预防腰痛复发的康复训练方法

在日常生活活动中有许多自己没有注意到的不良姿势。在医疗实践中认识到这些不良姿势可导致髋关节变位或是角度异常,直接影响到骨盆和脊柱以及躯体的内外旋转,全身肌肉分布不匀称等,产生肌肉的异常紧张等表现。从形态上看表现为左、右侧及下肢的长短,内旋外旋、内收外展的差异,成为身体倾斜和腰痛的主要原因之一。有些腰痛的患者经过按摩、推拿等手法治疗之后,暂时的缓解了疼痛,但没过多久又出现了腰痛,笔者观察到这类患者占总手法治疗患者的２０%左右,因此作为一个理疗医生,不能在做完手法治疗之后简单地告诉患者“好了,可以回家了”,这是…     

腰痛外治法介绍

我院对1999年2月～2000年10月间就诊的腰背部疼痛患者,126例运用外治法治疗,疗效显著 ,介绍如下：1 方法介绍针灸疗法：适用于慢性腰痛。取肾俞、气海俞、大肠俞为主穴,合腰眼、命门、阳关,针后 可加灸,每次10～20 min,1次/d;也可加拔罐法,在疼痛部用投入法或闪火法,并留罐5～ 10 min;也可加用耳穴压豆法,以王不留行1枚置于剪好的胶布上,贴敷于耳穴,并自行挤 压,每日数次,以有酸麻胀感为度。推拿疗法：适用急慢性腰痛,肿瘤病人禁用,孕妇慎用。采取推、按、揉、擦等法取肾俞、 大肠俞、巨等及腰部压痛点,手法中先在腰痛处…     

老年性痴呆的家庭康复训练

1自我能力训练 痴呆老人常无法完成一些简单的日常活动,家属可以对其进行自我能力训练,如穿衣、梳洗、沐浴,目的是帮助他们保持外表整洁,强化自我形象的概念,每次训练时间为 20～ 30min。鼓励他们自行完成。可有秩序地给予口头提示,如有需要,可先示范,再让老人模仿。 2缅怀活动 尽管老人的近事记忆力差了,判断能力也减弱了,但缅怀他们过去的光辉岁月及成就,会使其增强自信心,增添对生活的满足感,他们更有力量面对未来。一些旧照片、一张历史的图片、一段怀旧的音乐、一件多年未穿的衣服,都会勾起老人对从前生活的点滴回忆,引…     

脑瘫儿童的家庭康复训练

对脑瘫儿童施行实行家庭康复训练,经济方便,切实可行,可显著提高脑瘫儿童的日常生活质量.     

脑卒中后肩痛的家庭康复训练

脑卒中后肩痛是影响患者全面康复的主要障碍 ,对康复训练有很大影响。所以在整体康复中 ,应优先考虑肩的正确治疗 [1] ,尤其是脑卒中患者出院后出现肩痛将丧失获得的康复成果。作者从 1 997年起指导家庭训练员运用关节松动术对 2 8例脑卒中后肩痛患者进行家庭康复训练 ,效果满意。1　资料与方法1 .1　一般资料　脑卒中后肩痛患者 2 8例 ,男 1 5例 ,女 1 3例 ;年龄 49- 77岁 ;病程 1 - 38个月 ;脑出血 1 3例 ,脑梗死 1 5例 ,其中合并肩关节半脱位1 4例 ;住院期间即出现肩痛 1 9例 ,出院后出现肩痛9例。1 .2　方法　 1松动肩胛骨 :患者仰卧 ,…     

介绍一种康复训练车

脑梗死、脑出血、脑外伤、格林巴利综合征、急性脊髓炎等神经系统疾病，可引起病人偏瘫和肢体无力等。肢体功能锻炼对病人康复有极其重要的作用。病人病情稳定后需及早下床进行功能锻炼，以预防肌肉失用性萎缩、关节挛缩，促进肢体功能恢复。一般情况下陪护人员扶持病人下床锻炼，则病人依赖性强，只依靠陪护人员的力量向前行走，不利于肢体功能恢复。现介绍一种康复训练车，既利于肢体功能锻炼，又能减轻陪护人员的负担，经临床应用效果满意。     

