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oflowerlimbpathologiesFunctionalAnatomyPathologiesInjuries病理學(xué),PTMTTTreatmentandTraining治療和科高大EiboDirectorofEducation SorehaExpertTeamCertifiedClinicalTrainingInstructor a科TableofPTMTT

SomeimportantfactsFunctionalAnatomyofHip,KneeandPathologies,Injuries,DiseasesGeneralRehabilitationConsiderationsAssessmentandExamination 科MTT科SomeimportantfactsPTTreatmentMTT

The(Central)GaitPa0erns中心步態(tài)Ini$alcontact(IC初始著地Loadingresponse負(fù)重反應(yīng)HipExtension伸髖KneeExtensionSensorya?erentinput感覺沖動(外周)科Someimportantfacts

Ini$alcontactPTMTT科

SomeimportantfactsLoadingresponse&sensory(a?erent)負(fù)重反應(yīng)&

PTMTT科

Someimportant

AtTerminalStancetheHipJointshouldachieveanExtensionof10–15oMTT

科MTT科SomeimportantfactsPTMTT

Mostimportantm.glutaeusmediusm.glutaeus=carryingweightofpelvicduringstance=科Someimportantfacts

iPadAnimationsIPADPTTreatmentMTT

HipProIIIAnimationsKneeProIIIAnimationsAnkleProIIIAnimations科Anatomy

第一楔骨oscuneiformeI第二楔骨oscuneiformeII第三楔骨oscuneiformeIIIPTTreatmentMTT

足舟

osos科

Inspec9on檢instandingposi$onin

PTMTT

Inspec9on檢instandingposi$onandin PTMTT科MTT

Inspec9on檢instandingposi$onandin科

AnatomyMTT

anteriorcar$lagesurfaceofiswiderthantheposteriorpart科MTT

Anatomy遠(yuǎn)端脛-腓關(guān)節(jié)間歇在足背伸時變Fullwideningonlypossiblewithmuscularnotbypassivemeasures(joint只有在肌肉主動活動的情況下才能達(dá)到完全的開, 情況下不可以(關(guān)節(jié)松解)科PTMTT

Final(or:counter-)rotationinknee=externalrotationoffemuragainstinternalrotationoftibiainfullkneeTightenedACLandcollateralligamentsformorestability定科MTT

ACLstretchinflexion屈膝時ACL=stabilizingthekneejoint,kee femurandtibia“together”.科

ACLstressinanteriortranslationof=ACLsavingtibiaanteriorPTMTT科MTT

=stabilizingthekneejointagainsthyperextension;relaxedin穩(wěn)定膝關(guān)節(jié)對抗過伸;在膝時放科PTMTT科SomePathologies

MTT科SomePathologies

DistalFibulafracture(WeberB)withandavulsionofanterior腓骨遠(yuǎn)端骨折(WeberB)PTMTT科

SomePathologies

PTMTT

科SomePathologies

here:ACL/PCLiPad- PTMTT科SomePathologies ACLMTT科SomePathologiesMTT

Arthroscopickneesurgeryhere:meniscusandACL科SomePathologies Painwhenclimbingstairsanteriorknee MTT科SomePathologiesTotalTotalKneeReplacementMTT科SomePathologies

PTMTT科SomePathologiesMTT

Femur asepticnecrosis科SomePathologies

HipJointPTMTT

normal,科

SomePathologies

HipJoint

iPadPTMTT科SomePathologiesPTTreatmentMTT

Femurfracturescollumfracturetrochanterfracturefemurshankfracture123科SomePathologies MTT科SomePathologiesPTMTT

iPad科PTTreatmentMTT科ActiveRehabilitationPTTreatmentMTT

傳統(tǒng)Medication藥物Bedrest臥床休息PhysicalTCM中醫(yī)治療Passive

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

傳統(tǒng)Medication藥物Bedrest臥床休息PhysicalTCM中醫(yī)治療Passive科ActiveRehabilitationPTTreatmentMTT

傳統(tǒng)Medication藥物Bedrest臥床休息PhysicalTherapyTCM中醫(yī)治療Passive科ActiveRehabilitationPTTreatmentMTT

傳統(tǒng)Medication藥物Bedrest臥床休息PhysicalTCM中醫(yī)治療Passive科ActiveRehabilitationPTTreatmentMTT

傳統(tǒng)Medication藥物Bedrest臥床休息PhysicalTCM中醫(yī)治療Passive科ActiveRehabilitationPTTreatmentMTT

傳統(tǒng)Medication藥物Bedrest臥床休息PhysicalTCM中醫(yī)治療Passive科ActiveRehabilitationPTTreatmentMTT

傳統(tǒng)Medication藥物Bedrest臥床休息PhysicalTCM中醫(yī)治療Passive療科ActiveRehabilitation 現(xiàn)代PTTreatmentMTT

Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

Basic

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

Manual Orthopedic

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

Vojta療法/Bobath療Neurologicfield神經(jīng)

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

FunctionalGeriatricfield

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

Exercisesin

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMPsychologicalsupportFango泥療(Fango泥)WorkconditioningWorkhardening科ActiveRehabilitationPTTreatmentMTT

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主(MTTTCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主MedicalTraining(MTT)醫(yī)學(xué)訓(xùn)練療法TCM中醫(yī)治療Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCM中醫(yī)治Information康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTTreatmentMTT

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening科ActiveRehabilitationPTTreatmentMTT

現(xiàn)代Medication藥物PhysiotherapyPT治療&PhysicalTherapy物理治療Activeexercises主動鍛煉MedicalTrainingTherapy(MTT)醫(yī)學(xué)訓(xùn)練療法TCMInformation康復(fù)知識講座Psychologicalsupport心理指導(dǎo)Workconditioning工作模擬Workhardening工作強化科ActiveRehabilitationPTMTT

WhyActive為什么要進行主動康科ActiveRehabilitationPTTreatmentMTT

Importancyofac9veneuromuscularInjuriesand 損傷和手Injuredarea損傷部BasicmotorcapabilitiesCoordina$on協(xié)調(diào)性Endurance耐力Speed速Complexmotorprograms復(fù)雜運動控科PTTreatmentMTT

ModernRehabilitationmustActive主動MultidisciplinalInterdisciplinal科

HowtoestablishPTMTT科

ChangeinRehabilitationFrommonodisciplinarytomultidisciplinary由單一學(xué)科治療轉(zhuǎn)為全方位綜合治Teamworktreatment綜合治

Rehab康復(fù)醫(yī)

MTT醫(yī)學(xué)訓(xùn)練 療

PTMTT

物理治療

TCM中醫(yī)治科Multidisciplinaryrehabilitation多學(xué)科綜合康復(fù)理

醫(yī)學(xué)訓(xùn)練療PTTreatmentMTT

作業(yè)治

主動康復(fù)治Training

科InterdisciplinaryTreatment多學(xué)科綜合治

Care護

PTMTT

Therapy作Swallow

MedicalTherapy醫(yī)學(xué)訓(xùn)練療科Multi-andinterdisciplinaryComprehensiveCombinationofpassiveandactive

Proprioception

Rangeof

MusclePTTreatmentMTT

Physical

ADLjob

Strength&科

Internationalclassificationoffunction,disabilityand國際功(ICFWHO

健康狀(殘疾或疾病PTMTT

身體功能和結(jié)(損傷

運(受限綜合因

社會參(受約束

環(huán)境因 個人因科ICFTheRehab 康復(fù)治

診斷、測

評估、再測

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干預(yù)、治科Treatmentgoal訓(xùn)練目 診斷、測

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Active主動Active主動康復(fù)訓(xùn)Re-buildingofmuscularLocalstrengthendurance

康復(fù)的階therapy(MTT)PTMTT

ReintegrationofneuromuscularAccelerationwound Automobilisation(passiv– Improvementrangeofmotion科

Phasemodelof

診斷、測MTT

1促進傷口愈1Automobilisation(passiv–關(guān)節(jié)自主活動 主動科

Phasemodelof

診斷、測

PTTreatmentMTT

Localstrengthendurance2局部力量和耐力訓(xùn)2恢復(fù)神經(jīng)肌肉控Improvementrangeof提高活動范 科

Phasemodelof

診斷、測

3Re-buildingof3肌肉力量重

Medicaltrainingtherapy(MTT)PTTreatmentMTT科

Phasemodelof

診斷、測制定康PTTreatmentMTT

4 Medicaltrainingtherapy(MTT)4科

Phasemodelof55

診斷、測制定康

專項任務(wù)訓(xùn)

Medicaltrainingtherapy(MTT)PTTreatmentMTT科PTMTT科PTMTT

Anamnesis fortordisorder:pain臨床癥狀:疼痛情Casehistory:病例歷史:發(fā)病機Progressionof fortfrombeginningtocurrentstatus病情從發(fā)病到impactonacticityand對日常活動的socialdevelopment–worksituation–對社會活動的generalhealth整體健康狀family史科PTMTT

