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Ukuphonononga indima ye-Thoracolumbar Fascia kwi-Back Pain

Ukuphonononga indima ye-Thoracolumbar Fascia kwi-Back Pain

Ngaba i-thoracolumbar fascia inokubangela okanye igalelo kwiintlungu ezisezantsi kunye nokuvuvukala?

Ukuphonononga indima ye-Thoracolumbar Fascia kwi-Back Pain

I-Thoracolumbar Fascia

I-tissue emva kwekholamu yomgogodla, ebekwe kumanqanaba amabini asezantsi kunye naphakathi, ixhunywe kwi-thoracolumbar fascia, ebizwa ngokuba yi-lumbodorsal fascia okanye i-LF. I-fascia sisihlunu esiqinileyo esigquma kwaye sixhasa zonke izihlunu zomzimba, amathambo, imisipha, iiligaments kunye namalungu. I-fascia iqulethe i-nociceptive nerve endings, eyaziwa ngokuba yi-nerve endings yamahhala, ephuma kwi-system ye-nervous central, oko kukuthi, ingqondo kunye nentambo yomgogodla, enokuthi ibe noxanduva lwezinye iintlobo zentlungu kunye nokuqina okubangelwa ukulimala okanye ukuvuvukala.

Anatomy

I-thoracolumbar fascia yohlulwe yangamacandelo amathathu:

  1. Umaleko ongemva okanye ongasemva.
  2. Umaleko ophakathi
  3. Umaleko wangaphambili okanye wangaphambili. (Willard, FH et al., 2012)

Uninzi lwemisipha yangemva inamathele kwi-thoracolumbar fascia. Iqela le-erector spinae muscle, elaziwa ngokuba yi-paraspinals, lihamba ixesha elide phantsi komqolo. Zifakwe kwi-thoracolumbar fascia kunye ne-bony spine. Inxalenye ye-lumbar ye-posterior layer ye-thoracolumbar fascia isuka kwintambo ephantsi ukuya phezulu kwithambo le-hip okanye i-iliac crest. Kwindlela efanayo, idibanisa ne-transverse abdominal muscle. Uxhumo lwe-thoracolumbar fascia lunceda ukudibanisa imisipha yangasemva kwimisipha yodonga lwesisu. I-latissimus dorsi, i-back muscle enkulu ethwala kwaye ihambisa ubunzima bomzimba ngeengalo kunye namagxa, iphinde idibaniswe ne-thoracolumbar fascia, kunye neentambo eziphuma ngaphandle kwi-fascia. Inxalenye engaphambili ye-thoracolumbar fascia, okanye i-anterior layer, igubungela isihlunu esibizwa ngokuba yi-quadratus lumborum. Esi sihlunu sigoba i-trunk ecaleni, inceda ukugcina i-posture enempilo, kwaye ihlala igxininisekile kwiintlungu ezisezantsi ezinxulumene nezihlunu.

Yintoni eyenziwa yiFascia

I-thoracolumbar fascia, ehlolwe ngasemva komzobo we-anatomical okanye umzobo, i-diamond-shaped. Ubume bayo, ubungakanani obukhulu, kunye nendawo esembindini iyibeka ngendlela ekhethekileyo ukudibanisa kunye nokulungelelanisa iintshukumo zomzimba ongasentla kunye nomzimba ongezantsi. Iintsinga ze-fascia zomelele kakhulu, zivumela i-tissue sheath ukuba iboleke inkxaso (Willard, FH et al., 2012). I-tissue nayo iguquguqukayo, ivumela ukuba incede ukujikeleza amandla okunyakaza kunye nokunyakaza kwe-contralateral njengoko i-back muscle contract kwaye iphumule. Umzekelo kukuhamba.

Umqolo obuhlungu

Izazinzulu kunye noogqirha abazi ngokuqinisekileyo, kodwa kunokwenzeka ukuba i-thoracolumbar fascia inokufaka isandla kwiintlungu ezisezantsi. Uphononongo lufumene ukuba i-fascia inokuvelisa iintlungu zangasemva ngokusekelwe kwi: (Wilke, J. et al., 2017)

  • Ukugcina i-micro-innjuries kunye / okanye ukuvuvukala, okuhlala kuhambelana, kunokubangela utshintsho lwesignali kwi-nerve endings kwi-fascia. Iziphelo zemithambo-luvo zifumana ulwazi kwiindawo ezingaphandle zomzimba, njengesikhumba kunye nenye i-fascia, kwaye ziyibuyisele kwinkqubo ye-nervous central. Ithiyori kukuba xa i-fascia isondele kwesikhumba yenzakala, yonakaliswe, kunye / okanye ixhaswa ngamachiza avuthayo kunye nezinto, idluliswa njengentlungu kunye nezinye iimvakalelo ezibuyela kwingqondo kunye nentambo yomgogodla.
  • Emva kokulimala komqolo, izicubu ziqinisa kwaye ziqine. Olunye uphononongo lwezigulane ezineentlungu zangemva ziphawule utshintsho kwi-thoracolumbar fascia yabo.
  • Ukulimala kudla ukuvuselela imithambo-luvo, nto leyo enokukhokelela ekwandeni kovakalelo.

I-Chiropractic yezoNyango zeChiropractic kunye ne-Functional Medicine Clinic igxininise kwaye iphatha ukulimala kunye neentlungu ezingapheliyo ngezicwangciso zokunakekelwa komntu eziphucula amandla ngokusebenzisa ukuguquguquka, ukuhamba, kunye neenkqubo zokunciphisa intlungu. Ababoneleli bethu basebenzisa indlela edibeneyo yokudala izicwangciso zokhathalelo lomntu ngamnye kwisigulane ngasinye, kubandakanywa ne-Functional Medicine, i-Acupuncture, Electro-Acupuncture, kunye nemigaqo yezoNyango zeMidlalo. Injongo yethu kukukhulula intlungu ngokwemvelo ngokubuyisela impilo kunye nokusebenza komzimba. Ukuba olunye unyango luyadingeka, uDkt Jimenez uye wadibanisa kunye noogqirha abaphezulu, iingcali zeklinikhi, abaphandi bezonyango, kunye nababoneleli bokubuyisela ukubonelela ngonyango olusebenzayo.


Sciatica, Iimbangela, Iimpawu, kunye neengcebiso


Ucaphulo

Willard, FH, Vleeming, A., Schuenke, MD, Danneels, L., & Schleip, R. (2012). I-thoracolumbar fascia: i-anatomy, umsebenzi kunye neengqwalasela zeklinikhi. Ijenali ye-anatomy, i-221 (6), i-507-536. doi.org/10.1111/j.1469-7580.2012.01511.x

UWilke, J., Schleip, R., Klingler, W., & Stecco, C. (2017). I-Lumbodorsal Fascia njengoMthombo onokuthi ube nguMthombo weentlungu ezisezantsi: ukuphononongwa kwenkcazo. Uphando lweBioMed lwamazwe ngamazwe, 2017, 5349620. doi.org/10.1155/2017/5349620

Eyona nto ixhaphakileyo yokulimala kweWrestling kunye nendlela yokuphilisa

Eyona nto ixhaphakileyo yokulimala kweWrestling kunye nendlela yokuphilisa

Kubadlali be-wrestling okanye abo bacinga ngokungena kumdlalo, ngaba ukwazi malunga nokulimala okuqhelekileyo kunokunceda ekubuyiseleni nasekukhuseleni?

Eyona nto ixhaphakileyo yokulimala kweWrestling kunye nendlela yokuphilisa

Wrestling Ukwenzakala

IWrestling ngumdlalo onzima nofuna ngamandla. Uphononongo lufumene ukuba ibhola ekhatywayo kunye ne-wrestling yimidlalo emibini yezikolo eziphakamileyo ezinomngcipheko omkhulu wokwenzakala kakhulu kubadlali (Iziko loPhando loLimele kunye noMgaqo-nkqubo, ngo-2009). Izinga lokulimala kubadlali beekholeji kukulimala kwe-9 kwi-1,000 ye-athlete exposures. (Kroshus, E. et al., 2018) Ngelixa uninzi lokonzakala kwi-wrestling lubandakanya i-sprains kunye ne-sprains, kusenokubakho ukwenzakala okubuhlungu kunye nokungaqhelekanga. Ukusebenzisa izixhobo ezifanelekileyo zokhuseleko kunye nokufunda iindlela ezichanekileyo kunokunciphisa kakhulu umngcipheko wokwenzakala. Uninzi lwenzeka ngexesha lokhuphiswano.

Common

Ukulimala okuxhaphakileyo kwe-wrestling kuyafana nakweminye imidlalo kwaye kubandakanya:

Ukudumba kwezihlunu

  • Ubuhlungu bezihlunu obunamava kwiiyure ezili-12 ukuya kwezingama-48 emva kokuzilolonga ngamandla okanye ukhuphiswano.
  • Ukuphumla kudla ngokuba yeyona nto ifunekayo ukuze uchache.

Ukugruzuka kunye neeNxukuxa

  • Ukuqhawula, ukuhla, kunye nokuhla ngokukhawuleza kunokukhokelela kwimikrwelo eyahlukeneyo kunye nokuphazamiseka.

Iintlobo kunye neeNtle

  • Ukuphumla, umkhenkce, ukunyanzeliswa, kunye nokuphakama kuyacetyiswa ukuba uphathe i-sprains kunye neentlobo ngokukhawuleza.

IAnkle Sprains

  • I-Ankle sprains iyenzeka xa iigaments ezijikelezayo zolula kwaye zikrazula ngeenxa zonke.

IWrist Sprains

  • Ngokuqhelekileyo, kwenzeka xa ulula okanye ukrazula i-ligaments.
  • Ukuwa okanye ukuwela ezandleni yimbangela eqhelekileyo.

I-Overtraining Syndrome

  • Kwenzeka rhoqo kwiimbaleki ezizilolongela ngaphaya kwamandla omzimba okubuyela kwimeko yawo.

emzimbeni

  • Xa uzama ukwenza ubunzima, ukuphelelwa ngamanzi emzimbeni kunokuba yingxaki enkulu yempilo eyenziwa ngabadlali abaninzi.

Okunye Ukwenzakala

Olunye ukonzakala oluxhaphakileyo kwi-wrestling:

  • I-tendonitis yesandla
  • Ukwaphuka kweminwe
  • I-Iliotibial band syndrome
  • Iinyembezi ze-meniscus
  • Ukutsalwa kwegroin
  • Umtya wokutsala okanye ukukrazula
  • Isihlunu sethole esitsaliweyo
  • I-Achilles tendonitis
  • Ukuqhekeka kwethoni ye-Achilles
  • Ukwaphuka kweClavicle/Collarbone
  • Ingqungquthela

Inzulu

Ukunyanzeliswa komdibaniso ngaphaya koluhlu lwawo oluqhelekileyo lokunyakaza yimbangela eqhelekileyo yokulimala kakhulu. Owona nzakala kakhulu wokulwa ichaphazela intamo, igxalaba, i-elbow, kunye nedolo kwaye ibandakanya:

Neck

  • I-vertebrae yomlomo wesibeleko ivame ukunyanzeliswa kwiindawo ezisengozini ngexesha lobuchule obuhlukeneyo kunye nokunyakaza, oku kunokubangela ukulimala kwentamo. Iindidi eziqhelekileyo ziquka:
  • Uxinzelelo lweNtamo
  • Whiplash
  • Ukuqhekeka koMbeleko

Ngamahlombe

  • Ukudityaniswa komgangatho kunye nokujija kubangela uninzi lokulimala okuphezulu komzimba kunye namagxa ngexesha lokhuphiswano. Iindidi zokulimala kwamagxa ziquka:
  • Ukulimala kwebhola ye Rotator
  • Ukwahlukana kwamagxa
  • Ukuhlulwa kwamagxa

Ukususwa kweElbow

  • Iingqiniba ziphantsi koxinzelelo olukhulu xa uqhuba.
  • Ukuchithwa kwentloko ye-radial kudla ngokuhambelana nomdlali obambezela ukuwa kwingalo eyoluliweyo ngexesha lokuhla.

idolo

  • Uninzi lokulimala kwamadolo kwenzeka kwiigaments of the knee joint.
  • Ezi ziquka i-anterior and posterior cruciate ligament okanye i-ACL / PCL ukulimala.

Safety

I-Wrestling idinga ukuguquguquka, amandla, kunye nobuchule obufanelekileyo bokuthintela ukulimala, kudibaniswa nomyalelo opheleleyo kunye nokuqeqesha kunye nokulandela imilinganiselo yokhuseleko olusisiseko. Ezinye iingcebiso ziquka.

Ukhuseleko lweGear

  • Nxiba iintloko ezifanelekileyo kunye nezikhuselo zomlomo ngexesha lokuziqhelanisa, iintlanganiso, kunye neetumente.

Ukuphucula ukuguquguquka okuManyeneyo

  • Abadlali abanezinga eliphezulu lokuguquguquka kwamagxa banokulimala okumbalwa.
  • Ukuguquguquka komqolo osezantsi, i-hamstrings, i-elbows, kunye nomqolo wesibeleko kufuneka kusetyenzwe.

Yandisa okanye Unciphise Ubunzima ngokuKhuselekileyo

  • Gwema ukulahleka kwesisindo esimangalisayo kunye nezicwangciso zokufumana ubunzima ngokugcina ukutya okunempilo kunye nokuhanjiswa kwamanzi ngexesha lonyaka.

Ukuphepha Ukubamba okuNgozi kunye nokuhamba kweSlam

  • Iindlela ezikhuselekileyo zokujijisana kufuneka zilandelwe njengoko ezi zinokuvelisa ukwenzakala okukhulu.

Nokuba ixhaphake kangakanani na okanye ayibonakali iyingozi kangakanani na okanye imeko yezempilo, kubalulekile ukuphumla kwaye uchache kwaye uxelele umqeqeshi kwaye ingcali yezempilo, njengoko ezinye iingozi kunye neemeko zinokuba yingozi xa zinganyangwa. I-Chiropractic yezoNyango zeChiropractic kunye ne-Functional Medicine Clinic igxininise kwaye iphatha ukulimala kunye neentlungu ezingapheliyo ngezicwangciso zokunakekelwa komntu eziphucula amandla ngokusebenzisa ukuguquguquka, ukuhamba, kunye neenkqubo zokunciphisa intlungu. Ababoneleli bethu basebenzisa indlela edibeneyo yokwenza izicwangciso zokunakekelwa komntu ngamnye kwisigulane ngasinye, kubandakanywa neMithi eSebenzayo, i-Acupuncture, i-Electro-Acupuncture, kunye nemigaqo yeMithi yeMidlalo. Injongo yethu kukukhulula intlungu ngokwemvelo ngokubuyisela impilo kunye nokusebenza komzimba. Ukuba olunye unyango luyadingeka, uDkt Jimenez uye wadibanisa kunye noogqirha abaphezulu, iingcali zeklinikhi, abaphandi bezonyango, kunye nababoneleli bokubuyisela ukubonelela ngonyango olusebenzayo.


