Joint Manipulation – Joint Mobilization: Research Studies & 治療 

What is Joint Manipulation – Joint Mobilization?

Joint mobilization is a manual therapy intervention, a type of passive movement of a skeletal joint. It is usually aimed at a ‘target’ synovial joint with the aim of achieving a therapeutic effect. Joint mobilization is used in restoring decreased mobility, however, this method may not be as effective as perceived.

Joint Manipulation – Joint Mobilization: Research Studies

1. A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. A systematic review by Rubinstein et al. researched the the effectiveness of spinal manipulation therapy for those suffering from chronic lower back pain.²⁴ This study assessed 26 randomized controlled trials including 6070 participants.²⁴  Evidence showed no significant difference between spinal manipulation therapy and other intervention approaches.²⁴ 
2. A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. A systematic review published by Canter and Ernst studied the effectiveness of spinal manipulation for treatment of multiple regions of pain, including, but not limited to, back and neck pain.³² 16 trials were included for the purpose of this study.³² Evidence suggested that spinal manipulation was ineffective for all evaluated forms of pain.³² 

Based on the evidence presented in the included systematic reviews, spinal manipulation does not appear to be an effective form of treatment for different pain types, including back pain.  While spinal manipulation is seen as ineffective, ASTR treatment has shown evidence in a recent study that show it can be effective for many evaluated forms of pain. ASTR stands for Advanced Soft Tissue Release, a manual therapy specialty developed by Dr. Joesph Jacobs, DPT. ASTR takes a holistic approach to treating the source of soft tissue restriction in a way that is virtually pain-free and highly effective.

有效的止痛治療

ASTR 通過解決肌肉失衡、疤痕組織、觸發點、筋膜限制、炎症、姿勢、身體力學（通常是疼痛的根源），以溫和、有效和自然的方式治療肌肉和關節疼痛。 ASTR 採用整體方法來解決疼痛的根本原因，而不僅僅是症狀。 ASTR 治療可以在家中進行肌肉和關節疼痛。

參考：

24. Rubinstein SM、Terwee CB、Assendelft WJ、Boer MRD、Tulder MWV。脊柱手法治療急性腰痛。 脊柱. 2011;36(13):825-846。 doi:10.1002/14651858.cd008880.pub2。

25. Gattie E, Cleland JA, Snodgrass S. 物理治療師對肌肉骨骼疾病觸發點幹針的有效性：系統評價和薈萃分析。 骨科與運動物理治療雜誌. 2017;47(3):133-149。 doi:10.2519/jospt.2017.7096。

26.  Dunning J、Butts R、Mourad F、Young I、Flannagan S、Perreault T. 幹針：對臨床實踐指南有影響的文獻綜述。 物理治療評論. 2014；19(4):252-265。 doi:10.1179/1743288x13y.0000000118。

27. Morihisa R Eskew J McNamara A, et al. Dry Needling in subject with muscular trigger points in the lower quarter: a systematic review. Int J Sports Phys Ther. 2016;11(1):1-14. 

28. Cotchett MP, Landorf KB, Munteanu SE。幹針和注射與足跟痛相關的肌筋膜觸發點的有效性：系統評價。 J足踝水庫。 2010；3:18。

29. 卡明斯 TM，白色 AR。治療肌筋膜觸發點疼痛的針刺療法：系統評價。Arch Phys Med Rehabil 2001；82:986-92。 

30. Xue CC、Helme RD、Gibson S 等人。電針對慢性肌肉骨骼疼痛患者阿片類藥物消耗的影響：隨機對照試驗方案。 試驗. 2012；13:169。 doi:10.1186/1745-6215-13-169。

31.  Scott N. A., Guo B., Barton P. M., Gerwin R. D. Trigger point injections for chronic non-malignant musculoskeletal pain: a systematic review. 止痛藥. 2009;10(1):54-69。 doi: 10.1111/j.1526-4637.2008.00526.x。 

32. Ernst E，坎特 PH。對脊柱手法系統評價的系統評價。 皇家醫學會雜誌. 2006;99(4):192-196.