脉冲枪(中英文)

1、脉冲治疗仪TECHNIQUEImpulse Adjusting Technique脉冲调整技术A Chiropractic Analysis of the spine & pelvis that incorporates findings from:整脊疗法结合下列的检查对脊椎和骨盆进行分析History (signs & symptoms, pattern recognition):Exam Findings: Orthopedic tests (tests that have high sensitivity & specificity)Joint alignmentJoint movem

2、ent (symmetry with opposite side)Pain over bonePain over soft tissueMuscle and nerve reaction to movement and pressure病史（体征和症状，模式识别）：检查结果：骨科测试（具有较高的灵敏度和特异性的测试）关节对位对线关节运动（双侧对称）骨疼痛软组织疼痛肌肉和神经对运动和压力的反应The Sacroiliac, Pubic, and Hip joints骶骨关节，耻骨，髋关节脉冲治疗仪TECHNIQUE1. BilateralNachlas Test1.双侧Nachlas测试4. C

3、ompressionTests for Lower Ext.Involvement受累下肢的压迫测试 3. Hip RotationTests髋关节旋转测试2. UnilateralNachlas Test单侧Nachlas测试5. CompressionTests for Supra-PelvicInvolvement受累盆骨上端的压迫测试Presence of PainRange of MotionAsymmetryStrength存在疼痛运动范围不对称性强度5 Step Lumbo-Pelvic Analysis Flowchart5步腰腹骨盆分析流程图Step 1: Bilateral

4、 Nachlas Test第1步：双侧Nachlas测试Step 2: Unilateral Nachlas Test第2步：单侧Nachlas测试Step 3: Hip Rotation Tests第3步：髋关节旋转测试Step 4: Lower Extremity Compression Tests第4步：下肢压迫测试Step 5: Supra-Pelvic Compression Test第5步：盆腔上端压迫测试Bilateral Nachlas Test双侧Nachlas测试Positive阳性Negative阴性Unilateral PainBelow Waist腰部以下单侧疼痛SI

5、 JointInvolvementSI关节受累Unilateral PainAbove Waist腰部以上单侧疼痛LumbarInvolvement腰椎受累CentralLow Back Pain中间腰背疼痛Lumbo-SacralInvolvement腰骶受累Proceed to Unilateral Nachlas Test开始单侧Nachlas测试Flowchart for Step 1第1步流程图Test and AdjustInvolved SIJ测试和调整受累的SIJTest and AdjustInvolved Lumbar测试和调整受累的腰椎Test and Lumbo-Sac

6、ral Joint(Dual Styluses)测试和调整腰骶关节(双针)Neuromechanical Innovations Slides TestStep 1: Bilateral Nachlas Test第1步：双侧Nachlas测试Step 1: Bilateral Nachlas Test第1步：双侧Nachlas测试Clinical Considerations: 临床注意事项：Ask, “Does this cause any pain anywhere?”Do both legs flex the same?Is one leg heavier than the other?

7、How does the pelvis move during the test?问诊“这会引起任何部位的疼痛吗？”两条腿屈曲程度相同吗？一条腿比另一条腿重吗？检查过程中盆骨如何移动？Unilateral Nachlas Test单侧Nachlas测试Positive阳性Negative阴性Unilateral PainBelow Waist腰部以下单侧疼痛SI JointInvolvementSI关节受累Unilateral PainAbove Waist腰部以上单侧疼痛LumbarInvolvement腰椎受累CentralLow Back Pain腰背部中间疼痛Lumbo-SacralI

8、nvolvement腰骶受累Proceed toHip Rotation Tests开始髋关节旋转测试Flowchart for Step 2第2步流程图Test and AdjustInvolved SIJ测试和调整受累的SIJTest and AdjustInvolved Lumbar测试和调整受累的腰椎Test and Lumbo-Sacral Joint(Dual Styluses)测试腰骶关节(双针)Step 2: Unilateral Nachlas Test第2步：单侧Nachlas测试Begin with side of involvement (symptomatic sid