LeglengthPelvislevelGreaterTrochanterKneeAnkle科

Inspec9oninstandingposi$oninrest

MTT

~科Passivemo9on 活動

anterioranklejointChopardLine

PTMTT

toeMTT

Jointplay關(guān)節(jié)活動科

IJointplaytests關(guān)節(jié)活動MTT

CuneiformeIIIvsVS足舟骨/科

2Jointplaytests關(guān)節(jié)活動MTT

CuneiformeIIvscuneiforme科

3Jointplaytests關(guān)節(jié)活動檢MTT

CuneiformeIIvscuneiforme科

4Jointplay關(guān)節(jié)活動PTMTT

Navicularevs科

5

Jointplay關(guān)節(jié)活動檢MTT

Talusvs科6

Jointplay關(guān)節(jié)活動檢PTMTT

Calcaneusvs科

7Jointplay關(guān)節(jié)活動檢MTT

Trac$onproximal科

8

Jointplay關(guān)節(jié)活動檢PTMTT

Calcaneus科

9Jointplay關(guān)節(jié)活動檢PTMTT

Trac$ondistal科

Jointplay 關(guān)節(jié)活動檢MTT

Crusventraldorsal科

Transla9onaljointplayandmobility關(guān)節(jié)的平移和活動PTTreatmentMTT科

Translatoricjointplayandmobility關(guān)節(jié)平移和活動度MTT

Translatoricjointplayandmobility關(guān)節(jié)平移和活動度PTMTT

科 Translatoricjointplayandmobility關(guān)節(jié)平移和活動度MTT

科 Translatoricjointplayandmobility關(guān)節(jié)平移和活動度MTT

Translatoricjointplayandmobility關(guān)節(jié)平移和活動度PTMTT

Di?erent科

Translatoricjointplayandmobility關(guān)節(jié)平移和活動度MTT

Compressionacrossthemetatarsal科PTMTT

Translatoricjointplayandmobilitytests關(guān)節(jié)平移和活動度檢Testonproximalphalanxjoint對近端趾骨關(guān)節(jié)的 科

ExaminationKneePainloca9on疼痛的定

Flex$on屈

Choose選擇另一個動PTMTT

ofPa 遠(yuǎn)端滑動髕Posteriorgliding科

Examina$onof larjointExamina$on$biofemoral檢查股脛關(guān)

ExaminationKneePainloca9on疼痛的定

Impactonaxisstanding對站 線性的影Pain疼痛 Compression

選擇另一個動 關(guān)

Examina$onPTMTT

Compressionon joint擠壓股髕

$biofemoral檢查股脛關(guān)Examina$onof larjoint科

ExaminationKneeInspectioninrestandmotion在靜態(tài)/活動狀態(tài)下觀察解剖PTMTT

Inspectioninstandingposition站姿望-fromfront-fromrear-frombothsides側(cè)Notedifferencesfromnormalsuch-Axis lastanding髕-Gait步科

ExaminationKneepalpationinrest靜態(tài)觸ysisof分析以下情況-Heat

-lymphaticproblems淋巴回流PTMTT科

ExaminationKneepalpationinactiveandpassive動態(tài)觸診 活動下觸

-Flexion-firstactive,thenpassiveforROMand?endofROM-首先主動,然 的關(guān)節(jié)活動范圍,“關(guān)節(jié)活動范圍的終末端感覺-Extension-firstactive,thenpassiveforROMand?endofROM-首先主動,然 的關(guān)節(jié)活動范圍,“關(guān)節(jié)活動范圍的終末端感覺-rotationat90旋-firstactive,thenpassiveforROMand?endofROM-首先主動,然 的關(guān)節(jié)活動范圍,“關(guān)節(jié)活動范圍的終末端感覺 PTMTT

Resultsexamples)檢查結(jié)

treatment治療stretching,decreasemuscle科

Examinationmuscle

-quadricepmuscle二頭-hipflexors髂-calfmuscles

mIliopsoas髂(flexorofPTMTT

Resultsexamples)結(jié)果toolong過長too

ExaminationKneejointplay關(guān)節(jié)活

?roll&glide轉(zhuǎn)動&滑動

inrestposition靜 ofROM活動范圍終末感atendofROM(nopicture)活動范圍 PTMTT

Resultsexamples)結(jié)果

stabilization固定科

ExaminationKneejointplay關(guān)節(jié)活 la髕PTTreatmentMTT

traction,ExaminationKnee

jointplay關(guān)節(jié)活 startat30°flexion,increasetofullextension屈曲30°,直到全伸normal:no infullextension正常情況下:全伸時無間 PTMTT

Resultsexamples)結(jié)果

bracesupport, ,科ExaminationKnee

jointplay關(guān)節(jié)活動anteriordrawertesttestat90°flexion,在屈曲90°測試movetibiaforwardandbackwardnormal:noorminimalforwarddrawingoftibia