Ukunyamezela kunye namandla


Ucaphulo

Isibhedlele saBantwana kuzwelonke. (2024). Iziko loPhando loLimele kunye noMgaqo-nkqubo. www.nationwidechildrens.org/research/areas-of-research/center-for-injury-research-and-policy

Kroshus, E., Utter, AC, Pierpoint, LA, Currie, DW, Knowles, SB, Wasserman, EB, Dompier, TP, Marshall, SW, Comstock, RD, & Kerr, ZY (2018). Iminyaka elishumi yokuQala ye-Web-Based Sports Surveillance Surveillance: I-Epidemiology echazayo yokulimala kwi-US High School Boys 'Wrestling (2005-2006 Through 2013-2014) kunye ne-National Collegiate Athletic Association Men's Wrestling (2004-2005 ngokusebenzisa i-2013-2014) . Ijenali yoqeqesho lweembaleki, i-53 (12), i-1143-1155. doi.org/10.4085/1062-6050-154-17

Ukuthintela kunye nokuNyanga i-Plantar Fasciitis ngezolulo ezahlukeneyo

Ukuthintela kunye nokuNyanga i-Plantar Fasciitis ngezolulo ezahlukeneyo

Ngaba izolulo ezahlukeneyo zinokunceda abantu abane-plantar fasciitis ukunciphisa intlungu yonyawo kunye nokubuyisela ukusebenza kwe-gait?

intshayelelo

Njengabantu, sihlala sihamba, kwaye iinyawo zethu zezona zithatha umngcipheko emva kosuku olude. Iinyawo zinemisipha eyahlukeneyo, i-ligaments, i-tendon, kunye nezicubu ezithambileyo ezinceda ukukhusela amalungu kunye nokubonelela ukuzinza. Iinyawo ziyinxalenye yeendawo ezisezantsi ezincedisa ukuhamba kunye namandla omzimba ophezulu. Xa abantu abaninzi behlala bemi ngeenyawo, izihlunu kunye neeligaments zisebenza kakhulu kwaye zinokukhula zibe yimiba efana neentlungu. Amaxesha amaninzi iba kukuqaqanjelwa sisihlunu neentlungu; nangona kunjalo, xa ukunyakaza okuphindaphindiweyo kuqala kubangela iingxaki ezininzi ezinyaweni, kunokukhokelela kwiinyembezi ezincinci kwi-fascia yonyawo. Oku, kwakhona, kunokukhokelela ekuphuhlisweni kwe-plantar fasciitis, echaphazela amandla omntu wokuhamba. Inqaku lanamhlanje lijonga indlela i-fasciitis ye-plantar echaphazela ngayo ukusebenza kwe-gait kunye nendlela ezahlukeneyo ezolula ezinokunceda ngayo ukunciphisa i-fasciitis ye-plantar. Sixoxa nababoneleli bezonyango abaqinisekisiweyo abadibanisa ulwazi lwezigulane zethu ukuvavanya i-plantar fasciitis kunye ne-comorbidities ehambelana nayo. Sikwazisa kwaye sikhokela izigulana kwiindlela ezahlukeneyo ze-plantar fasciitis kwaye sibuze ababoneleli bezonyango abanxulumene nabo imibuzo entsonkothileyo ukudibanisa isicwangciso sonyango esilungiselelwe ukubandakanya ukunwebeka okuninzi ukunciphisa iimpawu ezinjengeentlungu ezihambelana nayo. UDkt Jimenez, DC, uquka olu lwazi njengenkonzo yezemfundo. isikhanyeli.

 

I-Plantar Fasciitis ichaphazela njani ukusebenza kweGait

Ngaba uziva ngathi uhamba egoso ukusuka kwenye indawo ukuya kwenye? Ngaba uziva intlungu ehlabayo xa uthatha amanyathelo akho okuqala? Okanye ngaba uziva iintlungu eziqhubekayo ezinyaweni zakho ngelixa uphumle? Njengoko bekutshiwo ngaphambili, abantu abaninzi bahlala bemi ngeenyawo kwaye bajongana neentlungu ezinokuthi zichaphazele umgangatho wobomi babo. Ekubeni iinyawo ziyingxenye yesigxina somzimba ophantsi, umntu ofumana intlungu eninzi kwizithende zabo unokukhokelela kwimeko engapheliyo ye-musculoskeletal eyaziwa ngokuba yi-plantar fasciitis. I-fascia ye-plantar idlala indima enkulu kumzimba womntu njengoko inceda nge-biomechanics eqhelekileyo yonyawo, ixhasa i-arch, kwaye ibonelele ukufunxa ukothuka xa umntu enyathela. (Buchanan et al., 2024) Xa umntu esenza ukunyakaza okuphindaphindiweyo ezinyaweni zabo, kunokukhokelela ekuphuhlisweni kwe-plantar fasciitis. I-Plantar fasciitis sisifo esiqhelekileyo se-musculoskelet esibangela utshintsho olungapheliyo kwi-fascia plantar. Esi sifo se-musculoskelet sikwadibaniswa nezinto zemishini ezifana nokuphindaphinda uxinzelelo kunye nokuthwala ubunzima obunokukhokelela kwii-microtears kwi-muscle fibers. (Tseng et al., 2023) Loo ngongoma ibangela ukuba abantu abaninzi babe neengxaki zokuhamba kunye nezinye izifo.

 

 

Eminye imingcipheko enxulumene ne-plantar fasciitis iyancipha i-ROM kwi-plantarflexion kunye nokwanda komthwalo onzima, onokubangela ukuba abantu abaninzi babe nemiba yokuhamba xa behamba. (Hamstra-Wright et al., 2021) Ekubeni abantu abaninzi baxhomekeke ekuhambeni kwaye bafumana intlungu kwi-fasciitis plantar, kungekhona nje umsebenzi wabo we-gait ochaphazelekayo, kodwa Izihlunu ezijikelezileyo emilenzeni nazo ziyachaphazeleka. Iimpawu zentlungu ezifana nobuthakathaka bemisipha yangaphakathi, ukunciphisa amandla emisipha emilenzeni kunye ne-dorsiflexion, ukungafani kobude bomlenze, kunye nokukhubazeka kwe-arch kunokunyusa amathuba okuba i-plantar fasciitis ikhule. (Khammas et al., 2023) Oku kunokubangela ukuba abantu abaninzi babe ne-gait dysfunction kuba iintlungu azinyamezeleki. Ukongezelela, xa abantu bejongana ne-plantar fasciitis, batshintsha ubunzima babo kwelinye icala lemizimba yabo ukuze banciphise intlungu kwaye bavumele imisipha yabo yesibini ukuba ithathe umthwalo ongeyomfuneko. Ngethamsanqa, kukho iindlela zokunciphisa iintlungu ezinjengeentlungu ze-plantar fasciitis kunye nokunceda ukubuyisela umsebenzi wokuhamba komntu.

 


Yintoni i-Plantar Fasciitis?-Ividiyo


Ukolulwa okusebenzayo ukuthomalalisa i-Plantar Fasciitis

 

Xa kufikwa ekunciphiseni i-plantar fasciitis, abantu abaninzi bafuna unyango olwahlukeneyo ukunciphisa iimpawu ezinjengeentlungu ezibangela ukungasebenzi kakuhle kwe-gait. Abantu abaninzi bafuna unyango olungangoqhaqho kunye nonyango lokufumana isisombululo esifanelekileyo se-plantar fasciitis. Ngokuxhomekeke kubunzima beentlungu ezichaphazela iinyawo zabo, eyona njongo iphambili kukunciphisa umthwalo ocinezelayo wezicubu kunye nokubonelela ngesicwangciso sonyango lomntu siqu sokufundisa kunye nokunyanga i-plantar fasciitis. (Morrissey et al., 2021) Enye yezona ndlela zokunciphisa intlungu kwi-fasciitis ye-plantar kukubandakanya iintlobo ezahlukeneyo. Izahlulo ezahlukeneyo ze-plantar fasciitis zinokusebenza njengoko zinokunceda ukuthomalalisa iintlungu kunye nokuphucula amandla emisipha kwimisipha yangaphandle kunye neyonyawo lwangaphakathi. (Boonchum et al., 2020) Ngezantsi kukho ukunweba apho abantu abaninzi abajongene ne-plantar fasciitis bangayenza ekhaya ukuze banciphise intlungu.

 

Itawuli Yolula

Olu lulula olulula lufanelekile kusasa, ngakumbi ngaphambi kokuba uthathe amanyathelo akho okuqala.

Indlela yokwenza ngayo:

  • Hlala ecaleni kwebhedi kunye nemilenze yakho ngqo phambi kwakho.
  • Jika itawuli ujikeleze ibhola yeenyawo kwaye ubambe isiphelo ngasinye ngezandla zakho.
  • Tsala itawuli ijonge kuwe ngelixa uzama ukugcina amadolo athe nkqo ude uzive usolulekile emazantsi onyawo lwakho kunye nethole.
  • Bamba indawo ye-15 ukuya kwi-30 imizuzwana.
  • Phinda amaxesha angama-2-3 ngonyawo ngalunye.

 

Ithole Lizolula

Izihlunu eziqinileyo zethole zingenza ukuba i-plantar fasciitis ibe nzima. Ukolula amathole akho kunokunciphisa uxinzelelo kwi-fascia yakho ye-plantar.

Indlela yokwenza ngayo:

  • Yima kufuphi nodonga unyawo olunye umva kunye nolunye unyawo phambi kwakho.
  • Gcina isithende sakho singasemva emhlabeni kwaye ugobe idolo lakho langaphambili de uve ukolula kwisihlunu sethole somlenze wangasemva.
  • Bamba malunga nemizuzwana engama-30 kwaye utshintshe.
  • Phinda amaxesha angama-2-3 ngomlenze ngamnye.

 

Plantar Fascia Yolula

Ukwelula ngokuthe ngqo i-fascia plantar kunokunceda ukunciphisa intlungu kunye nokuphucula umsebenzi weenyawo.

Indlela yokwenza ngayo:

  • Hlala kunye nonyawo lwakho oluchaphazelekayo kwaye ulubeke ngaphaya kwelinye icala.
  • Sebenzisa isandla sakho ukutsala iinzwane zakho ngasemva ukuya kwi-shin de uzive ukolula ecaleni kwe-arch yonyawo lwakho.
  • Bamba ukolula ubuncinci imizuzwana eyi-15 kwaye uphinde ukolula kathathu.

 

Achilles Tendon Yolula

Olu luhlu lunceda zombini izihlunu zethole kunye ne-plantar fascia.

Indlela yokwenza ngayo:

  • Yima ngonyawo lwakho oluchaphazelekayo emva kwakho.
  • Gcina isithende sakho phantsi kwaye ugobe idolo lakho kancinci.
  • Bamba indawo ye-15-20 imizuzwana, uze uphumule.
  • Phinda amaxesha angama-2-3 ngomlenze ngamnye.

 

Ukuthatha iMarble

Ukomeleza imisipha ejikeleze unyawo lwakho kunokuxhasa inkqubo yokuphilisa.

Indlela yokwenza ngayo:

  • Hlala kwisitulo
  • Emva koko, pintambo yeebhastile ezingama-20 kunye nesitya phantsi phambi kweenyawo zakho.
  • Sebenzisa iinzwane zakho ukuchola ibhastile elinye kwaye ulibeke esityeni esinye ngexesha.
  • Phindaphinda ude ube nawo onke amabhastile esityeni.

 


Ucaphulo

Boonchum, H., Bovonsunthonchai, S., Sinsurin, K., & Kunanusornchai, W. (2020). Umphumo womsebenzi wokwelula owenziwe ekhaya kwi-multi-segmental foot motion kunye neziphumo zeklinikhi kwizigulane ezine-plantar fasciitis. J Musculoskelet Neuronal Interact, 20(3), 411-420. www.ncbi.nlm.nih.gov/pubmed/32877978

www.ncbi.nlm.nih.gov/pmc/articles/PMC7493445/pdf/JMNI-20-411.pdf

Buchanan, BK, Sina, RE, & Kushner, D. (2024). I-Plantar Fasciitis. Kwi StatPearls. www.ncbi.nlm.nih.gov/pubmed/28613727

Hamstra-Wright, KL, Huxel Bliven, KC, Bay, RC, & Aydemir, B. (2021). Imiba yoMngcipheko we-Plantar Fasciitis kubantu abaSebenza ngoMzimba: Ukuphononongwa okuCwangcisiweyo kunye nohlalutyo lweMeta. Impilo yezemidlalo, 13(3), 296-303. doi.org/10.1177/1941738120970976

Khammas, ASA, Mahmud, R., Hassan, HA, Ibrahim, I., & Mohammed, SS (2023). Uvavanyo lwe-plantar fascia kunye neziphumo ze-ultrasound kwizigulane ezine-plantar fasciitis: ukuphononongwa ngokuchanekileyo. J Ultrasound, 26(1), 13-38. doi.org/10.1007/s40477-022-00712-0

Morrissey, D., Cotchett, M., Wathi J'Bari, A., Ngaphambili, T., Griffiths, IB, Rathleff, MS, Gulle, H., Vicenzino, B., & Barton, CJ (2021). Ulawulo lweentlungu zesithende sesityalo: isikhokelo esihle kakhulu esichazwe ngokuphononongwa okucwangcisiweyo, ingcali yokuqiqa kwezonyango kunye nemilinganiselo yesigulane. Br J Midlalo yeMed, 55(19), 1106-1118. doi.org/10.1136/bjsports-2019-101970

Tseng, WC, Chen, YC, Lee, TM, & Chen, WS (2023). I-Plantar Fasciitis: Uphononongo oluhlaziyiweyo. J Med Ultrasound, 31(4), 268-274. doi.org/10.4103/jmu.jmu_2_23

isikhanyeli

I-Neuropathic Gait: Uhlalutyo lokuhamba ngokungaqhelekanga

I-Neuropathic Gait: Uhlalutyo lokuhamba ngokungaqhelekanga

Ngaba unyango lomzimba lunokunceda ukunyanga i-steppage gait ephezulu kukwenzakala okanye iimeko zonyango kunye nokubuyisela iipatheni eziqhelekileyo zokuhamba kwabantu abanayo okanye abaphuhlisayo?

I-Neuropathic Gait: Uhlalutyo lokuhamba ngokungaqhelekanga

Ukuhamba okanye ukuhamba uhlalutyo lwe-anthropometric kwi-treadmill

I-Neuropathic Gait

I-neuropathic gait, i-aka equine okanye i-high steppage gait, luhlobo lokuhamba okungaqhelekanga okubangela ukuba abantu baphakamise izinqe zabo ukuze baphakamise imilenze yabo phezulu kunesiqhelo. Kwenzeka xa abantu behla unyawo okanye i-ankle equinus ngenxa yokulahlekelwa yi-dorsiflexion. Ngenxa yoko, unyawo lujinga ngeenzwane ezijonge phantsi, nto leyo eyenza ukuba iinzwane zirhuqe xa uhamba. Unyawo lusenokubonakala luthambile xa luwa. Ukuhla kweenyawo kubangelwa ubuthathaka okanye ukukhubazeka kwe-tibialis muscle yangaphambili phambi kwethambo le-shin. I-anterior tibialis muscle contracts ukuze uncede ukuguqula unyawo kunye ne-ankle ngelixa uhamba, uqinisekisa ukuba unyawo luhlambulula umgangatho kwaye aluyi kudonsa. Abantu abanobuthakathaka be-tibialis yangaphambili okanye ukukhubazeka banokuba ne-neuropathic gait kwaye bagobe ngokugqithiseleyo i-hip kunye nedolo ngelixa beqhubela phambili, bephakamisa umlenze wabo phezulu phantsi ukuze basuse unyawo ukuze bagweme ukukhubeka. Iqela lonyango lomzimba linokunceda ngepatheni ephezulu ye-steppage gait emva kokugula okanye ukulimala.

Izizathu

Iimeko ezinokubangela ubuthathaka be-tibialis yangaphambili okanye ukukhubazeka kunye nephethini ephezulu ye-steppage gait ibandakanya:

Sciatica

  • Intlungu ebangelwa ukunyanzeliswa okanye ukucaphuka kwe-nerve ye-sciatic iqala kumqolo ophantsi kwaye ihambe phantsi komlenze. (McCabe, FJ, McCabe, JP 2016)

Injury Peroneal Nerve

  • Umonakalo kumasebe e-peroneal nerve avela kwi-nerve ye-sciatic enceda ukuhambisa umlenze ophantsi kunye nonyawo. (Johns Hopkins Medicine. 2024)

Isifo sokugubhuka

Stroke

Umboneleli wezempilo osisiseko unokuthumela iqela lonyango lomzimba ukunceda ukulungisa ipateni ye-neuropathic gait.

impatho

Unyango lunokubandakanya iindlela ezahlukeneyo zonyango ezijolise kwi-anterior tibialis muscle.

