Osteopatía Científica最新文献

Aim

To detect varus forefoot disorder, define the characteristics of plantar pressures and analyze the effect of articulation and manipulation osteopathic techniques to correct this disorder.

Method

A prospective controlled experimental study was carried out in two groups, a control group and a treatment group, with an analysis based on Student's t-test. Articulation and manipulation techniques were applied in 62 pupils between the ages of 6 and 12 years, diagnosed with varus forefoot, in order to correct the affected bone segments. The extent of the forefoot varus angle and the rearfoot valgus was measured using a goniometer. Plantar pressures were measured using a pedobarographic device.

Results

The reduction of the varus forefoot angle was statistically significant in the treatment group. The static evaluation revealed that no mark was registered on the plantar surface either from the midfoot or from the head of the first metatarsal bone. During gait analysis, the trajectory of the pressure center of the foot was linear. The vertical peak force of the forefoot was found on the head of the second and third metatarsal bones.

Conclusions

Goniometry is an effective method to detect disorders due to varus forefoot. The angle of inversion of the metatarsal heads is significantly reduced by the application of articulation and manipulative osteopathic techniques. The correction in the disorder is demonstrated by a more balanced plantar pressure in the foot whilst standing and walking.

Thrust techniques are highly effective for the treatment of sutures. The jugular foramen is one of the most important targets in cranial treatment because it is transversed by highly important vascular and nerve structures. The occipital mastoid thrust technique can be used to modify the intersutural connective tissue, improving temporal and occipital mobility.

The zygoma is a paired bone situated in the face and is frequently unnoticed in osteopathic practice. However, the importance of this bone lies in its participation in the ocular orbit and the temporomandibular joint, since it articulates with the temporal bone and gives rise to the masseter muscle. The most frequent zygomatic bone dysfunction is eversion dysfunction, caused by the masseter muscle.

Objective

The purpose of this systematic review is to discuss the evidence for manipulative methods of management of shoulder pain and chiropractic management techniques used within the literature.

Methods

A literature search of MEDLINE, CINAHL, MANTIS, the Cochrane Musculoskeletal Group trials register and the Cochrane Controlled Trials Register was conducted. Search terms included chiropractic or manipulative therapy and shoulder pain, impingement, rotator cuff, shoulder instability, shoulder joint, treatment or rehabilitation exercises. Publications were included if they contained shoulder pain or contained a specific clinical diagnosis of a shoulder pain syndrome in the title; a detailed description of the treatment intervention which was typical of the profession; treatment performed by a registered practitioner and outcome measures were included in the studies. Exclusion criteria included the diagnosis of adhesive capsultis or referred/pathological pain. The articles were reviewed and clinical trials ranked on the Physiotherapy Evidence Database scale.

Results

From a total of 913 retrieved publications, 22 case reports, 4 case series and 4 randomized, controlled trials met the inclusion and exclusion criteria for this review.

Conclusions

The literature contains 2 articles of reasonably sound methodology. The evidence for chiropractic management of shoulder pain is limited to low level evidence in the form of case reports and case series and 1 small controlled trial. There is a need for more welldesigned, trials investigating multi-modal chiropractic management for shoulder pain.

The cranial-cervical region is designed to move the head in the three planes of space. Somatic C0-C1 dysfunctions involve not only limited mobility but also vascular alterations (due to their arterial and vegetative association) such as headache, dizziness, and ringing in the ears, etc. Manipulating the back of the head aims to restore the biomechanical properties to the joint. Correct diagnosis, description of how the technique is performed and analysis of contraindications are required to resolve these movement restrictions.

The Tug navicular technique is generally used in any problem of the foot, which is important for posture, and for the treatment of ascending lesions arising in the foot. The aim is to correct external rotation of the navicular bone. For this technique to be effective, its indications and contraindications should be taken into account to determine its suitability and a correct prior diagnosis is essential.

Objectives

To compare the results obtained in the amplitude of vertical mouth opening (VMO), pressure pain threshold (PPT) and subjective pain perception with the visual analog scale (VAS) between the myofascial anchorage (MFA) and muscular energy (ME) techniques applied bilaterally to the masseter muscles.

Hypothesis

The MFA and ME techniques applied bilaterally to the masseter muscles in patients with bruxism will increase VMO and PPT and will reduce pain perception measured with the VAS.

Material and method

An experimental, randomized, blind study was performed. Measurements were taken of VMO, PPT and of pain perception using the VAS before the intervention and twice after the intervention by two independent, previously trained, blind evaluators. Measurements were taken by the digital algometer (Wagner, FDX50, USA) and caliber (Schwyz, China). The sample was composed of 76 patients with a diagnosis of bruxism, divided in 3 groups: group A, AMF (n = 26); group B, ME (n = 25); and group C, control group (n = 25).

Results

Group A (MFA) showed signifi cant changes in VMO (p = 0.03) and in the VAS (p = 0.001) but not in PPT (p > 0.05). Group B (ME) showed no statistically signifi cant changes in any of the three variables (p > 0.05). No changes were found in group C (control).

Conclusions

The MFA technique increases VMO and decreases pain perception in patients with bruxism. The ME technique produced no statistically signifi cant changes in the variables studied.

Spinal manipulative therapy (SMT) acts on the various components of the vertebral motion segment. SMT distracts the facet joints, with faster separation when a cracking sound is heard. Intradiscal pressure may decrease briefly. Forceful stretching of the paraspinal muscles occurs, which induces relaxation via mechanisms that remain to be fully elucidated. Finally, SMT probably has an inherent analgesic effect independent from effects on the spinal lesion. These changes induced by SMT are beneficial in the treatment of spinal pain but short-lived. To explain a long-term therapeutic effect, one must postulate a reflex mechanism, for instance the disruption of a pain-spasm-pain cycle or improvement of a specific manipulation-sensitive lesion, whose existence has not been established to date.