Cov kws tshaj lij Suav ntawm Orthopedic Rehabilitation
Cov ntsiab lus yooj yim ntawm Kev Kho Mob Orthopedic Requilation Kev Kho Mob Yuav Tsum Muaj: Kev Kho Mob Lub Cev, Kev Kho Mob, Kev Kho Mob, Kev Pab Tsiaj thiab Orchaticial, thiab lwm yam.
Orthopedic Rehabilitation suav nrog kev tswj hwm kev pheej hmoo, tab sis kuj tseem ceeb saib xyuas kom rov ua haujlwm, tab sis kuj tseem ua haujlwm rov qab ua haujlwm rau kev ua kom tau txais txiaj ntsig. Kev tswj hwm dav yog suav nrog kev txo qis kev tawm tsam, los ntshav, thiab mob; Tiv Thaiv Kab Mob Thiab Venous Thromboembolism, thiab lwm yam) Kev Ntsuam Xyuas Mob (VAS) (3) Cov lus tsa suab sib koom tes (ROM) sib koom tes: Nkag siab txog cov lus tsa suab ntawm cov ceg ntoo pob qij txha thiab txha nraub qaum. (4) Ntau hom kev sib koom ua ke nplai: Siv lub zog phais mob, thiab lwm yam) thiab lwm yam. (6) GAIT Kev tshuaj xyuas, gait tsom xam cov system. (7) Cov haujlwm ntawm kev ntsuas txhua hnub (ADL) Kev Ntsuas Txhua Hnub (ADL, cov haujlwm ntawm kev nyob txhua hnub (IADL), hloov kho Babbitt Index (MBI). (8) Qhov Kev Ntsuas Lub Neej: Cov Lus Qhia Kev Noj Qab Haus Huv (SF-36), GENERMOL-100), thiab lwm yam (9) ntsuas kev txwv ntev / ncig. (10) Caw Nyiaj Tau Ua Haujlwm: Berg sib npaug nplai, kev ntsuas qhov sib npaug. (11) Kev sim ua haujlwm: Sijhawm kuaj thiab taug kev mus kuaj (FTSTS) (2) Kev ntsuas kev sib tsoo kom kho qib; (3) kev tshuaj ntsuam xyuas kab mob kev ruaj khov; (4) Kev ntsuam xyuas tus txha caj qaum raug mob hnyav (AIS); (5) Kev Ntsuam Xyuas urodynamic; (6) Kev Tshuaj Ntsuam Xyuas ntawm Neurophysiology . 3. Cov Tsev Neeg Prehabilitation: Muab cov tsev neeg qhia txog kev koom tes zoo rau kev ua tiav kev qhia paub txog kev ua tiav thiab posloperative cob qhia kev cob qhia. (2) Qhov kev ntsuam xyuas preOperative kev ntsuas ntawm tus neeg mob lub siab lub ntsws thiab lawv tuaj yeem tiv thaiv kev phais mob orthopedic thiab kev sib koom tes nrog kev kho mob posroperative kho. (3) Kev qhia kev kho kom rov kho dua: Kev ua haujlwm tau npaj ua ntej kev phais ua ntej kom cov neeg mob hloov kho thiab kawm kev tawm dag zog kom rov zoo. Xws li pob luj taws, Rom, QuadricKs, hamstring thiab lwm yam dag zog kev cob qhia; Npaj thiab siv cov khoom siv pabcuam taug kev (xws li taug kev AIDS, cov pas txheem); Kev npaj ua pa tawm, xws li kev tawm tsam tam sim no, hnoos thiab kev khiav dim hnoos thiab hnoos qeev thiab pulmonary muaj nuj nqi; Kev mus pw rau kev tso zis kom tiv thaiv kev tso zis rau kev tso zis thiab anemetittrition thiab anemiaittrition thiab anemia, kev phais mob, cov khoom noj muaj txiaj ntsig yuav tsum tau ua ua ntej kev phais. Firstly, kho tus mob tseem ceeb rau cov neeg mob anemia; Ib txhij sib raug zoo rau kev kho mob anemia. (5) txo lub sijhawm yoo mov: Cov neeg mob tuaj yeem noj zaub mov tawv 8 teev ua ntej kev phais; 2-3 teev ua ntej kev phais mob, noj kom meej tuaj yeem tswj; Txhawb cov neeg mob kom haus cov dej haus kom zoo rau hmo ua ntej kev phais mob thiab 2-3 teev tom qab. (6) Kev Tswj Xyuas Pw tsaug zog: Kev txhim kho ntawm cov tsos mob insomnia tuaj yeem txhawb kev mob rov qab thiab ua kom muaj kev lom zem sai {54} txo qis kev puas tsuaj:
Tsawg dua kev phais mob raug phais kom tsawg tus neeg phais tsis tshua muaj qhov tseem ceeb rau kev rov qab sai. Kev phais me me thiab cov leeg ua haujlwm sib txawv ua rau muaj kev puas tsuaj tsawg dua, tsawg dua los ntshav, thiab kev rov qab sai ntawm tus neeg mob ua haujlwm sai. Thaum lub sijhawm ua haujlwm, kev saib xyuas yuav tsum tau them rau kev xaiv ntawm kev tswj xyuas tshuaj loog, ntsuas kub, thiab kev tiv thaiv dej, thiab kev tiv thaiv kev rov ua kom rov ua haujlwm:
