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Fysiologische effecten van manipulatie van de wervelkolom

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Stimulus

Samenvatting

Manipulaties (snelle duw- of trekbewegingen met een geringe bewegingsuitslag) worden veelvuldig toegepast bij de behandeling van rugpijn. Deze kritische bespreking van de mogelijke werkingsmechanismen is gebaseerd op het doorzoeken van databanken met als sleutelwoorden: ‘spinal manipulation’, ‘low back pain’, ‘osteopathy’, ‘physiotherapy’ en ‘chiropractic’.

Er kwamen drie werkingsmechanismen naar voren: een biomechanisch, een neuromusculair en een neurofysiologisch mechanisme. Er bestaat bewijs voor een mechanische opening van de facetgewrichten tijdens manipulatie, maar de klinische betekenis daarvan is niet duidelijk. Er is eveneens bewijs voor de theorie dat manipulatietechnieken spinale rekreflexen opwekken, resulterend in een korte spiercontractie mogelijk gevolgd door een periode van verminderde spieractiviteit. De artikelen bieden verder ondersteuning voor de antinociceptieve behandeleffecten van manipulatie, iets wat duidelijk voordelen voor de patiënt zou kunnen hebben. De conclusie luidt dat er in de literatuur bijval te vinden is voor elk van de mechanismen, maar dat er duidelijk meer onderzoek nodig is om meer van de mechanismen achter spinale manipulatie te begrijpen.

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  1. www.bsl.nl/shop/stimulus-online-0929-0591-onl.html

    Louise Potter, Christopher McCarthy & Jacqueline Oldham

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  1. Louise Potter
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  2. Christopher McCarthy
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  3. Jacqueline Oldham
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Additional information

Physiological effects of spinal manipulation: a review of proposed theories [Physical Therapy Reviews 2005;10:163-170]

Centre for Rehabilitation Science, Manchester University, Central Manchester and Manchester Children’s University Hospital’s NHS Trust, Manchester, Verenigd Koninkrijk.

Vertaling: Eric Schotsman

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Potter, L., McCarthy, C. & Oldham, J. Fysiologische effecten van manipulatie van de wervelkolom. STIM 26, 120 (2007). https://doi.org/10.1007/BF03063069

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  • DOI: https://doi.org/10.1007/BF03063069

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