理学疗法在脑卒中治疗过程中的作用。刘惠林 - 副本.pptVIP

BOBATH記念病院 古澤　正道;刘惠林 ;;理学疗法最关心的两件事: 一,肌张力 二,步行;;;;;理论基础及意义：;前馈(feedforward);预测性姿势调整为;■100ms前先于运动发生姿势调整是预备性预测性姿势调整pAPAs (preparatory APAs、pAPAs)。 The postural adjustments that precede the movement, often by more than 100 ms, have been referred to as preparatory APAs (pAPAs). ①Gahery Y : Associated movements, postural sdjustments and synergies : some 　　　　　　comments about history and significance of three motor concepts. Arch Ital Biol, 　　　　　125 : 345-360, 1987.　　　　　　②Shepens (2004) ; below. ■四肢随意运动中预测性姿势调整(APAs)先行且伴随着。这是对四肢运动产生ＣＯＭ预测混乱而准备身体。 　aAPAs（accompanying APAs、伴随预测性姿势调整）见于上肢及身体大运动时。 Voluntary movements of a limb are preceded and accompanied by anticipatory postural adjustments (APAs) that prepare the body for the expected disturbance of the center of the mass that will be produced by that movement. Schepens B, Drew T: Independent and convergent signals from the pontomedullary reticular formation contribute to the control of posture and movement during reaching in the cat. J Neurophysiol, 92 : 2217-2238, 2004. ;姿势调整 (Postural Adjustments) ■为促进四肢功能运动模式所需背景下姿势调整。　　　　　　 In order to facilitate any functional movement patterns of limbs, postural adjustments are needed on the background. ■姿势调整为防止重心位移(displacement)而局限于最小。　由此运动安全且有效。 P.A. prevent or minimize the displacement of center of mass, and then the movement is achieved safely and efficiently. Frank JS, Earl M : Coordination of posture and movement. 　　　　　　　　　 Phys Ther, 70 (12) : 855-863, 1990.;;Massion J : Postural control system. Current Opinion in Neurology, 4:877-887, 1994.;;Selective movement control of the trunk the limbs, both concentric and eccentric are interdependent and interactive a postural control mechanism. (i.e. balance);Therefore the recovery of selective movement is a pre-requisite for efficient postural control, alignment and function.　　　　　　　　　 (Bobath, Lynch Grisogono, Davies, Ryerson, IBITA);Rehabilitation is a process