(1) Pib Kev Kawm Thaum Rov Kho Mob: Cov Kws Kho Mob thiab Kws Kho Mob yuav cuam tshuam rau kev kawm thaum ntxov hauv kev kawm ua haujlwm. Cov neeg mob raug phais mob (xws li kev phais mob sib hloov) tuaj yeem pib nyob rau hnub tom qab phais tas. Kev phais mob kub ceev (xws li kev cob qhia thaum ntxov tom qab kev kho kom rov zoo dua tshiab tom qab kev nyab xeeb, thaum ua kom muaj kev nyab xeeb rau tus neeg mob sib deev thiab cov leeg leeg. (2) Kev tswj hwm mob: Cov ntsiab lus suav nrog kev kawm txog kev mob mob, kev ntsuas qhov mob kom tsim nyog, thiab postoperative tshuaj loog; Multi hom kev siv analgesic, tus kheej analgesia, siv cov tsis tau ntawm cov neeg tsis muaj tseeb los tiv thaiv {{cov tshuaj siv; Kev tiv thaiv cov teeb meem ntawm cov nonsteroidal anti {{6} kev siv yeeb tshuaj; Cov dej khov COMPRESS, thiab lwm yam (3) Kev kho mob Edem: o Tswj hwm anti - kev noj tshuaj yog tias tsim nyog. (4) Kev Tiv Thaiv Kev Tiv Thaiv Uas Muaj Ntau Yam: Kev phais cov kev phais mob yuav tsum ua kom tsis txhob muaj kev puas tsuaj rau kev puas tsuaj rau lub ntsej muag. Ua kom zoo rau kev siv kev sib tw; Tsa cov ceg ntoo uas cuam tshuam tom qab phais kom tiv thaiv kom txhob muaj kev sib sib zog nqus cov leeg pob; Kev hloov kho cov kua cua nruab nrab thaum lub sijhawm thiab tom qab kev phais mob, haus dej kom ntau, thiab zam lub cev tuag; Cov kev kawm ua ntu zus, txhawb kom cov neeg mob kom nquag tig, koom nrog kev tawm dag zog thaum ntxov, tawm ua pa thiab ua pa sib sib zog nqus; Qhia cov neeg mob txhawm rau txhim kho lawv txoj kev ua tsis taus pa, thiab graphs ua rau cov hlab ntsha ua kom muaj kev tiv thaiv lub cev, thiab cov neeg siv tshuab ua kom nruj Rau cov neeg mob uas tsis tuaj yeem tsim nyog rau kev ntsuas kev tiv thaiv lub cev ntawm cov ceg tawv cuam tshuam, kev tiv thaiv tuaj yeem ua tiav ntawm cov ceg txheem ceralateral. Tshuaj Tiv Thaiv Kev Tshuaj: Feem ntau siv cov tshuaj tiv thaiv cov kws kho mob suav nrog lub cev tsis muaj qhov tseeb, Vitamular lub cev tsis muaj qhov tseeb, Vitamiles Molecit, agel antagonists, thiab lwm yam (5) tiv thaiv kab mob posteroperative. (6) Cov kua dej Postoperative thiab tso kua dej kom ua kom tau zoo . 6. kev kho mob:
(1) Chav Tsev Department, Tsev Kho Mob Kho Tsev Kho Mob lossis Lub Zej Zog Kev Kho Mob. (2) Ua raws li kev tswj hwm: Ua raws li 50-3 lub lis piam tom qab phais, kev kuaj mob, kev kuaj mob, kom paub txog kev mob siab thiab kho cov teeb meem thiab kev kho mob ntawm cov teeb meem; Rov qab mus xyuas ntawm 3, 6, 12 hlis thiab ib xyoos tom qab, suav nrog kev ntsuam xyuas kev ntsuas, thiab tswj cov teeb meem kev sib haum ntawm cov khoom siv kho kom rov zoo:
Cov tswv yim, OrthoTotics, Kev taug kev, lub rooj sib kis lub rooj zaum, thiab lwm yam kab mob rau kev phais mob orthoperive hloov kho:
(1) Preoperative rehabilitation treatment: muscle strength and ROM training around the joint to be operated on; Teach patients the methods of postoperative functional training and the correct use of walking aids, axillary canes, and canes. (2) Postoperative rehabilitation treatment: ① The first stage of postoperative rehabilitation (within one week after surgery) aims to minimize pain and swelling to the greatest extent possible; Independent transfer (bed wheelchair toilet). Precautions and contraindications: Avoid hip flexion exceeding 90 °, adduction exceeding midline, and internal rotation exceeding neutral position (posterior lateral approach); Avoid lateral positioning during surgery; Place pillows between the knees when lying supine or on the healthy side; Avoid placing pillows under the knee joint when lying down to prevent hip flexion contractures; If patients undergo simultaneous osteotomy, they should reduce their weight to 20% to 30% of their body weight The rehabilitation goal for the second stage after surgery (2-6 weeks) is to walk independently without any assistive devices and have a normal gait; Independently engage in daily life activities. Caution: Avoid hip flexion exceeding 90 °, adduction exceeding midline, and internal rotation exceeding neutral position (posterior lateral approach); Avoid prolonged sitting (>1 teev); Zam kev cob qhia kev kho thiab ua haujlwm nyob rau hauv qhov mob. Cov ntsiab lus Rehabilitation: txuas ntxiv cov leeg nqaij muaj zog, rom, tshuav nyiaj li cas, thiab kev cob qhia proprioceptive; Ntsiav nqaij ua kom muaj zog kev kawm ua kom zoo dua; Gait kev cob qhia; Ruam nce qib (txij li 10 cm, 15 cm txog 20 cm); Kev kawm ua lub neej txhua hnub (hnav thiab tshem ris, thom khwm, tos cov khoom hauv av, thiab lwm yam); Yog tias cov neeg mob tso cai, hydrotherapy tuaj yeem ua lub hom phiaj kho kom rov kho dua rau theem peb tom qab phais (7-12 lub lis piam) yog yuav