwaje-gwaje na 4 kuma ya kammala wani karamin tasiri mai amfani don kasancewa mai aiki ga m, LBP maras kyau, amma babu amfani ga sciatica. Nazarin takwas game da kasancewa mai aiki da 10 akan hutun gado an haɗa su a cikin wani bincike na ƙungiyar Waddell. An haɗe wasu hanyoyin kwantar da hankali tare da shawarwari don ci gaba da aiki kuma sun haɗa da maganin analgesics, jiyya na jiki, makarantar baya, da kuma shawarwarin halayya. Kwanciyar gado don m LBP ya kasance kama da babu magani da placebo kuma ƙasa da tasiri fiye da madadin magani. Sakamakon da aka yi la'akari da shi a cikin binciken shine adadin farfadowa, zafi, matakan aiki, da asarar lokacin aiki. An sami ci gaba da aiki yana da tasiri mai kyau.

 

Bita na nazarin 4 da ba a rufe a wani wuri ba an tantance amfani da ƙasidu/littattafai. Yanayin ya kasance don babu bambance-bambance a cikin sakamako na ƙasidu. Banda ɗaya an lura da cewa waɗanda suka karɓi magudi ba su da alamun damun su a cikin makonni 4 kuma ƙarancin nakasa a cikin watanni 3 ga waɗanda suka karɓi ɗan littafin ƙarfafa kasancewa cikin ƙwazo.

 

A taƙaice, tabbatar da marasa lafiya cewa za su iya yin kyau da kuma ba da shawara su ci gaba da aiki kuma su guje wa barcin barci shine mafi kyawun aikin kulawa na LBP mai tsanani. Kwanciyar gado na ɗan gajeren lokaci na iya zama da amfani ga marasa lafiya masu raɗaɗi da ciwon ƙafa waɗanda ba su iya jure wa nauyi.

 

Daidaitawa/Manuni/Tarawa Vs Hanyoyi da yawa

 

Wannan bita ya yi la'akari da wallafe-wallafen kan matakai masu girma, ƙananan hanyoyi (HVLA), sau da yawa ana kiran su daidaitawa ko magudi, da tattarawa. Hanyoyin HVLA suna amfani da motsin motsa jiki da aka yi amfani da su cikin sauri; Ana amfani da motsi ta hanyar cyclyly. Ana iya taimaka wa tsarin HVLA da tattarawa ta hanyar injiniya; Ana ɗaukar na'urorin ƙwaƙƙwaran injina HVLA, kuma hanyoyin karkatar da hankali da ci gaba da hanyoyin motsi masu motsi suna cikin motsi.

 

 

Ƙungiyar ta ba da shawarar yin amfani da binciken binciken da Bronfort et al ya yi, tare da ƙima mai kyau (QS) na 88, yana rufe wallafe-wallafen har zuwa 2002. A cikin 2006, haɗin gwiwar Cochrane ya sake sake yin nazari na baya (2004) na maganin cututtuka na kashin baya (SMT). ) don ciwon baya wanda Assendelft et al. Wannan ya ba da rahoto game da karatun 39 har zuwa 1999, da yawa tare da waɗanda Bronfort et al suka ruwaito ta yin amfani da ma'auni daban-daban da bincike na labari. Ba su bayar da rahoton wani bambanci a cikin sakamako daga jiyya tare da magudi vs madadin. Kamar yadda ƙarin RCTs da yawa suka bayyana a cikin wucin gadi, dalilin sake fitar da tsohon bita ba tare da amincewa da sabon binciken ba a sani ba.

 

Babban LBP. Akwai tabbataccen shaida cewa HVLA yana da ingantaccen inganci na ɗan gajeren lokaci fiye da tattarawa ko diathermy da ƙayyadaddun shaida na ingantaccen ɗan gajeren lokaci fiye da diathermy, motsa jiki, da gyare-gyaren ergonomic.

 

LBP na kullum. Hanyar HVLA da aka haɗa tare da motsa jiki mai ƙarfafawa ya kasance mai tasiri don jin zafi kamar yadda ba a yi amfani da antiinflammatory ba tare da motsa jiki. Shaida ta gaskiya ta nuna cewa magudi ya fi gyaran jiki da motsa jiki na gida don rage nakasa. Shaida ta gaskiya ta nuna cewa magudi yana inganta sakamako fiye da kulawar likita na gaba ɗaya ko placebo a cikin ɗan gajeren lokaci kuma zuwa jiyya na jiki a cikin dogon lokaci. Hanyar HVLA tana da sakamako mafi kyau fiye da motsa jiki na gida, motsa jiki na motsa jiki, motsa jiki, motsa jiki, placebo da magudi, ko chemonucleolysis don ɓarkewar faifai.

 

Haɗaɗɗen (Cute and Chronic) LBP. Hurwitz ya gano cewa HVLA daidai yake da kulawar likita don ciwo da nakasa; ƙara magungunan jiki don magudi bai inganta sakamako ba. Hsieh bai sami wata mahimmiyar ƙima ga HVLA sama da makarantar baya ko kuma maganin myofascial ba. Ƙimar ɗan gajeren lokaci na magudi akan takarda kuma babu bambanci tsakanin magudi da fasaha na McKenzie Cherkin et al. Meade ya bambanta magudi da kulawar asibiti, yana samun fa'ida mafi girma don magudi akan duka gajere da na dogon lokaci. Doran da Newell sun gano cewa SMT ya haifar da haɓaka mafi girma fiye da farfadowa na jiki ko corsets.

 

Babban LBP

 

Kwatancen Lissafin Mara lafiya. Seferlis ya gano cewa marasa lafiya da aka jera an inganta su sosai da alamun alamun bayan wata 1 ba tare da la'akari da sa baki ba, ciki har da magudi. Marasa lafiya sun fi gamsuwa kuma suna jin cewa an ba su mafi kyawun bayani game da ciwon su daga masu aikin da suka yi amfani da farfadowa na hannu (QS, 62.5). Wand et al yayi nazari akan tasirin rashin lafiya-listing kansa kuma ya lura cewa ƙungiyar da ke karɓar kima, shawara, da magani sun inganta fiye da yadda ƙungiyar ke samun kima, shawara, da kuma waɗanda aka sanya su a cikin jerin jiran aiki na tsawon makonni 6. An lura da haɓakawa a cikin nakasa, lafiyar gaba ɗaya, ingancin rayuwa, da yanayi, kodayake ciwo da nakasa ba su bambanta ba a tsawon lokaci (QS, 68.75).

 

Tsarin Jiki da Motsa Jiki. Hurley da abokan aiki sun gwada tasirin magudi tare da maganin tsangwama idan aka kwatanta da kowane nau'i kadai. Sakamakon su ya nuna dukkanin ƙungiyoyin 3 sun inganta aikin zuwa mataki ɗaya, duka a cikin watanni 6 da kuma a cikin watanni na 12 (QS, 81.25). Yin amfani da ƙirar gwajin makafi guda ɗaya don kwatanta magudi don tausa da ƙananan matakan lantarki, Godfrey et al ba su sami bambance-bambance tsakanin ƙungiyoyi ba a cikin 2 zuwa 3-mako na lura da lokaci (QS, 19). A cikin binciken da Rasmussen ya yi, sakamakon ya nuna cewa 94% na marasa lafiya da aka bi da su tare da magudi ba su da alamun bayyanar cututtuka a cikin kwanaki 14, idan aka kwatanta da 25% a cikin rukuni da suka karbi diathermy na gajeren lokaci. Girman samfurin ya kasance ƙananan, duk da haka, kuma a sakamakon haka, binciken ya kasance mai ƙarfi (QS, 18). Bita na tsarin Danish yayi nazarin tsarin jagororin duniya na 12, 12 nazari na yau da kullum, da kuma 10 gwajin gwaji na asibiti akan motsa jiki. Ba su sami wani takamaiman motsa jiki ba, ba tare da la'akari da nau'in ba, waɗanda ke da amfani don maganin m LBP ban da McKenzie maneuvers.

 

Kwatancen Hanyar Sham da Madadin Manual. Nazarin Hadler ya daidaita don tasirin kulawar mai badawa da hulɗar jiki tare da ƙoƙari na farko a hanyar magudin magudi. Marasa lafiya a cikin rukunin da suka shiga gwaji tare da rashin lafiya mai tsawo a farkon an ruwaito sun amfana da magudi. Hakazalika, sun inganta da sauri kuma zuwa matsayi mafi girma (QS, 62.5). Hadler ya nuna cewa akwai fa'ida ga zaman guda ɗaya na magudi idan aka kwatanta da zaman taro (QS, 69). Erhard ya ba da rahoton cewa ƙimar amsa mai kyau ga jiyya ta hannu tare da motsi mai girgiza diddige ta hannu ya fi girma da motsa jiki (QS, 25). Von Buerger yayi nazarin amfani da magudi don m LBP, kwatanta magudin juyawa zuwa tausa mai laushi. Ya gano cewa ƙungiyar magudi ta amsa mafi kyau fiye da rukunin nama mai laushi, kodayake tasirin ya faru ne musamman a cikin ɗan gajeren lokaci. Sakamakon kuma ya sami cikas ta yanayin tilasta zaɓin zaɓin da yawa akan fom ɗin bayanai (QS, 31). Gemmell idan aka kwatanta 2 nau'i na magudi don LBP na kasa da 6 makonni na tsawon lokaci kamar haka: Meric daidaitawa (wani nau'i na HVLA) da fasaha na Activator (nau'i na HVLA na inji). Ba a lura da bambanci ba, kuma duka biyu sun taimaka wajen rage yawan zafi (QS, 37.5). MacDonald ya ba da rahoton fa'ida na ɗan gajeren lokaci a cikin matakan nakasa a cikin farkon 1 zuwa 2 makonni na farawa far don ƙungiyar magudi wanda ya ɓace ta makonni 4 a cikin ƙungiyar kulawa (QS, 38). Ayyukan Hoehler, ko da yake yana dauke da bayanan gauraye ga marasa lafiya tare da LBP mai tsanani da na kullum, an haɗa su a nan saboda yawancin marasa lafiya da LBP mai tsanani sun shiga cikin binciken. Marasa lafiya na magudi sun ba da rahoton agajin gaggawa sau da yawa, amma babu bambance-bambance tsakanin ƙungiyoyi a fitarwa (QS, 25).

