therapy

Rehabilitation：Usingthecomprehensiveapplicationofvariousmethodstoeliminateorreducethephysicaland

psychological,ncetheabilityofthepatientandimprovethequalityoflifesothatthe

patientcanreturntothefamilyorsociety.

狭义：Medicalrehabilitation

广义：comprehensiverehabilitation：

medicalrehabilitation

rehabilitationengineering

educationalrehabilitation

socialrehabilitation

vocationalrehabilitation

Rehabilitationrvicemodes：机构康复，上门康复服务，社区康复

①institution-badrehabilitation（IBR）

②out-reachingrehabilitationrvice（ORS

③community-badrehabilitation,（CBR

Rehabilitationmedicineandpreventivemedicine,healthcaremedicine,clinicalmedicineareknownasthe

"fourmajormedical".康复医学、预防医学、保健医学、临床医学被称为“四大医学”。

康复医学的组成：

Rehabilitationprevention：预防疾病的发生、发展

Rehabilitationevaluation：thefoundation；rmoredetailedthan

diagnosis.；Rehabilitationshouldbeginwithasssmentandendinasssment。

Rehabilitationtherapy：tomaximizetheimprovementofpatientswithdysfunction.

Commonlyudrehabilitationtherapy：P3

physiotherapy(PT)、occupationaltherapy(OT)、speechtherapy(ST)、psychologicalcounling(PsC)、rehabilitation

engineering(RE)、traditionalChinemedicine(TCM)、rehabilitationnursing(RN)、socialrvice(SS)

康复治疗团队：Theleaderisrehabilitationdoctor

流程：早期介入，全程服务

1、Earlyinterventionp4-5

Acutestage:ifthevitalsignshavebeenrecovered，rehabilitationtherapycanbeinvolvedin

2、Fullrviceofrehabilitationmedicine

康复的目标：短期目标(forafewdaysor1-2weeks)，长期目标

运动功能评估：

1.肌张力：Whenthemusclesarerelaxedtheirstatictensioncalledmuscletension.

Resting，postural，exerci

Hypermyotonia（肌张力增高），Hypermyotonia（肌张力增高）

Dysmyotonia（肌张力障碍）：Becauofthecontinuousmusclecontractionthebodytwistsorhasrepetitive

movementorhasabnormalposture.因持续的肌肉收缩导致扭曲，重复运动，异常姿势

方法：

lhistory:Askpatientsindetails

2、visualexamination:Ifthepatient'sbodytwistsorhasrepetitivemovementsorhasabnormalpostures.

3、palpation:touchthepatient’smusclestodeterminethemusclestension

4、reflection:tocheckwhetherthepatienthastendonhyperreflexia

5、Passiveactivity:hthehandsofinspectorstofeelthe

resistanceofthepatient’smuscles.

1Evaluationcriterionforspasm：themodifiedAshworthspasmratingscale

0level:normal

4level:themostrious

Commonlyudinspectionmethodsareasfollows：P40

Manualmuscletest(MMT)

Isometricmuscletest(IMMT)

isotonicmuscletest(ITMT)

isokineticmuscletest(IKMT)等速

MMT：

0无收缩

1有收缩，无活动

2不能抗重力

3抗中立不抗阻力

4抗mild阻力

5抗greater阻力

Checknotes注意事项：

1先健侧再患侧，先主动后被动Firstcheckthehealthside,andthenchecktheaffectedside,bilateralcontroltest

resultsaremeaningful.

2避免代偿运动Toavoidothermusclesproducecompensatory.

3Ifrepeatcheckisnecessary,theremustbeatleastanintervalof2minutes

temeasurementrequirestheuofinstrument

measurement.

5Ifthepatientisfatigue,aftermovementandaftermealitisunfavorableforinspection.

运动范围测定：protractor量角器最常用

注意事项：

(1)Befwecanobtainthe

ofpatient’scooperationandpreventerrorposture.

(2)whenwegivethepatientmeasurementouractionsshouldbegentleandslowsothatnottocaupain.

Whenthepatienthasacutejointinjury,dislocationorhismuscleligamentisnothealed,thejointactivitytestis

prohibited.

(3)Weshouldfirstmeasurethejoint’sactiverangeofmotion,andthenmeasurethejoint’spassiverangeof

motion.

