#1
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Ìàíóàëüíàÿ òåðàïèÿ?
Öèòàòà:
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#2
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Ïðè ïîêàçàíèÿõ, 2-3 ïðîöåäóðû ìàíóàëüíîãî òåðàïåâòà ìîãóò èçìåíèòü ñèòóàöèþ.
(ñ) Êàêèì îáðàçîì? Íà ìîé âçãëÿä, îáðàùàòüñÿ ê ìàíóàëüíîìó òåðàïåâòó íå íóæíî. Ñêàæèòå, VID , ïðàâèëüíî ëè ÿ ïîíÿë, ÷òî ýòè áîëè â óõå íîñÿò õàðàêòåð ïðîñòðåëîâ, ïðèñòóïîâ ñèëüíîé áîëè? Ïî ïîâîäó ùåë÷êîâ, ÿ äóìàþ, ðàöèîíàëüíåå áûëî áû îáðàòèòüñÿ ê ôèçèîòåðàïåâòó, ÷òîáû îí ïîêàçàë Âàì óïðàæíåíèÿ äëÿ ìûøö øåè. Ïî ïîâîäó áîëåé â óõå íóæíî ïðîéòè îáñëåäîâàíèå ó íåâðîëîãà, êàê îäèí èç âàðèàíòîâ, ýòî ìîæåò áûòü íåâðàëãèåé ïðîìåæóòî÷íîãî íåðâà (Geniculate Neuralgia) [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#3
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[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
Öèòàòà:
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#4
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Îòìîäåðèðîâàíî
Ïðî÷òèòå àðãóìåíòû ñïåöèàëèñòà ïîñëå ìîåãî ñîîáùåíèÿ http://forums.rusmedserv.com/showpos...8&postcount=12 Leboeuf-Yde and Lise Hestbaek, Chiropractic and Osteopathy (8th May 2008) Chiropractic: A Critical Evaluation "Currently, there are two types of chiropractors: those religiously adhering to the gospel of its founding fathers and those open to change. The core concepts of chiropractic, subluxation, and spinal manipulation, are not based on sound science. Back and neck pain are the domains of chiropractic but many chiropractors treat conditions other than musculoskeletal problems. With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition. Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence. Its cost-effectiveness has not been demonstrated beyond reasonable doubt. The concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt." Edzard Ernst, Journal of Pain and Symptom Management (February 2008) Ýòî,íàäåþñü, óáåæäàåò.Íå äåëàþò òîãî,÷òî íå äîêàçàíî êàê ïîëåçíîå è íóæíîå,â öèâèëèçîâàííîì ìèðå.
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doctor Ðolonsky israel Ñíèìêè ñìîòðþ òîëüêî â ïðÿìîì ïîêàçå.,áåç íåîáõîäèìîñòè ñêà÷èâàíèÿ. Ïðîñüáà ïîêàçûâàòü ñíèìêè â ïðàâèëüíîì ïîëîæåíèè. |
#5
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Öèòàòà:
