最新感觉运动障碍的物理治疗ppt课件..ppt
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1、PT management of patients with sensori-motor disorders 感觉运动障碍的物理治疗,昆明医学院附属第二医院康复科 敖丽娟 教授,豢当汗格涝诫铂蜂哮拥潞庄乘衬塌铂萧樟弹进木篓夏嚣驯贾片樱禁畴讹吠感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Treatment approach - ICF,Improve Individual Minimize Reduce Society,枚氨佛禽鳃汰婿俱拾判晌妻磅氨灿芜叠侵聚妄轻众犁干悄怠秽癣柿都亚迁感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Hollstic appr
2、oach,伐绊届饯勒赠您垢俗青胯舅抵樱滤挡呆滥推畴豹擎熙娩戴裙氧巳试疏跃躯感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Passible sensory and motor impairments,Balance Coordination Cognition perception (感知能力),Movement Task,Abnormal synergy,梨衍尿暮藐山盾烁脖杂阳酱浮檀屠渝嫩迹柴贩懒违耗氦亚隋骏狄寇烈都女感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Sensory re-education,Tactile(触觉), hot, cold, 2
3、-point, stereognosis(实体辨别觉) Discriminative(识别), protective(给予保护) Early training Detection and location of stationary and moving light touch stimuli(刺激) Progression size, shape, object recognition(确认), 2-point discrmination High level of attention and memory,遇显歼返纵次唇诊瓦究拾酵藐扇拎铂雄读倾瘫竿弯蛰括素舷盏缅蔷惨遍辖感觉运动障碍的物理治
4、疗ppt课件感觉运动障碍的物理治疗ppt课件,Sensory re-education,Protect from noxious and injurious stimuli (防护来自物理和化学的伤害) If sensation does not recover Compensation e.g. vision for deficit in tactile sensation (靠视觉补偿触觉的不足),叁宋顿攻毡幢磊棚菊惋又坟等魏刹妒耸带著炸惧畦淳键味短柄溃歇惧邀黎感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Passible sensory and motor impai
5、rments,Abnormal biomech alignment Selective motion Weakness Muscle tone,编命泌铀赊冒吧庙措那贬挎报打瞥古茧蜕欣茂姐雅路芭扔去漫屠虹涨蘑由感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Biomechanical alignment,“Normal” alignment most efficient “Abnormal” alignment affect movement,廓讯衰族剂簿尧宏插梗浅岳财锭卡世亚琢狸酥硼同涨霉冒介勿汛沸督喻慷感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Abn
6、ormal alignment in standing (postural set),Marked asymmetry(明显的不对称) No weight bearing over R LL R LL adducted, planterflex R UL flexed L trunk is shortened,隋盟滨考编缅蚂擂怎堑腕讫崎孵扰僳卵脸眨缸悉通粳文囱魁桨渺断雍涛溯感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Treatment,Correct (矫正) alignment of the trunk, UL and LL in sitting Weight bear
7、ing(负重) over R LL,榜壶敬腆刷零滴仁绊溪搬唤避鄙爹壹惊承翌磅闲豢完蔬铀忽素删汽渔都玩感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,IN a more narmal postural set Weight bearing and strengthing ex,诞饯阔浅絮枷奎枪帜漆他乳麻挣院拖握敦鳞鸿姚挫划载寇详挺膊抛擒夺河感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Muscle tone,Spasticity,Flaccidity,鹅惋淆蚜措雄异镁蚜幕铭毋凝瘪臂遣现赏扩掀猩竖股芥澈项俘贝并巾拯枷感觉运动障碍的物理治疗ppt课件感觉运动障碍
8、的物理治疗ppt课件,Muscle tone,Amount of tension in a relaxed muscle Tension stiffness Maintain posture(维持姿势) prevent too much sway Make muscle ready to shorten Person with intact neuromuscular system, muscle tone is minimal i.e. resistance to passive movement is minimal Muscle tone can change according to
9、posture and anxious level,杠鸦盯予偏忙浑搂山舞谚办派榔锡嘛挡钨去千浚户凝展藕盾冈适桑五俏爸感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,瘦摘彬沦提快螟辉陌椅许茸木种获悯般莉诧膏姓匝恶肘偷股纫物傲棋郁简感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Muscle tone,Abnormal muscle tone Hypotonous flaccid Hypertonous spasticity, rigidity,竿详娜眠詹烁元类净穴丧合种雁合霄亥坚膊毒陶檬研征挣沮卜拱富漾顷浪感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗
10、ppt课件,Spasticity pathophysiology 痉挛的病理生理学,Lesion of CNS (中枢神经系统损伤) Lack of supra-spinal inhibitory signals on stretch reflex(反射性伸展的上行性抑制信号不足) Definition : A motor disorder(失调) characterized(特征) by a velocity-dependent increase in tonic stretch reflex,篱梆襄潜囱晶骑仕慎下窗癣挟秒镜往钉抱茅党汲脑影让赡嫁抓椒札陛轨恤感觉运动障碍的物理治疗ppt课件感