tsum nce nce thiab nqis ntaiv; Tus kheej ua tiav muab tso thiab hle ris thiab nkawm khau thiab thom khwm; Cov txiaj ntsig ntawm kev ntsuam xyuas kev ua haujlwm xws li lub sijhawm sawv ntsug thiab taug kev, ib sab ceg sawv ntsug, thiab lwm yam. Rov qab ua haujlwm tshwj xeeb. Ceev faj: Zam kev koom nrog cov haujlwm txhua hnub thiab kev kho mob raws li kev mob; Saib xyuas cov qib kev ua ub no kom tsis txhob raug mob ntxiv. Cov ntsiab lus Rehabilitation: txuas ntxiv lub zog qoj ib ce thiab maj mam hloov mus rau kev cob qhia dhau los; Txuas ntxiv kev coj ua thiab nce qib; Kev xyaum cov kauj ruam uas pib ua ntej pib (los ntawm 10 cmm, 15cm txog 20cm); Yog tias cov neeg mob tso cai, hydrotherapy tuaj yeem ua tau. (3) tej yam txawv thiab lawv cov kev kho mob: ① tsis kho / kab mob ntawm lub qhov txhab: thaum ntxov rov qab ua haujlwm rov qab los, nws yog ib qho tsim nyog los kuaj qhov mob ntawm lub qhov txhab. Yog tias muaj mob hauv zos, tus kws phais mob yuav tsum tau ua raws li tus kws kho xwmtxheeb los tham txog txoj kev npaj khomob tom ntej no. Vein sib sib zog nqus: Tom qab kev phais cov ceg ntoo thiab cov tshuaj tiv thaiv kab mob siab, nws yog qhov tsim nyog itthogulation tau pom, nws yuav tsum tau tam sim ntawd Txheeb xyuas seb nws puas yog nyob rau theem kev nce qib lossis Quiescent theem. Thaum lub sij hawm kho kom rov zoo ntawm kev kho ectopic ectopic ectopic ectocic ossification, nws yog ib qho tsim nyog yuav tsum ua kom tsis muaj sia uas yuav ua rau muaj kev nthuav dav ntawm OSSSICICATION.
2. Cov lus qhia rau postperative reprumilitation ntawm ceg tawv nqaij, xws li yuav ua rau sib koom ua ke, thiab lwm yam. Kev kho lub cev, kev kho mob lub cev, thiab kev kho mob tau txais los ua kev ua haujlwm siab tshaj plaws rau kev raug mob ntawm ceg tawv, txhawm rau kom tau raws li kev xav tau ntawm lub neej txhua hnub thiab ua haujlwm.
Kev rov txhim kho kab mob postilitive ntawm cov pob txha nqaj sib cais tau faib ua peb ntu: Fibrous Startus tsim theem (hauv theem 48: Tsis pub dhau 48 teev tom qab phais). Lub hom phiaj rov kho tau yog txhawm rau tshem tawm o; Txo qhov mob; Tiv thaiv qhov tshwm sim ntawm cov teeb meem. Cov ntsiab lus Rehabilitation: Kev tiv thaiv cov ceg tawv, hauv zos immobilization, ICE daim ntawv thov, siab khi khi. Lub cim tseem ceeb ntawm kev cob qhia yog qhov muaj kev sib txuas lus tsis zoo ntawm cov leeg cev raug mob. Cov chaw kho thaum ntxov ntawm thaj chaw tsis raug mob los tiv thaiv kev ua haujlwm theem nrab tau ua ntej, ua rau nws muaj lub sijhawm tseem ceeb rau kev kho kom rov zoo. Lub hom phiaj rov kho tau yog kom maj nrawm dua kev cob qhia, nce cov leeg ua kom cov leeg ua kom muaj zog, rov tsim kho cov kev tswj hwm tsis zoo, thiab txhim kho lub cev muaj nuj nqi. Cov ntsiab lus Rehabilitation: Tsa cov ceg ntoo uas cuam tshuam thiab tswj txoj haujlwm raug; Sib npaug kev qhia ntev ntev; Kev cob qhia ntawm cov lus tsa suab ntawm cov sibntsiv thiab sib nrug ntawm thaj chaw raug mob; Kev kho lub cev: Mem tes hluav taws xob kev kho, qis}} kev siv hluav taws xob, thiab hluav taws xob stimulation kev kho mob tuaj yeem siv tau [12,13,14]. (2) Lub sij hawm hauv qab no yog qhov kev rov kho dua: Kev rov kho dua lub hom phiaj (5-12 lub lis piam) yog kom tshem tawm kev o. Softening thiab ncab kev cog lus ua ke cog lus; Ua kom muaj kev sib txuas lus ntau ntxiv; Rov qab ua kom muaj cov leeg nqaij. Cov ntsiab lus Rehabilitation: ① Txuas ntxiv kom nce rom kev kawm kom txog thaum sib koom ua ke tau rov qab los. ② Tom qab qhov nrawm nrawm, yog tias muaj kev sib txuas lus lossis kev sib koom ua ke, txuas ntxiv lossis flexion lossis flexion traction tuaj yeem ua. Nruam passive zog ncab yog ua los ntawm tus kws kho mob tawm dag zog, thiab kev ua kom zoo dua qub kev tawm dag zog, ua kom muaj kev tawm dag zog tau zoo tuaj yeem ua tau ntawm txhua pab pawg. Thiab kev txhawb nqa AEROBIC AVISTURUR kev kawm, txhawb cov haujlwm ua neej nyob txhua hnub, ua haujlwm, thiab kev lom zem. (3) Kev rov kho dua tshiab: Fracture kho lub sijhawm (tom qab lub lim tiam 12): Lub hom phiaj rov kho dua yog kom ua tiav cov lus tsa ua haujlwm tag nrho; Ua haujlwm rau cov leeg ua haujlwm zoo thiab thev naus laus zis; Koom