Ingeneral,therangeofpassivemotionofthejointisslightlylargerthanthatoftheactiverange.

(4)weshouldhaveacomparativeexaminationofbilateraljointactivity,andshouldalsomeasuretherangeof

motionoftheadjacentjoint.

(5)avoidinspectingimmediatelyafterthemassage,sportsorrehabilitationtreatment.

(Ⅰ)gaitcycle：aticleis

dividedintosupportandswingphas.支撑相，摆动相

（Ⅱ）ClinicalGaitAnalysis

1Historyreview

2physicalexamination

3Gaitobrvation

Staticbalance：Thehumanbodytokeepstablestatewhensittingorstanding

自动动态平衡Theautomaticdynamicbalance:regainthestablestatewhenexerciindependently.

他动动态平衡Antidisturbancedynamicbalance

评定方法：观察法、量表法BergBalanceScale

复合感觉：

1Skinlocationnsation

2Twopointdiscriminationnsation

3Theactualobjectnsation

4皮肤书写觉Graphesthesia:Thefeelingofgraphicsonbodysurface

心肺运动试验：metabolicequivalentMETS

Metabolicequivalentisconsumptionofenergywhenpeopleisquietandsits.

itisacommonlyudindexofrelat

isanimportantindextoevaluatethefunctionofheartandlung.

1MET=耗氧量3.5ml

ADL：ariesofactivitieswhichinordertotakecareofpeople'sbasicnecessitiesoflifeandtheindependent

communityactivitiesindailylife.

10个项目：进食，洗澡，修饰，穿衣，大、小便，如厕，床椅转移，行走，上下楼梯

满分100

>60good基本能自理

40-60moderatedisability

20-40veredisability

<20完全残疾

physicalmodalitytherapy

ateinflammation(Noninfectiousinflammation)

epain

rms

,hypnotic（催眠）

atenerveandmuscletissue

espasm

adhesions,softenscar

ewoundhealing

ratecallus（疤痕）formation

teimmunefunction

itization（脱敏）andanticancereffect

适应症：Pain，Inflammation，Damage，Adhesionandscar，Functionaldisorder

禁忌症：

icveredia(bleedingtendency,malignanttumor,highfever,disturbanceofconsciousness,

pregnancy)

ysicaltherapyspecificcontraindications（Metallicforeignthingsinthebody，Implantedcardiac

pacemaker（起搏器），skindamage,inflammation,purulentinflammation)

电疗

directcurrenttherapy

lowfrequencyelectrictherapy(0-1000Hz)

Effect:兴奋神经肌肉，缓解疼痛

TranscutaneousElectricNerveStimulation（TENS）

Functionalelectricalstimulationtherapy（FES）

intermediatefrequencyelectrictherapy(1-100kHz)：穿透性好，作用部位更深。消散硬结，软化瘢痕，松解

粘连

highfrequencyelectrictherapy(100kHz-300GHz)：无神经肌肉兴奋性；温热效应Internalheat和非热效应

non-thermal；不用紧贴皮肤

短波100to10meters，超短波10to1meters，微波<1meters

光疗法：都要戴护目镜，贴皮肤治疗

infraredtherapy:Curativeeffectismainlythermaleffect。Anti-inflammatory,analgesic,relievespasm,improve

bloodcirculation,reducetheswelling损伤24h后用

ultraviolettherapy：Thetreatmenteffectisphotochemical光化学效应effectp110

Anti-inflammatory,analgesicandantirickets（佝偻病）,promotetissueregeneration,sterilization,densitization

超声>20kHz

Mechanicalvibration,thermaleffect,chemicalreaction,reflection

Antispasmodic,analgesic,edemaabsorption,decompositionofadhesion,promotenerverepair,fracturehealing

Clinicalapplication:softtissueinjury,adhesion,osteoarthritis

关节松动技术jointmobilizationtechnique

四级手法：1、2-疼痛；3僵硬；4粘连

缓解疼痛，增大关节活动范围，增加本体反馈

occupationaltherapy(OT):Accordingtothepatient'sdysfunction,todevelopindividualworkactivities.

Occupationaltherapyfocusonimprovingupperlimbfunctionanddailylifeability.

orthosis(矫形器)分类：

upperlimborthosis

lowerlimborthosis

spinalorthosis