  • Ukuzivocavoca kwe-ankle ekujoliswe kuyo kunokunceda ukuqinisa izihlunu.
  • Ukuzolula ithole kunokunceda ukugcina uluhlu lokushukuma kweqatha.
  • Uqeqesho lwe-Gait ukuzilolonga.
  • Ukuzivocavoca ngokulinganisela kuya kunceda ekuphuculeni iproprioception iyonke, okanye ingqiqo yesikhundla somzimba kunye nokuhamba.
  • I-Neuromuscular electrical stimulation, okanye i-NMES, inokunceda ukuphucula umsebenzi we-muscle. (Hollis, S., McClure, P. 2017)
  • Ukukhuthazwa kombane kudibanisa ngokufanelekileyo i-muscle ukubuyisela umsebenzi ofanelekileyo.
  • Ngenxa yobuthathaka be-tibialis yangaphambili ebangelwa yi-sciatica, i-back decompression exercises ingamiselwa ukukhulula uxinzelelo kwi-nerve ye-sciatic.
  • Ukuzivocavoca kukhulula i-nerve ukubuyisela ukuhanjiswa kwesignali eqhelekileyo phezulu nasezantsi kwi-nerve kumqolo ongezantsi.
  • Ukukhuthazwa kombane we-Neuromuscular kungasetyenziselwa ukunceda ukuphucula ukusebenza kwemisipha.

Izixhobo zokuhamba ezincedisayo

Ugqirha usenokucebisa ukuba kusetyenziswe isixhobo sokuncedisa isigulana ukuze sihambe kakuhle. Oku kunokubandakanya umhambi onamavili okanye i-quad cane. Isisombululo sesikhashana sobuthakathaka be-tibialis yangaphambili kukuphakamisa unyawo ngelixa uhamba nge-band elastic. Bopha ibhanti emlenzeni ngaphantsi kwedolo kwaye uyikhusele kwibhola yonyawo. Xa uguqula umlenze phambili, ibhanti idonsa unyawo phezulu. Ukuyisebenzisa njengesisombululo sexeshana kunokunceda ukugcina ukuhamba okukhuselekileyo. Ngamanye amaxesha, ukukhubazeka kwe-anterior tibialis muscle kunokuba sisigxina. Kule meko, abantu ngabanye banokuzuza kwizibophelelo ezikhethekileyo ezibizwa ngokuba yi- i-anthosis ye-ankle-foot. Izihlangu zezilima ezidityaniswe ngentsinjana/ngeplangana zinceda ukuphakamisa unyawo neenzwane emhlabeni.

Kubantu abachaphazelekayo malunga nokulahlekelwa ukulinganisela kunye nokuwa, kukho iindlela zokuphucula iipatheni zokuhamba ukuze bahlale bekhuselekile. Umboneleli wezempilo unokuncoma unyango lomzimba ukulungisa ukuhamba, ukuqinisa i-anterior tibialis muscle, ukuphucula ukulinganisela, nokufundisa ngokuthintela ukulimala. Abantu ngabanye kufuneka baxoxe ngeempawu kunye neemeko kunye nogqirha oyintloko, umboneleli wezempilo, okanye ingcali ukuba ibakhokele kwicala elifanelekileyo kwaye inqume unyango olungcono.

I-Chiropractic yezoNyango zeChiropractic kunye ne-Functional Medicine Clinic isebenzisa indlela edibeneyo eyenzelwe umntu ngamnye egxile kwizinto ezisebenzelayo kunye nokuphatha ukulimala kunye ne-syndromes yentlungu engapheliyo ngezicwangciso zokunyamekela zomntu eziphucula amandla ngokusebenzisa ukuguquguquka, ukuhamba, kunye neenkqubo zokunciphisa intlungu. Ukuba olunye unyango luyadingeka, uDkt Jimenez uye wadibanisa kunye noogqirha abaphezulu, iingcali zeklinikhi, abaphandi bezonyango, kunye nababoneleli bokubuyisela ukubonelela ngonyango olusebenzayo.


Lawula ukunyakaza kweenyawo kunye nokuma


Ucaphulo

McCabe, FJ, & McCabe, JP (2016). Inkcazo engaqhelekanga ye-Sciatica ye-Right-Sided nge-Foot Drop. Iingxelo zeemeko kwi-orthopedics, i-2016, i-9024368. doi.org/10.1155/2016/9024368

Johns Hopkins Medicine. (2024). Ukulimala kwe-nerve peroneal. www.hopkinsmedicine.org/health/conditions-and-diseases/peroneal-nerve-injury

Kaykisiz, EK, & Unluer, EE (2017). Isizathu esingalindelekanga sokulahla unyawo olulodwa: I-Acute Stroke. Ijenali yasePakistan yezenzululwazi zonyango, 33 (5), 1288-1290. doi.org/10.12669/pjms.335.13593

Taylor, PN, Wilkinson Hart, IA, Khan, MS, & Slade-Sharman, DE (2016). Ukulungiswa kweFootdrop ngenxa ye-Multiple Sclerosis Ngokusebenzisa i-STIMuSTEP eFakelwe isivuseleli seenyawo eziwisiweyo. Ijenali yamazwe ngamazwe ye-MS care, i-18 (5), i-239-247. doi.org/10.7224/1537-2073.2015-038

Hollis, S., & McClure, P. (2017). I-Intramuscular Electrical Stimulation for Muscle Activation of the Tibialis Anterior Emva kokulungiswa koCwangciso: Ingxelo yeNgxelo. Ijenali yonyango lwamathambo kunye nezemidlalo, 47 (12), 965-969. doi.org/10.2519/jospt.2017.7368

Ukulawula i-TMJ kunye neMizilo eJolisiwe yokuZolula

Ukulawula i-TMJ kunye neMizilo eJolisiwe yokuZolula

Ngaba izahlulo ezahlukeneyo zinokubonelela ngeziphumo eziluncedo kubantu abafumana iintlungu zeTMJ ngokubonelela ngesiqabu emhlathini?

intshayelelo

Abantu abaninzi basebenzisa imihlathi ukuze banxibelelane, batye ukutya okumnandi, baze baveze iimvakalelo zabo. Umhlathi uyingxenye yemigangatho ephezulu njengoko inemisipha emihlanu evumela ukuba isebenze xa umlomo uvula okanye uvala, ukuhlafuna, kunye nokuhamba ukusuka kwelinye icala ukuya kwelinye. Xa iimoto eziqhelekileyo zisebenza njengokuzamla, ukuhlafuna, okanye ukuthetha kuvelisa iipopu ezikhwazayo okanye ucofa, kunokuba buhlungu kakhulu kwaye kaninzi kukhokelela kwi-temporomandibular joint dysfunction okanye i-TMJ. I-TMJ yingxaki edibeneyo enokuthi ichaphazele amandla omntu okusebenzisa imihlathi ngokufanelekileyo kwaye inokubangela ukuphazamiseka kwe-visceral-somatic enokuthi ichaphazele imilenze ephezulu, ibangele ukuba bahlupheke. Ngethamsanqa, abantu abaninzi banokubandakanya iindlela ezahlukeneyo zokunciphisa impembelelo ye-TMJ kwaye bancede ukukhulula imisipha eqinile ejikeleze umhlathi. Inqaku lanamhlanje lijonga imiphumo ye-TMJ, indlela iindlela ezahlukeneyo zokunciphisa i-TMJ, kunye nendlela unyango olongezelelweyo olungasebenzisi utyando olunokuyiphelisa ngayo intlungu ye-TMJ. Sixoxa nababoneleli bezonyango abaqinisekisiweyo abadibanisa ulwazi lwezigulane zethu ukuvavanya imiba efana neentlungu ezinxulumene ne-TMJ. Siyazisa kwaye sikhokela izigulane kwiindlela ezahlukeneyo ze-TMJ kwaye sibuze ababoneleli bezonyango abanxulumene nabo imibuzo enzima ukudibanisa isicwangciso sonyango esilungiselelwe ukunciphisa imiba efana nentlungu echaphazela imihlathi yabo. UDkt Jimenez, DC, uquka olu lwazi njengenkonzo yezemfundo. isikhanyeli.

 

Iziphumo zeTMJ

Ngaba uziva uqina emhlathini wakho emva kokubamba ixesha elide? Ngaba uyeva ukucofa okugqithisileyo xa uvula okanye uvala imihlathi yakho? Okanye ngaba ucinga ukuba umhlathi wakho uhlala uvaliwe, nto leyo eyenza kube nzima ukuvula okanye ukuvala umlomo wakho? Xa abantu abaninzi beqala ukuva iintlungu emihlathini ngokugqithisileyo, abaninzi bahlala becinga ukuba inokuba ziintlungu zamazinyo, kodwa eneneni, lilungu le-temporomandibular elibangela imiba. I-Temporomandibular joint disorder, okanye i-TMJ, inokuphuhliswa ngezizathu ezahlukahlukeneyo ezinokuchaphazela umhlathi womntu kwaye zingakhokelela kwiintlungu kunye nokungahambi kakuhle. Imiba yomatshini efana nokulimala kwemihlathi, isifo samathambo, ukuqhina kwamazinyo, kunye nokusila kunokubangela ukulayisha ngokugqithisileyo okanye okungalungelelananga ngokudibeneyo emhlathini, okunokuqhubela phambili uphuhliso lwe-TMJ. (Cardoneanu et al., 2022) Xa usebenzisana ne-TMJ, intlungu ingakhokelela kwiimpawu zobubele malunga nommandla odibeneyo womhlathi, ubunzima bokuhlafuna, intlungu yendlebe, kunye nokuqina.

 

 

Ngexesha elifanayo, iimpembelelo zentlungu ye-TMJ zihlala zibonakaliswa ngokungahambi kakuhle kwendawo, njengoko i-TMJ i-multifactorial musculoskeletal and neuromuscular disorder enokuba nzima ukuyifumanisa. (UAlolayan et al., 2022) Oku kungenxa yokuba bangaphi abantu abahlafuna ukutya kwabo kwelinye icala, nto leyo enokukhokelela ekukhuleni kwako. Xa izihlunu ze-masseter zomhlathi ziqala ukugqithiswa kwi-TMJ, inokuqalisa ukulungiswa kwakhona kwicala elingasebenziyo lomhlathi kwaye ibangele ukuba intlungu iphumelele ngokuhamba kwesikhathi. (Santana-Mora et al., 2013) Nangona kunjalo, xa ujongene nentlungu ye-TMJ, abantu abaninzi banokufuna iindlela ezahlukeneyo zonyango ezinokunciphisa ukukhubazeka kwemisipha kunye nokukhutshwa kwe-disc emhlathini kunye nokunceda ukuphucula uluhlu lwe-mandibular ye-motion. (UBrighenti et al., ngo-2023

 


INzululwazi yeVidiyo eshukumayo


Kutheni Ukolula Kunceda Nge-TMJ

 

Xa kufikwa ekunciphiseni iintlungu ze-TMJ, abantu abaninzi banokufuna unyango olungasebenzisi utyando ukunciphisa iimpawu zentlungu ezigqithileyo kunye nokubuyisela ukusebenza kwemihlathi. Ezinye zeenjongo eziphambili ezinokuthi iingcali ezininzi zeentlungu zithathelwe ingqalelo xa zijongene nentlungu ye-TMJ zinciphisa intlungu ye-reflex masticatory muscle kunye nokunceda ukwandisa umsebenzi we-TMJ ngokusebenzisa unyango oluhlukeneyo olunokuba nefuthe elihle emhlathini. (UFerrillo et al., ngo-2022) Olunye unyango olungelulo utyando lubandakanya ukolula okuninzi ukunceda ukukhulula izihlunu ezijikelezileyo kunye nomhlathi kunye nokunciphisa uxinzelelo kunye nokungahambi kakuhle okuhambelana ne-TMJ. 

 

Ukolulwa okusebenzayo koNcedo lweTMJ

Ukolula kunokuba yinxalenye yesicwangciso sonyango lomntu siqu sokunciphisa intlungu ye-TMJ kunye ne-comorbidities ezinxulumene nayo. Ukolula kunye nokuqinisa ukuzivocavoca kunokuchaphazela kakuhle intlungu ngelixa uphucula uluhlu lwentshukumo ye-TMJ kunye nokunceda abantu abaninzi babuyisele umsebenzi wabo womhlathi (Byra et al., 2020). Ngezantsi ezinye zezolula ezinokukunceda ukunciphisa intlungu ye-TMJ kwaye ukhulule imisipha yomhlathi. 

 

Ukuzilolonga kwemihlathi ekhululekile

  • Indlela yokwenza: Beka ulwimi ngobunono eluphahleni lomlomo emva kwamazinyo angaphezulu angaphambili. Oku kuvumela amazinyo ukuba ahlukane ngelixa ukhulula izihlunu zemihlathi.
  • benefits: Lo mthambo unceda ukukhulula umhlathi kunye nokunciphisa ukuxinezeleka kwemisipha.

 

Inxalenye yeGoldfish Yokuzilolonga

  • Indlela yokwenza: Beka ulwimi ngobunono eluphahleni lomlomo kunye nomnwe omnye phambi kwendlebe apho i-TMJ ikhona. Beka umnwe wakho ophakathi esilevini sakho. Beka umhlathi wakho ongezantsi phakathi kwaye uvale. Yenza lo msebenzi izihlandlo ezithandathu kwiseti enye.
  • benefits: Olu luhlu lunceda ukujolisa kwimihlathi yokunyakaza kunye nokunciphisa ukuqina kwamalungu.

 

Imithambo yeGoldfish epheleleyo

  • Indlela yokwenza: Kufana nokuvula ngokuyinxenye, kodwa vula umlomo wakho ngokupheleleyo ngeli xesha.
  • benefits: Olu luhlu lunceda ukunyusa uluhlu olupheleleyo lokunyakaza kunye nokunciphisa ukuqina kwamalungu.

 

I-Chin Tucks

  • Indlela yokwenza: Ukuhlala nkqo esitulweni, utsala isilevu sakho ngasemva, usenza "i-chin ephindwe kabini." Bamba imizuzwana emithathu, uze ukhulule.
  • benefits: Lo msebenzi unceda ukuqinisa imisipha yentamo, ukuphucula ukuma, kunye nokunciphisa ubunzima emhlathini.

 

Iingcebiso ezongezelelweyo zokunciphisa i-TMJ

Ngoku kunye nolu luhlu, iingcebiso ezongezelelweyo zokulawula kunye nokunciphisa i-TMJ ngokuphepha ukunyakaza okugqithisileyo kwemihlathi kunye nokusebenzisa iipakethi ezishushu / ezibandayo ukunciphisa nakuphi na ukudumba okushiyekileyo okuhambelana ne-TMJ. Xa abantu abane-TMJ beqala ukubandakanya unyango olungasebenzisi utyando kunye nokwelula ukuthomalalisa iintlungu, kunokunceda ukwandisa uluhlu lwe-mandibular olusebenzayo kunye nokubonelela ngesiqabu esiluncedo. (Urbanski et al., 2021) Oku, kwakhona, kuvumela abantu abaninzi abaneentlungu ze-TMJ ukuba bacinge ngakumbi ngomzimba kwaye benze utshintsho oluncinci kwimpilo yabo kunye nokuphila kakuhle.