tes nrog ua haujlwm ua haujlwm, ua haujlwm, thiab kev ua si uas ib txwm muaj. Cov ntsiab lus Rehabilitation: ① sib koom ua ke ntawm kev tawm dag zog, sib koom ua ke phais yuav tuaj yeem siv peb - thiab cov txheej txheem ntawm qib peb mob. Kev hnav cov kev sib tsoo lossis lub zog sib txuas tau nce ntxiv cov neeg mob sab hauv lub luj tshib, tes, thiab pob taws pob txha (15]. Kev sib zog ua ke thiab txhav txhav txhav tau nrog kev cob qhia kev sib koom ua ke ntawm tus neeg mob pib kom tsis txhob muaj zog ntawm cov leeg lub cev thiab cov leeg. Ua haujlwm kom rov zoo: Txhawb kev ua haujlwm txhua hnub, ua haujlwm, thiab kev lom zem {31 31 31 {31 31 31/ Lij Choj Rov ua kom rov zoo rau Kev Ua Si Kev Ua Si Tom Ntej
① The preoperative rehabilitation goal is to restore normal ROM; Normal gait and maximum muscle strength and function. KT2000 inspection; Constant speed testing/functional testing/balance testing; Customized postoperative braces; Support equipment installation and removal education; Cold therapy guidance; Progressive gait training; Lock the brace at 0 ° when using crutches, and practice partial weight-bearing and straight leg lifting within the tolerable range of the patellar tendon; Patellar loosening, passive extension of knee joint, active flexion, or active extension with assistance (90 °~0 ° training); Active ROM (AROM) or assisted AROM exercises; Progressive resistance exercises and functional activities; Electrical stimulation/biofeedback therapy. ② The first stage after surgery (0-2 weeks) aims to achieve complete passive extension; Control postoperative pain and swelling; ROM(0° ~90°); Early progressive weight-bearing; Prevent quadriceps suppression; Independently complete a family therapy plan. Caution: Avoid actively extending the knee by 40 °~0 °; Lock the support at 0 ° while walking; Avoid standing or walking for long periods of time. Rehabilitation content: towel roll stretching, prone position suspension training; Quadriceps relearning (quadriceps electromyography stimulation); Lock the brace in the 0 ° position and gradually increase the partial load to a tolerable range while supporting the crutch load; Patellar loosening; Active flexion/extension with assistance from 0 ° to 90 °; Straight leg elevation exercises (SLRs) in all directions; Short arm power cycling practice; Progressive hip resistance training; Proprioceptive training (bilateral weight-bearing); Kick training (bilateral/70 °~5 °); Upper limb cardiovascular system training; Cold therapy; Family practice plan based on assessment; Emphasize the patient's adherence to the training plan and the precautions/progressiveness of weight-bearing The second stage after surgery (2-6 weeks) aims to achieve a ROM of 0 °~125 °; Good patellar mobility; Mild swelling; Restore normal gait (painless); Painlessly and under good control, step up approximately 20 cm high stairs; Attention: Avoid repeatedly going downstairs until the quadriceps muscle is fully controlled and the lower limb line is restored; Avoid pain during training and functional activities. Rehabilitation content: When the quadriceps muscle is well controlled (there is no pain or delay when lifting the leg straight), adjust the angle of the brace (0 °~50 °) to gradually bear weight or bear weight within a tolerable range; When walking painlessly, remove the crutch; Follow the doctor's advice to change the brace; If ROM>115 degree, ntsuas kev ntsuas ntawm cov leeg muaj zog; Ncaws (80℃~ 0 degree); Pab Rom; Me me ntau yam mequatting / center ntawm lub ntiajteb txawj nqus hloov; Proprioceptive kev cob qhia; Xyaum ntawm cov ntaiv ntaiv ua ntej pib; Maj mam tsis kam nrog ncaj ceg litring ce; Kev cob qhia / Pasrotrocnius kev kawm yooj yim; Kev ua tiav kev ua dhau los ua qoj ib ce rau lub duav thiab cov leeg nqaij; Protactively txuas ntxiv lub hauv caug mus rau 40 degree; Kt2000 sib koom ua ke ntawm 6 lub lis piam tom qab phais (tsis txhob ua qhov siab tshaj plaws kev ntsuam xyuas); Nqa tawm cov kev tawm suab saib xyuas hauv tsev raws li kev ntsuam xyuas theem peb tom qab phais mob (6-14 lub lis piam) lub hom phiaj los rov ua dua qub ROM; Cov ceg qis qis yog tsis mob thiab tswj