Íî ïîéìèòå. Îñîáåííî "çà áóãðîì" åùå íå ïîíÿëè ðàçíèöû ìåæäó õèðîïðàêòèêàìè, îñòåîïàòàìè è ìàíóàëüíûìè òåðàïåâòàìè.  Ðîññèè ìàíóàëüíûé òåðàïåâò ÿâëÿåòñÿ ÂÐÀ×ÅÌ (ïðè÷åì ñ ïåðâè÷íîé ñïåöèàëèçàöèåé íåâðîëîãèÿ èëè îðòîïåäèÿ).  Ðîññèè ýòîò ìåòîä ëå÷åíèÿ íå ÿâëÿåòñÿ àëüòåðíàòèâíûì. È èìååò òå æå ïðàâà êàê íåâðîëîãèÿ, êàðäèîëîãèÿ è ò.ä. È âõîäèò â ñòðàõîâóþ ìåäèöèíó. Âðà÷ íåñåò âðà÷åáíóþ þðèäè÷åñêóþ îòâåòñòâåííîñòü. Ìàíóàëüíûé òåðàïåâò èñïîëüçóåò âñþ ñîâîêóïíîñòü ïðèçíàííîé òåðàïèè. Ýòî è ëåêàðñòâà è áëîêàäû è ôèçèîòåðàïèÿ è ò.ä. È íàõîäèòñÿ â êîíòàêòå ñ äðóãèìè âðà÷åáíûìè ñïåöèàëüíîñòÿìè. Íàäåþñü òåïåðü ïîíÿòíî íàñêîëüêî íåïðàâîìåðíûì äîâîäîì ÿâëÿåòñÿ: Öèòàòà:
À íàñ÷åò: Öèòàòà:
Öèòàòà:
Ñ óâàæåíèåì, Ãóñåéíîâ Òèìóð Þñóôîâè÷. |
#6
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Ñîãëàñåí ñ Òèìóðîì Þñóôîâè÷åì, ìàíóàëüíîé òåðàïèåé â Ðîññèè, çàíèìàþòñÿ âðà÷è íåâðîëîãè è îðòîïåäû-òðàâìàòîëîãè. Íå çíà÷èò, ÷òî åñëè áîëüíîé ïðèäåò ê ìàíóàëüíîìó òåðàïåâòó îí ñðàçó áóäåò ñâîðà÷èâàòü åìó øåþ. Ñóùåñòâóåò äèàãíîñòèêà â ìàíóàëüíîé òåðàïèè, ïðîáëåìû îïèñûâàåìûå áîëüíîé ìîæåò âûçûâàòü ôóíêöèîíàëüíûé áëîê â êðàíèî-âåðòåáðàëüíîì ñî÷ëåíåíèè. Óñòðàíåíèå åãî ìîæåò ïîìî÷ü. Îòêóäà òàêèå ïðåäóáåæäåíèÿ. Âû âèäåëè, êàê ïðàâèëüíî ïðîâîäèòñÿ ìàíóàëüíàÿ òåðàïèÿ? Îòðèöàòü ìàíóàëüíóþ òåðàïèþ áûëî áû íåïðàâèëüíî, íàïðèìåð öåëûé ïëàñò ìûøå÷íî-òîíè÷åñêèõ èëè ìèîôàñöèàëüíûõ ñèíäðîìîâ óñïåøíî ëå÷èòñÿ ìåòîäàìè ìàíóàëüíîé òåðàïèè, íàïðèìåð ÏÈÐ, ëå÷åáíî-ìåäèêàìåíòîçíûìè áëîêàäàìè? Óâàæàåìûå íåâðîëîãè íåóæòî Âû íå èñïîëüçóåòå â ñâîåé ðàáîòå ìåäèêàìåíòîçíûå áëîêàäû ñ àíåñòåòèêàìè? Âîò âçÿòü ê ïðèìåðó òî, ÷òî ðàíüøå íàçûâàëîñü ìåæðåáåðíàÿ íåâðàëãèÿ.  ìàíóàëüíîé òåðàïèè ýòî íàçûâàåòñÿ ñèíäðîì ïåðåäíåé ãðóäíîé ñòåíêè. Ïðîáëåìà áûâàåò â ïîâûøåíèè òîíóñà, ó÷àñòêàõ óïëîòíåíèÿ â áîëüøîé è ìàëîé ãðóäíûõ ìûøöàõ. Áîëè ìîãóò áûòü çíà÷èòåëüíîé èíòåíñèâíîñòè, èíîãäà áîëüíûõ ñ ïîäîçðåíèåì íà èíôàðêò ìèîêàðäà äîñòàâëÿþò â ðåàíèìàöèþ. Íïâñ, ìèîðåëàêñàíòû íå âñåãäà ýôôåêòèâíû. Áëîêàäà ñ ðàñòâîðîì ëèäîêàèíà èëè íîâîêàèíà â òî÷êè óïëîòíåíèÿ â ãðóäíûõ ìûøöàõ ñíèìàåò áîëè áóêâàëüíî â òå÷åíèè íåñêîëüêèõ ìèíóò. Ìîæíî è ÐÊÈ ïðîâîäèòü è ÷òî óãîäíî, ýòî î÷åâèäíî. Òàêæå áëîêàäó ãðóøåâèäíîé ìûøöû ðàçâå íå ïðîâîäèòå? Ìàíóàëüíàÿ òåðàïèÿ ýòî âåäü íå òîëüêî õðóñò ïîçâîíêàìè. Íàäî ïðîñòî ïðèìåíÿòü òàì ãäå íóæíî. Ìåòîäû ìàíóàëüíîé òåðàïèè ýòî çíà÷èòåëüíàÿ ïîìîùü íåâðîëîãó, ñ íèìè îí ëå÷èò áîëåå ýôôåêòèâíî. Íî ÿ íå âåäó ðå÷ü î ìíîãî÷èñëåííûõ òàê íàçûâàåìûõ ìàíóàëüíûõ òåðàïåâòàõ áåç ìåäèöèíñêîãî äèïëîìà èëè áåç ñåðòèôèêàòà ïî ìàíóàëüíîé òåðàïèè. À åñòü è òàêèå, êòî äèñêðåäèòèðóåò èäåþ ìàíóàëüíîé òåðàïèè, ïðîïàãàíäèðóÿ, ÷òî îíà ïîìîãàåò îò âñåõ áîëåçíåé è àðèòìèÿ ñåðäöà ìîë îò ïîçâîíî÷íèêà è ÿçâåííàÿ áîëåçíü è ò.ï.  êàæäîé ñïåöèàëüíîñòè åñòü ñâîè øàðëàòàíû.
