I-MechanoInceptive Pain: I-Peripheral kunye neendlela eziPhakathi

Iintlungu zokwamkela iMechanoreceptive: NgokweCDC, ngaphezulu kwe-50% yabantu abadala base-US (izigidi ezili-125) babene-musculoskeletal. ukuphazamiseka kweentlungu ngo-2012.�

�Ngaphezu kwe-40% yabantu abadala abaneentlungu zentlungu ye-musculoskeletal basebenzise indlela yezempilo eyongezelelweyo ngenxa yaso nasiphi na isizathu kwi-2012. Oku kwakuphezulu kakhulu kunokusetyenziswa phakathi kwabantu abangenayo intlungu ye-musculoskeletal disorder (24.1%). Ukusetyenziswa kweendlela zempilo ezongezelelweyo ngenxa yaso nasiphi na isizathu phakathi kwabantu abaneentlungu zentamo okanye iingxaki kwakungaphezu kokuphindwe kabini kunokusetyenziswa phakathi kwabantu ngaphandle kwezi ngxaki.

Ifunyenwe: www.cdc.gov/nchs/data/nhsr/nhsr098.pdf

UKUQONDA IINTLUNGU KUBALULEKILE

�Phakathi kwabantu abadala abanengxaki yentlungu ye-musculoskeletal, ukusetyenziswa kwayo nayiphi na indlela yezempilo eyongezelelweyo yayiphezulu phakathi kwabo banentlungu yentamo okanye iingxaki (50.6%), elandelwa ngabantu abanezinye iingxaki ze-musculoskeletal (46.2%).

�Ukusetyenziswa kweendlela zempilo ezongezelelweyo ngenxa yaso nasiphi na isizathu phakathi kwabantu abaneentlungu zentamo okanye iingxaki kwaba ngaphezu kokuphindwe kabini kunokusetyenziswa phakathi kwabantu ngaphandle kwezi ngxaki.

Ifunyenwe: www.cdc.gov/nchs/data/nhsr/nhsr098.pdf

YINTONI UMONGAMELI?

• I-Mechanoreceptors zi-receptors ze-sensory eziphendula uxinzelelo lomatshini okanye ukuphazamiseka.
• Ezi ziquka i-cutaneous receptors ye-touch, i-receptors ebeka iliso ubude bemisipha kunye noxinzelelo, i-auditory kunye ne-vestibular receptors kunye nabanye.

ITHIYORI YOLAWULO LWESANGO LEENTLUNGU

• Igalelo elingenabuhlungu livala amasango kwigalelo elibuhlungu.
• Oku kuthintela ukuva intlungu ekuhambeni ukuya kumanqanaba aphezulu e-cortical
• I-afferents encinci ye-diameter (intlungu) ithintela ukuvinjelwa kweentlungu
• I-afferents enkulu ye-diameter (i-vibration) ikholisa ukuvuyisa ukuvinjelwa kweentlungu.

• Le ngcamango iqinisekisa ukuba iifayili ezingenayo i-nociceptive zinokuphazamisa iimpawu ezivela kwiintlungu zentlungu, ngoko ke, zivimbela intlungu.
• Idayamitha enkulu A? iifibers zi-nonnociceptive (azihambisani ne-stimuli yentlungu) kwaye zivimbela iziphumo zokudubula ngu-A? kunye neeC fibers.

DORSAL IKHOLAM EMDIY INDLELA YEMNISCAL

UKUSETYENZISWA KOOMATSHINI BANGAPHANDLE UKUTSHINTSHA IINGQAQO ZENTLUNGU

SINOKUNCEDA NJANI?

I-REFLEX yokurhoxa

• I-afferent neuron echulumancisayo ivuselela i-interneuron e-excitatory ethi yona ivuselele i-efferent motor neurons enikezela ngee-biceps, isihlunu sengalo esigobayo (egoba) i-elbow joint. Ukufinyezwa kwe-biceps kutsala isandla kude nesitovu esishushu.
• I-afferent neuron ikwavuselela ii-interneuron ezithintelayo ezithi zona zithintele i-efferent neuron enikezela ngee-triceps ukuyinqanda ukuba ingasuki. Olu hlobo loxhulumaniso lwe-neuronal olubandakanya ukuvuselela ukunikezelwa kwemithambo-luvo kwisihlunu esinye kunye nokuvinjelwa kwangaxeshanye kwimithambo-luvo kwisisipha sayo esichasayo kwaziwa ngokuba yi-reciprocal inhibition.
• I-afferent neuron isavuselela ezinye ii-interneuron ezithwala umqondiso phezulu kwintambo yomgogodla ziyise ebuchotsheni ngendlela enyukayo. Kuphela xa impembelelo ifikelela kwindawo yengqondo ye-cortex ngumntu owaziyo intlungu, indawo yayo kunye nohlobo lokuvuselela. Ngaphezu koko, xa impembelelo ifika engqondweni, inkcazelo inokugcinwa njengenkumbulo yaye umntu unokucinga ngoko kwenzekileyo.

