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- Title
Manuelle Diagnostik und Therapie von Funktionsstörungen der oberen Halswirbelsäule und die Rolle von „Atlasfunktionsstörungen".
- Authors
Kayser, Ralph; Lange, Antje; Fünfgeld, Liv
- Abstract
Introduction: The area of the upper cervical spine, as one of the key areas, plays a central role in numerous offerings for learning manual medical diagnostic and treatment techniques. However, HVLA (high velocity low amplitude)-techniques, in particular those on the first cervical vertebra, are evaluated differently and integrated into the therapeutic concept. Question: The aim of this article is to answer the question of whether and if so to what extent a special treatment of upper cervical joint disorders can be justified from a practical manual medical and manual physiotherapeutic point of view, but also according to evidence-based scientific criteria, with an explicit focus on a special „atlas therapy". Material and methods: In order to answer this question, the authors got together to report on their experiences and to illustrate them with case studies. A scientific evaluation, a classification into current teaching concepts of manual medicine and manual therapy and a comparison with any existing treatment recommendations and guidelines also took place. A consensus of authors from various professional groups was developed. Results: Most practitioners of manual medicine and manual therapy favor a central role for the upper cervical spine. In teaching concepts, separate diagnostic and treatment techniques are taught and practiced. The main correlating anatomic structures of the transitional area between upper cervical spine and head (segments O/C1 to C2/3) are equipped with a high density of receptors. By the application of stimuli in this area a neurophysiological reflex response is obtained. Soft techniques and HVLA techniques are equally effective in this respect. A special consideration of the „atlas region" as the central regulator of the cervical area can be useful in practical work. Scientific evidence for an isolated view of this area is lacking. X-ray diagnostics should only be considered out of differential diagnostic considerations with a strict indication. Conclusion: The manual diagnostic and treatment of functional disorders of the upper cervical spine is useful and highly effective. The role of „atlas dysfunctions" should be considered within established teaching concepts of manual medicine and is then very useful. A high degree of palpatory experience is required for the diagnostic and treatment of atlas-associated functional disorders. An isolated "atlas treatment" outside of this context cannot be recommended.
- Subjects
SPINE diseases diagnosis; CERVICAL vertebrae radiography; CERVICAL vertebrae; SPINE diseases; TEACHING methods; PHYSICAL therapy; EVIDENCE-based medicine; MANIPULATION therapy; ATLAS (Vertebra)
- Publication
OUP - Orthopädische und Unfallchirurgische Praxis, 2023, Vol 12, Issue 3, p106
- ISSN
2193-5785
- Publication type
Article
- DOI
10.53180/oup.2023.0106-0112