PTMTT

hypermobile~1cmor過松-1cm科

bracesupport, bandage,ExaminationKnee

jointplay關(guān)節(jié)活anteriordrawertest前抽MTT科

ExaminationKneejointplay關(guān)節(jié)活tibiofibularjoint脛腓關(guān)PTMTT

cranialjointResultsexamples)結(jié)果

caudaljoint遠(yuǎn)端科ExaminationKnee

menisctest半月板B?hler/Kr?mertest,=McMurrayflex/extinfullROMwithadductionorabductionPTMTT

pain(menisc疼痛(半月板影響

correctingaxis糾正軸線surgery手科ExaminationKnee

menisctest半月板B?hler/Kr?mertest,=McMurrayPTMTT

pain(menisc疼痛(半月板影響

correctingaxis糾正軸線surgery手科ExaminationKnee

menisctest半月板AppleyPTMTT

pain(menisc疼痛(半月板影響科

correctingaxis糾正軸線surgery手

ExaminationKneemenisctest半月板Steinmann90°int.&ernalrotation–lateralexternalrotation–medialPTMTT

pain(menisc疼痛(半月板影響科

correctingaxis糾正軸線surgery手

ExaminationKneemenisctest半月板Steinmannpressurepainfromanterior(extendedknee)toposterior(flectedknee)移PTMTT

pain(menisc疼痛(半月板影響科

correctingaxis糾正軸線surgery手

ExaminationKneeorthopedicneurologicKnee膝關(guān)PTMTT

-segmentmuscles神經(jīng)節(jié)段肌-reflexsituation反射情-sensitivedisturbances感覺紊科

ExaminationKneeinstrumentaltestsKnee膝關(guān)PTMTT

strenghtpowerworkendurance

科 ysis步態(tài)PTMTT科 ysis步態(tài)PTMTT科 ysis步態(tài)PTMTT科ExaminationHip

HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Choose選擇其他動

Examhip檢查髖關(guān)PT

疼痛

疼痛

MTT

ERosilium髂骨科

Chooseanother選擇其他動ExaminationHip

HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Choose選擇其他動

Examhip檢查髖

PTMTT

IR:osilium

Choose選擇其他動科ExaminationHip

HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Chooseanother選擇其他動

Examhip檢查髖關(guān)PTMTT

Provokingpainright誘發(fā):右側(cè)軸疼

Osilium髂骨尾

疼痛

Choose選擇其他動科ExaminationHip

HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Choose選擇其他動

Examhip檢查髖PT

疼痛前短

Osilium髂骨顱

MTT

decreasingpainright右側(cè)軸疼痛減

Choose選擇其他動科ExaminationHip

HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Choose選擇其他動

Examhip檢查髖關(guān)

疼痛

PTMTT

Pain屈曲誘發(fā)疼

Extensionofosilium髂骨

Choose選擇其他動科ExaminationHip

HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Choose選擇其他動

Examhip檢查髖PT

?ec$onpain

疼痛前短

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HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Choose選擇其他動

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HIP髖關(guān)Painloca9on疼痛位置 Lumbarpain?髖部?骶髂關(guān)節(jié)?腰椎Chooseanother選擇其他動

NohipPTMTT

testright測試右

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康復(fù)進科PTMTT

?TheQualityofTreatmentcanonlybeasgoodastheExaminationitisbasedon.““療效取決于測JohnsonandThompson,科PTMTT

TestingandTherapy/Trainingmustbe測試和訓(xùn)練必須要通過主動方式進科

Adaption適應(yīng)原則PTMTT

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Assessmentofmuscular肌肉力量ProfessionalAssessment專業(yè)測試

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Assessmentofmuscular肌肉力量ProfessionalAssessment專業(yè)測試LumbarbacktestingIsometricTestingPTMTT

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evidence客觀-可靠-有效循證醫(yī)學(xué)認(rèn)可的Isometrictesting等長statictest靜態(tài)測onepositiontesting單一位置的測multiplepositiontesting多位置的科StrengthassessmentwithMultiJoint通過多關(guān)節(jié)等速力量測試系統(tǒng)進行力PTMTT

evidence客觀-可靠-有效循證醫(yī)學(xué)認(rèn)可的Isokinetictesting等速測dynamictest動態(tài)測neuromusculartest神經(jīng)肌肉測fullrangeofmotiontesting全關(guān)節(jié)活動范圍測Strengthwillbetestedthroughoutthewhole在整個關(guān)節(jié)科

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,office健康人 職

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Isokineticevaluation等速科PTMTT

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44科GuidelineforTreatmentprocedure診療

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NeuromusculartrainingcoordinationproprioceptionMTT科

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GaitSchoolExamples:例子MTT科MTT

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GaitTrainingExamplewalkingwithcrutchesWalkingupstairswith2crutches帶MTT科

GaitTrainingExamplewalkingwithcrutchesWalkingupstairswith1handonhandrailMTT科

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GaitTrainingExamplewalkingwithcrutchesWalkingdownstairswith1handonhandrail單MTT科MTT科

MobilizationExamplecyclingPTMTT科PTMTT

Mobilization關(guān)節(jié)活動Examplecyclingcrosswalking科MTT

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NeuromusculartrainingcoordinationproprioceptionMTT科

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PhasesofWoundhealingRepairRepairLatentPhasePTMTTmonths–months–周天科PTMTT

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