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Trabalho realizado por:
Dandarah Maciel
Greice Oliveira
Roberta Alvarenga
Zarimar de Oliveira
1. Qual a definição de Quiropraxia?
A Federação Mundial de Quiropraxia (World Federation of Chiropractic), em seu congresso bienal na Nova Zelândia em Maio de 1.999, propôs uma definição oficial de quiropraxia, a qual transcrevemos:
Quiropraxia:
“Profissão na área da saúde que se dedica ao diagnóstico, tratamento e prevenção de alterações mecânicas do sistema músculo-esquelético e seus efeitos sobre a função do sistema nervoso e da saúde em geral. Há uma ênfase em terapias manuais, incluindo a manipulação ou ajustamento vertebral”.
2. O que significa a palavra Quiropraxia?
Daniel David Palmer, o criador da quiropraxia, cunhou este termo em 1.898, a partir dos radicais gregos Keirós (Mãos), e práxis, (realização, atividade).
O dicionário Aurélio, edição 2.000 traz pela primeira vez a palavra “quiropraxia” a qual passa, portanto a integrar oficialmente a língua portuguesa.
3. Como a quiropraxia está estruturada como uma profissão na área da saúde?
Como profissão na área da saúde, a quiropraxia concentra-se basicamente na manutenção da saúde e bem-estar do organismo.
Nos Estados Unidos e países onde a educação em quiropraxia está estabelecida, os Quiropraxistas recebem uma educação intensiva de nível universitário, estando habilitados a realizar um exame completo nos pacientes; solicitar exames complementares quando necessário (como radiografias e exames laboratoriais); chegar a um diagnóstico e, a partir do diagnóstico, elaborar e realizar um plano terapêutico ou encaminhar o paciente para outro especialista, se necessário.
4. Quais as Condições tratadas pela Quiropraxia?
A prática da quiropraxia concentra-se principalmente em alterações do sistema neuro-músculo-esquelético, como lombalgias (dores nas costas), cervicalgias (dores no pescoço), cefaléias (dores de cabeça), alterações de postura, hérnias de disco, problemas musculares como distensões e tensão exagerada; problemas articulares em geral.
Há diversas patologias para as quais a quiropraxia pode aliviar os sintomas ou auxiliar no tratamento, como osteoartrite ou osteoartrose, tonturas, dores no peito, alguns casos de dores no peito e dores abdominais, entre outras patologias cujo tratamento tenha se mostrado benéfico através de pesquisas.
5. Como é o tratamento com quiropraxia?
O tratamento com quiropraxia se utiliza técnicas conservadoras, não sendo realizadas cirurgias ou prescrições de medicamentos. Os quiropraxistas trabalham em clínicas particulares, sendo comum sua integração com outros profissionais na área da saúde.
O quiropraxista sempre realizará uma conversa inicial, para conhecer o paciente, seu estado de saúde e o motivo da visita. A seguir, é realizado um exame físico minucioso, que auxiliará o quiropraxista a realizar um diagnóstico do problema do paciente. Após a realização do diagnóstico, o quiropraxista explica ao paciente seus achados e conclusões, e sugere um plano de tratamento. Neste momento tem início o tratamento.
Terapias manuais são a principal forma de tratamento utilizada. Entre elas, destaca-se o ajustamento ou manipulação articular. Após um detalhado exame da mobilidade de cada articulação, o quiropraxista diagnostica qual é o segmento articular que necessita deste tratamento. A manipulação é então realizada. Trata-se de um movimento rápido e preciso, normalmente acompanhado por um estalido da articulação manipulada. O objetivo da manipulação é restituir a mobilidade normal da articulação afetada. Após um ajustamento bem realizado, observa-se normalmente redução da dor e sensibilidade local, melhora do movimento e redução da tensão muscular.
Entretanto, a manipulação não é o único recurso terapêutico de que dispõem os quiropraxistas: várias outras manobras manuais, sobre articulações, músculos e tendões também, são utilizadas. Algumas destas técnicas necessitam de aparelhos especiais.
A prescrição de exercícios, e orientação postural são parte integrante do tratamento com quiropraxia. Neste sentido, a quiropraxia obedece aos preceitos mais contemporâneos de reabilitação, onde a uma terapia passiva, a manipulação, segue-se sempre uma terapia ativa, como exercícios, permitindo ao paciente um restabelecimento pleno de suas funções e impedindo a ocorrência de recidivas.
