WFU

2018年3月13日 星期二

骨盆調整



  整脊,一直以來都讓人覺得有神奇的魔力,近年來許多愛漂亮的女生更是瘋迷 骨盆調整正脊 來瘦腰、瘦臀,然而這項手法真的這麼有效嗎?在西方醫學眼中,究竟又是如何看待這項手法呢?


『 喀啦 』一聲,全部搞定 ?


  我們熟悉的"整脊"源自於西方醫學的關節鬆動術( Manipulation ) ,例如脊骨神經醫學( Chiropractice ) 就是代表性的例子。以往認為只要將歪斜的脊椎擺正、移位的關節復原就能解決身體的不適。但是經過實驗證實,改善痠痛不適感的原因並 不是 因為『矯正歪斜』,而是 改變 肌肉和關節的張力所致,就像老人家說的『身體若輕鬆,人就清爽!(台語)』。
   至於『喀啦』的聲響,和『矯正』完全 無關 。全身的關節都一樣,只要改變 關節內壓力 就會發出聲響,折手指就是最好的例子。所以下次有人說這樣可以矯正脊椎時,也許你也可以表演一下『矯正手指』!

 轉錄自YouTube 《果籽》


矯正歪斜?


  骨盆在人體扮演者 承上啟下 的重要角色,為了確保力量的傳遞和提供穩固的活動基礎,因此在解剖上骨盆的結構就非常的 穩固不易移動 。根據研究髂薦關節( Sacroiliac Joint, SI joint ) 躺著時只能動 不超 5  度,站著更是 不到 1 。若是用 X 光來檢視『矯正』前後的差別,會發現骨頭的位置 沒有 變化!


矯正長短腳


  根據統計,超過  90  %的人有長短腳的現象,所以長短腳就跟臉不對稱一樣,在現實世界上很 找到一個完全 相同 的人!
  而且用肉眼或尺在身體外量測的 誤差 會高達  16  毫米,所以醫學上要用 X 光測量差異超過 1 吋 ( 約 25 毫米 )才能確定長短腳。所以整脊改變的並不是雙腳骨頭的長度,而是 視覺上 的變化(跟縮小腹差不多)。


軟組織才是重點!


  既然整脊無法改變脊椎或骨盆的位置,那為什麼腰圍或臀圍會變小呢?
  回答這個問題前,先了解一下人體。我們所量的腰臀圍並不是只有脊椎骨和骨盆,它還 包含 周圍的肌肉、皮下脂肪,所以透過改變肌肉、筋膜的張力,我們可以改變 臀圍腰圍 (如同下方影片中的示範),但如果皮下組織太厚或生活習慣不改變,就算每天“調”骨盆也沒用。(不然醫美診所都可以收起來了!)
  令人嚮往的臀型除了從後方看起來要有 微笑曲線 外,側面還要有圓弧的 翹度。所以就如同影片中看到的,雖然我們能在 幾秒 內改變臀圍,但還是需要 訓練肌肉 來維持。所以只要用對方法不僅能 改變腰、臀圍 ,還能創造迷人的 臀線 喔!




參考文獻

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  2. Goode A, Hegedus EJ, Sizer P, Brismee J-M, Linberg A, Cook CE. Three-Dimensional Movements of the Sacroiliac Joint: A Systematic Review of the Literature and Assessment of Clinical Utility. The Journal of Manual & Manipulative Therapy. 2008;16(1):25-38.
  3. Al-Subahi M, Alayat M, Alshehri MA. The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. J Phys Ther Sci. 2017 Sep;29(9):1689-1694. doi: 10.1589/jpts.29.1689. Epub 2017 Sep 15.
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2018年3月5日 星期一

脊椎手術失敗症候群


  根據世界衛生組織的調查,每年約有15-45%不等的人口受下背痛所苦。僅只是英國,因為下背痛而直接與間接造成的經濟損失就超過 1 億英鎊(約 40 億台幣)。除了造成疼痛、肢體痠麻外,通常也會造成日常生活上的不便,因此許多人就選擇動手術來解決疼痛。
  也許你會問『 為什麼 已經開刀解決“脊椎壓迫,為什麼 還會 麻呢?』或『已經把出問題的關節 成人工關節,為什麼 還會 痛呢?』。這種症狀沒有改善或是手術後才出現疼痛等問題時,就會被稱為一一脊椎手術失敗症候群 Failed Back Surgery Syndrome, FBSS )


脊椎手術失敗症候群

  目前對脊椎手術失敗症候群的定義是: 在開刀的位置或相關聯的區域有疼痛,不論是手術後才出現或原有背痛未改善的,就稱為脊椎手術失敗症候群。( Lumbar spinal pain of unknown origin either persisting despite surgical intervention or appearing after surgical intervention for spinal pain originally in the same topographical location.
  而隨著手術的種類和診斷的不同,發生率從 5-36 % 不等。可能原因包含手術的技術、診斷的精確 、手術成果上的落差和手術前的心理狀態等。值得一提的是,在此類型的人身上可以發現一個有趣的現象: 背痛問題 ( 特別是已經持續疼痛一段時間 )單靠手術似乎是不夠的


從手術前到開刀後......

  從研究發現,慢性下背痛的人普遍有 對疼痛的過度反應和害怕活動 的問題。因此,除了手術前的疼痛教育與復健外,開刀後的動作訓練都是減少脊椎手術失敗症候群出現的方法!
  而對於已經開過刀,仍然有背痛、痠麻等問題的人來說,能接受妥善的評估找出持續疼痛的原因,並採取對應的活動訓練 有助於 擺脫 持續性的疼痛或痠麻問題!



參考文獻

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  6. Park KB, Shin JS, Lee J. Minimum Clinically Important Difference and Substantial Clinical Benefit in Pain, Functional, and Quality of Life Scales in Failed Back Surgery Syndrome Patients.  Spine (Phila Pa 1976). 2017 Apr 15;42(8):E474-E481. doi: 10.1097/BRS.0000000000001950.
  7. DeVine J, Norvell DC, Ecker E. Evaluating the correlation and responsiveness of patient-reported pain with function and quality-of-life outcomes after spine surgery. Spine (Phila Pa 1976). 2011 Oct 1;36(21 Suppl):S69-74. doi: 10.1097/BRS.0b013e31822ef6de.
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  9. O'Donnell JA, Anderson JT, Haas AR. Preoperative Opioid Use is a Predictor of Poor Return to Work in Workers' Compensation Patients after Lumbar Diskectomy. Spine (Phila Pa 1976). 2017 Aug 23. doi: 10.1097/BRS.0000000000002385. [Epub ahead of print]
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