tau zoo thaum kawg ntawm qhov siab txog 20 cm; Txhim kho Adl Apendurance; Txhim kho qis qis ceg yooj yim; Tiv thaiv cov patellemoral sib koom ua ke; Ceev faj: zam kev mob thaum kev kawm thiab ua haujlwm ua haujlwm; Zam tsis txhob khiav thiab qoj ib ce kawm kom txog thaum muaj zog ua kom muaj zog thiab phais neeg kev tso cai tau txais. Cov ntsiab lus Rehabilitation: Txhim Kho Cov Kev Tawm Mus Squatting, Pib xyaum ua ntu nqis ntaiv; Ncaws koj ob txhais ceg; Kauj ruam rau pem hauv ntej; 90℃~ 40℃sib npaug hauv caug txuas ntxiv (qhib cov saw); Advanced (cuam tshuam) proprioCeptive kev kawm; Kev cob qhia kev sib hloov (kev siv dag zog); Xyaum khiav rov qab lossis rov qab rau ntawm lub cos; Quadriceps ncab; Hauv ntej txheej txheem ntsuas; Kos rau KT2000 ntawm 3 lub hlis tom qab phais tas; Nqa tawm cov kev tawm suab saib xyuas hauv tsev raws li kev ntsuas theem thib tom qab phais (14-22 lub lis piam tom qab phais tas; Tuaj yeem ua tau kom tau lub zog siab tshaj plaws thiab yoog raws ADL; Thaum lub sij hawm dhia kuaj, tus pob caug cuam tshuam mus txog ntau dua 75% ntawm kev noj qab haus huv. Kev ceev faj: zam kev mob thaum lub sijhawm kev kho mob thiab kev ua haujlwm; Zam kev tawm dag zog kom ua kev qoj ib ce kom txog thaum lub zog muaj zog txaus yog rov qab thiab tus kws phais neeg tso cai rau nws. Cov ntsiab lus Rehabilitation: Tom qab ua tiav cov kauj ruam txog 20 cm siab, pib xyaum rau pem hauv ntej khiav ntawm treadmill; Txuas ntxiv kev xyaum ua qis qis qis zog lub zog thiab hloov tau yooj yim; Txhim kho qhov yooj / tshwj xeeb ntawm kev tawm dag zog; Thaum lub zog txaus, pib xyaum ua haujlwm ua haujlwm ua haujlwm; Tos rau hauv caug txuas ntxiv (tsis mob rau Arc) (kaw cov saw sib xyaw); Kev qhia nrawm nrawm (los ntawm kev nrawm mus rau nruab nrab ceev) (kaw cov saw ua ntej); Kt2000 Kev ntsuas kev sib koom ua ke ntawm 3 lub hlis posternively; Nqa tawm kev cob qhia kev kho tsev raws li kev ntsuas hauv theem thib tsib Posterative Theem (tom qab 22 lub lim tiam), lub hom phiaj yog kom tsis muaj kev ntshai ntawm lub cev muaj zog tshwj xeeb; Nrhiav kom tau txais lub zog siab tshaj plaws lub zog thiab hloov tau yooj yim kom tau raws li cov cai ntawm kev ua kis las tshwj xeeb; Thaum lub sijhawm dhia kuaj, cov pob caug cuam tshuam mus txog dua 85% ntawm sab qab nyob zoo.
Ceev faj: zam kev mob thaum lub sijhawm kev cob qhia thiab kev ua haujlwm; Zam kev tawm dag zog kom ua kev qoj ib ce kom txog thaum lub zog muaj zog txaus yog rov qab thiab tus kws phais neeg tso cai rau nws.
Cov ntsiab lus Reabilitation: txuas ntxiv ntxiv rau lub zog qis dua qis dua, hloov tau yooj yim, thiab kev tiv thaiv; Txhim kho kev ua haujlwm ntawm aluminium txav; Cov kev ntaus kis las tshwj xeeb hnav khaub ncaws; Saib xyuas tus neeg mob theem kev ua haujlwm theem thaum lub sijhawm kho kom rov zoo; Rov ntsuam xyuas tus neeg mob qhov tsis txaus siab ntawm tus neeg tsis txaus siab (piv txwv li mob / o-} sib haum txoj kev npaj); Yaum lawv kom ua raws li Txoj Kev Kho Tsev Neeg; Thaum 6 lub hlis postoperively, kt2000 tau siv los ntsuas kev ntsuas ruaj khov; Kho cov phiaj xwm kev kho mob hauv tsev neeg raws li kev ntsuas. (2) Kev rov kho dua ib ntus ntawm kev sib txuas ntawm ib ntus
① Kev Kho Mob Kom Rov Kho Kom Zoo Siab Kev Kho Mob: Qhia txog kev paub txog kev kawm; Tsom cov leeg cov leeg nqaij lub zog thiab cov kev kawm rom; Qhia cov neeg mob cov hau kev ntawm kev kawm ncua kev ua haujlwm thiab qhia ntawv rau kev siv axillary thiab lauj tshib care canes yog; Piav qhia rau tus neeg mob ua tau cov teeb meem tau, kho cov kev kho mob, thiab kev ceev faj txog kev rov kho dua tshiab thaum ntxov li sai tau, suav nrog kev kawm gaiter. Txwv tsis pub thaum ntxov ncua qhov hnyav- bearer yog txwv, thiab pob luj pob sib koom ua ke yog tsau hauv txoj haujlwm nruab nrab nrog plaster. Hauv cov txheej txheem ntxov ntawm kev kho mob, ib zaug ua kev xyaum pib, tshwj xeeb mloog, tshwj xeeb yuav tsum tau them nyiaj rau cov pob luj taws tuaj yeem ua rau
