如何处理痉挛.docx

康复治疗:

Therearealterationsthatoccurinmusclesandconnectivetissueassociatedwithchronicspasticity.Spasticmuscleshavebeenshowntohaveshorterrestingsarcomerelengthwithevidenceofchangesinconnectivetissueconstituents,suchascollagenandtitin(FridenandLieber,2003).

与慢性痉挛有关的肌肉和结缔组织会发生改变。痉挛肌的静息肌节长度变短，结缔组织的成分也发生明显的改变，如胶原蛋白和titin(FridenandLieber,2003).

Biomechanicalinterventions,includingrangeofmotionexercisesandsplinting,mayhelpminimizethesechanges.Passiverangeofmotionofspasticmuscles,performed

atleast2-3timesaday,shouldbeanintegralpartofanytreatmentregimenforspasticity.Althoughtheimprovementintoneisonlytemporary(severalhours),routinerangeofmotionexercisesmayhelppreventthedevelopmentofcontractures(Nuyens

etal.,2002).

生物力学干预，包括活动范围训练和夹板可能对减少这些改变有帮助。痉挛肌的被动活动范围练习每天至少进行2-3次，而且应该成为任何痉挛治疗训练课的主要部分。尽管肌张力的改善只是暂时的（几个小时），但常规的活动范围练习对预防发展成为挛缩可能有帮助(Nuyens

etal.,2002).。

Therearecertainphysicaltherapyphilosophiesthatstresstheinhibitionofspasticityintheirtreatmentapproach.Forexample,the neurodevelopmentaltechniqueisbasedonthe attemptto inhibittonicreflexesbypassivelybringingpatientsintoreflexinhibitorypostures(KabatandKnott,f954).

有些物理治疗体系的治疗方法中强调对痉挛的抑制。如神经发育技术就是基于被动地将病人置于发射性抑制体位来抑制张力反射的(KabatandKnott,f954).。

Thetechniquesofproprioceptiveneuromuscularfacilitation(PNF)emphasizestheinstructionofnormalpatternsofmovementtospasticpatients(Pierson,2002).Althoughstudieshavenotdemonstratedbetterfunctionaloutcomesinpatientstreatedwiththis

particulartechniquecomparedtoothers,patientswithmarkedspasticitymightbeonestobenefitfrom

thesetherapyapproaches(Gelberetal.,1995).

本体感觉神经肌肉促进技术（PNF）强调对痉挛病人进行正常运动模式的指导(Pierson,2002)。尽管研究显示用这些特定的治疗技术在功能改善方面并没有比用其它治疗方法更好，但有显著痉挛的病人可能已经从这些治疗方法中受益(Gelberetal.,1995).。

Anecdotalreportssuggestthatothertherapymodalitiesmighthelpreducemuscletone.Vibration,espe