平衡功能评定PPT.ppt

平衡和协调功能评定;平衡的概念;人体重心;;平衡的条件：经过人体重心所作的垂线必须落在支撑基底面之上才有可能保持平衡 平衡状态的优劣可用重心与支撑基底中心的连线与经过支撑基底面中心所作的垂线所成的夹角的大小来评定，此夹角越小，平衡越好，反之越差;;姿势和体位的变更实际上是身体各部位肌张力的重新调配，其最终结果是要保持身体的平衡，即所有作用于身体的力处于平衡状态 大脑皮质与延髓网状结构均参与姿势平衡的前馈性调节 前庭系统在姿势平衡的反馈性调节中起决定性作用（反馈性调节即补偿性调节方式） 适应性学习可以改善姿势反应 在行走活动中学习适应性姿势控制;平衡功能分类;Static Stability静态平衡;Dynamic Stability动态平衡;平衡的生理学机制;Somatosensory躯体感觉系统;;Vision视觉;Vestibular前庭器官;骨骼肌协同运动模式;姿势控制中的预备性活动;Central processing中枢处理过程;Sensory organization感觉整合;;Sensory weighting is task-dependent in normal individuals;Balance Control System;The gaze and postural stability systems are distinct because they rely on information from different senses, motor reactions of different parts of the body, and are mediated by different brain pathways. The two systems are, however, interdependent because gaze stability is not possible unless the body on which the head and eyes ride is also stable and because accurate vision, which is dependent on gaze stability, is a critical sensory input to postural control. 凝视稳定与姿势稳定系统是截然不同的，它们依赖于不同的感觉、身体不同部分的运动反应、不同的大脑传导路径 但此二系统相互依赖;Gaze Stabilization Components;The vestibulo-ocular reflex眼前庭反射;Postural Stabilization Components;SENSORY ORGANIZATION TEST (SOT);the SOT protocol systematically eliminates useful visual and/or support surface information and creates sensory conflict situations. These conditions isolate vestibular balance control, as well as stress the adaptive responses of the central nervous system. In short, patients may display either an inability to make effective use of individual sensory systems, or inappropriate adaptive responses, resulting in the use of inaccurate sense(s). 感觉统合试验将有效的视觉和/或支撑面信息消除而创造感觉混淆的情况，孤立前庭平衡控制以及中枢神经系统的适应性反应。总之，患者要么显示出不能有效应用个人感觉系统，要么产生不正确的适应性反应，从而导致错误感觉的使用。;;Ratio;SOT Comprehensive Report ;Sensory Analysis ratios are used in conjunction with the individual equilibrium scores to identify impairments of individual sensory systems. 感觉分析系数同个体平衡积分结合起来鉴别个体感觉系统的水平;Strategy Analysis quantifies the relative amount of mo