9、e first);Reproduction of symptoms unilaterally confirms SI joint involvementTest both sides with Unilateral Nachlas Test从受累侧开始(先测试有症状侧)单侧症状再现证实SI关节侵犯用单侧Nachlas测试法检查两侧Step 2: Unilateral Nachlas Test第2步：单侧Nachlas测试Flowchart for Step 2第2步流程图Unilateral Nachlas Test单侧Nachlas测试Positive阳性Negative阴性Unilater

10、al PainBelow Waist腰部以下单侧疼痛SI JointInvolvement骶髂关节受累Unilateral PainAbove Waist腰部以上单侧疼痛LumbarInvolvement腰椎受累CentralLow Back Pain腰背部中间疼痛Lumbo-SacralInvolvement腰骶受累Proceed toHip Rotation Tests开始髋关节旋转测试Test and AdjustInvolved SIJ测试和调整受累的SIJTest and AdjustInvolved Lumbar测试和调整受累的腰椎Test and Lumbo-Sacral Joi

11、nt(Dual Styluses)测试腰骶关节(双针)Unilateral Nachlas Test单侧Nachlas测试Positive阳性Unilateral PainBelow Waist腰部以下单侧疼痛SI JointInvolvementSI关节受累Test and AdjustInvolved SIJ测试和调整受累的SIJConfirm with SI Joint Compression Test通过SI关节压迫测试确认Literature review of tests to diagnose a SI lesion:用测试去诊断SI病变的相关文献综述：Binkley, et a

12、l, “Diagnostic classification of patients with low back pain: report on a survey of physical therapy experts,” Physical Therapy, 1993:73Symmetry Tests: 对称性测试：poor reliability and validity. 信度和效度差Pain Provocation Tests: 疼痛激发测试：evidence supports the validity of some pain provocation tests.证据支持某些疼痛激发测试

13、的效度。Prone Hip Extension Test俯卧伸髋测试“Sacral Cup,” Dr. Major DeJarnette, (The American Chiropractor, May 2007)“Prone hip extension test” (aka, “sacral cup test”) “俯卧伸髋测试”（又名“骶杯测试”）Tests the strength of the muscles crossing the posterior aspect of the SI joint.测试横跨SI关节后端的肌肉力量。SI sprain reduces patients

14、ability to extend the hip.SI扭伤降低患者的伸髋能力。SI joint horizontal sectionSI关节 - 水平横切位SI capsule contains a dense plexus of unmyelinated nerve fibers indicative of a nociceptive receptor system. SI关节囊含有密集的无髓鞘神经纤维丛，提示痛觉受体系统。Wyke, “Receptor systems in lumbosacral tissues in relation to the productionof low b

15、ack pain,” American Academy of Orthopaedic Surgeons Symposium onIdiopathic Low Back Pain, Mosby, 1982Location of SI adjustmentSI调整部位Sacroiliac Adjustment骶髂调整Sacroiliac Joint Adjustment骶髂关节调整 SCP: Sacroiliac joint, medial aspect of PSIS LOD: Anterior-Superior Setting: High or Medium SCP：骶髂关节，PSIS内侧 L

16、OD：前-上 设置：高或中 Impulse iQ Adjusting Instrument Audible Indicators & Clinical Decision Making脉冲IQ调整仪器的发声指标及临床决策Significant Improvement in at Least 2 Components of PART Documentation inRe-Assessment of Clinical Indicators在临床指标再评估中，PART文件中至少有2部分有明显改善AccelerationResponseMaximized加速反应最大化Single Beep单声Yes是N

17、o否Re-Assess Clinical Indicators重新评估临床指标Adjustment of Level orArea Successful水平或位置调整成功Adjustment of Level orArea Not Successful水平或位置调整不成功Significant Improvement in at Least 2Components of PART Documentation inRe-Assessment of Clinical Indicators在临床指标再评估中，PART文件中至少有2部分有明显改善36 ThrustsAccelerationRespon

