感觉运动障碍的物理治疗 ppt课件.ppt

Stretching, Resting splint * Practical 12 hours UL, LL, Trunk Review VCD You MUST change into T-shirt and Shorts for ALL PRACTICAL CLASSES * * Isolated / selective control * Abnormal flexor synergy (屈肌共同运动) Flexion of hip associated with flexion of the knee during heel-strike * Isolated knee and hip control * Spastic musclecan be weak * Spasticity and weakness Diplegia Walk on tip-toe Spastic gastrocaemius * Spasticity and weakness Marked weakness of gastrocaemius Rhizotomy Surgical procdure to reduce spasticity in gastrocaemius * Strengtheming will increase spasticity ? Chronic patients 9 months of stroke 10-week program of aerobic and strenthening exercise (concentric, eccentric) Improvement – Total peak torque of affected leg, walking speed improved, Quality of life with no increase in quad and plantar flexor spasticity Isokinetic strengthening increased muscle strength and gait velocity without increase in spasticity * Strengthing Care must be taken to strengthen a spastic muscle Correct movement patterns and optimal resistance It is inappropriate to use effortful exercise or any exercise that elicits associated reaction and/or abnormal synergy * Strengthening ~ Increase force output Functional electrical stimulation Assisted, active movement Proprioceptive neuromuscular facilitation Task specific Action (concentric, eccentric, isometric) Velocity, Angle * Functional electrical stimulation Reciprocal inhibition of antagonists Contraction of agonist * Sensory input Ice, tapping stroking brushing * Assisted active and active exercises * Proprioceptive NeuromuscularFacilitation Patients with neurological and orthopaedic conditions Sensory input – to regain strength using all available sensory inputs Tactile – manual contact to guide the motion Verbal – simple and precise Visual – patient’s eyes follow the movement Proprioceptive Movement – traction to stretch muscle to enhance contraction Stabilization – joint compression (approximation) to increase cont