Palpating muscles, massaging the evidence? An editorial relating to 'Terminology and classification of muscle injuries in sport: The Munich consensus statement'.
Palpating muscles, massaging the evidence? An editorial relating to 'Terminology and classification of muscle injuries in sport: The Munich consensus statement'.
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触诊肌肉、按摩证据？
DOI：
10.1136/bjsports-2012-091849
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发表时间：
2013
影响因子：
18.4
通讯作者：
Best,ThomasM
中科院分区：
文献类型：
--
作者：
Tol,JohannesL;Hamilton,Bruce;Best,ThomasM
不可否认，肌肉损伤的适当分类是临床医生和研究人员面临的主要挑战。这个问题中提出的分类系统是由经验丰富的临床医生开发的，对我们的日常实践和未来的研究都有潜在的影响。虽然提出的肌肉损伤分类可能反映了许多医生的日常实践，但它可能会挑战其他人的实践和思维方式。值得注意的是，该分类系统广泛包括各种形式的肌肉相关疼痛，并重申了病史和体格检查在肌肉损伤诊断和预测其后续临床轨迹中的核心作用。强调临床评估与近年来的手稿形成鲜明对比，后者优先使用成像作为关键诊断决定因素——以牺牲临床评估为代价。因此，作者是值得赞扬的。拟议的分类，可能比任何其他分类都更突出了证据的缺乏，无法据此制定分类。我们缺乏高水平的研究来自信地指导肌肉损伤的临床治疗。由于证据不足和挑战的复杂性，这种提出的肌肉损伤分类提出的问题与解决方案一样多，因此，它有可能促进该领域迫切需要的研究。
There is no denying the fact that appropriate classification of muscle injuries is a major challenge for both clinicians and researchers. The classification system proposed in this issue has been developed by highly experienced clinicians, and has the potential to impact upon both our daily practice and future research. 1 Although the proposed classification of muscle injuries may reflect the daily practice of many physicians, it will likely challenge the practice and mindset of others. Notably, this classification system is broadly inclusive of various forms of muscle-related pain, and reaffirms the central role of history taking and physical examination in the diagnosis of muscle injuries and in predicting their subsequent clinical trajectory. The emphasis on clinical assessment contrasts with manuscripts in recent years which have prioritised the use of imaging as a key diagnostic determinant—at the expense of clinical assessment. 2 3 The authors are therefore to be commended.The proposed classification, perhaps more than any other classification, highlights the paucity of evidence from which to develop classifications. We lack high-level studies to confidently guide clinical management of muscle injuries. As a result of both the poor state of evidence and the complexity of the challenge, this proposed classification of muscle injuries raises as many questions as solutions and, thus, it has the potential to promote urgently needed research in this area.