 

Magunguna. Coyer ya nuna cewa 50% na ƙungiyar magudi ba shi da wata alama a cikin mako 1 kuma 87% an fitar da su ba tare da wata alama ba a cikin makonni 3, idan aka kwatanta da 27% da 60%, bi da bi, na ƙungiyar kulawa (gado da analgesics) (QS) , 37.5). Doran da Newell sun kwatanta magudi, physiotherapy, corset, ko maganin analgesic, ta yin amfani da sakamakon da ke nazarin ciwo da motsi. Babu bambance-bambance tsakanin ƙungiyoyi na tsawon lokaci (QS, 25). Waterworth idan aka kwatanta magudi da ilimin lissafi na mazan jiya da 500 MG na diflunisal sau biyu a rana don kwanaki 10. Manipulation ya nuna babu fa'ida ga ƙimar dawowa (QS, 62.5). Blomberg ya kwatanta magudi zuwa injections na steroid da kuma zuwa ƙungiyar kulawa da ke karɓar maganin kunnawa na al'ada. Bayan watanni 4, ƙungiyar magudi ba ta da ƙayyadaddun ƙayyadaddun motsi a tsawo, ƙananan ƙuntatawa a gefe-gefe zuwa ɓangarorin biyu, ƙananan ciwo na gida a kan tsawo da kuma gefen dama na dama, ƙananan raɗaɗi mai zafi, da ƙananan zafi lokacin yin hawan kafa madaidaiciya (QS, 56.25). ). Bronfort bai sami bambance-bambancen sakamako ba tsakanin kulawar chiropractic idan aka kwatanta da kulawar likita a watan 1 na jiyya, amma an sami ci gaba mai kyau a cikin ƙungiyar chiropractic a duka 3 da 6 watanni (QS, 31).

 

Ciwon Baya

 

Tsayawa Aiki. Grunnesjo ya kwatanta tasirin haɗin gwiwar jiyya na hannu tare da shawara don kasancewa mai aiki ga shawara kadai a cikin marasa lafiya tare da LBP mai tsanani da kuma subacute. Ƙarin jiyya na hannu ya bayyana don rage ciwo da nakasa yadda ya kamata fiye da tunanin tsayawa aiki kadai (QS, 68.75).

 

Tsarin Jiki da Motsa Jiki. Paparoma ya nuna cewa magudi ya ba da mafi kyawun ci gaba da jin zafi fiye da motsin jijiya na lantarki (QS 38). Sims-Williams ya kwatanta magudi da �physiotherapy.� Sakamako ya nuna fa'idar ɗan gajeren lokaci don magudi akan zafi da ikon yin aikin haske. Bambance-bambancen da ke tsakanin ƙungiyoyi ya ragu a bibiyar watanni 3 da 12 (QS, 43.75, 35). Skargren et al idan aka kwatanta chiropractic zuwa physiotherapy ga marasa lafiya tare da LBP waɗanda ba su da magani ga watan da ya gabata. Ba a lura da bambance-bambance a cikin ingantattun lafiya, farashi, ko yawan maimaitawa tsakanin ƙungiyoyin 2 ba. Duk da haka, bisa ga ƙididdiga na Oswestry, chiropractic ya yi kyau ga marasa lafiya da ke fama da ciwo na kasa da 1 mako, yayin da ilimin lissafin jiki ya zama mafi kyau ga wadanda ke da ciwo fiye da 4 makonni (QS, 50).

 

Bita na tsarin Danish yayi nazarin tsarin jagororin duniya na 12, 12 nazari na yau da kullum, da kuma 10 gwajin gwaji na asibiti akan motsa jiki. Sakamakon ya nuna cewa motsa jiki, a gaba ɗaya, yana amfani da marasa lafiya da ciwon baya na subacute. An ba da shawarar yin amfani da ainihin shirin da za a iya gyara shi da sauri don saduwa da kowane majinyacin buƙatun. Batutuwa na ƙarfi, juriya, daidaitawa, da daidaitawa ba tare da ɗaukar nauyi mai yawa ba duk ana iya magance su ba tare da amfani da manyan kayan aikin fasaha ba. Horarwa mai zurfi wanda ya ƙunshi fiye da 30 da ƙasa da sa'o'i 100 na horo ya fi tasiri.

 

Kwatancen Hanyar Sham da Madadin Manual. Hoiriis idan aka kwatanta ingancin magudi na chiropractic zuwa placebo / sham don LBP mai zurfi. Duk ƙungiyoyi sun inganta akan ma'auni na ciwo, nakasa, rashin tausayi, da kuma Ƙimar Ƙarfafa Duniya. Maganin maganin chiropractic ya zana mafi kyau fiye da placebo a cikin rage ciwo da Ƙwararrun Ƙira na Duniya (QS, 75). Andersson da abokan aiki sun kwatanta magudin osteopathic zuwa daidaitattun kulawa ga marasa lafiya tare da LBP mai zurfi, gano cewa duka ƙungiyoyin sun inganta don tsawon makonni 12 a kusan daidai (QS, 50).

 

Kwatancen Magunguna. A cikin wani ɓangaren kulawa na binciken Hoiriis, an yi nazarin tasirin tasirin maganin chiropractic zuwa masu shakatawa na tsoka don LBP mai zurfi. A cikin duk ƙungiyoyi, zafi, nakasa, baƙin ciki, da Ra'ayin Duniya na Tsanani ya ragu. Magani na chiropractic ya fi tasiri fiye da masu shakatawa na tsoka a cikin rage Ƙimar Ƙwararrun Ƙwararru na Duniya (QS, 75).

 

LBP na kullum

 

Tsayawa Kwatancen Kwatance. Aure idan aka kwatanta da aikin hannu don motsa jiki a cikin marasa lafiya tare da LBP na yau da kullum waɗanda ba su da lafiya da aka jera. Kodayake ƙungiyoyin biyu sun nuna haɓakawa a cikin tsananin zafi, rashin aikin aiki, lafiyar gabaɗaya, da komawa zuwa aiki, ƙungiyar jiyya ta hannu ta nuna haɓaka mafi girma fiye da ƙungiyar motsa jiki don duk sakamakon. Sakamako sun yi daidai da na ɗan gajeren lokaci da na dogon lokaci (QS, 81.25).

 

Shawarar Likita / Kula da Lafiya / Ilimi. Niemisto ya kwatanta haɗin gwiwar magudi, motsa jiki na daidaitawa, da shawarwarin likita zuwa shawarwari kadai. Haɗin haɗin gwiwa ya fi tasiri a rage yawan zafin ciwo da nakasa (QS, 81.25). Koes ya kwatanta jiyya na gabaɗaya ga magudi, physiotherapy, da placebo (detuned duban dan tayi). An yi kimantawa a makonni 3, 6, da 12. Ƙungiyar magudi ta sami ci gaba da sauri da girma a cikin aikin jiki idan aka kwatanta da sauran hanyoyin kwantar da hankali. Canje-canje a cikin motsi na kashin baya a cikin ƙungiyoyi sun kasance ƙananan kuma marasa daidaituwa (QS, 68). A cikin rahoton da aka biyo baya, Koes ya samo a yayin bincike na rukuni cewa ingantawa a cikin ciwo ya fi girma don magudi fiye da sauran jiyya a cikin watanni 12 lokacin la'akari da marasa lafiya da yanayi na yau da kullum, da kuma wadanda ke da shekaru fiye da 40 (QS, 43). Wani binciken da Koes ya yi ya nuna cewa marasa lafiya da yawa a cikin magungunan da ba a yi amfani da su ba sun sami ƙarin kulawa yayin biyo baya. Duk da haka, haɓakawa a cikin manyan gunaguni da kuma aiki na jiki ya kasance mafi kyau a cikin ƙungiyar magudi (QS, 50). Meade ya lura cewa maganin chiropractic ya fi tasiri fiye da kulawar asibiti na asibiti, kamar yadda aka kiyasta ta amfani da Scale Oswestry (QS, 31). Wani RCT da aka gudanar a Masar ta hanyar Rupert ya kwatanta magudi na chiropractic, bayan kimantawar likita da chiropractic. Pain, gyare-gyare na gaba, aiki, da ƙafar ƙafar ƙafa sun haɓaka duk sun inganta zuwa mafi girma a cikin ƙungiyar chiropractic; duk da haka, bayanin madadin jiyya da sakamakon ya kasance m (QS, 50).

 

Triano idan aka kwatanta aikin jiyya zuwa shirye-shiryen ilimi don LBP na yau da kullun. An sami ci gaba mafi girma a cikin ciwo, aiki, da haƙuri na aiki a cikin ƙungiyar magudi, wanda ya ci gaba fiye da lokacin jiyya na 2-week (QS, 31).

