下腰痛课件ppt

somesome practicalpractical examinationsexaminations 手法手法检测检测检测检测 soreha education examination block 小关节错位 a. inspection in rest and motion 在静止和运动的状态下检查 soreha education examination block 小关节错位 active and passive motion 主动和被动活动 hyperflexion (finger to the floor)hyperextensionlateral flexion Results (examples) 结果treatment 治疗 hypermobile 活动度过大 stabilization 稳定性训练 hypomobile 活动度不足stretching, decrease muscle tonus, mobilization 拉伸，减少肌肉张力 soreha education examination block palpation (in motion) 触诊（运动中） Results (examples) 结果treatment 治疗 pain疼痛3-D-traction 三维拉伸 hypomobile 活动度不足mobilization 关节松解 palpation of combined movements 结合运动的触诊 soreha education examination block palpation (in rest) 触诊（静止状态） Results (examples)结果treatment治疗 pain 疼痛traction 拉伸 posture 调整姿态 (decrease lordosis) pain rosette: provoking pain by initiating spine contact 疼痛范围：触及某椎骨时出现明显疼痛 soreha education examination block joint play (example) 关节间隙活动 fix upper spine, move lower spine 固定上部椎骨， 活动下部椎骨 Results (examples) 结果treatment 治疗 hypermobile 活动度过大 stabilization 增强稳定 hypomobile 活动度不足traction, mobilization 拉伸，关键松动 soreha education examination block listhesis test 椎骨前移测试 fix upper spine, move lower spine backwards 固定上部椎骨，移动下部椎骨向后 Results (examples) 结果treatment 治疗 hypermobile, 1cm = Listhesis! stabilization, abdominal training 活动度 1cm = 椎骨前移！ 稳定训练，腹肌练习 soreha education examination block joint play (example) 关节间隙活动 sacroiliac joint block Left: normal Right: blockade on right side 骶髂关节错 位 左图：正常 右图：右侧错 位 Results (examples) 结果treatment 治疗 hypermobile 活动度过大 brace support, taping, bandage 护腰，支持带，绷带 hypomobile 活动度不足traction, mobilization 拉伸，关节松解 soreha education examination block muscle tests 肌肉测试 example: m. Iliopsoas (flexor of hip) 髂腰肌 （髋关节屈） Results (examples) 结果treatment 治疗 too long 过长 strengthening, stabilizing 力量，稳定训 练 too short 过短stretching 拉伸 (Influencing pelvic position影响骨盆位置) soreha education examination block Skin 皮肤 skin inspection (low back area) 观观察皮肤 （下腰部） - affection in surface, structure, color ? - 表皮，皮肤组织 ，颜色是否异常？ - consistency (swelling, temperature .) - 皮肤触摸的感觉（肿胀 ，温度） inflammation signs 炎症的表现 from 5 point examination scheme 3/5: orthopedic neurologic tests 骨科神经测试 low back下腰背 -Lasegue, Bragard拉赛格症 ， 布拉加德症 -segment muscles肌肉结段 -reflex situation反射状况 -sensitive disturbances有神经症状 soreha education Neuromuscular testing: 神经经肌肉测试测试 - strenght 力量 - p