I-RECEPTOR ESEKELWE UNYANGO

Uhlengahlengiso

• Ukusetyenziswa kwe-mechanoreceptors edibeneyo ngohlengahlengiso lwe-chiropractic inokulungelelanisa kwaye "isithunzi" imbono yobuchopho kwiifiber ezincinci zedayamitha.
• Ukuphindaphinda ukusebenza kwe-mechanoreceptors edibeneyo kunokudala iplastiki efanelekileyo kwiindlela ezihlukeneyo.
• Iplastiki entle inokuvala iintlungu

wentshukumo

• Ukuvuselela i-Vibratory kwiifrikhwensi ezithile kunokuguqula ukuqonda kweentlungu
• Ukuphindaphindwa kokusebenza kweediski zeMerkel kunye nee-corpuscles zikaMeissner kunokudala iplastiki elungileyo kwiindlela ezihlukeneyo.
• Kwakhona, iplastiki ekhangayo inokuvala iintlungu

IMALI

• �Olu didi lwesixhobo lusebenzisa iintshukumo ze-sinusoidal kwaye lunikeza i-amplitude ekhethiweyo eqhubekayo ye-0-5.2mm ngokuxhomekeke kwindawo yonyawo kunye nefrikhwensi ekhethiweyo ye-5-30Hz.�
• Uqeqesho lwe-WBV lubonakala lusebenza, lukhuselekile, kwaye lufanelekile kubasebenzi abasebenzayo abahleli phantsi abaneentlungu ezingapheliyo zomqolo.

• �I-Homotopic vibro-tactile stimulation ibangele i-40% yokunciphisa intlungu yokushisa kuwo onke amaqela ezifundo. Isiphazamiso asikhange sichaphazele iintlungu zovavanyo.�
• Ukuvuselela i-Vibro-tactile ngokusebenza ngokufanelekileyo kwiindlela ze-analgesic kungekhona kwi-NC kuphela kodwa nakwizigulane ezineentlungu ezingapheliyo ze-musculoskeletal, kuquka i-FM.

UKUKHANYA UKUPHATHA

• �Itotali, amavolontiya asempilweni angama-44 afumene iintlungu zobushushu kunye ne-CT optimal (i-slow brushing) kunye ne-CT sub-optimal (ibrashi ekhawulezayo okanye i-vibration). Iiparadigms ezintathu ezahlukeneyo zokulinga zisetyenzisiwe: Ukusetyenziswa okufanayo kweentlungu zokushisa kunye ne-tactile (ukuxubha kancinci okanye ukunyakaza) ukuvuselela; Ukuxubha okucothayo, kusetyenziswe ixesha eliguquguqukayo kunye nekhefu, ngaphambi kweentlungu zokushisa; Ukucotha xa kuthelekiswa nokubrasha ngokukhawuleza kwangaphambi kweentlungu zobushushu.�

• Ebantwini, ezona ndawo ziphambili zobuchopho ezifumana ulwazi lwe-C-LTMR zezenkqubo ye-somatosensory kwaye zichaphazela ukusetyenzwa kweenethiwekhi zobuchopho njenge-contralateral posterior insular cortex okanye i-medial prefrontal cortex. Ubunzima be-CT ejoliswe ekuthinteni ifakwe kwi-cortex yeprayimari kunye neyesibini ye-somatosensory cortex (i-S1 contralateral, i-S2 bilateral), ngelixa ubumnandi bufakwe kwi-cortex yangaphambili ye-cingulate. I-C-LTMRs iphinda isebenze imimandla echaphazelekayo ekuqhubeni umvuzo (i-putamen kunye ne-orbitofrontal cortex) kunye nokusetyenzwa kwe-stimuli yentlalo (i-posterior superior temporal sulcus).

YONKE I-PERIPHERAL inesiphumo esisembindini

INTO YOKUPHONONONGA

• Indoda eneminyaka engama-47 ubudala yahlupheka yashiya iCVA ngo-Okthobha we-2017.
• Akazange ashukume kwicala lasekunene lomzimba wakhe ukusukela oko kwenzeka ingozi.
• Ziziswe kwikliniki yethu kuba ufuna �ukubuyela kuyo.�

IIMBALASANE ZOVIWO LOMZIMBA

• Dysarthria
• Ukutshintsha ukuqonda intlungu
• Ubunzima ngezibalo ezilula
• I-Flaccid kwi-RUE kunye ne-RLE

IIMBALASANE ZOVIWO LOMZIMBA

• Isigulana sasingenamnyakazo de saqala ukuvavanya imvakalelo kunye neemvakalelo:

I-ALLODYNIA:�Ibhekisa kwi-central sensitization (impendulo eyandisiweyo yee-neurons) ilandela ngokuqhelekileyo ingenabuhlungu, ivuselela ngokuphindaphindiweyo.

• I-allodynia inokukhokelela ekuqaliseni ukuphendulwa kweentlungu ezivela kwi-stimuli, engavamile ukukhupha intlungu.
• Ukushisa okanye ukuvuselela umzimba kunokukhupha i-allodynia, enokuthi ivakale njengento evuthayo kwaye idla ngokuvela emva kokulimala kwisayithi.
• I-Alldynia yahlukile kwi-Hyperalgesia, ukusabela ngokugqithiseleyo, ukubaxiweyo kwi-stimulus, edla ngokuba buhlungu.

UNYANGO LWENYANGO

• wentshukumo
• Ukuchukumisa ukukhanya
• Acupressure
• Iifrikhwensi zeAcoustic
• Uhlengahlengiso!

EMVA KWEENTSUKU EZIMBINI

Iintlungu zeMechanoreceptive kunye ne-Receptor Based Therapy