 


Ucaphulo

Alolayan, A., Alsayed, SS, Salamah, RM, Ali, KM, Alsousi, M., & Elsayed, S. (2022). I-Temporomandibular joint (TMJ) ukuphazamiseka kokuxhaphaka kunye nokwazisa ngezenzo ezifanelekileyo zonyango, phakathi koluntu lwase-Al-Madinah eSaudi Arabia. F1000Res, 11, 395. doi.org/10.12688/f1000research.104272.2

Brighenti, N., Battaglino, A., Sinatti, P., Abuin-Porras, V., Sanchez Romero, EA, Pedersini, P., & Villafane, JH (2023). Iimpembelelo zeNdlela yeNtsebenziswano phakathi kweCandelo loLawulo lwe-Temporomandibular Disorders: uPhononongo lwe-Scoping. Int J Environ Res Impilo yoLuntu, 20(4). doi.org/10.3390/ijerph20042777

Byra, J., Kulesa-Mrowiecka, M., & Pihut, M. (2020). I-Physiotherapy kwi-hypomobility yamalungu e-temporomandibular. UFolia Med Cracov, 60(2), 123-134. www.ncbi.nlm.nih.gov/pubmed/33252600

Cardoneanu, A., Macovei, LA, Burlui, AM, Mihai, IR, Bratoiu, I., Rezus, II, Richter, P., Tamba, BI, & Rezus, E. (2022). I-Temporomandibular Joint Osteoarthritis: Iindlela ze-Pathogenic ezibandakanya i-Cartilage kunye ne-Subchondral Bone, kunye neZicwangciso eziNgcono zonyango zokuHlaziya ngokuHlanganyela. Int J Mol Sci, 24(1). doi.org/10.3390/ijms24010171

Ferrillo, M., Giudice, A., Marotta, N., Fortunato, F., Di Venere, D., Ammendolia, A., Fiore, P., & de Sire, A. (2022). Ulawulo lweentlungu kunye noBuyiselo kwi-Central Sensitization kwi-Temporomandibular Disorders: Ukuphononongwa okuBanzi. Int J Mol Sci, 23(20). doi.org/10.3390/ijms232012164

I-Santana-Mora, U., Lopez-Cedrun, J., Mora, MJ, Otero, XL, & Santana-Penin, U. (2013). Iziphazamiso zeTemporomandibular: Isiqhelo sokuhlafuna side syndrome. I-PLOS ONE, 8(4), e59980. doi.org/10.1371/journal.pone.0059980

Urbanski, P., Trybulec, B., & Pihut, M. (2021). Ukusetyenziswa koBuchule boBuchule kwi-Masticatory Muscle Relaxation njenge-Adjunctive Therapy kuNyango lwe-Temporomandibular Joint Disorders. Int J Environ Res Impilo yoLuntu, 18(24). doi.org/10.3390/ijerph182412970

isikhanyeli

Ukuqonda ukukhuthazwa kwemisipha yoMbane: Isikhokelo

Ukuqonda ukukhuthazwa kwemisipha yoMbane: Isikhokelo

Ngaba ukubandakanya ukuvuselela imisipha yombane kunceda ukulawula intlungu, ukuqinisa imisipha, ukwandisa umsebenzi womzimba, ukubuyisela ukunyakaza okulahlekileyo, kunye / okanye ukulawula ukuvuvukala kubantu abafumana intamo kunye neentlungu zangasemva?

Ukuqonda ukukhuthazwa kwemisipha yoMbane: Isikhokelo

Ugqirha obhinqileyo obeka izixhobo zonyango lwe-myostimulation kumqolo wesigulana

Ukukhuthazwa kwezihlunu zoMbane

Ukuvuselela izihlunu zombane okanye i-E-stim lunyango lomzimba olusetyenziselwa ukuvuselela amandla emisipha ukuba asebenze. I-E-stim isebenzisa izixhobo ezihambisa iimpembelelo zombane ngesikhumba ukujolisa kwimithambo-luvo kunye/okanye nezihlunu. Iifom eziqhelekileyo zibandakanya

  • I-Transcutaneous electric nerve stimulation, okanye i-TENS, yinto eyaziwayo kakhulu yokuvuselela umbane enika izixhobo ezinokusetyenziswa ekhaya okanye ekuhambeni.
  • Ukuvuselela imisipha yombane okanye i-EMS.
  • Kunyango lomzimba, i-E-stim ivuselela izihlunu ukuba zivumelane, ziqinise kwaye zikhuthaze ukujikeleza kwegazi.
  • Ukujikeleza kwegazi kunokuchaphazela ngokuthe ngqo imeko yezicubu zomzimba.
  • Ukukhuthazwa kwemisipha yombane kukwasetyenziselwa ukulimala kwentambo yomgogodla kunye nezinye iimeko ze-neuromuscular. (Ho, CH et al., 2014)

I-E-stim

Ngethuba lokunyanga, i-electrodes ifakwe kumatshini wokuvuselela umbane kwaye ibekwe entanyeni echaphazelekayo okanye kwindawo yangasemva.

  • I-electrodes iya kufakwa esikhumbeni ngenxa yokulimala kwentamo okanye umva.
  • Ukubekwa kwee-electrodes kuxhomekeke kwisizathu sonyango kunye nobunzulu okanye ubunzulu bokuvuselela umbane.
  • Ii-electrodes zihlala zibekwe kufuphi nendawo ye-motor ye-muscle ukuze kuqinisekiswe ukucutha okuchanekileyo.
  • Umgqirha uya kulungelelanisa ukulawulwa komatshini wokuvuselela ukufezekisa ukunyanzeliswa kwemisipha ngokucokisekileyo kunye nokuphazamiseka okuncinci.
  • Ukuvuselela kunokuhlala kwi-5 - imizuzu ye-15, kuxhomekeke kwisicwangciso sonyango kunye nobukhulu bokulimala.

Uzinziso oludityanisiweyo loMnqonqo

Ukusebenza kwemisipha kunokunceda ukwandisa ukuzinza komgogodla, ukuphucula iingxaki zokungazinzi komgogodla. (Ho, CH et al., 2014) Ukukhuthazwa kwemisipha yombane kucatshangelwa ukuba kuphuculwe inkqubo yokuzivocavoca i-therapist ichaza ukunceda ukugcina ukuzinza ngokubambisana. Ukuvuselela umbane kunokunceda ukwakha amandla emisipha kunye nokunyamezela. (Veldman, MP et al., 2016) Ukunyamezela kwemisipha kukuphindaphinda i-muscle enokuthi ivume ngaphambi kokuba idinwe.

UkuPhilisa kunye noLawulo lweeNtlungu

Unyango lokuvuselela imisipha yombane lunokuphucula ukuphulukiswa kwezicubu kunye nokunceda ukulawula ukuvuvukala ngokunciphisa ukuvuvukala kunye nokwandisa ukujikeleza. Inokunciphisa ukuvakalelwa kweentlungu ngokuthintela ukuhanjiswa kwe-nerve kwintambo yomgogodla. (Johnson, MI et al., 2019) Uchwepheshe wezempilo unokucebisa i-TENS okanye iyunithi yokuvuselela umbane ekhaya ukulawula iimpawu. (Johnson, MI et al., 2019)

impatho

Iindlela zonyango ezidibeneyo ezilungiselelwe umva okanye intlungu yentamo yomntu zifunyenwe zibonelela ngeziphumo ezilungileyo. Ukuzivocavoca, i-yoga, unyango lwexesha elifutshane lokuziphatha, i-biofeedback, ukuphumla okuqhubekayo, i-massage, unyango lwezandla, kunye i-acupuncture zinconywa ngentamo okanye intlungu emva. (Chou, R. et al., 2018) Ukuthatha amayeza achasene nokudumba okungeyo-steroidal nako kunokunceda. Ukukhuthazwa kwemisipha yombane kunokuba yintamo esebenzayo okanye unyango lwangasemva.

Abantu abangaqinisekanga ukuba bayayidinga okanye baya kuxhamla kumbane kufuneka baxoxe ngeempawu kunye neemeko kunye nogqirha oyintloko, umboneleli wezempilo, okanye ingcali ukuba ibakhokele kwicala elifanelekileyo kwaye imisele unyango olulungileyo. I-Chiropractic yezoNyango zeChiropractic kunye ne-Functional Medicine Clinic igxile kwinto esebenzela isigulane kwaye izama ukuphucula umzimba ngokusebenzisa iindlela zophando kunye neenkqubo zempilo epheleleyo. Ukusebenzisa indlela edibeneyo, siphatha ukulimala kunye ne-syndromes yeentlungu ezingapheliyo ngokusebenzisa izicwangciso zokunyamekela zomntu eziphucula amandla ngokuguquguquka, ukuhamba, kunye neenkqubo zobuchule ezenzelwe umntu ukuba anciphise intlungu. Ukuba olunye unyango luyadingeka, uDkt Jimenez uye wadibanisa kunye noogqirha abaphezulu, iingcali zeklinikhi, abaphandi bezonyango, kunye nababoneleli be-premier rehabilitation ukubonelela ngonyango olusebenzayo.


Intlungu yeThoracic Spine


Ucaphulo

Ho, CH, Triolo, RJ, Elias, AL, Kilgore, KL, DiMarco, AF, Bogie, K., Vette, AH, Audu, ML, Kobetic, R., Chang, SR, Chan, KM, Dukelow, S. , Bourbeau, DJ, Brose, SW, Gustafson, KJ, Kiss, ZH, & Mushahwar, VK (2014). Ukuvuselela umbane osebenzayo kunye nokulimala komgogodla. Iyeza lomzimba kunye neeklinikhi zokuvuselela kwiNyakatho Melika, i-25 (3), i-631-ix. doi.org/10.1016/j.pmr.2014.05.001

Veldman, MP, Gondin, J., Indawo, N., & Maffiuletti, NA (2016). Iziphumo ze-Neuromuscular Electrical Stimulation Training kwi-Endurance Performance. Imida kwiPhysiology, 7, 544. doi.org/10.3389/fphys.2016.00544

UJohnson, MI, Jones, G., Paley, CA, & Wittkopf, PG (2019). Ukusebenza kweklinikhi ye-transcutaneous electrical nerve stimulation (TENS) yentlungu ebuhlungu kunye nengapheliyo: iprotocol ye-meta-analysis yezilingo ezilawulwa ngokungahleliwe (RCTs). BMJ vula, 9(10), e029999. doi.org/10.1136/bmjopen-2019-029999

Chou, R., Côté, P., Randhawa, K., Torres, P., Yu, H., Nordin, M., Hurwitz, EL, Haldeman, S., & Cedraschi, C. (2018). I-Global Spine Care Initiative: ukusebenzisa izikhokelo ezisekelwe kubungqina ekulawuleni okungahambiyo kweentlungu zentlungu kunye nentamo kuluntu oluphantsi kunye nephakathi. Iphephancwadi laseYurophu lomqolo : ukupapashwa ngokusemthethweni kwe-European Spine Society, i-European Spinal Deformity Society, kunye neCandelo laseYurophu leCervical Spine Research Society, i-27 (Suppl 6), i-851-860. doi.org/10.1007/s00586-017-5433-8

Unyango oluQalayo oluNgelulo utyando lwaManqaku e-Musculoskeletal Trigger Points

Unyango oluQalayo oluNgelulo utyando lwaManqaku e-Musculoskeletal Trigger Points

Ngaba abantu abajongene ne-musculoskeletal trigger points bafuna unyango olungasebenzisi utyando ukuze banciphise iintlungu kwiindawo zabo?

intshayelelo

Inkqubo ye-musculoskeletal inemisipha eyahlukeneyo, i-tendon, i-ligaments, kunye nezicubu ezithambileyo ezivumela ukuba iindawo ezisezantsi neziphezulu zisebenze kwimisebenzi emininzi eyenziwa ngumntu. Ukusuka kwimisebenzi yomzimba ukuya ekuphumleni okanye ukwenza nje uhambo, inkqubo ye-musculoskeletal inobudlelwane obumangalisayo kunye nazo zonke iinkqubo ezahlukeneyo zomzimba. Inceda ukukhusela amalungu abalulekileyo kwizinto ezisingqongileyo kunye nokulimala. Nangona kunjalo, xa iimeko zokusingqongileyo okanye ukulimala kuchaphazela umzimba, iiprofayili ezininzi ezigqithiseneyo zomngcipheko zichaphazela i-quadrants ephezulu nasezantsi, ngaloo ndlela ichaphazela imisipha kunye nezicubu ezithambileyo. Xa inkqubo ye-musculoskeletal iqala ukuva iimpawu zentlungu kunye nokungahambi kakuhle, kunokubangela intlungu ye-visceral-somatic ebhekiselwe kwiindawo ezahlukeneyo zomzimba kwaye ibangele ukuphuhliswa kwamanqaku e-trigger kwizicubu zomzimba. Oku kubangela ukuba umntu abe neentlungu ezibuhlungu kunye nokungonwabi kwaye ufuna unyango lokunciphisa iimpawu ezinjengeentlungu. Inqaku lanamhlanje lisinika ukuqonda ngamanqaku okubangela i-musculoskeletal trigger kunye nendlela ezahlukeneyo zonyango ezingasebenzisi utyando ezinokunciphisa amanqaku e-musculoskeletal triggers emzimbeni. Sixoxa nababoneleli bezonyango abaqinisekisiweyo abadibanisa ulwazi lwezigulane zethu ukuvavanya imiba efana nentlungu echaphazela inkqubo yabo ye-musculoskeletal ehambelana nokuqalisa intlungu. Siyazisa kwaye sikhokela izigulana kwiindlela ezahlukeneyo zonyango ezingezizo utyando kwaye sibuze ababoneleli bezonyango abanxulumene nabo imibuzo entsonkothileyo ukudibanisa isicwangciso sonyango esilungiselelwe ukunciphisa iintlungu ze-musculoskeletal trigger point. UDkt Jimenez, DC, uquka olu lwazi njengenkonzo yezemfundo. isikhanyeli.