6. Qual é o status da pesquisa em Quiropraxia?
A grande mudança em pesquisa na área da saúde nos últimos anos consiste no que em inglês é denominado "evidence-based medicine”, ou seja, a medicina baseada em evidência.
Isto significa que cada vez mais as propostas terapêuticas estão passando por um escrutínio mais severos, onde apenas são consideradas as pesquisas feitas com grande rigor científico.
Felizmente, desde há vários anos a quiropraxia tem se dedicado intensamente à produção de estudos clínicos controlados e randomizados, ou seja, realizados com metodologia científica preconizada.
Por exemplo, considerando o que dizem os especialistas com relação aos métodos terap6euticos disponíveis para o tratamento de lombalgia: Nos últimos 8 anos, quatro estudos foram feitos procurando revisar toda a literatura científica para definir quais as melhores terapias para o tratamento de lombalgia: Pela corporação RAND, USA, 1991; Pelo ministério da saúde do Canadá, em 1993; pelo departamento de saúde dos Estados Unidos, em 1.994; e pela associação de clínicos gerais dos Estados Unidos, 1996. Em todos estes casos, concluiu-se que a manipulação articular deve ser realizada, podendo ser benéfica e podendo encurtar o período de dor. O motivo pelo qual estes painéis chegaram a esta conclusão é a grande quantidade de pesquisa produzida pelas faculdades de quiropraxia.
Em minha recente viagem aos EUA, tive a oportunidade de ver diversos projetos serem desenvolvidos, inclusivo com o patrocínio do Instituto Nacional de Saúde dos EUA.
Estudo realizado na Cooperativa de Saúde do Grupo de Puget Sound pelo prof. dr. Daniel C. Scherkin, de Seattle, e pelo prof. dr. Frederick A. MacCornack, de Greely, Colorado, concluiu que pacientes de médicos de família com dores lombares necessitavam, em média, 1de 39,7 dias para retornar às atividades normais, ao passo que pacientes de quiropraxistas necessitavam, em média, de 10,8 dias. Segundo os pesquisadores, “quase”.
Metade (48%) dos pacientes de médicos de família informaram ter ficado confinados por mais de uma semana, em comparação com 17% dos pacientes de quiropraxistas “(Western Journal of Medicine, março/1989, p. 354)”.
7. Qual é a aceitação da quiropraxia por outros profissionais na área da saúde?
Com a integração da quiropraxia nos sistemas nacionais de saúde de cada país, a quiropraxia está se tornando cada vez mais aceita por profissionais de outras áreas. Atualmente, é comum médico e quiropraxistas dividirem o mesmo consultório, ou realizarem pesquisas juntos.
No Canadá, por exemplo, constatou-se em 1989 que 62% dos médicos de família referiam pacientes para serem tratados por quiropraxistas; e que 10% dos próprios médicos eram, eles mesmos, pacientes de quiropraxistas.
Em 1987, o Colégio Americano de Cirurgiões, o Colégio Americano de Radiologia e A Associação Americana de Hospitais emitiram documentos oficiais em que afirmam seu desejo de manter uma completa cooperação com quiropraxistas, tanto em termos profissionais como para o desenvolvimento de pesquisas.
8. Que tipo de profissional na área da saúde é o quiropraxista?
Em inglês existe um termo que define quiropraxistas, osteopatas e médicos, e este termo é “Physician”. Este termo define um profissional da área da saúde que tem a competência para examinar, diagnosticar e tratar um paciente independentemente.
Entretanto, a quiropraxia concentra-se mais em afecções do sistema neuro-músculo-esquelético, e os quiropraxistas são treinados, desde o início do curso, para serem especialistas nesta área.
A quiropraxia também tem como princípio o fato de proporcionar uma modalidade de tratamento não-medicamentosa e não-invasiva. Ou seja, diferentemente dos médicos, os quiropraxistas não prescrevem medicamentos e não realizam cirurgias.
9. Como o Quiropraxista atua no Brasil?
Em países como EUA, Austrália, Canadá, Dinamarca e México, entre dezenas de outros, a Quiropraxia é regulamentada por lei e sua prática está integrada aos sistemas nacionais de saúde.
