多元化关节松动术医学课件.ppt

* * * * * 1.Neutralizes pressure in joint without actual surface separation 2.Separates articulating surfaces, taking up slack or eliminating play within joint capsule Used initially to determine joint sensitivity 3. Involves stretching of soft tissue surrounding joint Increase mobility in hypomobile joint * * * * * * * * * * * * * * * * * * * * Spin is the rotation of the movable joint surface on the fixed adjacent surface Essentially the same point on each surface remains in contact with each other. Examples of this type of movement would be a top 陀螺spinning on a table.If the top remains perfectly upright, the top spins in one place. Examples in the body would be any pure (relatively speaking) rotational movement such as the humerus rotating medially and laterally in the glenoid fossa, or the head of the radius spinning on the capitulum of the humerus. * * the knee joint motion demonstrates clearly that all three types of arthrokinematic motion are necessary to obtain full knee flexion and extension. In this motion during weight-bearing, the femoral condyles roll on the tibial condyles. Because of the large range of flexion and extension permitted at the knee, the femur would roll off the tibia if the femoral condyles did not also glide posteriorly on the tibia. Because the medial and lateral femoral condyles are different sizes, and the medial and lateral aspects of the knee joint move at different speeds, there must be spin (medial rotation) of the femur on the tibia during the last 15 degrees of knee extension. * * * * * * * * * * * * * * * * * Graded oscillation technique - Maitland 神经生理学原理 振动手法为核心（生理运附属运动） 分级幅度1-4级 手法快速，有节奏 主要用于镇痛 sustained translatory joint play technique - Kaltenborn 机械学原理 平移性动作为核心（牵引与滑动） 分级幅度1-3级 手法缓慢，持续 主要用于增加ROM 手法速度、节奏和持续时间 第I、 IV 级为快速的振动 第II、 III 级振动为规则平顺的振动 每秒振动2~3下，连续1~2分钟 改变振动速度达到不同效果 对于疼痛的关节，间歇性牵引7~10秒，中间休息几秒，可多次重复进行 对于运动受限的关节，給予最少6秒的牵引，接着稍放松，间隔3~4秒后重复慢速的间隙性牵引 低幅度高速的振动抑制疼痛 低速的振动放松防卫性肌紧张 治疗的开始 休息位第2级持续牵引技术 第二天 患者反应