 

Tsarin Jiyya na Jiki. Gibson (QS, 38) ya ruwaito wani gwaji mara kyau don magudi. An ba da rahoton ɓarna diathermy don samun kyakkyawan sakamako akan magudi, kodayake akwai bambance-bambance na asali tsakanin ƙungiyoyi. Koes yayi nazarin tasiri na magudi, physiotherapy, jiyya ta babban likita, da placebo na duban dan tayi. An yi kimantawa a makonni 3, 6, da 12. Ƙungiyar magudi ta nuna sauri da haɓakawa a cikin ƙarfin aikin jiki idan aka kwatanta da sauran hanyoyin kwantar da hankali. Bambance-bambancen sassauci tsakanin ƙungiyoyi ba su da mahimmanci (QS, 68). A cikin rahoton da aka biyo baya, Koes ya gano cewa wani bincike na rukuni ya nuna cewa ingantawa a cikin ciwo ya fi girma ga wadanda aka bi da su tare da magudi, duka ga ƙananan (b40) marasa lafiya da wadanda ke da yanayi na yau da kullum a 12-watanni (QS, 43) . Duk da marasa lafiya da yawa a cikin ƙungiyoyin da ba su da hannu sun sami ƙarin kulawa a yayin da ake biyo baya, haɓakawa ya kasance mafi kyau a cikin ƙungiyar magudi fiye da ƙungiyar jiyya ta jiki (QS, 50). A cikin wani rahoton daban na rukuni ɗaya, an sami gyare-gyare a cikin duka physiotherapy da ƙungiyoyin jiyya na manual game da tsananin gunaguni da tasirin da ake gani a duniya idan aka kwatanta da kulawar likita na gaba ɗaya; , 2). Mathews et al sun gano cewa magudi ya gaggauta dawowa daga LBP fiye da sarrafawa.

 

Modality Modality. Hemilla ya lura cewa SMT ya haifar da mafi kyawun raguwa na nakasa na dogon lokaci da gajeren lokaci idan aka kwatanta da jiyya na jiki ko motsa jiki na gida (QS, 63). Wani labarin na biyu na wannan rukuni ya gano cewa babu tsarin kashi ko motsa jiki ya bambanta da mahimmanci daga farfadowa na jiki don kula da alamun bayyanar cututtuka, kodayake tsarin kashi yana da alaƙa da ingantacciyar ɓangarorin gefe da gaba-gaba na kashin baya fiye da motsa jiki (QS, 75). Coxhea ya ruwaito cewa HVLA ya ba da sakamako mafi kyau idan aka kwatanta da motsa jiki, corsets, traction, ko babu motsa jiki lokacin da aka yi nazari a cikin gajeren lokaci (QS, 25). Sabanin haka, Herzog bai sami bambance-bambance tsakanin magudi, motsa jiki, da ilimin baya ba don rage ko dai ciwo ko nakasa (QS, 6). Aure idan aka kwatanta da aikin jiyya don motsa jiki a cikin marasa lafiya tare da LBP na yau da kullun waɗanda kuma ba su da lafiya da aka jera. Kodayake ƙungiyoyin biyu sun nuna haɓakawa a cikin tsananin zafi, rashin aikin aiki, da lafiya gabaɗaya kuma sun dawo aiki, ƙungiyar jiyya ta hannu ta nuna haɓaka mafi girma fiye da ƙungiyar motsa jiki don duk sakamakon. Wannan sakamakon ya ci gaba da kasancewa na ɗan gajeren lokaci da na dogon lokaci (QS, 81.25). A cikin labarin da Niemisto da abokan aiki suka yi, an bincika tasirin haɗin gwiwar haɗin gwiwa, motsa jiki (nau'i na daidaitawa), da kuma shawarwarin likita idan aka kwatanta da shawarwari kadai. Haɗin haɗin gwiwa ya fi tasiri a rage yawan zafin ciwo da nakasa (QS, 81.25). Binciken Beam na United Kingdom ya gano cewa magudi da motsa jiki ya biyo baya ya sami matsakaicin fa'ida a cikin watanni 3 da ƙaramin fa'ida a cikin watanni 12. Hakanan, magudi ya sami fa'ida kaɗan zuwa matsakaici a cikin watanni 3 da ƙaramin fa'ida a cikin watanni 12. Motsa jiki kadai yana da ɗan fa'ida a cikin watanni 3 amma babu fa'ida a cikin watanni 12. Lewis et al ya sami ci gaba lokacin da aka bi da marasa lafiya ta hanyar haɗin gwiwar magudi da kuma motsa jiki na kashin baya vs amfani da nau'in motsa jiki na 10.

 

Bita na tsarin Danish yayi nazarin ka'idodin 12 na kasa da kasa na jagororin, 12 nazari na yau da kullum, da kuma 10 gwajin gwaji na asibiti akan motsa jiki. Sakamakon ya nuna cewa motsa jiki, a gaba ɗaya, yana amfani da marasa lafiya tare da LBP na yau da kullum. Ba a san hanyar da ta fi dacewa ba. An ba da shawarar yin amfani da ainihin shirin da za a iya gyara shi da sauri don saduwa da kowane majinyacin buƙatun. Batutuwa masu ƙarfi, juriya, daidaitawa, da daidaitawa ba tare da ɗaukar nauyi ba duk ana iya magance su ba tare da amfani da kayan aikin fasaha ba. Horarwa mai zurfi wanda ya ƙunshi fiye da 30 da ƙasa da sa'o'i 100 na horo ya fi tasiri. Marasa lafiya tare da LBP mai tsanani mai tsanani, ciki har da waɗanda ba a aiki ba, ana kula da su sosai tare da shirin gyaran gyare-gyare na multidisciplinary. Don gyaran gyare-gyaren bayan tiyata, marasa lafiya da suka fara makonni 4 zuwa 6 bayan aikin tiyata a karkashin horo mai zurfi suna samun fa'ida mafi girma fiye da shirye-shiryen motsa jiki na haske.

 

Sham da Madadin Hannun Hannu. Triano ya gano cewa SMT ya haifar da sakamako mafi kyau don jin zafi da nakasa na ɗan gajeren lokaci, fiye da yin amfani da sham (QS, 31). Cote ba ta sami wani bambanci ba akan lokaci ko don kwatance a ciki ko tsakanin ƙungiyoyin magudi da ƙungiyoyi (QS, 37.5). Marubutan sun nuna cewa gazawar lura da bambance-bambance na iya kasancewa saboda ƙarancin amsawa don canzawa a cikin kayan aikin da aka yi amfani da su don algometry, haɗe tare da ƙaramin samfurin. Hsieh bai sami wata mahimmiyar ƙima ga HVLA sama da makarantar baya ko jiyya na myofascial (QS, 63). A cikin binciken da Licciardone ya yi, an kwatanta kwatanta tsakanin magudi na osteopathic (wanda ya hada da ƙaddamarwa da kuma tsarin nama mai laushi da kuma HVLA), magudi na sham, da kuma kulawar rashin kulawa ga marasa lafiya da LBP na kullum. Duk ƙungiyoyi sun nuna ci gaba. Sham da osteopathic manipulation an haɗa su da haɓaka mafi girma fiye da yadda aka gani a cikin ƙungiyar da ba a yi amfani da su ba, amma ba a sami bambanci tsakanin ƙungiyoyin sham da magudi ba (QS, 62.5). Dukansu matakan da suka dace da na haƙiƙa sun nuna haɓaka mafi girma a cikin ƙungiyar magudi idan aka kwatanta da sarrafa sham, a cikin rahoton Waagen (QS, 44). A cikin aikin Kinalski, maganin manual ya rage lokacin jiyya na marasa lafiya tare da LBP da kuma raunin diski na intervertebral concomitant. Lokacin da raunukan diski ba su ci gaba ba, an lura da raguwar hypertonia na tsoka da haɓakar motsi. Wannan labarin, duk da haka, an iyakance shi da ƙarancin bayanin marasa lafiya da hanyoyin (QS, 0).

 

Harrison et al ya ba da rahoton wani gwajin gwagwarmayar da ba a ba da izini ba na jiyya na LBP na yau da kullum wanda ya ƙunshi 3-point lankwasawa traction da aka tsara don ƙara curvature na kashin baya na lumbar. Ƙungiyar gwaji ta sami HVLA don kula da ciwo a cikin makonni 3 na farko (jiyya na 9). Ƙungiyar kulawa ba ta sami magani ba. Biyewa a cikin makonni na 11 ba ya nuna wani canji a cikin ciwo ko matsayi na curvature don sarrafawa amma karuwa mai yawa a cikin kullun da rage jin zafi a cikin ƙungiyar gwaji. Matsakaicin adadin jiyya don cimma wannan sakamakon shine 36. Tsawon lokaci mai tsawo a cikin watanni 17 ya nuna ci gaba da amfani. Ba a bayar da rahoton dangantaka tsakanin canje-canjen asibiti da canjin tsari ba.