No Brasil, onde não há regulamentação específica, os profissionais atuam de três diferentes formas: utilizando título obtido em outra área da saúde legalmente reconhecida (como medicina, fisioterapia, enfermagem, etc.), associando-se a outros profissionais com títulos reconhecidos.
QUIROPATIA (QUIROPRAXIA) E OSTEOPATIA
Tanto a QUIROPRAXIA como a OSTEOPATIA são técnicas manipulativas da coluna vertebral, com o intuito de harmonizar as estruturas.
A técnica Quiropraxia foi desenvolvida pelo medico Dr. DAVID PALMER, no século XIX. Certo que Hipócrates, o pai da medicina, já cogitava a possibilidade da cura de varias doenças através do tratamento adequado da coluna vertebral.
A Osteopatia é uma técnica de origem norte americano desenvolvida pelo Dr. Andrew Taylor Still, também no século XIX. Dizia que nosso corpo tem condições de promover seu próprio reequilíbrio. A função do osteopata é favorece as estruturas ósseas a voltarem a seus lugares originais, ou seja, harmonizar as estruturas, deixando a natureza cumprir o seu papel.
Quiropraxia é a técnica de ajustes das vértebras (ossos sobrepostos que compõem a coluna vertebral), desbloqueando, dessa forma o sistema nervoso.
O cérebro controla as funções do corpo enviando ordens e recebendo informação como temperatura, pressão, etc de todas as partes do corpo. Toda esta troca de informações ocorre através das sinapses nervosas entre os neurônios, chamados de nervos. Estes nervos, que partem do cérebro, passam por dentro da coluna vertebral e saem desta para o seu destino, órgãos, vísceras ou membros, através de forames (buracos) entre uma vértebra e outra.Quando nossa coluna esta em perfeito estado, estes forames têm o tamanho suficiente para a passagem dos nervos, mas quando ocorre um desvio (por exemplo: espondilolistese) de uma ou mais vértebra ocorre um pinçamento de nervos que por lá passem. Ocasionando, desta forma, dor parestesia (formigamento) ou mau funcionamento de alguma vértebra.
Se o pinçamento for na coluna cervical é comum aparecerem dores de cabeça que não cedem com medicação. Se o bloqueio for na coluna torácica podem surgir sintomas como dor de estômago, abdome, etc. Se for na coluna lombar a pessoa terá dores no quadril ou nas pernas (a famosa dor de ciático), mau funcionamento da bexiga ou intestino etc.
A função da quiropraxia é fazer o ajuste, ou seja, reposição das vértebras a sua localização ideal. Estes ajustes são realizados manualmente, com o uso de muito tato, técnica e conhecimento da anatomia humana.
De acordo com a Associação Brasileira de Quiropraxia, filiada à Federação Mundial de Quiropraxia, para ser um quiropraxista, com a responsabilidade de diagnosticar e prescrever tratamentos, é necessário submeter-se a uma rigorosa formação de nível superior. A Quiropraxia é, portanto, um curso de nível universitário com duração entre quatro anos e meio a seis anos (5000 horas). O curriculum consiste em uma extensa educação em ciências biomédicas, métodos diagnósticos e prática clínica.
Então... é regulamentado que a quiropraxia é especialização da fisioterapia... portanto no BRASIL apenas fisioterapeutas especializados em Quiropraxia podem atuar. Espero ter ajudado.
Keep these articles coming as they've opneed many new doors for me.
Bem, espero que quem leia o texto perceba que não tem nada a ver o que o Fransico escreveu, pois ele não deve saber ler com interpretação do texto e possivelmente esta se valendo disso para esclarecer algo de forma incorreta. Por favor , Sr.Francisco, leia o texto novamente e procure se informar o que a OMS refere sobre quem realmente pode atuar como quiropraxista. Pois senão você acabará como a maioria, trabalhando com "esteticista" e fazendo massagem com "estralinhos" para alivio de dores com uma péssima remuneração, jogando fora tudo o que você aprendeu de grande utilidade durante sua faculdade de Fisioterapia, que já possui um campo amplo e demarcado no nosso país. Obrigado Dr. Francisco Att. Angelo Rucca Médico Ortopedista Quiropraxista
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