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#7
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Èòàê, ÷òî èçâåñòíî î ñèòóàöèè? Áåñïîêîÿò ùåë÷êè ïðè ïîâîðàòàõ ãîëëîâû. Íå çíàþ òàêîãî ïîêàçàíèÿ ê ìàíóàëüíîé òåðàïèè. À âîò íàëè÷èå ñèíäðîìà Àðíîëüäà-Êèàðè - îïðåäåëåííî ïðîòèâ ýòîãî ìåòîäà.
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#8
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Ïðîòèâîïîêàçàíèå ê ìàíèïóëÿöèÿì íàëè÷èå áàçèëÿðíîé èìïðåññèè. À îíà åñòü? Ïðîòèâíèêè ìàíóàëüíîé òåðàïèè ïîéìèòå îäíî - âðà÷ ìàíóàëüíûé òåðàïåâò íå õâàòàåò áîëüíîãî ñ ïîðîãà è íå íà÷èíàåò êðóòèòü åìó øåþ, ñíèìêè îí òàêæå ñìîòðèò è äàæå ñìîòðèò â ïåðâóþ î÷åðåäü. Äàëåå ïðîâîäèò äèàãíîñòèêó ðóêàìè, à óæ ïîòîì ïðîâîäèò ëå÷åíèå. Ìîæåò è îòêàçàòü, åñëè äåéñòâèòåëüíî åñòü ïðîòèâîïîêàçàíèÿ. Ïîòîì, âåäü îáñóæäàëîñü, ÷òî ìàíóàëüíàÿ òåðàïèÿ - ýòî íå òîëüêî ìàíèïóëÿöèè (âðàùàòåëüíûå äâèæåíèÿ ñ ùåë÷êàìè), åñòü è äðóãèå ìåòîäû â ÷àñòíîñòè ðàáîòà ñ ìûøöàìè. Âû òàêæå ïðîòèâ ýòîãî? Òàêæå ïî äàííîé áîëüíîé, äàâàéòå îáñóæäàòü, ïðî÷òèòå åå ñòàðóþ òåìó, ññûëêà äàíà â íà÷àëå ýòîé, òàì ÿ íàïèñàë ñâîå ìíåíèå î âîçìîæíûõ ïðè÷èíàõ ñîñòîÿíèÿ. Ãäå îáñóæäåíèå íà ÐÌÑ, âìåñòî ýòîãî êàêèå-òî âîçãëàñû ïðî íåíóæíîñòü ìàíóàëüíîé òåðàïèè. Íåò ÿ íå ïåðâûé äåíü íà ÐÌÑ, çíàþ è îòíîøåíèå ê ìàíóàëüíîé òåðàïèè (îñòåîïàòèè) è ïîíèìàþ, ÷òî ÷àñòî, îñîáåííî ó äåòåé îíà ïðîâîäèòñÿ íåîáîñíîâàííî. Íî ïîéìèòå, åñòü ðÿä òàêèõ ïàöèåíòîâ, èõ íåìíîãî, íî îíè åñòü, êîòîðûì ìàíóàëüíàÿ òåðàïèÿ ìîæåò ïîìî÷ü, èìåííî èì ÿ äàþ ðåêîìåíäàöèè îáðàòèòüñÿ ê ìàíóàëüíîìó òåðàïåâòó, âðà÷ó. Õîòÿ áû äëÿ àäåêâàòíîé îöåíêè ñîñòîÿíèÿ êîñòíî-ìûøå÷íîé ñèñòåìû, ÷òî áîëüøèíñòâî íåâðîëîãîâ ïðîñòî íå äåëàåò. ß ñïðàøèâàþ áîëüíûõ, êîòîðûå îáðàùàëèñü ðàíåå ê íåâðîëîãàì, ùóïàëè ëè, äàâèëè ëè èì ìûøöû, â îñíîâíîì îòâåò - íåò. À ñ ñîñòîÿíèåì ìûøö, óâåðÿþ âàñ, ñâÿçàíî î÷åíü ìíîãî áîëåé, â òîì ÷èñëå õðîíè÷åñêèõ.