 

Ukuqonda amanqaku e-Musculoskeletal Trigger Points

Ngaba uhlala uziva iintlungu emilenzeni, ezingalweni, ezandleni nasezinyaweni imini yonke? Kukangaphi ufumana iimpawu zokuqina kunye nokungahambi kakuhle entanyeni yakho, ehlombe, okanye ngasemva? Okanye ngaba uziva ushukuma kwaye uziva ndindisholo ezandleni nasezinyaweni zakho? Ngokuphindaphindiweyo kunokuba kunjalo, abantu abaninzi abafumana le miba yeentlungu ezigqumayo kwinkqubo yabo ye-musculoskelet system banokuba namanqaku okuqalisa kwi-muscle fibers. Amanqaku e-Trigger ayinxalenye yemeko ebuhlungu ye-musculoskeletal eyaziwa ngokuba yi-myofascial pain syndrome. Le meko ye-musculoskelet ebuhlungu yenza indawo e-hyperirritable ngaphakathi kwebhendi ye-taut ye-musculoskeletal system, ebangela intlungu xa ixinzelelwe. (Lavelle et al., 2007) Xa umntu ejongene namanqaku e-musculoskeletal trigger points, baya kuhlala befumana intlungu ethunyelwe kunye nokuphazamiseka, ukungasebenzi kweemoto, kunye nemiba yokuzimela. Oku kungenxa yokuba xa abantu abaninzi beva intlungu kwi-quadrants ye-muscle ephezulu okanye esezantsi, bajongana neentlungu ezigqithisiweyo ezivela kwizihlunu ezichaphazelekayo. Xa izihlunu ezichaphazelekayo zinemimandla engaqhelekanga yezihlunu zethenda, kunokukhokelela ekuhambeni okungahambi kakuhle okuhambelana nezihlunu ezichaphazelekayo kuyo nayiphi na indawo edibeneyo. (Macdonald, ngo-1980)

 

 

Ukongezelela, amanqaku e-musculoskeletal trigger points angachongwa njenge-latent okanye esebenzayo ngokusekelwe ekuphuhliseni apho intlungu ivela khona ngaphakathi kwenkqubo ye-musculoskeletal system. Ukuza kuthi ga ngelo xesha, xa iimeko zokusingqongileyo okanye ukulimala ziphuhlisa iingongoma ezibangela iintlungu, iimpawu ezinjengeentlungu ezifana nokuqina kwemisipha, ukungasebenzi kakuhle, kunye noluhlu oluthintelweyo lokunyakaza lubonisa xa ingcali yeentlungu ivavanya umntu. (Shah et al., 2015) Ngethamsanqa, amanqaku e-musculoskeletal trigger points akunzima ukunyanga xa umthombo wentlungu ufumaneka kwi-musculoskeletal system. Oku kungenxa yokuba unyango olungenalo utyando lunceda ukulawula iimpawu ezinjengeentlungu ngokuvala iingongoma ze-trigger kunye nokubuyisela izihlunu ezichasayo ezichaphazelekayo kuluhlu lwazo olupheleleyo lokunyakaza. (Irubin, 1981)

 


Indlela engeyiyo Utyando kwiVidiyo yeMpilo-ntle


Unyango olungaSebenziyo lotyando kwiiNqaku zeMusculoskeletal Trigger

Xa kufikwa kunyango lwe-musculoskeletal trigger points, abantu abaninzi bafuna unyango olwahlukeneyo ukunciphisa iimpawu ezifana neentlungu. Ekubeni amanqaku e-musculoskeletal trigger points anokuvela kwintlungu encinci ukuya kwintlungu enzima, inokuchaphazela imisebenzi yemihla ngemihla yomntu kwaye ibangele ukuba bahlupheke. Ngethamsanqa, amanqaku e-musculoskeletal trigger points angancitshiswa ngonyango olungasebenzisi utyando. Unyango olungasebenzisi utyando lunokwahluka ngokuxhomekeke kubunzima bentlungu amanqaku abangela kwi-musculoskeletal system. Kwangaxeshanye, abantu abaninzi banokuba nonyango oluninzi olungazenziyo utyando njengoko lunokwenziwa ngokwezifiso, lungabizi kakhulu, kwaye lube lolwamntu kunyango lomntu. Ngezantsi kukho unyango olungasebenzisi utyando olunokunceda ukunciphisa amanqaku e-musculoskeletal trigger points.

 

Ukhathalelo lweChiropractic

 

Ukhathalelo lweChiropractic lusebenzisa ukuguqulwa komatshini kunye nencwadana yenkqubo ye-musculoskelet kwaye inokunceda ukunciphisa imiphumo ehambelanayo yamanqaku e-musculoskeletal trigger points. IiChiropractors zibandakanya iindlela ezahlukeneyo zobugcisa kunye noxinzelelo lwe-ischemic ukukhulula intlungu kunye nokubonelela ngokukhululeka. (UVernon kunye noSchneider, ngo-2009) Ukongezelela, ii-chiropractors ziyakwazi ukufumana amanqaku e-trigger ngokucinezela izicubu ze-muscle okanye ukuxhaphaza i-muscle fibers. I-Chiropractors inokudibanisa unyango lwe-massage ukukhulula amanqaku e-trigger kunye neempawu zentlungu ezinxulumene nokubuyisela umzimba ekusebenzeni kakuhle. Thyindibaniselwano yetoti zibandakanya iindlela ezahlukeneyo zokwandisa ukujikeleza kwegazi kwi-muscle echaphazelekayo, ukunceda ukudiliza izicubu ezinqabileyo ezingenakuguquka, kunye nokunceda ukubuyisela umsebenzi we-muscle kwimida. 

 

Ukwenza i-Acupuncture

Olunye uhlobo lonyango olungenalo utyando lokunciphisa amanqaku e-musculoskeletal trigger points yi-acupuncture. I-acupuncture idibanisa iinaliti eziqinileyo, ezibhityileyo ezibekwe kwii-acupoints ezahlukeneyo emzimbeni yingcali. Yintoni eyenziwa yi-acupuncture kukuba xa iinaliti zifakwe kwi-acupoints ye-muscle echaphazelekayo, inokunceda ukuvuselela inkqubo ye-nervous kunye nokunceda ukuququzelela iikhemikhali zendalo zokunciphisa iintlungu zendalo ukukhaba-ukuqala inkqubo yokuphilisa. Ukongezelela, xa abantu bebandakanya i-acupuncture yokunciphisa amanqaku e-musculoskeletal trigger points, igalelo le-sensory ebangela ukuba intlungu iyancipha kwaye inokubonelela ngokukhululeka kwexesha elide. (UMelzack, ngo-1981)

 

Uhlengahlengiso kwindlela yokuphila

Xa kufikwa ekunciphiseni amanqaku e-trigger kunye nokudibanisa unyango olungasebenzisi utyando, abantu abaninzi abajongana neeprofayili zeentlungu ezigqithisiweyo ukusuka kumanqaku e-musculoskeletal trigger points banokwenza uhlengahlengiso lwendlela yokuphila ukuthintela ukukhula kwayo. Ukwenza uhlengahlengiso oluncinci kumsebenzi womntu kunye neendawo zokuhlala kunokunciphisa uxinzelelo ekubeni yi-co-factor ekuphuhliseni amanqaku e-trigger kwi-fiber muscle. Okunye okuncinci Uhlengahlengiso olunjengokuphucula ukuma kunye nokusebenzisa iindlela zokuphumla ezifana neyoga, ukucamngca, okanye umthambo wokuphefumla nzulu kunokuncedisa ukunciphisa uxinzelelo lwemisipha kunye noxinzelelo kubomi bemihla ngemihla. Ukubandakanya unyango olungenalo utyando ukunciphisa nokulawula i-musculoskeletal triggers kunokubonelela ngesiphumo esihle, esiluncedo ekuphuculeni ukusebenza kwemisipha kunye nokuvumela abantu ukuba baphile ubomi obuphilileyo. 

 


Ucaphulo

Lavelle, ED, Lavelle, W., & Smith, HS (2007). Amanqaku e-Myofascial trigger. I-Anesthesiol Clin, 25(4), 841-851, vii-iii. doi.org/10.1016/j.anclin.2007.07.003

Macdonald, AJR (1980). Izihlunu ezithambileyo ezingaqhelekanga kunye neentshukumo ezibuhlungu ezinxulumeneyo. Ubuhlungu, 8(2), 197-205. doi.org/10.1016/0304-3959(88)90007-3

UMelzack, R. (1981). I-Myofascial trigger points: inxulumene ne-acupuncture kunye neendlela zentlungu. IiNqoloba zoLwazi lweMpilo kunye nokuHlaziya, 62(3), 114-117. www.ncbi.nlm.nih.gov/pubmed/6972204

Rubin, D. (1981). I-Myofascial trigger point syndromes: indlela yokulawula. IiNqoloba zoLwazi lweMpilo kunye nokuHlaziya, 62(3), 107-110. www.ncbi.nlm.nih.gov/pubmed/6453568

Shah, JP, Thaker, N., Heimur, J., Aredo, JV, Sikdar, S., & Gerber, L. (2015). Amanqaku e-Myofascial Trigger emva koko kwaye ngoku: Umbono weMbali kunye neNzululwazi. PM R, 7(7), 746-761. doi.org/10.1016/j.pmrj.2015.01.024

Vernon, H., & Schneider, M. (2009). Ukulawulwa kwe-Chiropractic ye-myofascial trigger points kunye ne-myofascial pain syndrome: ukuphononongwa ngokuchanekileyo kweencwadi. J Uluhlu lwePhysiol Ther, 32(1), 14-24. doi.org/10.1016/j.jmpt.2008.06.012

isikhanyeli

Ukufikelela kwiMpilo ePhakamileyo ngoNyango loMzimba

Ukufikelela kwiMpilo ePhakamileyo ngoNyango loMzimba

Kubantu abanobunzima bokuhambahamba ngenxa yeentlungu, ukulahlekelwa koluhlu lokunyakaza, kunye / okanye ukunciphisa amandla, ngaba ukubandakanya ukusebenza kunye nonyango lomzimba kunceda ukukhulula intlungu kunye nokubuyisela umsebenzi?

Ukufikelela kwiMpilo ePhakamileyo ngoNyango loMzimba

Inkosikazi ene-orthosis esebenza nonyango lomzimba

IiNzuzo zonyango loNyango

Abaninzi bayazibuza ukuba ngaba bangabaviwa bonyango lomzimba okanye ukuba unyango lomzimba lunokunceda ukwenzakala, ukugula, okanye imeko. Impendulo nguewe; Uninzi lwabantu lunokuxhamla kunyango lomzimba, nokuba imeko yabo yi-ankle sprain okanye ingxaki ye-neurological disorder. Iingcali zonyango zinokunceda ukuphuhlisa izicwangciso zokulawula iintlungu kunye nokuthintela ukulimala. Unyango lomzimba lunokunceda abantu nokuba khange benzakele; njengeengcali zentshukumo, abanyangi bomzimba banokuqeqesha abantu ukuba bancede ukukhusela ukulimala kunye nokugcina ukuguquguquka.

Iindlela zoMzimba

Iingcali zonyango zisebenza kwiindawo ezahlukeneyo, kubandakanywa izibhedlele, amakhaya asebekhulile, ezemidlalo, kunye neekliniki ze-chiropractic. Ukuba kuyimfuneko, banokuza endlwini yakho emva kokulimala. Basebenza nabantu abavela kuzo zonke iinkalo zobomi njengendlela yonyango elondolozayo yokulawula, ukuphilisa, kunye nokuthintela ukulimala kunye nokukhubazeka. Unyango lomzimba lusebenzisa izixhobo ezingasebenzisiyo ukunceda ukuphucula ukusebenza komzimba wonke. Unyango lomzimba lugxile koku:

  • Ukuphelisa iintlungu
  • Ukukhuthaza ukuphiliswa
  • Ukubuyisela umsebenzi
  • Ukubuyisela intshukumo
  • Ukuququzelela kunye nokulungelelanisa ukwenzakala okuthile.
  • Unyango lukwajolisa kuqeqesho lomatshini womzimba, ukomelela, kunye nokuba sempilweni. (Obekekileyo, S. et al., 2021)
  • Kungakhathaliseki ubudala, abantu abaneengxaki zokuguquguquka kunye nokuhamba banokuzuza ngokusebenza kunye nonyango lomzimba ukubanceda babuyele ekusebenzeni kakuhle.

Iimeko Unyango loNyango lunoNcedisa ukuNyanga

  • Izihlunu kunye noxinzelelo.
  • Ukwenzakala okunxulumene nomsebenzi.
  • Ukulimala okuphindaphindiweyo kwentshukumo.
  • Ukwenzakala okunxulumene nezemidlalo.
  • Intlungu yomqala.
  • Iintlungu ezisezantsi.
  • I-Neuro-rehabilitation - i-post-stroke kunye nentambo yomgogodla okanye ukulimala kwentloko.
  • I-arthritis - kwindawo enye okanye ezininzi.
  • Iingxaki zokuhamba.
  • Imiba yokulinganisela.
  • Iingxaki zedolo, iqatha kunye nonyawo.
  • Amagxa, ingalo, isandla, kunye nokwenzakala esihlahleni kunye neengxaki.
  • Ukwaphuka.
  • Iingozi zokutyibilika nokuwa kunye nezinye iingozi.
  • Iimeko zamathambo.
  • Ukudinwa okungapheliyo.
  • Ubuthathaka obungapheliyo.
  • Imeko yangaphambi nasemva kotyando kunye nokomeleza.
  • Ukhathalelo lwamanxeba njengamanxeba esifo seswekile kunye namanxeba angapholiyo okwenzakala okanye emva kotyando.
  • Ngaphambi - ngexesha lokukhulelwa kunye neenkqubo zasemva kokubeleka.
  • Imfundo yokufaneleka kunye nokuba sempilweni.
  • Ukunyamezela kwentliziyo.
  • Ukuvuselelwa kwentliziyo.
  • Iingxaki zokuphefumla.
  • Ukungaphumeleli kwamathumbu okanye isinyi.
  • Ukuchacha komhlaza.

Abantu abangaqinisekanga ukuba bayayidinga okanye baya kuzuza kunyango lomzimba kufuneka baxoxe ngokhetho lwabo kunye nogqirha oyintloko, umboneleli wezempilo, okanye ingcali ukuba ibakhokele kwicala elifanelekileyo. I-Chiropractic yezoNyango zeChiropractic kunye ne-Functional Medicine Clinic igxile kwinto ekusebenzelayo kwaye izama ukwenza ngcono umzimba ngokusebenzisa iindlela zophando kunye neenkqubo zempilo epheleleyo. Ukusebenzisa indlela edibeneyo, siphatha ukulimala kwezigulane kunye neentlungu ezingapheliyo ngezicwangciso zokunakekelwa komntu eziphucula amandla ngokuguquguquka, ukuhamba, kunye neenkqubo zobuchule ezenzelwe umntu ukuba anciphise intlungu. Ukuba olunye unyango luyadingeka, uDkt Jimenez uye wadibanisa kunye noogqirha abaphezulu, iingcali zeklinikhi, abaphandi bezonyango, kunye nababoneleli be-premier rehabilitation ukubonelela ngonyango olusebenzayo.


Ukuvula Ukuphila


Ucaphulo

Ohloniphekileyo, S., Ritter, R., & Allen, DD (2021). Iindleko zokuSebenza kunye neZiphumo zokuFikelela ngokuthe ngqo kwiNyango yoMzimba kwi-Musculoskeletal Disorders xa kuthelekiswa nokuFikelela koGqirha-Okokuqala e-United States: Ukuphononongwa ngokuchanekileyo kunye nohlalutyo lweMeta. Unyango lomzimba, i-101 (1), i-pzaa201. doi.org/10.1093/ptj/pzaa201

Ukutya okuNgqongileyo ebusuku: Ukonwabela iiThwalo zasebusuku

Ukutya okuNgqongileyo ebusuku: Ukonwabela iiThwalo zasebusuku

Ngaba ukuqonda iminqweno yasebusuku kunokunceda abantu abahlala besitya ebusuku bacwangcise ukutya okwanelisayo nabakhetha amashwamshwam anesondlo?

Ukutya okuNgqongileyo ebusuku: Ukonwabela iiThwalo zasebusuku

Ukutya Ebusuku

Ukutya emva kokutya kunye nokutya ebusuku kuqhelekileyo kwaye akubi; nangona kunjalo, ukutyiwa ngengqondo kunokunceda ubani ukuba akonwabele ngokwenene kwaye angcamle amashwamshwam. Qwalasela ezinye zezizathu zokuba kutheni ungalamba okanye unganeliseki ngokupheleleyo emva kwesidlo sangokuhlwa. Ukuphucula isondlo sokutya kwasebusuku kunokwenza indlala yasebusuku isebenze ekuhlangabezaneni neemfuno zesondlo. Izizathu eziqhelekileyo ziquka:

  • Ukungahlangabezani nebhalansi ye-macronutrient efanelekileyo ngexesha lesidlo sakusihlwa.
  • Ukungoneliseki ngokupheleleyo ngesidlo sangokuhlwa.
  • Ukuphelelwa ngamanzi emzimbeni.