18、se Not YetMaximized36次推力后加速反应尚未达到最大化Double Beep双声Yes是No否Re-Assess Clinical Indicators临床指标再评估Adjustment of Level orArea Successful水平或位置调整成功Adjustment of Level orArea Not Successful水平或位置调整不成功 Insure Contact was Correct with Consistent Preload Throughout Adjustment在进行调整过程中确保接触正确和加压稳定 Impulse iQ Adjusti

19、ng Instrument Audible Indicators & Clinical Decision Making脉冲IQ调整仪器的发声指示及临床决策Significant Improvement in at Least 2Components of PART Documentation inRe-Assessment of Clinical Indicators在临床指标再评估中，PART文件中至少有2部分有明显改善No SignificantImprovementin AccelerationResponse加速反应无显著改善No Beep无声Yes是No否Re-Assess Clin

20、ical Indicators重新评估临床指标Adjustment of Level orArea Successful水平或位置调整成功Adjustment of Level orArea Not Successful水平或位置调整不成功 Insure Segmental Contact Point was Correct Insure Line of Drive Was Correct Consider that Area May Not Change保证节段接触点正确确保方向正确考虑位置可能不变 Impulse iQ Adjusting Instrument Audible Indica

21、tors & Clinical Decision Making脉冲IQ调整仪器的发声指示及临床决策“Interactions between the vestibular and proprioceptive inputs triggering and modulating human balance-correcting responses differ across muscles,” Allum & Honnegger, Experimental Brain 前庭和本体冲动之间的互动，透过肌肉诱发和调整人的平衡-纠正反射的不同Research, 1998:121Unilaterally

22、reduced or altered hip or SI motion produces rotation of the trunk.单侧髋或骶髂关节活动减少或改变而引起躯干旋转。This excites lumbar joint receptors triggering muscular contractions (primarily the QL) to counter the rotary forces and provide stability.这刺激腰椎关节受体，引发肌肉收缩（主要是腰方肌QL）抵抗旋转力，并提供稳定。“Differences in lumbopelvic motio

23、n between people with and people without low back pain during two lower limb movement test,” Scholtes, et al, Clinical Biomechanics, 2008:24腰背痛和无腰背痛的人在下肢活动测试时的不同的腰骨盆运动“During (prone) knee flexion and hip lateral (external) rotation, people with low back pain demonstrated a greater maximal lumbopelvi

24、c rotation angle and earlier lumbopelvic rotation, compared to people without low back pain.”“在（俯卧）膝关节屈伸和髋关节外侧（向外）旋转期间，腰痛者与无腰疼者相比，最大腰盆旋转角度更大，且腰盆旋转更早。”In patients without low back pain but with “positive abnormal spine patterns:对于无腰痛但有“脊椎异常模式阳性的人中：the mean onset times for the hamstring, ipsilateral e

25、rector spinae, and contralateral erector spinae muscles were prior to the onset of leg movement during prone extension.在俯卧伸展期间，腘绳肌、同侧竖脊肌和对侧竖脊肌肌肉的平均启动时间在腿部运动启动之前。the mean onset time for the gluteus maximus occurred after (inhibited) the onset of leg movement.臀大肌的平均启动时间在腿部运动开始之后（被抑制）。“An investigation

26、 into motor pattern differences used during prone hip extension between subjects with and without low back pain,” Bruno, Bagust, Clinical Chiropractic, 2007:10腰痛病人和无腰痛者在俯卧位髋伸展的运动模式之间的不同PI-EXAS-INPSAIPubic Symphysis Dysfunction耻骨联合功能障碍Adjust up on the AS ilim side,Down on the PI ilium side.AS髂骨端向上，PI

