神經(jīng)肌肉骨骼系統(tǒng)-introcuction

IntroductionofNeuromusculoskeletalExaminationandAssessment中山大學(xué)附屬第一醫(yī)院劉鵬目的topresenttothereaderaunifiedapproachtotheexaminationandassessmentofneuromusculoskeletaldysfunction,takingintoaccountestablishedandemergingconceptsofneuromusculoskeletalmanagement

bytherapists，andthenewlyemergentsupportingresearch介紹檢查和評(píng)估神經(jīng)肌肉骨骼功能不良的統(tǒng)一的方法，重視由治療師建立和形成神經(jīng)肌肉骨骼的處理概念發(fā)展ThefirstmentionofaprofessorofphysiotherapydatesbacktoAD585,whenonewasappointedundertheSuidynastyinChina.宋代Hippocratespracticedtheuseofbothmanipulation

andtraction

bookPhysicaltreatmentbymovement,manipulationandmassage(1917)trainingincarefulmanipulativetechniqueswasintroducedintotheundergraduatetrainingofphysiotherapists.

Intheearly1950s,DrJ.Cyriax,devisedasystemofassessinganddiagnosingdisordersofthemovingpartsofthebody建立身體運(yùn)動(dòng)部分障礙的評(píng)估和診斷系統(tǒng)GeoffreyMaitland(1986,1991)iswidelyregardedasoneofthemostimportantoriginalcontributorstothemethodofsystematicexaminationandtreatmentofneuromusculoskeletaldisordersbymobilization/manipulationtechniques.用運(yùn)動(dòng)/操作技術(shù)系統(tǒng)的神經(jīng)肌肉骨骼障礙的檢查和治療方法Theobjectivesofthistextaretoenablethereaderto：lIdentifypossiblecausesofneuromusculoskeletaldysfunctionineachregioncoveredbythetext找出導(dǎo)致神經(jīng)肌肉骨骼系統(tǒng)功能障礙的可能的原因lCarryoutafullsubjectiveexaminationforeachneuromusculoskeletalregioninorderto:完成整個(gè)主觀檢查-fullyidentify,describeandrecordpain/symptomaticareas充分地確認(rèn)、描述和記錄疼痛/癥狀的范圍-understandthebehaviourandrelationshipofsymptomsandtheirimplications了解癥狀的表現(xiàn)和關(guān)系以及其影響-

befamiliarwith,andunderstand,theimplicationsofresponsestospecialquestionsrelatingtoeachregion熟悉和了解與每一部位有關(guān)的特殊問題的影響-

conductafullinvestigationintothehistoryofthepatient‘spresentconditionandpastmedicalhistory對(duì)患者現(xiàn)病史和既往病史進(jìn)行完整的調(diào)查-evaluatethesubjectiveexaminationandplanaphysicalexaminationbasedonthesubjectivefindings評(píng)價(jià)主觀檢查并在其基礎(chǔ)上制定合適的體格檢查計(jì)劃l

Carryoutafullandappropriatephysicalexaminationforeachneuromusculoskeletalregion,toincludethefollowing:進(jìn)行每一部位的完整的和適當(dāng)?shù)捏w格檢查-

observation-

jointtests-

muscletests-

neurologicaltests-

specialtests-

functionaltests-

palpationandaccessorymovementsandtounderstandtheimplicationsofbothpositiveandnegativetestresultsE