Kev Koom Tes Uas Tsis Txaus Ntseeg. Kev Kho Mob Lub Cev Kev Kho Mob Pib 6 lub lis piam tom qab phais tas. Cov neeg mob tau raug zam lub cev hnyav - kev cob qhia kev cob qhia nrog kev pab ntawm cov pas txheem lossis cov neeg taug kev. Nyob rau hauv thawj theem, kev tsom xam cov txiaj ntsig ntawm tsev neeg txoj kev qhia, muab kev kawm ntxiv rau cov neeg mob, thiab ua rau kev nce qib hauv rom ntawm ntau lub dav hlau. Soj ntsuam cov neeg mob uas muaj peev xwm ua rau muaj kev ntxhov siab thiab kev ntxhov siab thiab txawm tias txoj kev ua tiav ntawm kev kho mob tag nrho. Cov txheej txheem ntawm kev rov kho dua yog txiav txim siab los ntawm kev ua haujlwm. Nws yog tsim nyog hais tias feem ntau ntawm cov kev tshawb fawb thiab theories txhawb kev qhia txog kev kho kom rov zoo dua yog cuam tshuam nrog cov haujlwm ua haujlwm ruaj khov (FAI). Txoj kev tsim kho ntawm sab saum toj ntawm tesnle thiab cov lus qhia zoo ib yam li cov neeg mob, cov qoj ib ce muaj zog thiab cov leeg nqaij muaj zog kuj tseem ceeb. Nws yuav siv sijhawm li 3 lub hlis tom qab kev phais mob los rov ua qoj ib ce lossis kev ua kis las. Piv rau cov sij hawm kho kom rov zoo, muaj kev qhia ntxiv yuav tsum muab tso rau cov neeg mob cov kev xav thiab ntsuas ntsuas qhov ntsuas tau. Nws kuj tseem yog qhov tseem ceeb los qhia txog tus neeg mob tus kheej lub peev xwm thiab cov hom phiaj kho kom rov zoo. Rau cov neeg ncaws pob, nws yog qhov zoo tshaj plaws kom siv pob luj taws nrog txoj hlua khi kom tiv thaiv lawv cov qij taws thaum thawj 4-6 lub hlis ntawm lawv rov qab los ntawm kev tawm dag zog. (3) Kev rov kho kom rov zoo rau Rotator CUFF kho kev raug mob:
① Thawj theem tom qab phais: Lub sijhawm tiv thaiv tshaj plaws (45℃rau sab hauv lub nroog), nrog rau kev phais mob sab hauv), nrog rau kev phais sab nraud, thiab tso cai rau kev cob qhia kev ywj pheej hauv tsev. XIM: Tom qab kev cob qhia, hnav ib lub pob txha. Tsis txhob nquag txav cov kev cuam tshuam ntawm sab xub pwg. Maj mam txav lub luj tshib, dab teg, thiab txhais tes ntawm koj tus kheej kom tsis txhob tshaj qhov chaw tau teev tseg ntawm tus kws phais neeg. Zam kev mob thaum lub sij hawm ntawm cov kev tawm dag zog thiab cov kab mob ometric. Cov ntsiab lus Rehabilitation: hnav kev raug tshem tawm; Kev kho ntawm lub neej niaj hnub txav; Dej khov compress; Pendulum xyaum; Kev pab thiab kev tawm dag zog ua haujlwm; Cov kev ua si sib cav ua ke ua los ntawm kws kho mob; Kev pab ua ke flexion nrog txoj haujlwm supine thiab kev txhawb nqa contralilateral; Siv cov kev sib tw ua si los ua kev sib hloov sab hauv thiab sab nraud ntawm lub dav hlau scapular hauv txoj haujlwm supine; Nquag ntawm cov lus tsa suab rau lub lauj kaub, caj npab, dab teg, thiab tes; Lub xub pwg kev tawm tsam kev tawm tsam {{}} txoj haujlwm tom qab; Nruab nrab luj tshib flexion nrog submaMal rectopents oment, txhim kho cov ntaub so ntswg, txhim kho lub ntsej muag, txhim kho lub xub pwg nyom thiab Neuromuscular tswj. Kev ceev faj: zam qhov mob thaum lub sijhawm ua si txhua hnub, zam kev nquag los ua kom muaj kev tawm tsam thiab kev kho mob, thiab zam kev rau kev cob qhia kev cob qhia thiab kev kho mob. Cov ntsiab lus Rehabilitation: txuas ntxiv thawj theem ntawm kev coj ua thiab nce ntau ntawm cov kev ua ub no tsis pub muaj kev txwv; Tso tawm qhov raug ncua; Cov kev pab nquag hauv kev tawm dag zog ntau yam: xyaum ua kev khoov rau pem hauv ntej thiab sab nraud / sab nraud nrog lub seepine gymnetics stick; Sib koom tes xoob txheej txheem thiab kev kawm nruj; Xyaum rau scapular ruaj khov ntawm kev kho pob; ISometric Contraction ce: Txhim kho nruab nrab txoj hauj lwm sab hauv thiab sab nraud sib hloov (submaximal), nruab nrab txoj hauj lwm rectop leeg ometric meraction; Tos kom nruj thiab cog lus qoj ib ce. ③ theem thib peb tom qab phais (7-13 lub hom phiaj XIM: Txwv tsis pub dhau ntawm lub taub hau dhau los ntawm lub taub hau, tsis txhob shrugging thaum ua si thiab kev tawm dag zog, thiab cov neeg mob yuav tsum zam kev ua si thiab nqa cov khoom hnyav. Cov ntsiab lus rov ua dua: Kev txhim kho ntawm cov haujlwm, txuas ntxiv kho mob khaub thuas yog tias tsim nyog; Txuas ntxiv kev xyaum ua ke nrog cov ntaus pob ncaws pob ua: sab hauv thiab sab nraud tig, flexion; Txuas ntxiv ua ke cov txheej txheem loosque - hloov mus rau qib III thiab IV; Kev ua yeeb yam yooj yim, kev rov tav kev kab rov tav; Ua haujlwm ua haujlwm; Kev tawm dag zog rau xub