最新版脊髓损伤肌力检查.ppt

脊髓损伤神经学分类国际标准(2011年修订) 肌力检查 荆州市第一人民医院 康复医学科 赵峰 C5 屈肘| 肱二头肌, 肱肌 3级 病人体位: 肩关节内收，肘伸直，前臂旋后，腕关节放松位. 治疗师体位: Support the wrist. 提示: Bend your elbow and try to reach your hand to your nose. Action: The patient attempts to move through the full range of motion in elbow flexion. C5 屈肘| 肱二头肌, 肱肌 45级 病人体位: 肩关节内收，肘关节屈曲90°， 前臂旋后. 治疗师体位: 固定肩前部，抓住腕关节施加伸肘的力. 提示: Hold your arm. Don’t let me move it. Action: The patient resists the examiner’s pull and attempts to maintain the elbow flexed at 90°. C5 屈肘| 肱二头肌, 肱肌 2级 病人体位: 肩关节内收，内旋，前臂放在腹部上方。肘关节屈曲30°，前臂肘关节放松. 治疗师体位: Support the arm. 提示: Bend your elbow and try to bring your hand to your nose. Action: The patient attempts to move the elbow through a full range of motion in elbow flexion. C5 屈肘| 肱二头肌, 肱肌 01级 病人体位: 同2级 治疗师体位: 一手托住前臂，一手握住肘关节，触诊或看到肌腱的收缩. 提示: Bend your elbow and try to bring your hand to your nose. Action: The patient attempts to move the elbow through a full range of motion in elbow flexion. C6 伸腕| 腕长、腕短伸肌 3级 病人体位: 肩关节内收，肘关节伸直，前臂旋前，腕关节屈曲. 治疗师体位:One hand supports the distal forearm to allow the wrist to be pre-positioned in sufficient flexion for testing. 提示: Bend your wrist upwards. Lift your fingers toward the ceiling. Action: The patient attempts to extend the wrist through a full range of motion. C6 伸腕| 腕长、腕短伸肌 45级 病人体位:同上，除腕关节伸展. 治疗师体位: 一手握住腕关节，一手在掌骨施加屈腕的力. 提示: Hold your wrist up. Don’t let me push it down. Action: The patient resists the examiner’s push and attempts to maintain the wrist in the fully extended position. C6 伸腕| 腕长、腕短伸肌 0，12级 病人体位: 同3级/肩关节稍屈曲，内旋，内收，上臂放在腹部上方，屈肘90°，前臂旋前，腕关节屈曲. 治疗师体位: 一手握住腕关节，一手触诊腕背侧. 提示: Bend your wrist backwards. Action: The patient attempts to extend the wrist though a full range of motion in wrist extension. C7 伸肘| 肱三头肌 3级 病人体位: 肩前屈90°，肘关节屈曲，手贴近耳朵. 治疗师体位: Support the upper arm. 提示: Straighten your arm. Action: The patient attempts to move through the full range of elbow extension. C7 伸肘| 肱三头肌 45级 病人体位: Same as grade 3, except the elbow is in 45° of flexion. 治疗师体位: Support the upper arm