27、髂骨端向下调整Flowchart for Step 3第3步流程图Hip Rotation Tests髋关节旋转测试InternalRotation内旋ExternalRotation外旋Positive阳性Negative阴性Positive阳性Negative阴性AdjustPosteriorTrochanter调整后方转子Proceed toLower Ext.Compression Tests继续下肢压迫测试AdjustAnteriorTrochanter调整前方转子Proceed toLower Ext.Compression Tests继续下肢压迫测试HyperactiveInte

28、rnal Rotators内旋肌过度活跃HyperactiveExternal Rotators外旋肌过度活跃Normal: 35-40 degrees正常：35-40度Normal: 50-60 degrees正常：50-60度Step 3: Hip Rotation Test第3步：髋关节旋转测试Internal Rotation of the Right Hip右髋关节内旋External Rotation of the Right Hip右髋关节外旋Step 3: Hip Rotation Test第3步：髋关节旋转测试Internal Rotation of the Left Hip

29、左髋关节内旋External Rotation of the Left Hip左髋关节外旋Step 3第3步Hip Rotation Tests髋关节旋转测试InternalRotation内旋Positive阳性AdjustPosteriorTrochanter调整后方转子Hyperactive or InhibitedExternal Rotators外旋肌过度活跃或受抑制Internal rotation of right hip:右髋关节内旋35-40 degrees35-40度Posterior Hip Adjustment后方髋关节调整 SCP: Posterior aspect

30、of the greater trochanter SCP:大转子的后面 LOD: Anterior LOD: 前 Setting: High or Medium 设置：高或中Posterior Hip Adjustment(For Loss of Hip Internal Rotation)后方髋关节调整（髋关节内旋受损）External Rotators外旋肌Muscles, Testing and Function with Posture and Pain, Kendall et al, 2005, Lippincott Williams & WilkinsFlowchart for

31、Step 3第3步流程图Hip RotationTests髋关节旋转测试InternalRotation内旋ExternalRotation外旋Positive阳性Negative阴性Positive阳性Negative阴性AdjustPosteriorTrochanter调整后方转子Proceed toLower Ext.Compression Tests继续下肢压迫测试AdjustAnteriorTrochanter调整前方转子Proceed toLower Ext.Compression Tests继续下肢压迫测试Hyperactive or InhibitedInternal Rota

32、tors内旋肌过度活跃或受抑制Hyperactive or InhibitedExternal Rotators外旋肌过度活跃或受抑制 Step 3第3步Hip RotationTests髋关节旋转测试ExternalRotation外旋Positive阳性AdjustAnteriorTrochanter调整前方转子Hyperactive or InhibitedInternal Rotators 内旋肌过度活跃或受抑制External rotation of right hip:右髋关节外旋50-60 degrees50-60度Anterior Hip Adjustment 前端髋关节调整

33、SCP: Anterior aspect of the greater trochanter SCP:大转子的前面 LOD: Posterior LOD: 后 Setting: High or Medium 设置：高或中Anterior Hip Adjustment(For Loss of Hip External Rotation)前端髋关节调整（髋关节外旋受损）Hip Internal Rotators: TFL髋关节内旋肌：TFLMuscles, Testing and Function with Posture and Pain, Kendall et al, 2005, Lippin

34、cott Williams & WilkinsHip Internal Rotators髋关节内旋肌Muscles, Testing and Function with Posture and Pain, Kendall et al, 2005, Lippincott Williams & WilkinsUnilateral Hip Rotation Range of Motion Asymmetry in Patients With Sacroiliac Joint Regional Pain有骶髂关节局部疼痛的病人单侧髋关节旋转范围不对称Cibulka et al. Spine: Volu

35、me 23(9) 1 May 1998 pp 1009-15The patients with LBP with evidence of SIJ dysfunction had significantly reduced hip internal rotation unilaterally, specifically on the side of the posterior innominate.有证据显示骶髂关节功能失调的腰背痛病人，会有明显的单侧髋关节内旋受限，特别是在髂脊后旋的一侧。From the *Jefferson County Rehabilitation and Sports