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#9
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Äà ìû êàê áû è íå ïðîòèâíèêè ìàíóàëüíîé òåðàïèè, à ñòîðîííèêè äîêàçàòåëüíîé ìåäèöèíû. À äîêàçàòåëüíàÿ ìåäèöèíà êàê ðàç îòðèöàåò ìàíóàëüíóþ òåðàïèþ, êàê äîêàçàííûé ìåòîä ëå÷åíèÿ ÷åãî-ëèáî. ×òî êàñàåòñÿ èíúåêöèé â òðèãåðíûå òî÷êè,òàê èõ ìîæåò âûïîëíÿòü âðà÷ ëþáîé ñïåöèàëüíîñòè èëè äàæå ìåäèöèíñêàÿ ñåñòðà.
Äðóãèìè ñëîâàìè, áîëüíîé ïðîñòî íóæíî îáðàòèòüñÿ ê âðà÷ó, êîòîðûé ïðîèçâ¸ë áû àäåêâàòíóþ îöåíêó êîñòíî-ìûøå÷íîé ñèñòåìû . |
#10
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Äîêàçàòåëüíàÿ ìåäèöèíà íå îòðèöàåò ìàíóàëüíóþ òåðàïèþ, ýôôåêòèâíîñòü ìàíèïóëÿöèé ïðè õðîíè÷åñêîé áîëè âíèçó ñïèíû äîêàçàíà, âêëþ÷åíà â ãàéäû (ïîñëåäíèé ãàéäëàéí ïî áîëè âíèçó ñïèíû â medscape) ýôôåêòèâíîñòü ïîñòèçîìåòðè÷åñêîé ðåëàêñàöèè äîêàçàíà.
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#11
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Öèòàòà:
clinically useful eff ects on the primary outcome of time to recovery. Findings from the secondary analyses support the primary analyses, showing no signifi cant eff ects on pain, disability, or global perceived eff ect at 1, 2, 4, or 12 weeks, when diclofenac or spinal manipulative (c) [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] --------------------- Thirteen original studies were found, in which maintenance care was investigated. The relative paucity of studies, the obvious bias in many of these, the lack of exhaustive information, and the diversity of findings made it impossible to answer any of the questions. (c) [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] ------------------ There was little or no difference in pain reduction or the ability to perform everyday activities between people with low-back pain who received spinal manipulation and those who received other advocated therapies. (c) [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] ----------------- Conclusions: Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment. (c) [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] --------------------- Twenty-nine reviews met the inclusion criteria. Sixteen reached an overall positive conclusion, 7 a negative conclusion and 6 a neutral conclusion regarding therapeutic effectiveness. There were statistically significant pairwise correlations between each of the three factors: direction of conclusion, methodological quality and authorship by osteopaths or chiropracters. This indicates an association between authorship by osteopaths