 

Haas da abokan aiki sunyi nazarin tsarin amsawar kashi na magudi don LBP na kullum. An ba da marasa lafiya ba tare da izini ba ga ƙungiyoyi masu karɓar 1, 2, 3, ko 4 ziyara a kowane mako don makonni 3, tare da sakamakon da aka rubuta don tsananin zafi da rashin aiki. Kyakkyawan tasiri mai mahimmanci da asibiti na adadin maganin chiropractic akan tsananin zafi da nakasa a cikin makonni 4 an hade tare da ƙungiyoyin da ke karɓar mafi girma na kulawa (QS, 62.5). Descarreaux et al ya tsawaita wannan aikin, yana kula da ƙananan ƙungiyoyi na 2 don makonni 4 (sau 3 a kowace mako) bayan ƙididdigar asali na 2 da aka raba ta makonni 4. Sai a yi maganin rukuni guda kowane mako 3; dayan bai yi ba. Kodayake ƙungiyoyin biyu suna da ƙananan ƙima na Oswestry a makonni 12, a cikin watanni 10, haɓakawa kawai ya ci gaba ga ƙungiyar SMT mai tsawo.

 

Magunguna. Burton da abokan aiki sun nuna cewa HVLA ya haifar da ingantawa na ɗan gajeren lokaci a cikin ciwo da nakasa fiye da chemonucleolysis don sarrafa diski (QS, 38). Bronfort yayi nazarin SMT hade tare da motsa jiki vs haɗuwa da magungunan anti-inflammatory marasa steroidal da motsa jiki. An sami irin wannan sakamako ga ƙungiyoyin biyu (QS, 81). Yin amfani da karfi mai karfi tare da maganin sclerosant (allurar maganin da ke tattare da dextrose-glycerine-phenol) an kwatanta shi da ƙananan magudi tare da injections na saline, a cikin binciken Ongley. Ƙungiya da ke karɓar magudi mai ƙarfi tare da sclerosant sun fi kyau fiye da rukunin madadin, amma ba za a iya raba tasirin tsakanin hanyar jagora da sclerosant (QS, 87.5). Giles da Muller sun kwatanta hanyoyin HVLA zuwa magani da acupuncture. Manipulation ya nuna babban ci gaba a cikin yawan ciwon baya, ƙananan ciwo, Oswestry, da SF-36 idan aka kwatanta da sauran ayyukan 2. Abubuwan haɓaka sun kasance har tsawon shekara 1. Rashin raunin binciken an yi amfani da bincike-bincike kawai-kawai a matsayin niyya don magance Oswestry, kuma Siffar Analogue na gani (VAS) ba ta da mahimmanci.

 

Sciatica/Radicular/Radiating Ƙafafun Ƙafa

 

Kasancewar Kwanciyar Hankali/Hutun Kwanciya. Postacchini yayi nazarin ƙungiyoyin marasa lafiya tare da LBP, tare da kuma ba tare da radiating ciwon ƙafa ba. Za a iya rarraba marasa lafiya a matsayin mai tsanani ko na yau da kullum kuma an kimanta su a makonni 3, watanni 2, da watanni 6 bayan farawa. Jiyya sun haɗa da magudi, maganin miyagun ƙwayoyi, physiotherapy, placebo, da hutun gado. Ciwon baya mai tsanani ba tare da radiation ba da ciwon baya mai tsanani ya amsa da kyau ga magudi; duk da haka, a cikin ɗaya daga cikin ƙungiyoyin da aka yi ta hanyar magudi da sauran shisshigi (QS, 6).

 

Shawarar Likita / Kula da Lafiya / Ilimi. Arkuszewski ya dubi marasa lafiya da ciwon lumbosacral ko sciatica. Ƙungiya ɗaya ta karɓi magunguna, physiotherapy, da gwajin hannu, yayin da na biyu ya ƙara magudi. Ƙungiyar da ke karɓar magudi tana da ɗan gajeren lokacin jiyya da kuma ingantaccen ci gaba. A biyo bayan watanni 6, ƙungiyar magudi ta nuna aikin tsarin neuromotor mafi kyau da kuma ikon ci gaba da aiki. Nakasa ya kasance ƙasa a cikin ƙungiyar magudi (QS, 18.75).

 

Tsarin Jiyya na Jiki. Arkuszewski ya yi nazarin ilimin motsa jiki tare da magudin hannu da magani, ya bambanta da wannan makirci tare da magudi, kamar yadda muka gani a sama. Abubuwan da aka samu daga magudi sun kasance mafi kyau ga aikin neurologic da aikin motsa jiki da nakasa (QS, 18.75). Postacchini ya kalli marasa lafiya tare da m ko na yau da kullun bayyanar cututtuka da aka kimanta a makonni 3, watanni 2, da watanni 6 bayan farawa. Manipulation bai kasance mai tasiri ba don sarrafa marasa lafiya tare da radiating ciwon kafa kamar sauran magunguna (QS, 6). Mathews da abokan aiki sunyi nazarin jiyya da yawa ciki har da magudi, traction, amfani da sclerosant, da allurar epidural don ciwon baya tare da sciatica. Ga marasa lafiya tare da LBP da ƙuntataccen gwajin ɗaga ƙafar ƙafa, magudi ya ba da taimako mai mahimmanci, fiye da madaidaicin tsoma baki (QS, 19). Coxhead et al sun haɗa a cikin batutuwan su marasa lafiya waɗanda ke da zafi mai zafi aƙalla zuwa gindi. Matsalolin sun haɗa da jan hankali, magudi, motsa jiki, da corset, ta amfani da ƙirar ƙira. Bayan makonni 4 na kulawa, magudi ya nuna mahimmancin fa'ida akan ɗaya daga cikin ma'aunin da aka yi amfani da shi don tantance ci gaba. Babu ainihin bambance-bambance tsakanin ƙungiyoyi a watanni 4 da watanni 16 bayan jiyya, duk da haka (QS, 25).

 

Modality Modality. A cikin yanayin LBP bayan laminectomy, Timm ya ruwaito cewa motsa jiki ya ba da amfani ga duka don jin zafi da kuma farashi (QS, 25). Manipulation yana da ɗan ƙaramin tasiri akan inganta ko dai alamun ko aiki (QS, 25). A cikin binciken da Coxhead et al ya yi, radiating zafi zuwa akalla ƙwanƙwasa ya fi kyau bayan 4 makonni na kulawa don magudi, sabanin sauran jiyya da suka ɓace watanni 4 da watanni 16 (QS, 25).

 

Sham da Madadin Hanyar Manual. Siehl ya dubi yin amfani da magudi a karkashin maganin sa barci ga marasa lafiya tare da LBP da unilateral ko biyu radiating kafa zafi. An lura da haɓakar asibiti na ɗan lokaci kawai lokacin da shaidar electromyographic na al'ada na shigar da tushen jijiya ya kasance. Tare da ƙananan electromyography, an ba da rahoton magudi don samar da ci gaba mai ɗorewa (QS, 31.25) Santilli da abokan aiki idan aka kwatanta da HVLA zuwa latsa mai laushi ba tare da wani kwatsam ba a cikin marasa lafiya tare da matsananciyar matsananciyar baya da ƙafa. Hanyoyin HVLA sun fi tasiri sosai wajen rage ciwo, kai ga matsayi mara zafi, da kuma yawan adadin kwanakin da zafi. An lura da bambance-bambance masu mahimmanci na asibiti. An ƙaddamar da jimlar jimlar jiyya a 20 a kan adadin 5 sau a mako guda tare da kulawa dangane da jin zafi. Binciken ya nuna sauƙi yana ci gaba har tsawon watanni 6.

 

Magunguna. Haɗaɗɗen ciwo mai tsanani da ciwo mai tsanani tare da radiation da aka bi da su a cikin binciken ta amfani da makamai masu yawa na magani an kimanta su a makonni 3, watanni 2, da watanni 6 da ƙungiyar Postacchini ta sake farawa. Gudanar da magani ya fi kyau fiye da yin magudi lokacin da aka nuna ciwon kafa (QS, 6). Sabanin haka, don aikin Mathews da abokan aiki, ƙungiyar marasa lafiya tare da LBP da ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙafa sun fi mayar da martani ga magudi fiye da steroid na epidural ko sclerosants (QS, 19).

 

Disk Herniation

 

Nwuga ya yi nazarin batutuwa 51 da ke fama da cutar sankarau na tsatsauran ra'ayi kuma waɗanda aka tura su don aikin jiyya. An ba da rahoton yin amfani da manipulation ya fi na al'ada magani (QS, 12.5). Zylbergold ya gano cewa babu bambance-bambancen kididdiga tsakanin jiyya guda 3, motsa jiki na jujjuyawar lumbar, kulawar gida, da magudi. Marubucin ya gabatar da ɗan gajeren lokaci na ɗan gajeren lokaci da ƙaramin samfurin samfurin a matsayin tushen rashin ƙin ƙin yarda da ra'ayi mara kyau (QS, 38).

 

Darasi

 

Motsa jiki yana ɗaya daga cikin mafi kyawun nau'ikan maganin cututtukan ƙananan baya. Akwai hanyoyi daban-daban don motsa jiki. Don wannan rahoto, yana da mahimmanci kawai don bambanta gyare-gyare na multidisciplinary. An tsara waɗannan shirye-shiryen don marasa lafiya tare da yanayi na yau da kullun tare da manyan matsalolin psychosocial. Sun haɗa da motsa jiki na gangar jikin, horar da aikin aiki gami da kwaikwaiyon aiki/koyarwar sana'a, da ba da shawara na tunani.