36、Clinic, Crystal City, Missouri, the Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, the Jefferson County Rehabilitation and Sports Clinic, Crystal City, Missouri, and the Department of Physical Therapy, School of Health and Rehabilitation Sciences, Univers

37、ity of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.来自*密苏里州水晶城杰斐逊县康复和体育诊所；密苏里州圣路易斯华盛顿大学医学院物理治疗课题组；密苏里州水晶城杰斐逊县康复和体育诊所；宾夕法尼亚州匹兹堡大学医学中心卫生和康复治疗科学学院物理治疗系。“The Hip Joint: Myofascial and Joint Patterns,” Marc Heller, DC, Dynamic 髋关节：肌筋膜和关节模式Chiropractic, May 7, 2007:“The hip joint is an absolutely c

38、ritical component of both lower back and lower extremity problems.”“髋关节绝对是引起下腰部和下肢问题的关键部位。”Internal rotation is the first motion affected with hip capsular problems and DJD.内旋是髋关节囊问题和关节退行性病变影响的第一个动作。“When you find a severe lack of internal rotation in the hip and this motion cannot be restored, the

39、patient is usually on their way to hip replacement surgery.”“当您发现髋关节内旋严重受限且该动作无法恢复时，该患者通常要接受髋关节置换手术。”“The Hip Joint: Myofascial and Joint Patterns,” Marc Heller, DC, Dynamic Chiropractic, May 7, 2007:Flowchart for Step 4第4步流程图Lower ExtremityCompressionTests下肢压迫测试LateralHamstrings外侧腘绳肌Peroneals腓骨肌Pos

40、itive阳性Negative阴性Positive阳性Negative阴性ImpulseLateralHamstrings冲击外侧腘绳肌ImpulsePeroneals冲击腓骨肌Proceed toSupra-pelvicCompression Tests继续盆骨上方压迫测试HyperactiveMuscles肌肉过度活跃HyperactiveMuscles肌肉过度活跃Step 4第4步Lower ExtremityCompressionTests下肢压迫测试LateralHamstrings外侧腘绳肌Positive阳性ImpulseLateralHamstrings冲击外侧腘绳肌Hyper

41、activeMuscles肌肉过度活跃Positive Findings:MyospasmTendernessTrigger PointsGuarding阳性结果：肌痉挛柔软压痛触点保护Lateral Hamstring (Biceps Femoris m.)外侧腘绳肌（股二头肌 股肌）Muscles, Testing and Function with Posture and Pain, Kendall et al, 2005, Lippincott Williams & WilkinsStep 4. Lower Extremity Compression Tests(for Lateral

42、 Hamstring and Peroneal m. involvement)第4步下肢压迫测试（外侧腘绳肌肉和腓骨肌受累）Lateral Hamstring Compression Test外侧腘绳肌肉压迫测试Peroneal Compression Test腓骨肌压迫测试Lateral Hamstring Adjustment外侧腘绳肌调整 SCP: Taught/Tender area of muscle belly of Biceps Femoris m SCP:股二头肌肌腹的敏感压痛处 LOD: Anterior LOD: 前 Setting: Medium or Low 设置：中或

43、低Lateral Hamstring Adjustment侧面腘绳肌调整Step 4第4步Lower ExtremityCompressionTests下肢压迫测试Peroneals腓骨肌Positive阳性ImpulsePeroneals冲击腓骨肌HyperactiveMuscles肌肉过度活跃Peroneal m.腓骨肌Muscles, Testing and Function with Posture and Pain, Kendall et al, 2005, Lippincott Williams & WilkinsStep 4. Lower Extremity Compressio