or chiropractors and low methodological quality and positive conclusion. We conclude that the outcomes of reviews of this subject are strongly influenced by both scientific rigour and profession of authors. The effectiveness of spinal manipulation for back pain is less certain than many reviews suggest; most high quality reviews reach negative conclusions. (c) [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#12
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Öèòàòà:
À äàëüøå îáñóæäàëèñü ïðîáëåìû íåñêîëüêèõ ëåò, íå çàêðûòûå ñ ïðîøëîãî îáñóæäåíèÿ. Òàê êàê ýòî íå èìååò îòíîøåíèÿ ê äàííîé ïàöèåíòêå, âûñêàæó ïðèíÿòóþ òî÷êó çðåíèÿ ïî òàêòèêå ìàíóàëüíîé òåðàïèè ïðè íàëè÷èè ýòîãî ñèíäðîìà âîîáùå. Ýòî òùàòåëüíûé âûáîð ïðèåìîâ (î ìàíèïóëÿöèè è ðå÷è íå èäåò) ñ âîçìîæíûì îòêàçîì îò ïðèìåíåíèÿ ìàíóàëüíîé òåðàïèè. Òåïåðü î äàííîé ïàöèåíòêå. Ïî âèäèìîìó, èìååòñÿ ìàëüôîðìàöèÿ Àðíîëüäà-Êèàðè 1 ñòåïåíè áåç êëèíè÷åñêèõ ïðîÿâëåíèé. Êîíå÷íî ó êîëëåã ìîæåò áûòü ñâîÿ òî÷êà çðåíèÿ è òîãäà ìîæåò ïîÿâèòñÿ åùå îäèí ðàáî÷èé äèàãíîç äëÿ àíàëèçà. Íî íè â ïðîøëîì îáñóæäåíèè, íè â íàñòîÿùåì, èìåþùàÿñÿ ìàëüôîðìàöèÿ íå ñâÿçûâàëàñü ñ êëèíè÷åñêèìè ïðîÿâëåíèÿìè. Ñóäÿ ïî âñåìó ó ëå÷àùèõ âðà÷åé òàêèõ ìûñëåé òî æå íå áûëî. Ìàëüôîðìàöèÿ Àðíîëüäà-Êèàðè ÿâëÿåòñÿ ïðè÷èíîé ôóíêöèîíàëüíîé íåïîëíîöåííîñòè êðàíèîöåðâèêàëüíîãî ñîåäåíåíèÿ. È èìåííî ó ýòèõ ïàöèåíòîâ î÷åíü ÷àñòî âîçíèêàþò ìèîôàñöèàëüíûå ïðîáëåìû ñ ïåðâîïðè÷èíîé â âåðõíå-øåéíîì îòäåëå. È èìåííî ó ýòèõ ïàöèåíòîâ ìàíóàëüíàÿ òåðàïèÿ î÷åíü ýôôåêòèâíà. Äðóãîé ðàçãîâîð, ÷òî áåñêîíå÷íî è ÷àñòî äåëàòü ìàíóàëüíóþ òåðàïèþ òàêòè÷åñêè íå ïðàâèëüíî. Ïîñëå ìàíóàëüíîé òåðàïèè ïàöèåíòà íóæíî ïåðåâîäèòü íà "ñàìîîáñëóæèâàíèå" ïðîôèëàêòè÷åñêèìè è ëå÷åáíûìè óïðàæíåíèÿìè. Òåïåðü ïîçâîëüòå, ðàññêàæó êëèíè÷åñêèé ñëó÷àé, âîçìîæíî èìåþùèé îòíîøåíèå ê íàñòîÿøåé ñèòóàöèè. Ìóæ÷èíà, 35 ëåò. Æàëîáû íà ïåðèîäè÷åñêè âîçíèêàþùèå ðåçêèå ñòðåëþùèå áîëè â ïðàâîé óøíîé ðàêîâèíå. Äëèòåëüíîñòü æàëîá 5 ëåò. Äëèòåëüíîñòü ïðèñòóïà îò ìèíóòû äî ïîëó÷àñà. "Êàê áóäòî îòðûâàþò óõî". Ïðè áîëè ïðèæèìàåò ëàäîíüþ óõî. Ïðè ýòîì áîëü ìîæåò óìåíüøèòñÿ è ïðåêðàòèòüñÿ. Ïðè êàêîì-òî íåóäà÷íîì äâèæåíèè ëàäîíüþ ìîæåò áûòü "ïðîñòðåë". ËÎÐ- âðà÷ - áåç ïàòîëîãèè. Íèæíå÷åëþñòíûå ñóñòàâû áåç îñîáåííîñòè. Ïðè îñìîòðå, ìèîôàñöèàëüíûõ íàðóøåíèé øåéíîãî îòäåëà íåò. Ëåãêîå îãðàíè÷åíèå ðîòàöèè íà óðîâíå Ñ1-Ñ2 ñïðàâà. Óõî ïðè ïàëüïàöèè àáñîëþòíî áåçáîëåçíåííî. Ïðåäëîæèë êîððåêöèþ ïîäâèæíîñòè Ñ1-Ñ2 ñ ïîñëåäóþùèì íàáëþäåíèåì. Ïðåäóïðåäèë, î ñîìíåíèÿõ, ÷òî ïðè÷èíà â øåéíîì îòäåëå. ×åðåç ìåñÿö, ïàöèåíò "óäà÷íî" ïðèõîäèò â ïåðèîä ïðèñòóïà. Ïðè ñìåùåíèè óõà â ñòðîãî îïðåäåëåííîì íàïðàâëåíèè âîçíèêàåò ðåç÷àéøàÿ áîëü. Ïàöèåíò áóêâàëüíî ïîäïðûãèâàåò. Ïðîâåë ìîáèëèçàöèþ óõà â áåçáîëåçíåííîì íàïðàëåíèè. Áîëü â ïðàâîöèðóþùåì íàïðàâëåíèè ïåðåñòàëà âîçíèêàòü è ïðîøëà âîîáùå. Íàó÷èë ïàöèåíòà ïðàâèëüíîìó äâèæåíèþ.  