平衡性的机制和训练培训课件.ppt

平衡系统的评定。平衡是一个多维的系统。平衡需要多维的测试和评定。没有一个单独的或者测试足以帮助你理解你的病人的平衡问题。 1. 测试的目的：是排除，是预测，还是评价？2. 你的病人的功能的水平和特征（包括年龄，诊断，和疾病的严重程度）3. 要求（病人保险公司的要求，你工作的单位的要求）4. 测试的特征；4.你各人的偏好；6. 你的概念的结构 很多的功能测试是和平衡有关的。 采用的方法完全取决于你对正常平衡的机理的理解和你的病人平衡问题的原因的理解；系统理论：平衡问题的原因是复杂的和多因素引起的；单独的一种治疗方式是不够的。 平衡性的训练 Nintendo Wii Fit System Fall Unintentional injuries External causes of the injury Multifactorial causes e.g. falls due to intrinsic factors vs. extrinsic factors Intrinsic (Personal) factors for Falls Aged (over 65 years) Female Low mobility or fragility – lower extremity weakness, and poor grip strength Functional impairments - limited Activities of Daily living (ADL) Poor gait and balance Low body weight Intrinsic (Personal) factors for Falls Cognitive impairment or dementia Chronic illness - Parkinson disease, visual difficulties, stroke, hypertension, or urinary incontinence Psychoactive medication - tranquilizers or antidepressants Previous falls Heavy drinking Extrinsic or Environmental Factors Person’s environment: Uneven surfaces Obstacles, stairs, curbs Poor lighting, sudden changes in lighting Slippery surfaces Poor footwear Poorly fitted assistive devices for walking Incidence rates of Falls in U.S. One of every three adults over 65 years fall in every year Most common cause of injury death for 65+ 90% of hip fractures in older adults Most common cause of non-fatal injuries 恶性循环 Fall ↗ ↘ Imbalance ← Inactive Where are people likely to fall? For people 65 years old or older….. Nursing Home 10% Home 60% Public Places 30% Consequences of Falls Mortality Morbidity Fractures Soft tissue injuries Head trauma Joint distortions and dislocations Loss of confidence - fear of falling Restricted activity In 1994, estimated fall-related injury cost was $20.2 billion. Consequences of Falls Fractures 3% of all falls cause fractures. Approx. 95% of hip fractures in older people aged over 65 years are the result of a fall People who have a