 

 

A cikin sake dubawa na Cochrane na baya-bayan nan game da motsa jiki don kula da LBP marasa takamaiman (QS, 82), tasiri na aikin motsa jiki a cikin marasa lafiya da aka rarraba a matsayin m, subacute, da na yau da kullum an kwatanta shi da babu magani da madadin magani. Sakamakon ya haɗa da kima na ciwo, aiki, komawa zuwa aiki, rashin zuwa, da / ko ci gaban duniya. A cikin bita, gwaje-gwaje na 61 sun hadu da ka'idojin haɗakarwa, mafi yawan abin da suka yi aiki tare da na yau da kullum (n = 43), yayin da ƙananan lambobi sunyi magana mai tsanani (n = 11) da subacute (n = 6) zafi. Gabaɗayan ƙarshe sun kasance kamar haka:

 

• motsa jiki ba shi da tasiri a matsayin maganin LBP mai tsanani,
• shaida cewa motsa jiki yana da tasiri a cikin yawan jama'a na yau da kullum dangane da kwatancen da aka yi a lokuta masu biyo baya,
• ma'anar ingantawa na 13.3 maki don ciwo da 6.9 maki don aiki da aka lura, kuma
• akwai wasu shaidun cewa aikin motsa jiki-daraja yana da tasiri ga ƙananan LBP amma kawai a cikin saitin sana'a

 

Binciken ya yi nazarin halayen yawan jama'a da shiga tsakani, da kuma sakamakon da aka samu don cimma matsaya. Cire bayanai game da komawa aiki, rashin zuwa, da kuma ci gaban duniya ya tabbatar da wahala sosai cewa zafi da aiki kawai za a iya kwatanta su da yawa.

 

Nazari takwas sun sami sakamako mai kyau akan mahimmin ma'aunin inganci. Game da mahimmancin asibiti, yawancin gwaje-gwajen sun gabatar da cikakkun bayanai, tare da 90% suna ba da rahoton yawan yawan binciken amma kawai 54% kawai yana kwatanta aikin motsa jiki. An ba da rahoton sakamako masu dacewa a cikin kashi 70% na gwaji.

 

Motsa jiki don m LBP. Daga cikin gwaje-gwaje 11 (jimlar n = 1192), 10 ba su da ƙungiyoyin kwatancen motsa jiki. Gwajin sun gabatar da hujjoji masu karo da juna. Gwaje-gwaje marasa inganci takwas sun nuna babu bambance-bambance tsakanin motsa jiki da kulawa na yau da kullun ko babu magani. Bayanan da aka tattara sun nuna cewa babu wani bambanci a cikin gajeren lokaci na jin zafi tsakanin motsa jiki da babu magani, babu bambanci a farkon bibiyar jin zafi idan aka kwatanta da sauran ayyukan, kuma babu wani tasiri mai kyau na motsa jiki akan sakamakon aiki.

 

Babban darajar LBP. A cikin nazarin 6 (jimlar n = 881), ƙungiyoyin motsa jiki 7 suna da ƙungiyar kwatancen marasa motsa jiki. Gwaje-gwajen sun ba da sakamako masu gauraya dangane da shaidar tasiri, tare da tabbataccen shaida na tasiri ga shirin ayyukan motsa jiki da aka ƙididdige shi a matsayin kawai sanannen ganowa. Bayanan da aka tattara ba su nuna shaida ga ko dai goyon baya ko karyata yin amfani da motsa jiki don LBP mai zurfi ba, ko dai don rage ciwo ko inganta aiki.

 

LBP na kullum. Akwai gwaje-gwaje 43 da aka haɗa a cikin wannan rukunin ( jimlar n = 3907). Talatin da uku na karatun suna da ƙungiyoyin kwatanta marasa motsa jiki. Ayyukan motsa jiki sun kasance aƙalla kamar yadda sauran masu ra'ayin mazan jiya na LBP, da kuma 2 high-quality karatu da kuma 9 ƙananan binciken da aka gano cewa motsa jiki ya fi tasiri. Waɗannan karatun sun yi amfani da shirye-shiryen motsa jiki daban-daban, suna mai da hankali musamman akan ƙarfafawa ko daidaitawar gangar jikin. Akwai gwaje-gwajen 14 waɗanda ba su sami bambanci tsakanin motsa jiki da sauran ayyukan masu ra'ayin mazan jiya ba; daga cikin waɗannan, 2 an ƙididdige su sosai kuma 12 an ƙididdige ƙasa. Yin amfani da bayanan ya nuna ma'anar ingantawa na 10.2 (95% tazarar amincewa [CI], 1.31-19.09) akan ma'aunin zafi na 100-mm don motsa jiki idan aka kwatanta da babu magani da 5.93 (95% CI, 2.21- 9.65) maki idan aka kwatanta da sauran jiyya na mazan jiya. Har ila yau, sakamakon aikin ya nuna ingantawa kamar haka: 3.0 maki a farkon biyo baya idan aka kwatanta da babu magani (95% CI,? 0.53 zuwa 6.48) da 2.37 maki (95% CI, 1.04-3.94) idan aka kwatanta da sauran magunguna masu ra'ayin mazan jiya.

 

Binciken rukuni na kai tsaye ya gano cewa gwaje-gwajen da ke nazarin yawan nazarin kiwon lafiya suna da ma'anar ingantawa a cikin ciwo da aiki na jiki idan aka kwatanta da ƙungiyoyin kwatanta su ko kuma gwaje-gwajen da aka saita a cikin sana'a ko yawan jama'a.

 

Marubutan bitar sun ba da shawarwari masu zuwa:

 

1. A cikin LBP mai tsanani, motsa jiki ba su da tasiri fiye da sauran ayyukan mazan jiya. Meta-bincike ya nuna babu wani amfani a kan rashin maganin ciwo da sakamakon aiki a kan gajeren ko dogon lokaci.
2. Akwai tabbataccen shaida na tasiri na shirin motsa jiki na matakin aiki a cikin ƙananan LBP a cikin saitunan sana'a. Babu tabbas kan tasirin sauran nau'ikan maganin motsa jiki a cikin sauran jama'a.
3. A cikin LBP na yau da kullum, akwai kyakkyawar shaida cewa motsa jiki yana da akalla tasiri kamar sauran jiyya masu ra'ayin mazan jiya. Shirye-shiryen ƙarfafawa ko daidaitawa da aka ƙera ɗaya ɗaya suna da tasiri a cikin saitunan kiwon lafiya. Meta-bincike ya gano sakamakon aikin ya inganta sosai; duk da haka, tasirin ya kasance ƙananan ƙananan, tare da ƙasa da 3-point (na 100) bambanci tsakanin ƙungiyoyin motsa jiki da kwatanta a farkon biyan. Hakanan an inganta sakamakon raɗaɗi a cikin ƙungiyoyi masu karɓar motsa jiki dangane da sauran kwatancen, tare da ma'anar kusan maki 7. Tasirin sun kasance iri ɗaya akan dogon bibiya, kodayake tazarar amincewa ta ƙaru. Ma'anar haɓakawa a cikin ciwo da aiki na iya zama mai ma'ana a asibiti a cikin binciken daga al'ummomin kiwon lafiya wanda ingantawa ya fi girma fiye da waɗanda aka gani a cikin nazarin daga jama'a ko gauraye.

 

Ƙungiyar Danish na nazarin motsa jiki ta iya gano 5 nazari na yau da kullum da kuma jagororin 12 da suka tattauna motsa jiki don m LBP, 1 nazari na yau da kullum da kuma jagororin 12 don subacute, da 7 nazari na yau da kullum da 11 jagororin na kullum. Bugu da ƙari, sun gano bita na tsari guda 1 waɗanda aka zaɓa waɗanda aka tantance don lokuta bayan tiyata. Ƙarshe sun kasance daidai da bita na Cochrane, tare da ban da cewa akwai iyakacin tallafi ga maneuvers na McKenzie ga marasa lafiya da ke fama da mummunan yanayin da kuma shirye-shiryen gyaran gyare-gyare mai tsanani don 4 zuwa 6 makonni bayan tiyata faifai akan shirye-shiryen motsa jiki na haske.

 

Tarihin Halitta da Jiyya na LBP

 

Yawancin karatu sun nuna cewa kusan rabin LBP zai inganta a cikin mako 1, yayin da kusan 90% na shi zai tafi ta hanyar 12 makonni. Har ma fiye da haka, Dixon ya nuna cewa watakila kusan 90% na LBP zai warware kansa, ba tare da wani sa baki ba. Von Korff ya nuna cewa yawancin marasa lafiya tare da LBP mai tsanani za su sami ciwo mai tsanani idan an lura da su har zuwa shekaru 2.

 

Phillips ya gano cewa kusan 4 na mutane 10 za su sami LBP bayan wani labari a cikin watanni 6 daga farkon, koda kuwa ciwon asali ya ɓace saboda fiye da 6 a cikin 10 zai sami akalla 1 sake dawowa a cikin shekara ta farko bayan wani lamari. Waɗannan sake dawowa na farko suna faruwa a cikin makonni 8 galibi kuma suna iya sake faruwa akan lokaci, kodayake suna raguwar kashi.

 

An lura da raunin raunin ma'aikata na tsawon shekara 1 don bincika tsananin alamun da matsayi na aiki. Rabin wadanda aka yi nazari sun rasa lokacin aiki a cikin watan farko bayan rauni, amma 30% sun rasa lokaci daga aiki saboda raunin da suka samu a cikin shekara 1. Daga cikin wadanda suka rasa aiki a watan farko saboda raunin da suka samu kuma sun riga sun sami damar komawa bakin aiki, kusan kashi 20% ba su samu ba a cikin wannan shekarar. Wannan yana nuna cewa yin la'akari da komawa aiki a wata 1 bayan raunin da ya faru ba zai kasa ba da alamar gaskiya na na kullum, yanayin yanayin LBP. Kodayake yawancin marasa lafiya sun koma bakin aiki, daga baya za su fuskanci matsalolin ci gaba da rashin aiki. Rashin lahani a cikin fiye da makonni 12 bayan raunin da ya faru na iya zama mafi girma fiye da abin da aka ruwaito a baya a cikin wallafe-wallafen, inda adadin 10% ya kasance na kowa. A gaskiya ma, ƙimar kuɗi na iya haura zuwa sau 3 zuwa 4 mafi girma.