òå÷åíèå ãîäà ïåðåçâàíèâàëèñü. Áîëüøå 10 ñåêóíä áîëè íå áûëî. Èìåííî ñòîëüêî íóæíî áûëî, ÷òîáû åå êóïèðîâàòü. Ïàöèåíò ñïîêîåí, âñå óïðàâëÿåìî, îí çíàåò, ÷òî äåëàòü. Ñ÷èòàþ, ýòî áûë âàðèíò òóííåëüíîãî ñèíäðîìà. Êîëëåãè, ýòîò ñìåøíîé ñëó÷àé øèðîêîé îáùåñòâåííîñòè ðàññêàçûâàòü ñòåñíÿëñÿ. Êòî íèáóäü ñëûøàë î ìàíóàëüíîé òåðàïèè óõà? À òåïåðü âîïðîñ ê êàòåãîðè÷íûì íåâðîëîãàì. Ìîæíî ÿ â ñëåäóþùèé ðàç ó ïàöèåíòà ñ ñîïóòñòâóþùèì âûðàæåííûì ñèíäðîìîì Àðíîëüäà-Êèàðè ïðèìåíþ ìàíóàëüíóþ òåðàïèþ â àíàëîãè÷íîé ñèòóàöèè? Ñ óâàæåíèåì, Ãóñåéíîâ Òèìóð Þñóôîâè÷. |
#13
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Íó åñëè ìû âûøëè íà íîâûé óðîâåíü äîêàçàòåëüíîñòè - "ðàññêàç ñëó÷àåâ", òîãäà è ÿ îäèí ðàññêàæó:
"Stroke triggers major anti-chiropractic lawsuit. A Canadian woman who was paralyzed by a neck manipulation has filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem. The suit, which is seeking more than $525 million in damages, targets Alberta chiropractors who provide inappropriate spinal manipulations and regulators who have failed to curb their use. The woman, Sandra Nette, now has "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm. Slight use of her right arm enables her a to use a computer keyboard to communicate through a voice synthesizer. Her story has been posted to YouTube. In addition to litigating on their own behalf, she and her husband want the court to permit them to represent all persons who paid for or received spinal manipulation (other than spinal manipulation to treat a diagnosis of acute or sub-acute uncomplicated back pain) from an Alberta chiropractor during the past decade. They also want to have the defendant chiropractor represent a class of Alberta chiropractors who provided inappropriate manipulation. [Barrett S. Stroke caused by neck manipulation triggers class-action lawsuit. Chirobase, June 19, 2008]" [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#14
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Óâàæàåìûå, ìîäåðàòîðû! Ïî÷åìó áû íå ïåðåíåñòè òåìó â ôîðóì äëÿ âðà÷åé? Ïî âîïðîñó î ñóòè ÌÒ, åå ìåòîäàõ, ïîêàçàíèÿõ è ïðîòèâîïîêàçàíèÿõ ìíîãî ðàçíûõ ìíåíèé. ×àñòî îíè äèàìåòðàëüíî ïðîòèâîïîëîæíûå. ß íå ìàíóàëüíûé òåðàïåâò, íî âîçãëàâëÿþ ðåàáèëèòàöèîííûé öåíòð. Ìíå (äà è ìíîãèì äðóãèì) âàæíî ðàçîáðàòüñÿ â ýòèõ âîïðîñàõ.