Iprofayile ye-Macronutrient

Ukufumana isixa esifanelekileyo secarbohydrates, amafutha, kunye neprotheyini ngexesha lesidlo sangokuhlwa kubalulekile ekuziveni wanelisekile. Abantu abadala bafuna i-130g ye-carbohydrates, i-56g yeprotheni, kunye ne-3.7L yamanzi yonke imihla. Umthamo wamafutha afunekayo uyahluka, kodwa amafutha e-monounsaturated kunye ne-polyunsaturated ngawona mafutha anempilo anokutyiwa, anceda umzimba ukuba uzive wanelisekile. Izifundo ezininzi zibonisa ukuba ukutya iiprotheyini ngexesha lokutya kunciphisa indlala kwaye kunciphisa iminqweno. (Kohanmoo, A. et al., 2020)

Isidlo sangokuhlwa esinganelisiyo

Esinye isizathu sokuba abantu batye ebusuku kukuba abanelisekanga kukutya kwakusihlwa. Ukutya ukutya okwanelisayo kunokunceda ingqondo nomzimba uzive ugcwele ubusuku bonke.

  • Ukwaneliseka yimvakalelo yokwaneliseka ekutyeni.
  • Ukutya okuphezulu kwifiber kunye namafutha anempilo kuyaziwa ukunceda ukuvelisa ulwaneliseko.
  • Xa umzimba ugcwele kwaye wanelisekile, uvelisa iihomoni ezibonisa ingqondo ukuba akukho mfuneko yokuqhubeka nokutya.
  • Zama ukucwangcisa ukutya okunempilo okunika umdla ngokwenene ukukutya.
  • Yenza ixesha lokupheka kunye nokwenza nokutya ukutya onokukonwabela ngokwenene.

emzimbeni

Ngamanye amaxesha, xa umzimba uphelelwe ngamanzi, kunokuba nzima ukwahlula unxano kwindlala. Ngenxa yoko, abanye banokutya ngenxa yokuphelelwa ngamanzi emzimbeni. Oku akusoloko kubi, njengoko ukutya okunye, ngokukodwa ukutya okutyebileyo ngamanzi njenge-melon kunye nezinye iziqhamo, kunokubonelela nge-hydration. Kodwa ngamanye amaxesha, abantu ngabanye abaqondi ukuba bafunda kakubi ukunxanelwa kwemizimba yabo yokulamba, kwaye bafikelela nakokuphi na ukutya. Basaphelelwe ngamanzi emzimbeni, ngoko baqhubeka besitya. Ukuba indlala iyaqhubeka emva kwesidlo sangokuhlwa, sela iglasi yamanzi kwaye ulinde imizuzu engama-20 ukubona ukuba oko kuyayichaphazela indlala.

Ukwandisa Isondlo

Ukutya ebusuku akukubi, kodwa kububulumko ukucwangcisa ukuqinisekisa ukuba umzimba ufumana umlinganiselo ofanelekileyo wezondlo.

Yanelisa Iminqweno

Abaninzi banqwenela into eswiti emva kwesidlo sangokuhlwa okanye kamva. Ukutya ukutya okunempilo okwanelisa iminqweno kuya kunceda ukuqalisa amahomoni axelela umzimba ukuba ugqibile ukutya. Gcina okuthandayo iziqhamo kunye nemifuno ngokuluma ngokukhawuleza ukufumana ubumnandi kunye nefayibha. Imifuno efana ne-red bell pepper kunye ne-karoti inika ubumnandi kunye nobumnandi kwaye inokwanelisa. I-pepper encinci ebomvu inika i-100% ye-Vitamin C ecetyiswayo yonke imihla kwiikhalori ezingama-20. (ISebe lezoLimo lase-US. INkonzo yoPhando lwezoLimo. 2018)

Ukutya okukhuthaza ukulala

Ukutya okukhethiweyo kunokuchaphazela ukulala. Iinkozo ezipheleleyo, i-walnuts, i-cherries, kunye ne-kiwi zonyusa i-serotonin kwaye zinciphisa i-hormone yoxinzelelo i-cortisol. Iicarbohydrates ezintsonkothileyo zinemelatonin, ihomoni ebangela ukuba umntu azive uyozela. I-snack egcwele ingqolowa lukhetho olunempilo ngaphambi kokulala. (Nisar, M. et al., 2019) Olunye uphando lubonisa ukuba itshokholethi emnyama isisityebi kwi-magnesium kwaye inokunceda ukukhuthaza ubuthongo obunzulu. Nangona kunjalo, iqulethe i-caffeine, enokuthintela ukulala. Ukuba itshokholethi emnyama uyintandokazi, qiniseka ukuba uyitye kwangoko ngokwaneleyo ngokuhlwa.

Eyenye indlela yasebusuku

Abanye abantu batya ngenxa yokukruquka ebusuku. Ukuthintela oku, abantu abakolu didi kufuneka batshintshe iindlela zabo zesiqhelo. Nazi iingcebiso ezimbalwa zokunceda ukulungelelanisa imikhwa yasebusuku.

Imisebenzi Esempilweni Yasemva KweSidlo

  • Hamba uhambe ngokukhawuleza emva kwesidlo sakusihlwa. Imizuzu eyi-10 ukuya kwengama-20 inokunceda, njengoko umsebenzi womzimba ubonisa ukusuka kwisidlo sangokuhlwa ukuya kweminye imisebenzi yangokuhlwa.
  • Ikwanika umzimba ithuba lokuva imvakalelo yokugcwala.
  • Izinto zokuzilibazisa kunye nezinye izinto ezilula zokucamngca zinokunceda ukususa ingqondo ekutyeni.

Bukela umabonakude Ngengqondo

  • Abantu abaninzi batya ngakumbi ebusuku kuba ukutya okutyiwayo kunokuqhubeka nokuqhubeka phambi komabonwakude.
  • Sebenzisa amacebo ahlakaniphileyo nasempilweni wokutya njengokulawula isahlulo.
  • Khumbula ukusela amanzi phakathi kokutya.
  • Hlala usebenza - imisebenzi elula okanye imisebenzi ngelixa ubukele i-TV ingakunceda ukuphepha ukutya kakhulu.

Phumla kwaye ulale

  • Ukungalali ngokwaneleyo kuye kwanxulunyaniswa nokunyuka komdla wokutya. (Hibi, M. et al., 2017)
  • Zibandakanye kwimisebenzi yokukhuthaza ukuphumla.
  • Ukucamngca kunokunceda ukuthomalalisa ingqondo nomzimba.
  • Cinga ngokulala kwangoko.

Ukusebenzisa indlela edibeneyo, iQela likaDkt Jimenez eliSebenzayo leMedicine lijolise ekubuyiseleni impilo kunye nomsebenzi kumzimba ngokusebenzisa iSondlo kunye neMpilo, iMithi eSebenzayo, i-Acupuncture, i-Electro-Acupuncture, kunye ne-Sports Medicine protocols. Sigxila kwinto esebenzela umntu ngokusebenzisa iindlela zophando kunye neenkqubo zempilo epheleleyo.


Ukutya Ngokufanelekileyo ukuze uzive Ngcono


Ucaphulo

Kohanmoo, A., Faghih, S., & Akhlaghi, M. (2020). Umphumo wokusetyenziswa kweeprotheyini ezimfutshane kunye nexesha elide kwi-appetite kunye ne-appetite-regulating hormones yesisu, ukuphononongwa okucwangcisiweyo kunye nohlalutyo lwemeta yezilingo ezilawulwa ngokungahleliwe. IPhysiology kunye nokuziphatha, 226, 113123. doi.org/10.1016/j.physbeh.2020.113123

ISebe lezoLimo lase-US. INkonzo yoPhando lwezoLimo. FoodData Central. (2018). Iipepile, ziswiti, zibomvu, zikrwada. Ifunyenwe kwi fdc.nal.usda.gov/fdc-app.html#/food-details/170108/nutrients

Nisar, M., Mohammad, RM, Arshad, A., Hashmi, I., Yousuf, SM, & Baig, S. (2019). Impembelelo yokuThatha ukutya kwiiPatheni zokulala zaBafundi bezoNyango. Cureus, 11(2), e4106. doi.org/10.7759/cureus.4106

Hibi, M., Kubota, C., Mizuno, T., Aritake, S., Mitsui, Y., Katashima, M., & Uchida, S. (2017). Isiphumo sobuthongo obufutshane kwinkcitho yamandla, ubushushu bomzimba obungundoqo, kunye nomdla wokutya: ulingo olungenamkhethe lomntu. Iingxelo zenzululwazi, 7, 39640. doi.org/10.1038/srep39640

Amaqhinga okuQophela ukukhubazeka kwiKliniki yeChiropractic

Amaqhinga okuQophela ukukhubazeka kwiKliniki yeChiropractic

Ngaba abaqeqeshi bezempilo kwiklinikhi ye-chiropractic babonelela njani ngendlela yeklinikhi yokuqaphela ukukhubazeka kwabantu abaneentlungu?

intshayelelo

 

Naliphi na inqaku olifundayo malunga nokusetyenziswa kakubi kweziyobisi phakathi kwabongikazi ngokuqinisekileyo liya kuphinda amabango enziwe yi-American Nurses Association, ethi, ngokuhambelana noluntu ngokubanzi, i-10% yabongikazi, okanye omnye kwabalishumi okanye malunga nama-300,000 abongikazi ababhalisiweyo eUnited States. States, zixhomekeke kwiziyobisi zohlobo oluthile. Ukonakala kwalo naluphi na uhlobo emsebenzini, ngakumbi ukuba lusuka kusetyenziso gwenxa lweziyobisi okanye kusetyenziso, lunokuba neziphumo ezibi kumongikazi nakumsebenzi wokonga ngenxa yezizathu ezininzi. Ukuchaneka, ukuchaneka, amandla okucinga nzulu, kunye noqwalaselo kubalulekile kumsebenzi wokonga. Ngenxa yokuba iimpazamo okanye iingozi zinokuthi zenzeke, nakuphi na ukungakwazi ukuhambisa ezi zakhono kubeka izigulane, abantu osebenza nabo kunye nomongikazi emngciphekweni. Ukongezelela, abantu bajonga abongikazi njengabathembekileyo, abathembekileyo nabanyanisekileyo. Ukonakala kunokuyonakalisa loo mbono, ngakumbi ukuba iziswa butywala okanye iziyobisi. Kula macandelo alandelayo, siza kuphonononga ukonakaliswa, izizathu zako, kunye nezibophelelo zakho ezisesikweni nezomthetho ukuba ukholelwa ukuba umntu osebenza naye wonakele. Inqaku lanamhlanje lijolise kwindlela yeklinikhi yokuqaphela ukukhubazeka kwimeko yeklinikhi. Sixoxa nababoneleli bezonyango abaqinisekisiweyo abadibanisa ulwazi lwezigulane zethu ukuvavanya imiba efana neentlungu ezijongene nazo. Siyazisa kwaye sikhokela izigulana kunyango olwahlukeneyo kwaye sibuze imibuzo entsonkothileyo kwabo banxulumene nabo ababoneleli bezonyango ukudibanisa isicwangciso sonyango esilungiselelweyo. UDkt Jimenez, DC, uquka olu lwazi njengenkonzo yezemfundo. isikhanyeli.

 

Inkcazo yokonakala

Inkcazo esisiseko yokwenzakala ithi “Imeko yokuncipha, ukuba buthathaka okanye yokwenzakala, ngakumbi ngokwasengqondweni okanye ngokwasemzimbeni” (“Ukonakala,” nd”) Uya kubona ukuba le yinkcazelo nje yobume kwaye akukho sizathu sinikiweyo. Esi sisiphumo sobuninzi bezizathu ezinokwenzeka. Ngelixa ezinye izizathu zinokuba lula ukubonisa ubungqina, ezinye zisenokungabi njalo. Ngenxa yoko, kubalulekile ukuchonga nokuqwalasela umxholo kunye nonobangela, ukuba uyaziwa, ngelixa uthetha ngomonakalo. Uluntu olukhubazekileyo olusingqongileyo njengabongikazi lu: Bazizigulana zethu. Bakwimeko encitshisiweyo, ebuthathaka, okanye eyonakeleyo, nangona inokuba sengozini ngenxa yesifo okanye ukwenzakala. Ngokufanayo, usengozini yokugula ukuba uye wasebenza iishifti enomkhuhlane ombi. Iimpawu zokuziva ucotha, ukucinga ngokuphazamiseka, kunye ukuphonononga umsebenzi wakho rhoqo yimizekelo yothintelo kwimeko yeklinikhi.

 

Isifo okanye ukwenzakala kunokuba neziphumo ezahlukeneyo kwaye kuchaphazele indlela owenza kakuhle ngayo umsebenzi wakho ukuya kumaqondo ahlukeneyo, kodwa njengoko iqondo lokukhubazeka lisanda, liya kuba njalo nethuba lokuba wenze impazamo. Ukhuseleko lwakho nobabini kunye nabo bakungqongileyo, kubandakanywa izigulana zakho kunye nabantu osebenza nabo, lunxulunyaniswa nenqanaba lokwenzakala kwakho. Wena, izigulana zakho, kunye nabantu osebenza nabo anikhuselekanga kangako njengoko ukusebenza kwenu kuchaphazeleka kakubi. Nangona abongikazi besazi ukuba izigulana zisesichengeni ngenxa yokuba zisengozini ngandlel’ ithile. Siyazi kwakhona ukuba izithintelo zinokukwenza ukuba wenze iimpazamo. Ungumntu onoxanduva kwaye awunakuze usebenze ukuba ukukhubazeka kwakho bekuqatha ngokwaneleyo ukubeka izigulana zakho emngciphekweni. Noko ke, kuthekani ukuba umntu osebenza naye unesiphene? Okubi nangakumbi, kuthekani ukuba ucinga ukuba ngandlel’ ithile wazenza ngokwakhe? Uqhuba njani? Ngaba uyathetha nabo? Ngaba uyamchazela omnye umntu ngayo? Ngaba unethemba lokuba akukho nto imbi yenzekayo kwaye ungayihoyi?

 

Ukugcina ukhuseleko lwesigulane yeyona nto iphambili kubongikazi kuluhlu lwabo lomsebenzi. Luxanduva lwakho ukwazi into omawuyenze kunye nendlela ongayenza ngayo ukuba umntu osebenza naye ubonakala echaphazeleka. Kodwa ukufezekisa oko, kufuneka ukwazi ukubona ukonakala okunokwenzeka kuwe nakwabanye abantu. Iimfuno zolawulo nezifunekayo zokunika ingxelo kufuneka zaziwe kuwe. Kwakhona kufuneka uqaphele iziphumo ezinokubakho kuwe ukuba awenzi nto.

 

Iimbangela zoKuthomalalisa

Unokucinga ukuba sixoxa ngokusetyenziswa kweziyobisi ngeli xesha usivayo okanye ufunda ibinzana elithi ukonakala emsebenzini. Noko ke, kukho abanye oonobangela ngaphandle kokusetyenziswa kakubi kotywala neziyobisi, yaye ukwenza izigqibo eziphosakeleyo ngokufuthi kunokuba nemiphumo engalindelekanga. Akunyanzelekanga ukuba ujonge okanye ufumanise ukuba yintoni ebangela umntu osebenza naye abonakale ekhubazekile. Lowo ngumsebenzi wabanye. Kufuneka uchonge izalathisi zomonakalo kwaye uthathe amanyathelo afanelekileyo. Enye yezinto omawuziqwalasele phambi kokuba uxele umntu osebenza naye ngokukhotyokiswa ziziyobisi kukuba ubona okanye awuboni ukonakala kwenyani. Wonke umntu ukhe abe neemvakalelo zokugula, ukucaphuka, okanye uxinezeleko. Nokuba sisenokungasebenzi njengesiqhelo, akukho nto malunga nokusebenza kwethu ebeka nabani na emngciphekweni, kwaye ayenzeki rhoqo. "Ukuphazamiseka kwinkqubo yokunakekelwa kwempilo kuchazwa njengokungakwazi okanye ukungabikho kokungakwazi ukwenza, okwahlulahlulwe ngamacandelo amabini anokuchaphazela zombini ingcali kunye nesigulane" (Baldisseri, 2007). Le ngxelo iyayichitha imeko yangaphambili apho unokuhamba kancinane kunesiqhelo ngenxa yengqele eqhaqhazelisa amazinyo.

