functionalorthopedicstimulationtherapy(fost)：功能矫形刺激疗法（fost）

《functionalorthopedicstimulationtherapy(fost)：功能矫形刺激疗法（fost）》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、FunctionalOrthopedicStimulationTherapy(FOST)–LumbarpartSeonghyungCho.M.D.KoreanIntegrativeMedicineInstituteFOST의진단과치료적접근Aboveall,beforetreatmusculoskeletalpainsincludingsegmentalneuropathy,wemustthinkabouttheFUNCTIONofabody&BALANCEofmusclesIdealalign

2、ment(tensegrity):STATICOptimummovement:DYNMICKoreanIntegrativeMedicineInstituteThingstoRemember요통의90%는Disc가dura를압박해서통증이생긴다.나머지10%가척추후구조물(인대,후관절,근막등)이나비역학적척추질환(종양,감염,염증)이나비척추성질환(내부장기)의한것이다요통의진단과치료가실패하는주원인은가장중요한병력과이학적검사를소홀히하고기계적검사(영상진단등)에의존하기때문이다CT:위양성률

3、15.5%위음성률40%MR:위양성률13.2%위음성률35.7%KoreanIntegrativeMedicineInstituteThingstoRemember요통의해부학적원인적분류1)LBPd/tdura디스크에의한요통의가장중요한원인으로디스크가dura를압박하면backache나lumbago가생기고척추신경의duralsleeve를압박하면sciatica가생긴다2)LBPd/tligament디스크가손상되면척추후구조물(인대.후관절,근막)에부하가심하게걸려strain이발생하

4、여통증이생긴다.여기에는정상조직에장시간의정적부하가걸려서생기는자세증후군과strain이발생한비정상조직에부하가걸려생기는기능부전증후군이속한다3)LBPd/tstenosis척추에퇴행성변화가지속되어척추강이나lateralrecess의면적감소에의해발생되는통증이다KoreanIntegrativeMedicineInstituteL.B.P의Anatomy직립의문제:인간은네발짐승에서직립으로진화하였으나해부학적구조가미쳐직립에적응하지못해서디스크의퇴행과요통이쉽게발생한다:네발짐승은신전

5、부하에저항하게anteriorannulus와ALL이훨씬발달해있다-직립에의한굴곡부하에약하다:네발짐승은axial부하에노출되기어렵다-직립에의해지속적인axial부하에노출되어디스크가조기퇴행이일어난다그러므로직립시요추전만을유지하는것이디스크가후방으로이동하는것을방지하고디스크에걸리는axial부하를후지지구조물에분산하여요통의발생을예방하는데가장중요하다.KoreanIntegrativeMedicineInstituteL.B.P의Anatomy디스크의나이는수분함유량과비례한다(수분

6、감소-디스크퇴행)디스크는스폰지와같아서외부부하가강하면수분이줄고외부부하가줄면수분이증가한다.(영양분과노폐물의이동경로)그러므로디스크를건강하게유지하는비결은외부부하를줄이는자세(전만을유지하는자세)를취하고자주자세를바꿔주어디스크에수분및영양공급을원할히해주어야한다KoreanIntegrativeMedicineInstituteL.B.P의AnatomyL4-L5디스크protrusion은L4root,L5root혹은두개모두를압박할수있다L5-S1디스크protrusion은L5ro

7、ot,S1root혹은두개모두를압박할수있다즉L5root은L4나L5디스크에의해압박될수있다신경근의duralsheath가압박되면segmentalpain이나타나고nervefiber가압박되면pinsandneedlessense(paresthesia)-sensoryandmotordeficit이나타난다KoreanIntegrativeMedicineInstituteSpine의degenerativeprocess-과도한부하와immobilization(오래앉아있는자세)-

8、>디스크수분감소및영양결핍->디스크의turgor감소->annulartear->posteriornucleardisplacement->discbulging-protrusion->discheight감소->osteophytosis,facetarthrosis,vertebralcanalandIVFnarrowingKoreanIntegrativeMedicineInstituteFOST(Lumbarpart)1)Painpattern2)SLRtestneg