PNF_本体感觉神经肌肉易化技术11111.pptVIP

特殊操作方法及技术 Classification of Techniques Techniques directed to agonists直接作用主动肌 Techniques using antagonists to facilitate contraction of agonists利用拮抗肌促进主动肌收缩 Techniques using antagonists for relaxation of agonists利用拮抗肌放松主动肌 Rhythmic Initiation The one exception to active motion in PNF Progression used for those who are very weak or unable to initiate a motion (passive to active-assisted to active) Rhythmic motion through a desired ROM beginning with passive motion Rhythmic Initiation节律性起动 Description of technique Therapist moves the patient passively through a desired ROM, using speed and verbal commands to cue movement Patient is asked to move actively with therapist through ROM Therapist then begins to apply resistance 节律性起动（rhythmic initiation） 先给患者进行数次被动运动，然后让患者利用病变轻的肢体或借助滑车、重锤等工具给患肢进行数次自主的辅助运动，再试让患者自己作主动运动，成功后可作轻的抗阻运动。要注意与运动方向相反的运动是由治疗师完成的（回返动作） RI有改善起动运动的能力。RI对于帕金森综合征、较严重痉挛等难以起动运动的情况有用。 Techniques Using Antagonists to Facilitate Contraction of Agonists利用拮抗肌促进主动肌收缩 Slow reversal缓慢逆转 Repeated alternating concentric contractions of agonists and antagonists Slow reversal hold缓慢逆转维持 Adds isometric hold/s at weak point/s in ROM Rhythmic stabilization节律性稳定 Co-contraction, muscle “setting” Quick reversal Repeated alternating concentric contractions of agonists and antagonists at increased pace 神经肌肉本体感觉促进技术 (proprioceptive neuromuscular facilitation) PNF 背景 1940-1954年，Dr. Herman Kabat 在Washington，D.C.首先开始使用PNF的治疗技术，用于治疗骨性疾患的疾病； 1956年，第一本PNF的书出版； 随后，PNF被进一步发展； 英文第二版1999年出版 Introduction Initially developed (Knott Voss, 1940’s-1950’s) for patients with permanent neurological disorders – techniques can be applied to athletic injuries/rehabilitation Goal is to have an increased neuromuscular response (usually an increase in strength) but can also be used to increase relaxation (inhibition) 概念 利用运动觉、姿势感觉等刺激，增强有关神经肌肉反应，促进相应肌肉收缩； 利用牵张、关节压缩、牵引和施加阻力等本体感觉刺激，促进功能恢复； PNF治疗作用 在不同的姿势发展稳定和动态平衡 同等地增强所有肌群的肌力 增强耐力 改善协调 改善运动控制技能 在增加运动的同时产生放松 PNF技术的神经生理学原理 交互抑制：肌肉收缩时肌梭将兴奋传递到运动神经元，同时将抑制