44、n Tests(for Lateral Hamstring and Peroneal m. involvement)第4步下肢压迫测试（涉及侧面大腿肌肉和腓骨肌）Lateral Hamstring Compression Test外侧腘绳肌压迫测试Peroneal Compression Test腓骨肌压迫测试Peroneal m. Adjustment腓骨肌调整SCP:Taught/Tender area of muscle belly of Peroneal m. SCP:腓骨肌肌腹的敏感压痛处LOD:Anterior LOD:前Setting: Medium or Low 设置：中或低P

45、eroneal m. Adjustment腓骨肌调整Flowchart for Step 5第5步流程图Supra-pelvicCompressionTests盆骨上方压迫测试LeftQuadratusLumborum左腰方肌RightQuadratusLumborum右腰方肌Positive阳性Negative阴性Positive阳性Negative阴性Impulse theQuadratusLumborum冲击腰方肌Proceed toLumbarAnalysis继续腰椎分析Impulse theQuadratus Lumborum冲击腰方肌Proceed toLumbarAnalysis

46、继续腰椎分析HyperactiveQuadratus腰方肌过度活跃HyperactiveQuadratus腰方肌过度活跃Step 5第5步Supra-pelvicCompressionTests盆骨上方压迫测试QuadratusLumborum腰方肌Positive阳性Impulse theQuadratusLumborum刺激腰方肌HyperactiveQuadratus腰方肌过度活跃Positive Findings:MyospasmTendernessTrigger PointsGuarding阳性结果：肌痉挛压痛触点保护Step 5. Supra-Pelvic Compression

47、Tests(for Quadratus Lumborum m. involvement)第5步 盆腔上方压迫测试（腰方肌受累）Step 5. Supra-Pelvic Compression Tests(for Quadratus Lumborum m. involvement)第5步 盆腔上方压迫测试（腰方肌受累）Quadratus Lumborum m. Adjustment腰方肌调整 SCP: Taught/Tender area of muscle belly of Quadratus Lumborum m. SCP：腰方肌肌腹的敏感痛处 LOD: Anterior LOD：前 Set

48、ting: Medium or Low 设置：中或低Quadratus Lumborum m. Adjustment腰方肌调整 Summary of tests to identify the dysfunctional SI joint (PI Ilium):确定功能失调性SI关节（PI髂骨）的测试摘要： 1. Pain in one SI, buttock, thigh with Bilateral Nachlas test2. Positive Nachlas test (the fixated SI joint)3. Pain in the fixated SI with compre

49、ssion or digital palpation4. Reduced prone hip extension on fixated side5. Asymmetrically reduced hip rotation on fixated SI joint side6. Hypertonic (with trigger points) lateral hamstring on fixated side7. Hypertonic QL on fixated side1. 双侧Nachlas测试法检查SI、臀部、大腿疼痛2. 阳性Nachlas测试（固定的SI关节）3. 采用压迫或手指触诊检查

50、固定的SI疼痛4. 减少固定端的侧俯卧伸髋5. 不对称性减少固定的SI关节端的髋关节旋转6. 固定侧外侧腘绳肌张力升高（触点）7. 固定侧腰方肌张力升高Cervical Spine颈椎脉冲调整TECHNIQUECervical Zygapophyseal Joint Pain Referral Patterns颈椎椎骨关节突关节疼痛转诊模式Cervical Spine颈椎The articular facets of C3 through C7 are oriented at 45 degrees to the transverse plane & parallel to the fronta

51、l plane. C3-C7 的关节面与横切面成45度，与额状面平行。Kinematics of C3 through C7C3-C7的运动学(Management of Common Musculoskeletal Disorders, Hertling & Kessler, 1990, Lippincott)Rotation and lateral bending occur together to the same side (coupling).同侧一起发生旋转和侧屈（耦合）。“As one articular facet joint slides forward and upward

52、, its mate slides backward and downward, translating to a sidebending component in the frontal plane and a rotatory component in the transverse plane.”“一个小关节突关节向前和向上滑动，其配对体向后和向下滑动，转化成在额状面的侧弯和横切面的旋转”C3 & 4 right facets not gliding anterior and superior.C3和C4右面没有前上滑动Kinematics of Occiput-C1-C2枕部C1-C2的

