Tänapäeva kiropraktika

 

Viimaste aastakümnete, eriti viimaste aastate jooksul on teadusuurimuste arv kasvanud märkimisväärselt, mis on suunatud biomehhaanilisele ja neurofüsioloogilisele mudelile. Meetodite kvaliteet on paranenud ning tänaseks suudetakse kvantitatiivselt mõõta liigesmanipulatsiooni teatud efekte. Uuringud näitavad, et kiropraktilise korrigeerimise efektid tulenevad neurofüsioloogilisest mõjust. Isegi kui seletusmudelid on üles ehitatud juba olemasolevale biomehaanikale ja füsioloogiale on siiski hüpoteese ebapiisavate tõenditega, mis nõuavad rohkem teaduspõhiseid uuringuid.

Mis puudutab kroonilist nimmepiirkonna problemaatikat, leidub suur hulk kõrgekvaliteetseid eksperimentaalseid uuringuid, milledele toetuda kiropraktilises ravis. Terve rida rahvusvahelisi sõltumatuid institutsioone nagu SBU Rootsis ning Danish Institute for Health Technology Assessment toovad välja oma raportides seose manuaalselt korrigeerivas ravis. Seos tuuakse välja ka mõnedes kõrgekvaliteedilistes uuringutes nagu Aure m fl Giles ja Muller, Niemisto jt, samuti Meade jt.

Mis puutub akuutsesse alaselja valusse, siis leidub taas tõestust ülalnimetatud Rootsi ja Taani institutsioonide poolt , samuti 2 suure rahvusvaheliste uuringute, Agency for Health Care Policy and Research ja RAND abiga.

On läbi viidud palju uuringuid krooniliste kaelavalude puhul. Toetavaks raviks korrigeerimistehnikatega leidub uuringutes, mida on läbi viinud Hoving et al ja Evens et al, kuid toetus seda liiki ravile leidub ka kahes suures rahvusvahelises kontrollinstitutsiooni uuringus nii Cochrane kui ka RAND.

Akuutsed kaelaprobleemid on piirkond, mis nõuab rohkem kõrgekvaliteetseid uuringuid. Kuid juba tänaseks leidub uuringuid, milledega on pandud alus manipulatsiooni raviks sellel alal. Tõestust juhivad raportid SBU ja RAND.

Kuna kiropraktik tegeleb kogu liikumiselundkonna raviga on uuringud, mis puudutavad ülejäänud regioone huvitavad. Tõendusmaterjal, mis puudutab manipulatsiooni ravi whiplash puhul on publitseeritud The Quebec Task Force. Leidub kaks uuringut, mis annavad aluse korrektsioonravile nii pingepeavalu kui ka cervikogeenne ehk kaela piirkonnast tulenev peavalu puhul , McCrory ja Penzien samuti RAND. Korrigeeriv ravi seoses rindkere valudega on publitseeritud Australian Acute Musculoskeletal Pain Guidelines Group poolt jam is on mahukas uuring ning mis on saanud suure rahvusvahelise kaja.

Mõned uuringud näitavad et kombinatsioon "manipulatsioon ja treening" annab hea efekti nii kaela kui ka seljaproblemaatika ravis. See toetab kiropraktika teooriat, mis põhineb liigeste ja lihaste düsfunktsiooni tähtsuses. Korrigeering osutab paranenud ja suurenenud liikumisele ning treening omakorda stabiliseerimaks hüpermobiilseid segmente. Mõlemad meetodid põhinevad närvisüsteemi suutlikkuses koordineerida liigutusi. Kui kombineerida neid meetodeid saab mittekorrektseid liikumismustreid korrigeerida efektiivsemalt. See ravistrateegia kombinatsioonis rehabiliteerimisega on hetkel väga aktuaalne ning uuritav paljudes teadustöödes lähitulevikus.

Kokkuvõtteks võib konstateerida, et on olemas kindel tõestus kiropraktilistele seletusmudelitele ning kiropraktilisele korrigeerimisele. Aastakümnete jooksul kiropraktikale panustatud uurimine on kandnud vilja ja tänapäeval on kiropraktikud etableeritud, litsentseeritud tervishoiutöötaja kutseala esindajad.

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