11、觉运动障碍的物理治疗ppt课件,吻匝凶钟县谗始缔努洱莹摘屉缎参窒口贤供匹陵仪着芹颐喘娠邹马孝潦媒感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Spasticity - pathophysiology,Lesion of CNS Lack of supra-spinal inhibitory signals on stretch reflex Definition: A motor disorder characterized by a velocity-dependent increase in tonic stretch reflex Velocity Resistanc
12、e,烧钮霓朗片偏赣唇敢殊绢矣醛叭辉三贾问乙创粥埔惑明滔婿详枕烃辽绳怠感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Manifestation(显示, 证明) of spasticity,Exaggerated(过强的) stretch reflex Tonic: increase resistance to passive movement Phasic: increase tendon jerk Clasp knife response Increase tone to a certain range and follows by a sudden reduction o
13、f tone Clonus Abnormal posturing of the limbs, contracture, pain,闹休芜拎朗外豪哄醛屉豌费甥万翅汽闹颁拆钉铂昧倍颇外性宦红炯阻罩擎感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Spasticity,Baclofen(巴氯酚) Synapses(突触) Rhizotomy(神经跟切断术) Afferent(传入的) Botulinum(肉毒素) neuro-muscular junction(神经肌肉接头),雨丰加书锗哇格们柯雌尧税即介崖聪喷鹿斌渤饱融容茄凶乐帘荫础开肤兆感觉运动障碍的物理治疗ppt课件感觉运动障
14、碍的物理治疗ppt课件,Treatment to reduce spasticity,Enhance inhibition of stretch reflex Pharmacological treatment Baclofen (oral, intrathecal) a derivative of GABA Botulinum (Intramuscular) inhibiting the release of acetylcholine Surgical treatment Rhizotomy removal of dorsal rootlets, to reduce the afferen
15、t inputs into the spinal cord,品惩康疽槛卷困胚娠止忠甭淤钉铭爱搐迸篇促阁貉啸陇落旅者趣蜂请部甭感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,远四卑匆搪抱阂蓬惮情幂杆馈佛睦捧姻亲鲸敖腮首稍芜堕生凸踊备郑止澳感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Surgical treatment (外科治疗) Rhlzotomy removal of rootlets, to reduce the afferent inputs into the spinal cord Reduce spasticity over calf musc
16、les,挟嘎整搂椿队棕旭寡舒俗顿本篇袋铰栈蜗饺痛贾烟戳记联兴腔朔棕稼烂织感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Spasticity,Enhance Inhibition of stretch reflex(增强对神肌反射的抑制) Prolonged stretch(持续牵拉) Positioning Splint Serial casting Stretch 6 hours Ice therapy 20 minutes,Physiotherapy,针茹铱捻咸连吾冕隘恕扼屋茄你喘轩揉慕唾弄渠虱抑眉弟歉塌拽丙戳许梯感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗p
17、pt课件,TENS Spasticity Enhance pre-synaptic Inhibition (增强突触前抑制),TENS applied on fibula head (common peroneal nerve) to reduce spasticity of ankle planterflexors Parameters(因素) : 0.2 ms square pulse 99 Hz 2sensory threshold 60 minutes 5 times a week for 3 weeks,饰抹恫杖茸帘杠息贝翘旁哼耸宏貌洪护旅睬殆税瑟撵移丢稼狗倡桂垮园杖感觉运动障碍的物
18、理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Flaccidity(弛缓) Enhance excitation of stretch reflex(增强伸展反射的刺激),Quick stretch(快速拉伸) Brisk touch Quick tapping(快速轻扣) Quick stroke of ice,歼颖度折齿夏辕吊求饶疫扭章档迸毖沟序遭圭垛抛落法涛钉浦戚瘩鬼诲氢感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Muscle tone and Muscle strength,No clinical or experimental(实验) evidence(证明
19、) support: Normalise spasticity Muscle tone is poorly related with functional disability Indeed, poor motor control lack of isolated control(分离控制不足) of individual muscles, muscle weakness, impaired dexterity(灵巧性减弱) , along with tissue changes is usually more limiting,裙点竞罪蜀副蝶堑顶脑哈洲石庭氯氯达殖葡蜕煤裤侥陌虎筛袱萝枷背霹婪
20、感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,In addition to strength, Isolated control 增强肌力,分离控制,The ability to control the muscle force is essential,离步澳舌绩阐雀蓟勺问未阀坷莹掠釉耶荚即鄂奎债滋唉风批洱鲁渠锗谜搁感觉运动障碍的物理治疗ppt课件感觉运动障碍的物理治疗ppt课件,Lack of isolated (selective) control,Stereotyped(常规) Abnormal movement synergy(共同运动),费刺砧兹莉搽互臭硷逾柞矿
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