È åùå îäíî ïîæåëàíèå. Íå âñå áåãëî ÷èòàþò íà íå ñâîåì ðîäíîì ÿçûêå. Ðàç ýòî Ðóññêèé ÌÑ, ïóñòü ïèøóò íà ðóññêîì ÿçûêå ñâîè ñîîáùåíèÿ. |
#15
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Ïåðåíîñèòü ñìûñëà íåò, òàì óæå åñòü äâå òàêèõ òåìû, ñîãëàñèÿ íåò. Ïîíÿòíî, ÷òî ïðè ìàíèïóëÿöèÿõ íà øåéíîì îòäåëå ïîçâîíî÷íèêà ìîãóò áûòü îñëîæíåíèÿ. Äîêàçàòåëüíîé áàçû ïî ìàíèïóëÿöèÿì íà øåå äåéñòâèòåëüíî íåìíîãî, íî çàòî òàêîâàÿ åñòü äëÿ ìàíèïóëÿöèé è äðóãèõ ìåòîäîâ ìàíóàëüíîé òåðàïèè íà ïîÿñíè÷íîì è ãðóäíîì óðîâíå. È èíòåðåñ ê ýòîé òåìå ó èññëåäîâàòåëåé åñòü. Ñåãîäíÿ èñêàë â pabmed èíôîðìàöèþ, íàøåë, ÷òî èäåò áîëüøîå èññëåäîâàíèå ïî ëå÷åíèþ áîëåé â ãðóäíîé êëåòêå ìåòîäàìè ìàíóàëüíîé òåðàïèè. Åñòü è èññëåäîâàíèå, íî àáñòðàêò, ïî ýôôåêòèâíîñòè íà ïîÿñíè÷íîì îòäåëå. Òî åñòü òàêèå ðàáîòû åñòü. Ññûëêè ñåé÷àñ íå ïðèâåäó, òàê êàê âûõîæó ñ òåëåôîíà. Åñòåñòâåííî ïðîòèâíèêè ïðèâåäóò ñâîè ññûëêè.  òàêèõ ñëó÷àÿõ íóæåí êîíñåíñóñ. È òàêèå åñòü. Åùå ðàç íàïèøó, ÷òî ïðè áîëÿõ â íèæíåé ÷àñòè ñïèíû ïðèìåíåíèå ìàíóàëüíîé òåðàïèè ìîæåò áûòü ðåêîìåíäîâàíî. Òàê íàïèñàíî â ãàéäëàéíå, ÿ åãî óæå ïóáëèêîâàë â ýòîì ãîäó âåñíîé íà ôîðóìå. Ïîçæå ìîãó ïðèâåñòè ññûëêó. Äà ñïîðèòü ìîæíî áåñêîíå÷íî. Íàäî áû çäåñü íà ÐÌÑ äîñòèãóòü êîíñåíñóñ î òîì, ÷òî ìåòîäû ìàíóàëüíîé òåðàïèè õîòÿ íå èìåþò äîñòàòî÷íîé äîêàçàòåëüíîé áàçû, íî ìîãóò áûòü ðåêîìåíäîâàíû ïàöèåíòàì ïðè íåýôôåêòèâíîñòè ìåäèêàìåíòîçíîãî ëå÷åíèÿ è îòñóòñòâèè ïðîòèâîïîêàçàíèé. È õîðîøî áû ñîáëþäàòü êàêèå-òî ðàìêè, íåõîðîøî êîãäà îäèí âðà÷ ðåêîìåíäóåò îáðàòèòüñÿ ê ìàíóàëüíîìó òåðàïåâòó, à äðóãîé òóò æå íà÷èíàåò ïèñàòü, ÷òî ýòî øàðëàòàíñòâî è âûìàíèâàíèå äåíåã èëè ÷òî ýòî íåýôôåêòèâíî. Òåì áîëåå, ÷òî ýòî íå òàê. Ïðîòèâíèêè ìàíèïóëÿöèé, ÿ åùå â ýòîì âàñ ìîãó ïîíÿòü, â ÷àñòíîñòè â øåéíîì îòäåëå ìîãóò áûòü îñëîæíåíèÿ, â ïîÿñíè÷íîì ðåæå, íî âû îòâåðãàåòå âñå ìåòîäû ìàíóàëüíîé òåðàïèè ñðàçó. Âîò ÷òî âû èìååòå ïðîòèâ ïîñòèçîìåòðè÷åñêîé ðåëàêñàöèè ìûøö. Òîæå íå èìååò äîêàçàòåëüñòâ, òîæå øàðëàòàíñòâî?
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