 


Impembelelo yoNyango oluSebenzayo ngaphandle kwaMajoyinti-Ividiyo


Umahluko phakathi koKuthomalalisa kunye nosuku olubi

"Uthintelo luphawulwa kukungakwazi ukwenza imisebenzi yobungcali kunye noxanduva oluhambelana ngokufanelekileyo nemigangatho yokonga." Ukuba nosuku olubi kunokuchaphazela imo yomntu kunye nokuhamba komsebenzi. Ngamanye amaxesha, uluvo olutyhafileyo lokuba umntu akanguye uqobo lukhokelela koku kufunyanwa. Abo basebenza nabo basenokunganeliseki okanye bazive besoyika. Abaphathi banokubona ukunyuka kwenani lezikhalazo ezifakwe kumqeshwa okanye ngoogxa babo ngakuloo mntu. Iipateni zokuziphatha zibonisa imiba ekhoyo kwaye inokukhokelela ekuphuhlisweni kokubangela iimpazamo zonyango. Iimpazamo zonyango kwimibutho yokhathalelo lwempilo zinokudala ingxaki enkulu yempilo enokubeka emngciphekweni ukhuseleko lwesigulana. (Rodziewicz et al., 2024). Phambi kokuphonononga ezi patheni, masithathele ingqalelo ezinye zezizathu ezinokuthi zibekho ngaphandle kokusetyenziswa gwenxa kweziyobisi okanye iziyobisi ezinokuba negalelo ekwehleni kweendlela ezinobungozi kwimisebenzi yobunesi.

 

Iintsilelo zoQeqesho neMfundo

Imisebenzi eyingozi yomntu osebenza naye inokubangelwa kukungaqeqeshwa ngokwaneleyo, ulwazi, okanye ukuqhelaniswa nomsebenzi wangoku. Oku kusebenza ngokukodwa kwabongikazi abasandula ukufumana iimpepha-mvume kunye nabongikazi abatshintshayo ukusuka kwindawo yokuziqhelanisa ukuya kwenye. Abongikazi abakuqeqesho lokuhlaziya banokufuna ukuzithemba ngakumbi kwindlela izinto ebezisenziwa ngayo ngokwesiko okanye kufuneka bafundiswe uhlengahlengiso olucetyiswayo kumgaqo-nkqubo okanye iinkqubo. Uqeqesho oluhlaziyiweyo lusenokudibana nenkcaso okanye utshintsho kwaye lufuna ukuphumelela. Ukuba umongikazi akafuni kuvuma ukuba ulwazi okanye izakhono zabo azifikeleli kwinqanaba, ezi ntsilelo kwimfundo zinokubonakala njengomonakalo. Basenokuthatha ixesha elide kunabanye abongikazi ukwenza imisebenzi, phakathi kwezinye izalathisi. Iintelekelelo ezigwenxa malunga nokuba yeyiphi eyona ndlela ifanelekileyo okanye echanekileyo yokugqiba umsebenzi kunokukhokelela kwiimpazamo kwicala likamongikazi. Kungenjalo, basenokuba novakalelo olugqithisileyo xa begxekwa baze bazame ukuzigcina bezolile ngokugxininisa ukuba banobuchule.

 

Isigulo soMzimba

Sele siwuxoxile umcimbi wokuzama ukusebenza xa unomkhuhlane ombi. Kwabaninzi bethu, amava okuba nesigulo esincinci okanye usulelo olusibambeleyo luyaziwa. Nangona kunjalo, ukwanda kweemeko ezinganyangekiyo kunokukhokelela ekuthotyweni kweentsuku zokusebenza. Njengezinye izifo ezininzi, isifo seswekile, kunye nesifo samathambo sinokubangela ukuba umntu azive engaphantsi kwe-100% yakhe ngeentsuku ezithile. Kubalulekile ukukhumbula ukuba usenokungazi nokuba umntu osebenza naye unazo ezi zigulo. Ngokufuna isihloko esingcono okanye esifanelekileyo sokubeka oku phantsi, qiniseka ukuba umntu oza kumtyhola ngokusebenzisa kakubi iziyobisi akakhulelwanga phambi kokuba uqhubele phambili. Ngokwemvelo, olu luhlu oluyinxenye lwazo zonke iinkcazo ezibonakalayo ezibonakalayo. Sisikhumbuzo sobuhlobo nje ukuba sicinge nethuba lokuba umongikazi ongakwaziyo ukuphilwa ngokwasemzimbeni.

 

Ukwenzakala Emzimbeni

Njengeemeko zonyango, ukonzakala kusenokubangela ubani angakwazi ukwenza umsebenzi wakhe. Nangona kunokwenzeka ukuba kubekho iimpawu ezicacileyo zokwenzakala-ezifana nokuqhwalela okanye enye intshukumo engaqhelekanga, imimandla ebotshiweyo, okanye ukusebenzisa intonga yokuhamba okanye enye i-mechanical aid-oku akusoloko kunjalo. Umntu onomqolo okanye uhlobo oluthile lwemithambo-luvo unokuzama ukufihla ukungakhululeki kunye nemida yabo.

 

Uxinzelelo kunye nokudinwa

Ekubeni kuqhelekile ukuba ezi zizathu zenzeke kunye okanye ukuba enye ibonakale njengophawu lomnye, inokubonwa njengesizathu esihlangeneyo. Zisenokuba ziziphumo zeziganeko ezingaphandle kwendawo yokusebenza, ngaphakathi emsebenzini, okanye zombini. Umntu osandul’ ukuqhawula umtshato okanye umntu ongoyena mntu unyamekela isalamane esigula kakhulu ekhaya yimizekelo emibini. Zombini ezi meko azikho mnandi, kodwa kuthekani ukuba ezi zinto bezingeyonxalenye yeengxaki zemali? Bobabini ukuba nexhala malunga noku kunye nokuzama ukusebenza iishifti ezininzi ngenxa yemiceli mngeni yezoqoqosho kunokwenzakalisa ukukwazi kwabo ukulala. Umntu kwezi meko unokudinwa ngokukhawuleza ngokwasengqondweni nasemzimbeni. Kuxhomekeka kubuntu babo, bekungayi kuvakala nokuba oogxa babo bangabikho zingqondweni kobu bunzima. Kungenjalo, unobangela usenokuba ngokuthe ngqo njengoxinezeleko emsebenzini, okukhokelela ekudinweni nokuncipha kwenkuthazo. Ukudinwa nokunganeliseki emsebenzini, enyanisweni, “kuyinto eqhelekileyo kumsebenzi wokonga” (Van Bogaert et al., 2017)

 

Isigulo sengqondo

Nangona abongikazi bethanda ukuzicingela njengabomelele kwaye bengachatshazelwa ziimeko abanye abanokuthi bazibone njengobuthathaka, inyani yeyokuba sisengozini kwimiba yempilo yengqondo efana nokuxhalaba kunye nokudakumba, kunye nokuphazamiseka kokusetyenziswa kweziyobisi, ngenxa yezizathu ezininzi ezifanayo. . Kwiinkalo ezithile zokonga, sisebenza nezigulana ezisifa ngalo lonke ixesha-mhlawumbi nokufa kweentsana-okanye sibona iziphumo ezihlasimlisayo ngenxa yeziganeko zobundlobongela okanye ngengozi. Iimeko ezifana nezi zinokusebenza njengezandulela kwizigulo ezifana nePost Traumatic Stress Disorder (PTSD). Abongikazi abangobafazi abakhulu okanye amadoda amakhulu—kwakhona, le yimizekelo nje embalwa. Iingcali zezempilo zinokuchaphazeleka ukuba zichaphazela uluntu ngokubanzi.

 

Ukusetyenziswa kweziyobisi

Ukukhotyokiswa ziziyobisi mhlawumbi yeyona nto ingapheliyo kwaye iyonakalisa umntu, indawo, kunye nomsebenzi, nokuba ayiqhelekanga ngakumbi kunezizathu ezichazwe ngaphambili zomonakalo. Ukusetyenziswa kakubi kweziyobisi akunakwenzeka ukuba kuhambe ngokwalo ngokuhamba kwexesha ngaphandle koncedo oluvela kubasebenzi osebenza nabo kunye nabaphathi, ngokungafaniyo neemeko zonyango okanye ukulimala. Oku akuthethi ukuba ungenelelo lwezinye izizathu zomonakalo aluyomfuneko okanye kufuneka luphetshwe. Ukuba awukwenzi xa into efana neentlungu ezisezantsi zingunobangela wokuphazamiseka, unokuphela ukhoboke kwiipilisi zeentlungu kwasekuqaleni. Ibandakanyiwe kwingqokelela phantsi kwesi sifundo ukukhubazeka okuziswa kukusetyenziswa kakubi okanye ukusetyenziswa kakubi kwamayeza amiselweyo kubo okanye abanye. Ukuphazamiseka rhoqo kuhambelana nemiphumo emibi yokusetyenziswa ngokugqithiseleyo okanye ukugqithisa okukhulu. Kwangaxeshanye, inokuvela ngamaxesha athile kwiziganeko ezimbi ezinxulumene needosi eziqhelekileyo, ezifana nesicaphucaphu, ukozela, okanye isiyezi. Ukusetyenziswa okanye ukusetyenziswa kakubi "kweziyobisi zasesitalatweni" okanye izinto ezingachazwanga njenge-methamphetamine, ecstasy, okanye i-cannabis. Ukusetyenziswa kakubi ngokugqithisileyo okanye okungapheliyo okanye ukusetyenziswa kakubi kotywala. Umongikazi usenokunxila kakhulu okanye abe ne-hangover enzima, kodwa zombini ezi meko zinokuphazamisa izakhono zakhe. Ukusetyenziswa okungapheliyo kunokukhokelela kwizigulo zomzimba okanye ukuphazamiseka kwengqondo okwenza kube nzima ukuba umongikazi enze kwinqanaba eliphezulu ngokwaneleyo. Kuba indlela umongikazi azichaza ngayo igxile emsebenzini wakhe njengomongikazi, ukungena kokuphathwa gadalala okanye ukuba likhoboka labo kwindawo yempangelo kudla ngokuba luphawu lokuba isigulo sabo sikhule kangakanani na.

 

Ngenxa yokuba abasebenzi bezempilo bachonga umgca wabo womsebenzi, ubungqina besifo ngamanye amaxesha bukhomba kwinqanaba lokugula. Imiba yendawo yokusebenza idla ngokuba linqanaba lokugqibela lokuhla, kwaye xa isifo sifunyenwe, abantu osebenza nabo bahlala bemangalisiwe “(Washington State Department of Health, 2016, p.6). Xa umonakalo ubonakala ekuqaleni emsebenzini, abantu osebenza nabo kunye nabaphathi banokuwukhanyela okanye bawunciphise umcimbi, banike izizathu okanye baphephe ukuphikisana ngethemba lokuba umcimbi uya kunyamalala.

 

Imiba yoMngcipheko eyodwa kooMongikazi

Ithuba lokuba nengxaki yokusetyenziswa kweziyobisi kuphenjelelwa zizinto ezahlukeneyo, ezibandakanya imfuzo, indlela akhuliswe ngayo, uxinzelelo lwabazali noontanga, njalo njalo. Nangona kunjalo, ukusebenza njengomongikazi kubonisa izinto ezimbalwa ezinobungozi ezingekhoyo kweminye imisebenzi. Ezona meko ziphambili zomngcipheko weyure abongikazi abajongana nazo kwiziko lezempilo zezi:

  • Ukufikelela
  • Isimo sengqondo
  • istres
  • Ukungabikho kwemfundo (Hakim, ngo-2023)

 

Ukufikelela kunye nesimo sengqondo

Amachiza asemthethweni ukuba afunyanwe ngomyalelo kagqirha kusenokwenzeka ukuba asetyenziswe ngabongikazi kunoluntu ngokubanzi, nangona ukuphazamiseka kokusetyenziswa kweziyobisi akuchaphazeli abongikazi rhoqo kunabantu ngokubanzi. Ingcaciso yeyokuba abongikazi baphatha la mayeza mihla le, nangaphandle kwencwadi kagqirha. Koku, songeza ulwazi lwethu lolawulo lwamayeza, ukusetyenziswa, kunye nedosi kwaye sisebenza kwindawo apho izibonelelo zokusetyenziswa kwamayeza zibonakala. Oku kubonisa ukuba siqinisekile ngesakhono sethu sokuzixilonga nokuzinyangela kunye nokukwazi kwethu ukuphatha la mayeza.

 

istres

Ezinye zezinto ezibonisa ukuba bonke abongikazi ngamanye amaxesha bayinxalenye yoxinzelelo olubangele ukuba baphazamiseke ziquka:

  • Iinguqu ezongeziweyo
  • Umsebenzi onzima
  • Ukungabikho kwabasebenzi
  • Izigulana ezingxamiseke kakhulu ngelixa zizolile phantsi kweemeko ezibuhlungu kakhulu. 

Oku kuqikelelwa ukuba kwaziwa kubo bonke abongikazi kwaye ngamanye amaxesha kunokubalelwa kuxinzelelo lwendima. Zonke ziyinxalenye eyimfuneko yomgca onzima womsebenzi. Iishedyuli zomsebenzi zizodwa zibonise unxulumano oluyinzuzo nokusetyenziswa kweziyobisi. Iintlungu okanye ukuphuthelwa emva kokutshintsha okufunwayo zixhaphakile kwaye zihlala zisebenza njengesona sizathu sokuthatha amayeza ukunceda ngeentlungu kunye neentlungu, ukukhuthaza ukuphumla, okanye ukulala.

 

Ukunqongophala kweMfundo

Apha, igama elithi “ukunqongophala kwemfundo” alithethi ukungazi nto ngeziyobisi. Njengoko besesitshilo, akukho kunqongophala kwemfundo apho. Hayi. Kulo mongo, ukungazi ngeengxaki zokusetyenziswa kweziyobisi kunye neempawu ezilumkiso ezinxulumeneyo kunye neempawu kuthethwa. Amaxesha amaninzi, abaqeqeshi bezempilo abakwazi ukuchonga ezi mpawu kunye nezikhombisi kubo bobabini nakwabanye abantu. Nokuba bathe bazichonga, ukubekwa amabala kuphuma kukungabikho kolwazi malunga nezi ngxaki-ingakumbi ukuba umntu ogulayo ngumsebenzi wezempilo osebenza naye-kuba sikholisa ukubamba abaqeqeshi bezempilo-kubandakanywa nathi-kwimigangatho ephezulu kunokuba sisenza abasebenzi abangabakhathaleli bezempilo.