 

A cikin binciken da Schiotzz-Christensen da abokan aiki suka yi, an lura da haka. Dangane da izinin rashin lafiya, LBP yana da kyakkyawar hangen nesa, tare da 50% komawa aiki a cikin kwanakin 8 na farko kuma kawai 2% akan izinin rashin lafiya bayan shekara 1. Koyaya, 15% sun kasance cikin hutun rashin lafiya a cikin shekara mai zuwa kuma kusan rabin sun ci gaba da korafin rashin jin daɗi. Wannan ya nuna cewa wani mummunan lamari na LBP wanda ya isa ya sa mai haƙuri ya nemi ziyara ga babban likita ya biyo bayan wani lokaci mai tsawo na rashin nakasa fiye da yadda aka ruwaito a baya. Har ila yau, har ma ga waɗanda suka koma aiki, har zuwa 16% sun nuna cewa ba a inganta su ba. A cikin wani binciken da ke kallon sakamakon bayan makonni 4 bayan ganewar asali da magani na farko, kawai 28% na marasa lafiya ba su fuskanci wani ciwo ba. Mafi mahimmanci, dagewar ciwo ya bambanta tsakanin ƙungiyoyin da ke da zafi mai zafi da waɗanda ba su yi ba, tare da 65% na tsohon jin daɗin ingantawa a cikin makonni 4, vs 82% na karshen. Abubuwan da aka samu daga wannan binciken sun bambanta da wasu a cikin cewa 72% na marasa lafiya har yanzu suna jin zafi 4 makonni bayan ganewar asali na farko.

 

Hestbaek da abokan aiki sun sake nazarin labarai da yawa a cikin bita na tsari. Sakamakon ya nuna cewa adadin da aka ruwaito na marasa lafiya waɗanda har yanzu suna fama da ciwo bayan watanni 12 bayan farawa shine 62% a matsakaici, tare da 16% marasa lafiya da aka jera watanni 6 bayan farawa, kuma tare da 60% suna fuskantar koma baya na rashin aiki. Har ila yau, sun gano cewa ma'anar da aka ruwaito na LBP a cikin marasa lafiya da ke da abubuwan da suka gabata na LBP shine 56%, idan aka kwatanta da kawai 22% ga waɗanda ba su da irin wannan tarihin. Croft da abokan aiki sun yi nazari mai yiwuwa suna kallon sakamakon LBP a cikin aikin gabaɗaya, gano cewa 90% na marasa lafiya tare da LBP a cikin kulawa na farko sun daina yin shawarwari tare da bayyanar cututtuka a cikin watanni 3; duk da haka, yawancin suna fuskantar LBP da nakasa 1 shekara bayan ziyarar farko. Kashi 25% ne kawai suka murmure a cikin wannan shekarar.

 

Akwai ma sakamakon daban-daban a cikin binciken da Wahlgren et al. A nan, yawancin marasa lafiya sun ci gaba da jin zafi a duka watanni 6 da 12 (78% da 72%, bi da bi). Kashi 20% kawai na samfurin ya murmure sosai ta watanni 6 kuma kawai 22% ta watanni 12.

 

Von Korff ya ba da jerin jerin bayanai masu tsawo da ya yi la'akari da dacewa don tantance yanayin asibiti na ciwon baya kamar haka: shekaru, jima'i, kabilanci / kabilanci, shekarun ilimi, aiki, canji a cikin sana'a, matsayi na aiki, matsayin inshora na nakasa, matsayi na shari'a. , Recency / shekaru a farkon farkon ciwon baya, recency / shekaru lokacin da aka nemi kulawa, jinkirin ciwon baya, tsawon lokaci na halin yanzu / kwanan nan na ciwon baya, yawan kwanakin ciwon baya, ciwon zafi na yanzu, matsananciyar zafi mai tsanani, mummunan zafi mai tsanani, ƙididdiga na tsangwama tare da ayyuka, kwanakin ƙayyadaddun ayyuka, ganewar asali na asibiti don wannan batu, kwanakin hutu na gado, kwanakin asarar aiki, rashin jin dadi na ciwon baya, da tsawon lokaci na kwanan nan.

 

A cikin binciken da aka yi amfani da shi na lura da Haas et al na kusan marasa lafiya na 3000 tare da mummunan yanayin da aka bi da su ta hanyar chiropractors da likitocin kiwon lafiya na farko, an lura da ciwo a cikin marasa lafiya da ciwo mai tsanani har zuwa watanni 48 bayan shiga. A cikin watanni 36, 45% zuwa 75% na marasa lafiya sun ruwaito akalla kwanaki 30 na ciwo a cikin shekarar da ta gabata, kuma 19% zuwa 27% na marasa lafiya da ke fama da ciwo mai tsanani suna tunawa da ciwon yau da kullum a cikin shekarar da ta gabata.

 

Bambance-bambancen da aka lura a cikin waɗannan da sauran karatun da yawa za a iya bayyana su ta hanyar wahala wajen samar da cikakkiyar ganewar asali, ta hanyar tsarin tsararraki daban-daban da aka yi amfani da su wajen rarraba LBP, ta hanyar kayan aiki daban-daban da aka yi amfani da su a cikin kowane binciken da kuma wasu dalilai masu yawa. Har ila yau yana nuna matsananciyar wahala wajen samun iko akan gaskiyar yau da kullun ga waɗanda ke da LBP.

 

Alamomi gama gari da Haɗin Kima don LBP

 

Menene Ma'auni masu dacewa don kimanta Tsarin Kulawa?. An kwatanta ma'auni ɗaya a sama, cewa kasancewar tarihin halitta. Matsaloli da ƙayyadaddun haɗari suna da mahimmanci, kamar yadda batutuwan farashi suke; duk da haka, ingancin farashi ya wuce iyakar wannan rahoton.

 

An fahimci cewa marasa lafiya tare da LBP marasa rikitarwa sun inganta da sauri fiye da wadanda ke da matsaloli daban-daban, wanda mafi mahimmancin abin da ke haskaka zafi. Yawancin dalilai na iya rinjayar yanayin ciwon baya, ciki har da haɗin kai, abubuwan ergonomic, shekaru, matakin dacewa na mai haƙuri, abubuwan muhalli, da kuma abubuwan da suka shafi tunanin mutum. Ƙarshen yana karɓar kulawa mai yawa a cikin wallafe-wallafen, ko da yake kamar yadda aka gani a wani wuri a cikin wannan littafin, irin wannan la'akari bazai dace ba. Duk waɗannan abubuwan, kadai ko a hade, na iya kawo cikas ko jinkirta lokacin dawowa bayan rauni.

 

Yana da alama cewa abubuwan da ke tattare da kwayoyin halitta suna taka muhimmiyar rawa a cikin abubuwan da suka faru na farko na LBP da kuma matsalolin da ke ciki kamar asarar aiki; Abubuwan da ke tattare da ilimin zamantakewa sun zo cikin wasa sosai a cikin abubuwan da suka biyo baya na LBP. Abubuwan da ke tattare da kwayoyin halitta na iya haifar da tsagewar nama, wanda ke haifar da ciwo da iyakacin iyaka na shekaru masu zuwa. Ba za a iya ganin wannan lalacewar nama akan daidaitaccen hoto ba kuma yana iya bayyanawa kawai bayan rarrabawa ko tiyata.

 

Abubuwan haɗari ga LBP sun haɗa da masu zuwa:

 

• shekaru, jima'i, tsananin bayyanar cututtuka;
• haɓakar kashin baya, rage ƙarfin tsoka;
• kafin rauni ko tiyata na baya-bayan nan;
• motsin haɗin gwiwa mara kyau ko rage kayan aikin jiki;
• tsayin tsayin daka ko rashin kulawar mota;
• abubuwan da ke da alaƙa da aikin kamar aikin abin hawa, ɗaukar nauyi mai dorewa, sarrafa kayan;
• tarihin aiki da gamsuwa; kuma
• matsayin albashi.

 

IJzelenberg da Burdorf sun bincika ko alƙaluman jama'a, aikin da ke da alaƙa na zahiri, ko abubuwan haɗari na psychosocial da ke tattare da abubuwan da ke faruwa na yanayin musculoskeletal sun ƙayyade amfani da kiwon lafiya na gaba da izinin rashin lafiya. Sun gano cewa a cikin watanni 6, kusan kashi ɗaya bisa uku na ma'aikatan masana'antu tare da LBP (ko wuyansa da matsalolin babba) sun sake dawowa da rashin lafiya don wannan matsala da kuma 40% na sake dawowa da amfani da kiwon lafiya. Abubuwan da ke da alaƙa da aikin da ke da alaƙa da alamun musculoskeletal sun kasance daidai da waɗanda ke da alaƙa da amfani da kiwon lafiya da izinin rashin lafiya; amma, don LBP, tsufa da rayuwa kadai sun ƙaddara ko marasa lafiya da waɗannan matsalolin sun ɗauki kowane hutu mara lafiya. Yawan watanni na 12 na LBP shine 52%, kuma daga cikin wadanda ke da alamun bayyanar cututtuka a asali, 68% sun sake dawowa na LBP. Jarvik da abokan aiki suna ƙara baƙin ciki a matsayin mahimmancin tsinkaya na sabon LBP. Sun gano yin amfani da MRI don zama mai mahimmanci mai mahimmanci na LBP fiye da ciki.