pwg: scapular flexion, kev tawm dag zog sab nraud, ce roj hmab expastis, dogrbell ce, rotator cawb ncab ce, thiab lwm yam; Kev Kawm Ua Haujlwm Ua Haujlwm: Kev Hloov Tom Ntej; Txhim kho nruab nrab txoj hauj lwm elastic band los xyaum sab hauv thiab sab nraud kev sib hloov; Kev ua kom muaj zog: kev tawm dag zog tom ntej ntawm cov kev tawm dag zog hauv txoj haujlwm (scapular Txhim kho cov lus sib dhos kom ruaj khov; Sab saud kaw cov saw ce. ④ Qhov theem thib plaub tom qab phais (4-19 lub hom phiaj yog los txhim kho lub zog ntawm lub xub pwg nyom ntawm lub xub pwg nyom nyob rau hauv cov lus ntawm cov lus tsa suab ntawm tag nrho cov kev sib koom tes. Saib xyuas: nce ruaj khov ntawm lub xub pwg sib koom tes
Ntxiv nws thiab tom qab ntawd sim nqa taub hau dua. Cov ntsiab lus Rascilitation: txuas ntxiv ua cov txheej txheem muaj zog Kev hloov pauv yooj yim - ncab cov tshuaj tiv thaiv sab nrauv sib koom ua ke hauv txoj haujlwm tom qab; Ua scapular ruaj khov kev ce; Pib xyaum istokinetic kev tawm dag zog (sab hauv thiab sab nraud tig) ntawm lub scapular dav hlau. ⑤ theem thib tsib tom qab phais (20-24 lub lis piam tom qab phais tas, thiab rov qab ua haujlwm, kev lom zem, thiab cov haujlwm txhua hnub. Isokinetic Testing: 85% ntawm sab qab nyob zoo tuaj yeem koom tes nrog kev ua kom muaj kev kho dag zog ntawm kho kom tswj tau thiab txhim kho cov qib ua haujlwm. Ceev faj: zam kev tawm dag zog thiab cov dej num, zam kev tawm dag zog, thiab kev tswj hwm kev tawm dag zog kom tau, thiab kev tso cai rov qab los ntawm tus kws phais neeg. Cov ntsiab lus Rasilitation: txuas ntxiv ua cov txheej txheem muaj zog Kev cob qhia kev nrawm thiab kev ntsuas sab hauv thiab sab nraud; Txuas ntxiv kev xyaum ua kom yooj yim thiab muaj kev ruaj khov; Txoj Kev Npaj Rau Tus Kheej; Kev ua haujlwm ntawm cov aluminium) {{{{{{{{{{{re} Kev kho mob kho rau pob taws raug mob:
Cov pob luj taws uas muaj xws li pob taws pob txha pob txha, pob taws hluav taws xob, Achilles mendon rupture, hloov kho, thiab tiaj tus taw. Kab lus no tsom rua kev rov ua dua tshiab kev kho mob kho mob thiab pob txha lov. (1) Kev Kho Kom Rov Kho Mob Tom Qab Pob Hluav Taws Kub Hlob:
Raws sij hawm, kev kho kom rov zoo tuaj yeem faib ua thaum ntxov, nruab nrab, thiab lig kev kawm tiav: ① Cov kev kho kom rov zoo: Fibrous contepus tsim theem (lis piam 0-4). Lub hom phiaj ntawm cov mob theem Cov ntsiab lus rov ua dua: ntiv dej ua kom muaj kev tawm dag zog, muaj txiaj ntsig rau cov ntshav hauv qab, txhawb nqa cov kev tshem tawm ntawm o; Tom qab cov ntaub qhwv cov kev tiv thaiv tau qhib, kho lub cev, uas tuaj yeem suav nrog kev kho mob khaub thuas lossis semiconductor laser laser kom txhawb nqa kev tshem tawm kev tshem tawm thiab qhov txhab zoo. Subacute Theem Kev Kho Vajtshilitation (48 teev mus rau 4 lub lis piam tom qab phais), nrog lub hom phiaj ntawm kev rov qab ua haujlwm; Cov leeg ua kom muaj zog kev cob qhia; Txhim kho kev tswj hwm kev tswj hwm. Cov ntsiab lus rov ua dua: tsa cov ceg tawv, kho kom raug, kho hniav txias, cov ntaub qhwv lub teeb ua kom zoo nkauj); Kho lub cev (mem tes)
Mem tes hluav taws xob kev kho, qis {{{{}}} kev siv pulseed ultrasound kev kho); Sib npaug kev qhia ntev ntev; Cov kev cob qhia suab rau cov pob qij txha rau cov chaw raug mob (nquag muaj cov kev cob qhia rau lub hauv caug pob qij txha cov leeg, metatarsophanangeal pob qij txha). XIM: Yog tias muaj qhov o me me nyob rau hauv daim ntaub tom qab kev xyaum tom qab kev xyaum, txuas ntxiv mus tsa cov ceg cuam tshuam thiab siv dej khov ua rau thaj chaw sib koom ua ke. Kev ua kom tsis tu ncua mob hnyav, ua ntej ntsuas cov ntshav thiab taw, thiab yog tias muaj, txoj cai} 8 lub lis piam), nrog lub hom phiaj ntawm kev tshem tawm outidual; Softening thiab ncab kev cog lus ua ke cog lus; Ua kom muaj kev sib txuas lus ntau ntxiv; Rov qab ua kom muaj cov leeg nqaij. Cov ntsiab lus Rehabilitation: Daim ntawv thov ntawm kev kho lub cev; Sib koom ua ke ntawm cov lus tsa suab; Nce cov leeg txav distal lub zog thiab tiv thaiv cov leeg cov leeg ruaj khov, rov qab cov ceg ntoo uas cuam tshuam ua tiav cov haujlwm me me; Lub cev cov kabmob qhia, lub sijhawm no, cov neeg mob maj mam kawm nrog kev pab cuam lub zog, 9 {} 12 lub hlis), nrog lub hom phiaj ntawm kev txhim kho lub cev muaj zog thiab rov tsim kho cov kev tswj hwm; Coj kev cob qhia ADL kom tau raws li qhov xav tau ntawm cov haujlwm tshaj lij. Kev Kho Mob Kho Siab: Kho lub cev (tsawg-lub zog laser, lymphatic zaws, khoom siv lub siab siab, thiab lwm yam); Sib koom ua ke ntawm cov lus tsa suab; Cov leeg ua tau lub zog kev cob qhia (ua kom tiav phaus-cov kabmob, kev tawm tsam lub zog); Sib npaug kev cob qhia; Gait thiab kev cob qhia stair. (2) postoperative rabhabilitation ntawm Achilles tupton rupture:
① Thawj theem tom qab phais: Kev tiv thaiv thiab kho mob dorsema, ua kom muaj kev phais mob rau kev phais mob (0) kev taw qhia ntawm tus kws kho mob. Kev ceev faj: Zam kev ncawv ntawm cov Achilles tendon, txwv tsis pub ua haujlwm nruab nrab (0 degree) Cov ntsiab lus rov ua dua: raws li kev taw qhia tus kws kho mob, siv ib rab phom Axillas, siv cov pob txha Axillary lossis hnav cov khau ua paug nrog cov discs rau cov kabmob me me- bearing; Active pob luj taws dorsiflexion, cog ntoo, kev hloov pauv, thiab hloov dua siab; Zaws scars; Cov leeg cov leeg ua kom muaj zog; Dej khov compress. ② postoperative theem ob: kev ua haujlwm sib koom ua ke (15 Kho cov kev tawm dag zog thiab kev ua haujlwm zoo, thiab zam kom tsis txhob muaj kev puas ncab ntawm cov achilles tendon. Cov ntsiab lus Rehabilitation: Kev Tawm Tsam los ntawm thev taus hnyav {{{bearing} bearing fai-bearing firces nyob rau hauv kev tiv thaiv, thiab tuaj yeem tshem tawm cov crutches thaum tsis mob; Active pob luj taws dorsiflexion, cog ntoo, kev hloov pauv, thiab kev tawm dag zog; Proprioceptive kev cob qhia; Sib npaug ntev thiab isometric cov leeg zog; Pob luj taws conversion thiab eversion; 6 lub lis piam tom qab phais: 90℃pob taws cog flexation thiab dorsiflexion rau lub hauv caug flexion; 8 lub lis piam tom qab phais: Xyaum pob taws cog glexion thiab dorsiflexion hauv caug txuas txoj haujlwm; Kev xyaum tsheb kauj vab; Rov qab lub cos; Kho lub cev kho lub cev; Caws pliav zaws; Xyaum rau ntawm Stairs Post Ua Lag Luam Thib Peb: Kev Sib Tw Thaum Ntxov, Rov Qab Los Ntawm Kev Ua Haujlwm Tsis Txaus Siab, thiab Muaj Peev Xwm los nqis los ua tus ntaiv. Xim: Ntxiv rau cov saum toj no, nws kuj tseem tsim nyog kom tsis txhob muaj kev thauj khoom siab rau ntawm Achilles Toonillion (piv txwv li cov pob txha pob zeb hauv pob zeb hnyav lossis dhia). Cov ntsiab lus Rehabilitation: isometric thiab isokinetic inversion thiab hloov ce; Tsau tsheb kauj vab, kev cob qhia stairs; Proprioceptive kev cob qhia; Ntxiv dag zog rau pob taws thiab cog cov txheej txheem flexion; Kev txhim kho cov txuj ci tshwj xeeb hauv kev ua kis las hauv qab; Tsim cov phiaj xwm propriceptive; Txo cov leeg ntawm cov leeg ua kom muaj zog; Kev xyaum ceev xwm txheej ceev; Kev ncig xyuas yooj yim thaum cov haujlwm; Xyaum nteg ntaiv. ④ Cov leeg Postoperative Theem Plaub: Lub Zog 20-28), nrog rau cov kev ua haujlwm hauv lub neej, ua tiav cov haujlwm uas tsis muaj kev sib zog, thiab ua tiav cov kev ua haujlwm tsis muaj zog, thiab ua tiav cov kev ua haujlwm muaj zog ntau yam tsis muaj kev ntshai. Ceev faj: zam kev mob thiab kev ntshai thaum ua si, thiab zam kev khiav thiab kev tawm dag zog ua ntej ncav cuag lub zog txaus thiab yooj. Cov ntsiab lus rov ua dua tshiab: Pib xyaum khiav mus tom ntej ntawm lub cos; Kev ntsuam xyuas isokinetic thiab kev kawm; Txuas ntxiv kev xyaum ua cov leeg qis qis qis qis dua lub zog thiab hloov pauv tau; Kev sib tw viav vias txhim kho cov txiaj ntsig; Kev ua kom tiav me me ua kom tiav (dhia tawm dag zog nrog ob txhais ko taw); Txuas ntxiv mus ntxiv dag zog plantar flexal flexion lub zog qoj ib ce muaj zog (hais txog kev coj ua eccentric); Kev ua kis las heev; Txuas ntxiv cycling thiab kev cob qhia ntawm tus ntaiv; Txuas ntxiv mus ntxiv dag zog ua kom cov leeg ua kom muaj zog. Postoperative Theem 5: Kev Rov Qab Los Ntawm Kev Txawj Ntse (28% ntawm Kev phais mob (Cais Ceev faj: Zam kev tawm dag zog rau lub cev kom txog thaum koj tau muaj zog muaj zog thiab hloov tau. Cov ntsiab lus Rehabilitation: ntau cov kev kawm ua haujlwm zoo thiab ua tiav cov txheej txheem; Ua haujlwm zoo al aluminium txav; Kev cob qhia kev nrawm.