 

Ukuqonda Iimpawu

Xa umongikazi ebanjwe esebenzisa iziyobisi okanye utywala emsebenzini, eyona ndlela ifanelekileyo yokwenza kwezi ntsuku luncedo kunye nonyango kunokupheliswa kwangoko. Umbono kukuba umongikazi ekugqibeleni uya kukwazi ukubuyela emsebenzini emva konyango kunye nokubuyisela kwimeko yesiqhelo. Nangona kunjalo, ukungenelela kwangethuba yinxalenye ephambili yesi sicwangciso. Njengoko besesitshilo, ukusetyenziswa kweziyobisi kunokufuna ukuqhubeka ixeshana ngaphambi kokuba iimpawu zothintelo emsebenzini zibonakale. Ngoko ke, ekulandeleni umphumo ophumelelayo, ixesha ngokwalo liba yingozi. Kufanelekile ukuba sizikhumbuze ukuba ukusetyenziswa gwenxa kweziyobisi kusenokungabi kuphela kwengcaciso yothintelo njengoko sivavanya ezinye zezalathi ezinokuthi zibangelwe nokusetyenziswa kweziyobisi. Ngenxa yokhuseleko lwezigulane kunye nabasebenzi, kufuneka ungenelelo ngoncedo nokuba siyintoni na isizathu. Ukukhangela utshintsho lokuziphatha okanye utshintsho olusuka kwisiseko kunemisebenzi ethile mhlawumbi kunenzuzo ngakumbi. Emva kwayo yonke loo nto, sonke siyazi ukuba umongikazi ongakwaziyo ukusebenza kodwa ebesoloko ebonakala emdaka okanye ehamba kancinci kancinci kunabanye xa egqibezela imisebenzi. Mhlawumbi lukhetho lobuqu, kodwa ukuba umongikazi owayebonakala eqeqesheke kakuhle kwaye enemveliso ngequbuliso uqalisa ukwenza ubuvila nokungakhathali, kusenokubakho umba onzulu okhoyo.

 

Kwelinye icala, kuyaphawuleka ukuba umongikazi, obesoloko esonqena kwaye esonqena kodwa ebesoloko ehleli ngaphakathi kwiparamitha ezamkelekileyo, ngequbuliso akamkelekanga okanye wacotha kakhulu kwaye wonakele. Nangona kunjalo, utshintsho olubonakalayo lunokuba ngaphandle kwemeko yesinxibo sabo. Kwanomntu odla ngokuziphatha kakuhle unokubonakala edandathekile, esoyika, okanye esoyika. Umntu oqhele ukuzola unokubonakala edlamkile, ethetha kwaye enobubele. Kusenokwenzeka ukuba umntu oneentloni azimele yedwa ngaphezu kwesiqhelo, okanye umntu oqhele ukuthetha kwaye odlamkileyo uye athethe kakhulu kwaye asebenze ngakumbi kunesiqhelo. Khumbula ukuba ukuziphatha akubalulekanga kangako kwiimeko ezininzi kunokutshintsha ekuboniseni ingxaki. Kuyafana nokujonga ukutenxa kuxinzelelo lwegazi oluqhelekileyo okanye ubushushu njengophawu lomcimbi. Iimpawu ezongezelelweyo zotshintsho ekufuneka uzilumkele ziquka: 

  • Ukuhamba kweemvakalelo 
  • Ukutshatyalaliswa
  • Ukulala
  • Ukukhala okanye ukuhleka okungafanelekanga
  • Ukurhanela okanye ukuba novelwano ngokugqithisileyo ekugxekeni.
  • Ukungaguquguquki okanye ukubambelela ngokugqithisileyo kwiinkqubo xa zingafunwa.
  • Ukudideka, okanye inkumbulo embi

Xa kuziwa ekusebenzeni komsebenzi, unokujonga oku kulandelayo:

  • Ukunyuka kokulibazisa kunye nokungabikho, ngakumbi xa kulandelwa ipateni.
  • Iingcaciso ezingaqhelekanga zokungabikho
  • Unqumamo olude okanye ngaphezulu oluqhelekileyo 
  • Ukungabikho okungaqhelekanga emsebenzini, 
  • Ngaphambili, imisebenzi eqhelekileyo yayifuna ixesha elingakumbi.
  • "Iindlela ezimfutshane" ezingaqhelekanga okanye ezithandabuzekayo ezisetyenziswa kwimisebenzi aziyibambi inqanaba elilindelekileyo lokhathalelo. 
  • Xa umgangatho okanye umxholo we-charting uba yi-shoddy okanye uyingqayizivele, kukho ukungachaneki okukhulu kunye nokungakhathali. 
  • Ukunyuka kwezikhalazo okanye izikhalazo zomongikazi. 

Ngamnye kubo walatha kwinto enokwenzeka. Zisenokubonakala ngokucacileyo okanye zingaqhelekanga ngokwaneleyo ukuze zikunike ingcamango yokuba kukho into ecinyiweyo. Usenokuphawula ukuba basebenzisa izinto zokuphefumla, iminti, okanye itshungama ngokuphindaphindiweyo kunokuba bebesenza ngaphambili. Basenokumbombozela ngaphezu kwesiqhelo okanye babonise intetho emisiweyo ngokuchuliweyo nangokuthula ixesha elide ngelixa beqwalasela impendulo yabo. "Ngaba abafundi babo babecinezelekile (okanye bahlanjululwe)?" okanye “Ibibutywala obu ndabunuka?” yeminye imibuzo omawuzibuze yona xa uhamba. Njengabongikazi, sinokufumana i-hunches okanye intuition. Ukukwazi kwethu ukukwazi ukubona iziphumo zoqeqesho lwethu olubanzi kwaye olu lwazi luhlala lusekwe kuqwalaselo esilwenza singekho zingqondweni. Ngoko ke, nceda ungabahoyi. Ngelixa awufanelanga ukubahoya, akufanele ubamkele njengevangeli.

 

Ukuphambuka kweziyobisi

Ukufikelela kwichiza elikhethiweyo kunokuthintelwa umongikazi onengxaki yokusebenzisa iziyobisi xa engasebenzi. Oku kusenokuba ngenxa yezizathu ezahlukahlukeneyo, ezinje ngokuba usapho lwabo alusayi kunikwa elo chiza lithile, ugqirha wabo okanye usokhemisti uyakrokra, okanye ezinye izizathu. Bahlala bezama ukongeza olo fikelelo emsebenzini ngolu hlobo lwemeko. Kwaye umongikazi kuya kufuneka abe nobuchule bokufihla le ndlela yokuziphatha ngenxa yamanyathelo okhuseleko akhoyo, ngakumbi xa kuziwa kwizinto ezithintelweyo.

Phakathi kwezalathi ezilumkisayo ekufuneka uziqwalasele zezi:

  • Rhoqo okanye ngokuzimisela ukunikezela ukuba ngumongikazi kumachiza. 
  • Izigulane ziyaqhubeka zikhalaza malunga nokungonwabi nasemva kokufumana i-painkillers.
  • Amaxwebhu atyhila ukuba isigulana sanikwa amayeza okudambisa iintlungu ngakumbi kunokuba kuyimfuneko kwimeko yawo. 
  • Ziyanda iingxelo zokuchitheka kweziyobisi kunye nenkcitho. 
  • Xa lo mongikazi esenza imijikelo yamayeza ngokunxulumene nabanye abongikazi, inani eliphezulu ngokungaqhelekanga lamachiza alawulwayo asetyenziswayo. 

Ubalo lweziyobisi aluchanekanga; Ukuba awukayiboni ichiza elinikiweyo okanye elikhutshwayo, umongikazi unokukucela ukuba ulisayinele. Olu luhlu oluyinxenye, njengabanye. Njengolunye uluhlu, abongikazi balumke kakhulu ngenxa yemfundo yethu, uqeqesho, kunye namava, ngoko ngamanye amaxesha lithuku nje lethuku elikulumkisa ngomba onokwenzeka. Nangona kunjalo, njengesikhokelo esiqhelekileyo, nayiphi na into evakalelwa kukuba kufuneka ijongwe ngakumbi. Izibophelelo zakho kwizigulane zakho kunye nabo osebenza nabo zifuna oku. 

 

Ngoncedo

Umthetho wokuziqhelanisa noMongikazi waseFlorida waphulwa xa umongikazi eziqhelanisa ngoxa enxilile. Zombini izigulo kunye nokusetyenziswa kweziyobisi zidweliswe njengezinto ezinokuthi zibe ngunobangela wolu thintelo kumhlathi ochaza oku njengolwaphulo-mthetho kwaye kunokukhokelela kwisenzo soluleko. Kuya kuba semthethweni kwakhona ukusilela ukuxela ukonakaliswa kukamongikazi okanye ukubeka ukhuseleko lwesigulane emngciphekweni ngokusivumela ukuba sisebenze ngelixa sonakele. Kukhethwa wonke umntu ukuba akukho nzame yokugubungela umongikazi okanye ukuba umcimbi awuhoywa ngethemba lokuba uza kudlula. Njengomsebenzi, kuya kufuneka unxibelelane ngokupheleleyo nemimiselo kunye neenkqubo indawo nganye ekusenokwenzeka ukuba iyilelwe ezi meko. Ezi ziya kuba zidalwe ukuqinisekisa ukuthotyelwa kwazo zonke izibophelelo ezisemthethweni nezolawulo. Ayifanelekanga into yokuba uye kumntu osebenza naye oneziphene. Ngalo lonke ixesha ucela uncedo kumphathi okanye umongikazi. Umphathi okanye umphathi uya kuqhagamshelana nomongikazi okhubazekileyo kuqala; nangona kunjalo, ukuba nabantu abaninzi abakhoyo ngexesha longenelelo kuya:

  • Nika ubungqina obunikwe umongikazi ubunzima obuninzi kuba kunokwenzeka ukuba aphikisane nokwenzakala. 
  • Yiza namangqina eziganeko ezinokufuneka kwiingxoxo zetyala okanye iintlanganiso kamva.
  • Nika amandla kumyalezo, inkxaso yeemvakalelo, kwaye ugcine ukhuseleko ukuba umongikazi ubonisa ukuphazamiseka okanye ubundlongondlongo xa kuqhagamshelwana naye. 
  • Ungaze ungenelelo lokuqala lube sisityholo okanye lubandakanye ukuzama ukuchonga umba womongikazi. 

Kufuneka isekelwe kwinyani kwaye inike ubungqina obubhaliweyo bemigqaliselo kunye neenkxalabo ukwenza umongikazi aqonde ukuba kutheni umcela ukuba ayeke ukusebenza ngoku. Uthomalaliso kunye nalo naluphi na ungenelelo olulandelayo lunokuxelwa ngenye yeendlela ezimbini. IFlorida State Board of Nursing yeyokuqala kubo. Ngokuchanekileyo, iSebe lezeMpilo liya kufumana ingxelo, liphande ngezikhalazo, kwaye lithathe amanyathelo afanelekileyo. Inyathelo lesibini liya kuba kukuthumela ingxelo kwiProjekthi yokuNgenelela kwabongikazi (IPN). IPN yaqulunqwa ngo-1983 ngesenzo sowiso-mthetho ukukhusela impilo nokhuseleko loluntu (Chan et al., 2019). Ikwenza oku ngokubeka iliso elibukhali kubongikazi ababonwa bengakhuselekanga ekusebenzeni ngenxa yothintelo oluziswe kukusetyenziswa gwenxa kweziyobisi okanye utywala, ukusetyenziswa kakubi, okanye zombini, okanye ngenxa yesigulo somzimba okanye sengqondo esinokuphazamisa amandla omntu onephepha-mvume lokuziqhelanisa ngokukhuselekileyo nangobuchule. . 

 

Ezi nkqubo ezichasene nokuziphatha ziye zaphuhliswa kulo lonke ilizwe, kwaye eFlorida, ziyinxalenye yeNethiwekhi yeSigulana esiHlangeneyo (IPN) ngenxa yokuqaphela ukuba umongikazi onengxaki yokusetyenziswa kweziyobisi kufuneka afumane ukhathalelo kunye nonyango njengaye nabani na. enye into. Ngeenkqubo zayo, abongikazi banokufumana unyango olungenasohlwayo kunye nokubuyisela kwisimo sangaphambili. I-IPN iya kunceda ukuba umongikazi abuyele ngempumelelo emsebenzini ukuba uyavuma ukushiya umsebenzi kwaye agqibe inkqubo ngelixa egcina imfihlo-nkqu nakwiBhodi yoMongikazi. I-IPN iya kuyithumela ifayile kwiSebe lezeMpilo ukuba umongikazi uyayamkela le migaqo kodwa emva koko atshintshe iingqondo zakhe. Amatyala athile anokuxelwa kwiSebe lezeMpilo kunye ne-IPN, apho unyango KUNYE namanyathelo oluleko anokuqaliswa. Ukuthatha inxaxheba kweSebe lezeMpilo kunokukhokelela ekubeni iphepha-mvume likamongikazi linqunyanyiswe okanye lirhoxiswe, nto leyo eyenza kube nzima kakhulu ukuba abuyele emsebenzini. Kucingelwa ukuba ngokunikezela ngeendlela ezingezizo ezohlwayo, abongikazi baya kukhuthazwa ukuba bafune uncedo phambi kokuba bajongane nesohlwayo kwaye banokuthi ekugqibeleni bakwazi ukubuyela emsebenzini.

 

isiphelo

Ngenxa yeemeko ezizodwa ezingqonge imfundo noqeqesho lwethu, indlela esijongwa ngayo, kunye nenyaniso yokuba sizibona sinamandla ngandlel’ ithile kunabanye, umba wokukhubazeka emsebenzini wabongikazi unzima kakhulu. Kwixa elidlulileyo, ukuba umqeshwa wayeneziphene emsebenzini, kwakusenokuthatyathwa amanyathelo oluleko ngenxa yokonakaliswa kwakhe okanye ngenxa yeempazamo ezenziweyo. Oku kwakufanelekile ngokukodwa kwiimeko apho kwafunyaniswa ukuba umongikazi wayenxilile okanye wonakaliswe yenye into. Ubuphume ngomnyango zange ubuye emva koko. Kwakhona uya kuphulukana nelayisensi yakho, nto leyo ekuthintela ukuba ungaphinde ubuyele emsebenzini njengomongikazi. Okuvuyisayo kukuba, amanyathelo angenaluqeqesho aye abangelwa kukuqonda ukuba asikhuselekanga kuxinzelelo olufanayo njengabanye. Umbono ongemva kwala manyathelo kukuchonga iingxaki, kubandakanywa ukuphazamiseka kokusetyenziswa kweziyobisi, kwangethuba ukuze esona siphumo silungileyo sibe nokuphunyezwa kuwo onke amaqela.

 


Ucaphulo

Baldisseri, MR (2007). Ingcali yezempilo ebuthathaka. Crit Care Med, 35(2 Suppl), S106-116. doi.org/10.1097/01.CCM.0000252918.87746.96

Chan, CWH, Ng, NHY, Chan, HYL, Wong, MMH, & Chow, KM (2019). Uphononongo olucwangcisiweyo lweziphumo zeenkqubo zoqeqesho zabaququzeleli bocwangciso lokhathalelo. BMC Health Service Res, 19(1), 362. doi.org/10.1186/s12913-019-4192-0

Hakim, A. (2023). Ukuphanda imingeni yemfundo yeklinikhi ngokwembono yabafundisi bobuhlengikazi kunye nabafundi: Isifundo esinqamlezileyo. SAGE Vula i-Med, 11, 20503121221143578. doi.org/10.1177/20503121221143578

Ukonakala. (nd). KwiDictionary.com engafinyezwanga. Ifunyenwe kwi www.dictionary.com/browse/impairment

Rodziewicz, TL, Houseman, B., & Hipskind, JE (2024). UkuNcitshiswa kwempazamo yezoNyango kunye noThintelo. Kwi StatPearls. www.ncbi.nlm.nih.gov/pubmed/29763131

Van Bogaert, P., Peremans, L., Van Heusden, D., Verspuy, M., Kureckova, V., Van de Cruys, Z., & Franck, E. (2017). Abaqikeleli bokudinwa, ukubandakanyeka emsebenzini kunye nomongikazi baxela iziphumo zomsebenzi kunye nomgangatho wokhathalelo: isifundo sendlela edibeneyo. BMC Nurs, 16, 5. doi.org/10.1186/s12912-016-0200-4

Washington State Department of Health. (2016). Isikhokelo sokunceda oogxa babo ababonakalisa ukonakala emsebenzini. Ifunyenwe kwi www.doh.wa.gov/portals/1/Documents/Pubs/600006.pdf

 

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