 

Menene Ma'aunin Ma'aunin Sakamako?. Babban aikin aikin asibiti da aka tsara da ƙungiyar Chiropracticungiyar Cirbopractic da Kanada na allon katako na Chiropractic lura cewa akwai sakamakon da ake iya amfani da su don nuna canji a sakamakon magani. Waɗannan su zama duka abin dogaro da inganci. Bisa ga jagororin Kanada, ma'auni masu dacewa suna da amfani a cikin aikin chiropractic saboda suna iya yin waɗannan abubuwa masu zuwa:

 

• akai-akai kimanta tasirin kulawa akan lokaci;
• taimako yana nuna ma'anar matsakaicin haɓakar warkewa;
• gano matsalolin da ke da alaƙa da kulawa kamar rashin bin doka;
• ingantaccen daftarin aiki ga majiyyaci, likita, da ɓangarorin uku;
• bayar da shawarar gyare-gyare na manufofin jiyya idan ya cancanta;
• ƙididdige ƙwarewar likitancin likita;
• tabbatar da nau'in, kashi, da tsawon lokacin kulawa;
• taimaka samar da bayanai don bincike; kuma
• taimaka wajen kafa ma'auni na jiyya na takamaiman yanayi.

 

Babban nau'ikan sakamako na gabaɗaya sun haɗa da sakamakon aiki, sakamakon hangen nesa na haƙuri, sakamakon ilimin lissafin jiki, ƙididdigar kiwon lafiya gabaɗaya, da sakamakon ciwon subluxation. Wannan babin yana magana ne kawai game da sakamakon fa'ida na aiki da haƙuri waɗanda aka tantance ta tambayoyin tambayoyi da sakamakon aiki waɗanda aka tantance ta hanyoyin jagora.

 

Sakamakon Aiki. Waɗannan sakamako ne waɗanda ke auna gazawar majiyyaci wajen gudanar da ayyukansa na yau da kullun. Abin da ake kallo shine tasirin yanayi ko rashin lafiya akan mai haƙuri (watau LBP, wanda takamaiman ganewar asali bazai kasance ba ko zai yiwu) da sakamakonsa na kulawa. Yawancin irin waɗannan kayan aikin sakamako sun wanzu. Wasu daga cikin sanannun sun haɗa da:

 

• Roland Morris Tambayoyi na Nakasa,
• Tambayoyi na Nakasa Oswestry,
• Indexididdigar Nakasar Raɗaɗi,
• Indexididdigar Naƙasar Ƙwayar Wuya,
• Waddell Disability Index, da
• Tambayoyin nakasassu Miliyan.

 

Waɗannan su ne kawai wasu kayan aikin da ake da su don tantance aiki.

 

A cikin wallafe-wallafen RCT na yanzu don LBP, an nuna sakamakon aiki a matsayin sakamakon da ya nuna mafi girman canji da ingantawa tare da SMT. Ayyukan rayuwa na yau da kullum, tare da masu haƙuri da rahoton jin zafi, sune 2 mafi mahimmancin sakamako don nuna irin wannan cigaba. Sauran sakamakon ba su yi kyau sosai ba, gami da kewayon motsi (ROM) da ɗaga kafa madaidaiciya.

 

A cikin wallafe-wallafen chiropractic, abubuwan da aka samo asali da aka yi amfani da su akai-akai don LBP sune Roland Morris Disability Questionnaire da Oswestry Questionnaire. A cikin binciken da aka yi a 1992, Hsieh ya gano cewa duka kayan aikin biyu sun ba da sakamako daidai lokacin gwajinsa, kodayake sakamakon daga tambayoyin tambayoyin 2 ya bambanta.

 

Sakamakon Hauhawar Haƙuri. Wani muhimmin saitin sakamako ya haɗa da fahimtar haƙuri game da ciwo da kuma gamsuwa da kulawa. Na farko ya haɗa da auna canje-canje a cikin fahimtar jin zafi a tsawon lokacin ƙarfinsa, tsawon lokaci, da mita. Akwai wasu ingantattun kayan aikin da za su iya yin hakan, gami da masu zuwa:

 

Ma'auni na gani na gani - wannan layin 10-cm wanda ke da bayanin zafi da aka lura a ƙarshen wannan layin wanda ke wakiltar babu ciwo ga ciwo mai wuyar gaske; Ana tambayar mai haƙuri don yin alama akan wannan layin da ke nuna ƙarfin jin zafi da aka gane su. Akwai nau'i-nau'i masu yawa don wannan sakamakon, ciki har da Ƙididdigar Ƙididdigar Ƙididdiga (inda mai haƙuri ya ba da lamba tsakanin 0 da 10 don wakiltar yawan zafin da suke da shi) da kuma amfani da matakan zafi daga 0 zuwa 10 da aka nuna a hoto a cikin kwalaye, wanda majiyyaci zai iya dubawa. Duk waɗannan suna bayyana daidai abin dogaro, amma don sauƙin amfani, ko dai daidaitaccen VAS ko Sikelin Ƙimar Lambobi yawanci ana amfani da su.

 

Diary na jin zafi ana iya amfani da su don taimakawa wajen saka idanu daban-daban masu canjin ciwo (misali, mita, wanda VAS ba zai iya aunawa ba). Ana iya amfani da nau'o'i daban-daban don tattara wannan bayanin, amma yawanci ana cika su a kullum.

 

Tambayar Tambayoyi na McGill Pain Wannan sikelin yana taimakawa wajen ƙididdige abubuwan ilimin halin ɗan adam na ciwo kamar haka: fahimi-ƙimantawa, ƙarfafawa-tasiri, da wariya na azanci. A cikin wannan kayan aikin, akwai nau'ikan kalmomi 20 waɗanda ke bayyana ingancin jin zafi. Daga sakamakon, 6 daban-daban masu canji na ciwo za a iya ƙayyade.

 

An yi amfani da duk kayan aikin da ke sama a lokuta daban-daban don saka idanu kan ci gaba da maganin ciwon baya tare da SMT.

 

gamsuwa da haƙuri yana magana duka tasiri na kulawa da kuma hanyar karɓar wannan kulawa. Akwai hanyoyi masu yawa na tantance gamsuwar haƙuri, kuma ba duka an tsara su don amfani da su musamman don LBP ko don magudi ba. Koyaya, Deyo ya haɓaka ɗayan don amfani tare da LBP. Kayan aikin sa yana bincika tasirin kulawa, bayanai, da kulawa. Hakanan akwai Tambayoyin Gamsuwar Marasa lafiya, wanda ke tantance fihirisa daban-daban guda 8 (kamar inganci/sakamako ko ƙwarewar sana'a, alal misali). Cherkin ya lura cewa za a iya amfani da Tambayoyi na Musamman na Ƙarfafa Ƙarfafawa don kimanta sakamakon chiropractic.

 

Ayyukan da aka yi kwanan nan sun nuna cewa amincewa da haƙuri da gamsuwa da kulawa suna da alaka da sakamakon. Seferlis ya gano cewa marasa lafiya sun fi gamsuwa kuma suna jin cewa an ba su mafi kyawun bayani game da ciwon su daga masu aikin da suka yi amfani da farfadowa na hannu. Ba tare da la'akari da jiyya ba, marasa lafiya masu gamsuwa sosai a cikin makonni 4 sun fi dacewa fiye da marasa lafiya marasa gamsuwa don fahimtar ci gaba mai girma a cikin watanni na 18 a cikin binciken da Hurwitz et al. Goldstein da Morgenstern sun sami ƙungiya mai rauni tsakanin amincewa da jiyya a cikin maganin da suka samu da kuma mafi girma a cikin LBP. Magana akai-akai ita ce fa'idodin da aka lura daga amfani da hanyoyin magudi sakamakon kulawar likita da taɓawa ne. Nazarin kai tsaye gwajin wannan hasashen an gudanar da shi ta Hadler et al a cikin marasa lafiya da ke da mummunan yanayin kuma ta Triano et al a cikin marasa lafiya da ke fama da rashin ƙarfi da rashin ƙarfi. Duk binciken biyun sun kwatanta magudi da sarrafa wuribo. A cikin nazarin Hadler, daidaitawar sarrafawa don kulawa da lokaci da mita, yayin da Triano et al kuma ya kara da shirin ilimi tare da shawarwarin motsa jiki na gida. A cikin lokuta biyu, sakamakon ya nuna cewa ko da yake an ba da hankali ga marasa lafiya tare da ingantawa a tsawon lokaci, marasa lafiya da ke karɓar hanyoyin yin magudi sun inganta da sauri.

 

Gabaɗaya Sakamakon Ma'aunin Lafiya. Wannan al'ada ya kasance sakamako mai wahala don aunawa yadda ya kamata amma wasu sabbin kayan aikin kwanan nan suna nuna cewa ana iya yin sa cikin dogaro. Manyan kayan aikin 2 don yin haka sune Bayanan Tasirin Ciwon Lafiya da SF-36. Na farko yana kimanta ma'auni kamar motsi, motsa jiki, hutawa, aiki, hulɗar zamantakewa, da sauransu; na biyu yana kallon farko akan lafiya, matsayin aiki, da lafiyar gabaɗaya, da kuma sauran ra'ayoyin kiwon lafiya guda 8, don ƙayyadaddun ƙididdiga 8 waɗanda za a iya amfani da su don tantance matsayin lafiyar gabaɗaya. Abubuwan anan sun haɗa da aikin jiki, aikin zamantakewa, lafiyar hankali, da sauran su. An yi amfani da wannan kayan aikin a cikin saitunan da yawa kuma an daidaita shi zuwa gajerun siffofi kuma.