53、运动学Occiput-C1: 13 degrees of flexion-extension 8 degrees of lateral bending 10 degrees of axial rotation 枕部- C1： 13度屈-伸 8度侧弯 10度轴向旋转C1-C2: 10 degrees of flexion-extension 0 degrees of lateral bending 65 degrees of axial rotation C1 - C2： 10度屈-伸 0度侧弯 65度轴向旋转Cervical Compression Test:脊椎压迫测试：Cervical C

54、ompression Test:颈椎压迫测试：“+” in the area of the C-spine that pain and/or restriction is felt:在颈椎部位感到疼痛和/或束缚感“+”号：mid to lower C-spine - usually a loss of lordotic curve with inability to move into lordosis, primarily between C6-C3; upper C-spine usually suboccipital spasm interfering with normal occip

55、ital glide and C1-C2 movement.中-低段颈椎- 通常是前凸弯曲消失，不能活动到前屈位，主要在C6 C3上段颈椎 - 通常枕下痉挛，干扰正常的枕滑行和C1 - C2运动。Also tells examiner of presence of radicular pain indicating possible space occupying lesion.还告诉检查者存在根性疼痛，表明可能有占位性病变。Cervical compression test:颈椎压迫测试：Patient reports pain in upper neck or skull begin wi

56、th C2 analysis. Turn head to right and then left.Adjust C2 on side of restriction, not side of pain.患者报告颈部或颅骨疼痛 - 开始C2分析。头先转向右侧，然后向左。在束缚感的一侧调整C2，不痛。Right Cervical Rotation Test (for C2):右颈旋转测试（C2）：C2 adjustment (TP):C2调整（TP）：-SCP: C2 LPJ-LOD: Anterior-Superior-Setting: Low-Thrust(s): Single-SCP：C2 L

57、PJ-LOD：前上-设置：低-推力：单个Cervical Spine颈椎Occiput adjustment: (single stylus)枕部调整：（单针）C1 adjustment:C1调整：-SCP: C1 TP-LOD: Medial-Setting: Low-Thrust(s): Single-SCP：C1TP- LOD：内侧-设置：低-推力：单个-SCP: Occiput-LOD: Anterior-Superior-Setting: Low or Medium-Thrust(s): Single-Double stylus- SCP：枕部-LOD：前-上-设置：低或中-推力：单

58、个- 双针-SCP: C2 Bilateral LPJ-LOD: Anterior-Superior-Setting: Medium or Low-Thrust(s): Single or Multiple-Double stylus-SCP：C2双边LPJ-LOD：前-上-设置：“中”或“低”-推力：单个或多重- 双针If cervical compression test produces pain in mid to lower cervical spine, proceed to lateral flexion test.Begin at C3 on side of restricti

59、on, not pain.如果颈椎压迫试验造成中下段颈椎疼痛，则开始侧屈试验。开始在C3束缚感侧，不痛。Right Cervical lateral bending test for C3-C7:C3 - C7颈右侧弯测试：Right C3-7 TP adjustment: 右侧C3-7 TP调整：-SCP: Cervical LPJ-LOD: Anterior-Superior-Setting: Medium or Low-Thrust(s): Multiple-SCP：颈椎LPJ-LOD：前-上-设置：“中”或“低”-推力：多重Cervical Spine颈椎Cervical dual s

60、tylus adjustment to restore lordosis:颈椎双针调整恢复前凸：-SCP: Cervical Bilateral LPJ-LOD: Anterior-Superior-Setting: Medium or Low-Thrust(s): Single or Multiple-SCP：颈部双侧LPJ-LOD：前-上-设置：“中”或“低”-推力：单个或多重Muscles that hinder Occiput -C7 correction:阻碍枕部- C7肌肉的矫正：ScalenesUpper TrapeziusLevator scapulaeSplenius cap