 

Ma'aunin Sakamakon Jiki. Sana'ar chiropractic yana da sakamako mai yawa na ilimin lissafi wanda aka yi amfani da shi game da tsarin yanke shawara na kulawa da haƙuri. Waɗannan sun haɗa da irin waɗannan hanyoyin kamar gwajin ROM, gwajin aikin tsoka, palpation, rediyo, da sauran hanyoyin da ba su da yawa (binciken tsayin ƙafafu, thermography, da sauransu). Wannan babin yana magana ne kawai akan sakamakon ilimin lissafi da aka tantance da hannu.

 

Kewayon Motsi. Wannan tsarin jarrabawa yana amfani da kusan kowane chiropractor kuma ana amfani dashi don tantance rashin lafiya saboda yana da alaƙa da aikin kashin baya. Yana yiwuwa a yi amfani da ROM a matsayin hanya don saka idanu ingantawa a cikin aiki a kan lokaci kuma, sabili da haka, ingantawa kamar yadda ya shafi amfani da SMT. Mutum na iya tantance motsi na yanki da na duniya na lumbar, alal misali, kuma yayi amfani da wannan azaman alama ɗaya don ingantawa.

 

Ana iya auna kewayon motsi ta hanyoyi daban-daban. Mutum na iya amfani da daidaitattun goniometers, inclinometers, da ƙarin nagartattun kayan aikin da ke buƙatar amfani da na'urori na musamman da kwamfutoci. Lokacin yin haka, yana da mahimmanci a yi la'akari da amincin kowace hanya ɗaya. Yawancin bincike sun tantance na'urori daban-daban kamar haka:

 

• Zachman ya gano cewa yin amfani da na'urar na'urar yana da aminci sosai.
• Nansel ya gano cewa yin amfani da matakan maimaita 5 na motsi na kashin baya na mahaifa tare da inclinometer don zama abin dogaro,
• Liebenson ya gano cewa fasaha na Schrober da aka gyara, tare da ma'auni da masu mulki na kashin baya sun sami mafi kyawun goyon baya daga wallafe-wallafen.
• Triano da Schultz sun gano cewa ROM don gangar jikin, tare da ƙarfin ƙarfin gangar jikin da kuma aikin myoelectrical, ya kasance mai kyau alamar rashin lafiya na LBP, kuma
• Yawancin karatu sun gano cewa ma'aunin kinematic na ROM don motsi na kashin baya yana da aminci.

 

Aikin tsoka. Ana iya yin kimanta aikin tsoka ta amfani da tsarin sarrafa kansa ko ta hanyar hannu. Kodayake gwajin tsoka na hannu ya kasance aikin bincike na yau da kullun a cikin sana'ar chiropractic, akwai 'yan karatun da ke nuna amincin asibiti don hanyar, kuma waɗannan ba a la'akari da su na inganci.

 

Tsarin sarrafawa na atomatik sun fi dogara kuma suna iya yin la'akari da sigogi na tsoka kamar ƙarfin, iko, juriya, da aiki, da kuma tantance nau'o'i daban-daban na ƙwayar tsoka (isotonic, isometric, isokinetic). Hsieh ya gano cewa hanyar da aka fara haƙuri ta yi aiki da kyau don takamaiman tsokoki, kuma wasu nazarin sun nuna dynamometer don samun aminci mai kyau.

 

Rashin Daidaiton Tsawon Ƙafa. Ƙananan binciken da aka yi na tsawon ƙafar ƙafa sun nuna matakan da suka dace. Mafi kyawun hanyoyin tantance aminci da ingancin tsayin ƙafafu sun haɗa da hanyoyin rediyo don haka suna fuskantar fallasa ga radiation ionizing. A ƙarshe, ba a yi nazarin hanyar ba game da inganci, yin amfani da wannan a matsayin sakamako mai shakku.

 

Yarda da Nama mai laushi. Ana ƙididdige yarda ta hanyar hannu da injina, ta amfani da hannu kaɗai ko ta amfani da na'ura kamar algometer. Ta hanyar yin la'akari da yarda, chiropractor yana kallo don tantance sautin tsoka.

 

Gwaje-gwajen farko na yarda da Lawson ya nuna ingantaccen aminci. Fisher ya gano yana ƙaruwa a cikin yarda da nama tare da abubuwan da ke cikin jiyya ta jiki. Waldorf ya gano cewa yarda da nama mai sauƙi yana da kyakkyawan gwaji/saɓanin gwaji na ƙasa da 10%.

 

An tabbatar da haƙurin jin zafi da aka kimanta ta amfani da waɗannan hanyoyin, kuma Vernon ya gano cewa yana da ma'auni mai amfani wajen tantance musculature paraspinal na mahaifa bayan daidaitawa. Ka'idojin kungiyar daga Kungiyar Chiropracticungiyar Kanada ta Kamfanin Kanada ta kammala daki-kiyayya cewa �

 

 

Kammalawa

 

Shaidar bincike da ta wanzu game da amfanin gyare-gyare na kashin baya / magudi / tattarawa yana nuna masu zuwa:

 

1. Kamar yadda yawa ko fiye da shaida akwai don amfani da SMT don rage alamun bayyanar cututtuka da inganta aiki a cikin marasa lafiya tare da LBP na yau da kullum kamar yadda ake amfani da su a cikin LBP mai tsanani da ƙananan.
2. Yin amfani da motsa jiki tare da magudi na iya yin saurin sauri da inganta sakamako tare da rage yawan sake dawowa.
3. Akwai ƙarancin shaida don yin amfani da magudi ga marasa lafiya tare da LBP da radiating ciwo na ƙafafu, sciatica, ko radiculopathy.
4. Abubuwan da ke da tsananin alamun alamun suna iya fa'ida ta hanyar isarwa don daidaita alamun alamun tare da magani.
5. Akwai ƙananan shaida don amfani da magudi don wasu yanayi da ke shafar ƙananan baya da ƙananan labarai don tallafawa ƙima mafi girma.

 

An nuna motsa jiki da tabbatarwa don zama mai mahimmanci a cikin LBP na yau da kullum da ƙananan matsalolin da ke hade da alamun radicular. Yawancin daidaitattun kayan aiki, ingantattun kayan aikin suna samuwa don taimakawa kama ingantaccen ingantaccen asibiti a tsawon lokacin ƙarancin kulawa. Yawanci, haɓaka aikin (kamar yadda ya bambanta da sauƙi da aka ba da rahoton raguwa a matakan zafi) na iya zama ma'anar asibiti don saka idanu akan martani ga kulawa. Littattafan da aka yi bita ya kasance mai iyakancewa a cikin tsinkayar martani ga kulawa, daidaita ƙayyadaddun haɗuwa na tsarin sa baki (ko da yake haɗuwa da magudi da motsa jiki na iya zama mafi kyau fiye da motsa jiki kaɗai), ko tsara takamaiman shawarwarin yanayi don mita da tsawon lokacin sa baki. Tebur 2 yana taƙaita shawarwarin ƙungiyar, bisa la'akari da bayanan shaida.

 

 

Practical aikace-aikacen kwamfuta

 

• Shaida ta wanzu don yin amfani da magudi na kashin baya don rage alamun bayyanar cututtuka da inganta aiki a cikin marasa lafiya tare da LBP na yau da kullum, m, da subacute.
• Motsa jiki tare da magudi na iya yin sauri da inganta sakamako da rage maimaitawa.

 

A ƙarshe,Ƙarin binciken bincike na tushen shaida ya zama samuwa game da tasiri na kulawar chiropractic don ƙananan ciwon baya da sciatica. Har ila yau labarin ya nuna cewa ya kamata a yi amfani da motsa jiki tare da chiropractic don taimakawa wajen hanzarta tsarin gyaran gyare-gyare da kuma kara inganta farfadowa. A mafi yawan lokuta, ana iya amfani da kulawar chiropractic don kula da ƙananan ciwon baya da kuma sciatica, ba tare da buƙatar aikin tiyata ba. Duk da haka, idan ana buƙatar tiyata don samun farfadowa, mai chiropractor na iya tura mai haƙuri zuwa mafi kyawun ƙwararrun kiwon lafiya na gaba. 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

 

 

Ƙarin Maudu'i: Sciatica

 

Ana kiran Sciatica azaman tarin bayyanar cututtuka maimakon nau'in rauni ko yanayi guda ɗaya. Ana nuna alamun bayyanar cututtuka a matsayin raɗaɗɗen raɗaɗi, ƙwaƙwalwa da tingling sensations daga jijiyar sciatic a cikin ƙananan baya, ƙasa da gindi da cinya kuma ta ɗaya ko biyu ƙafafu da cikin ƙafafu. Sciatica yawanci shine sakamakon haushi, kumburi ko matsawa mafi girma na jijiyoyi a cikin jikin mutum, gabaɗaya saboda diski mai rauni ko ƙashi.

 

 

MUHIMMAN BUDURWA: KARIN KARAWA: Maganin Sciatica Pain