介绍一种康复训练车

脑梗死、脑出血、脑外伤、格林-巴利综合征、急性脊髓炎等神经系统疾病,可引起病人偏瘫和肢体无力等。肢体功能锻炼对病人康复有极其重要的作用。病人病情稳定后需及早下床进行功能锻炼,以预防肌肉失用性萎缩、关节挛缩,促进肢体功能恢复。一般情况下陪护人员扶持病人下床锻炼,     

医疗机构康复训练联合家庭康复训练治疗儿童孤独症效果分析

目的探讨医疗机构康复训练联合家庭康复训练治疗儿童孤独症的临床效果。方法将2012年2月—2015年5月西安市儿童医院收治的128例儿童孤独症随机分为联合组和常规组两组各64例,联合组采用医疗机构康复训练联合家庭康复训练治疗,常规组仅采用医疗机构康复训练治疗。观察比较两组治疗前和治疗12个月后孤独症儿童行为检查量表(ABC)、孤独症治疗评估表(ATEC)及中国版心理教育量表(C-PEP)评分。结果治疗前两组ABC、ATEC及C-PEP各方面评分及总评分比较差异均无统计学意义(P0.05)。治疗12个月后,联合组ABC、ATEC各方面评分及总评分均明显低于常规组,C-PEP各方面评分及总评分均明显高于常规组,差异有统计学意义(P0.05)。结论医疗机构康复训练联合家庭康复训练治疗儿童孤独症可显著改善患儿病情,消除患儿心理障碍。     

脑出血恢复期病人家庭康复训练体会

我科自 1998年 10月～ 2000年 10月通过对 40例重度高血压脑出血恢复期病人进行出院指导、定期随访、家庭康复护理指导,取得较满意的效果,现报道如下。 1资料与方法 本组脑出血致脑疝偏瘫病人 40例,其中男 21例,女 19例,年龄 50～ 72岁;入院时病人神志呈嗜睡或浅昏迷状态,失语、呼吸道通畅,一侧肢体肌张力 0～ 1度,住院天数 25～ 35d。 康复护理措施： (1)语言训练：让家属经常与病人对话,问简单的问题,利用各种刺激法,强化病人应答能力;给病人听音乐,做简易加减法,阅读短文回答问题,锻炼病人的语言功能,提高病人思维能力…     

家庭康复训练在血友病病人家庭护理中的应用

[目的]探讨家庭康复训练在血友病病人家庭护理实施中的应用效果。[方法]筛选山西省血友病诊疗中心15例血友病病人作为研究对象。由血友病诊疗中心康复治疗师、护士及病人家庭共同制定、实施家庭康复训练计划。分别于家庭康复训练前及训练后1个月、3个月、6个月,采用血友病功能独立性评分(FISH)和中文版血友病关节健康评估表(HJHS 2. 1)对血友病病人的日常生活活动能力以及病人关节的健康状况及步态进行评价。[结果]本组15例血友病病人家庭康复训练后1个月、3个月、6个月病人自我照顾、移行功能及转移功能较训练前提高(P0. 05)。病人双膝、双踝、双肘关节的健康状况及步态较康复前有所改善(P0. 05)。[结论]血友病家庭康复训练提高了血友病病人的生活自理能力和关节肌肉功能,帮助病人实现康复照护的连续性和一致性。     

下腰痛的诊断与康复

下腰痛不是病名 ,而是由多种疾病引起的一系列症状 ,在骨科门诊患者中 ,以下腰痛为主诉症状的约占2 0 %— 30 % ,其中大部分为中老年人。近年来 ,随着参加体育运动的人群不断扩大 ,部分体育爱好者出现下腰痛的也不少见。对腰痛患者 ,如何给予正确的诊断 ,选择何种检查 ,进而采取何种适合的治疗 ,这是社区医生经常要面临和解决的问题。1致病因素1.1脊柱疾患1.1.1创伤 :①急、慢性腰部扭伤 :扭伤是腰痛最常见的病因 ,在日常生活中 ,抬物不当、摔倒或体育运动等都可能扭伤腰部 ,特别是人到中年后 ,体重增加、运动减少 ,所以扭伤很常见。扭伤造…     

Gender-specific aspects in chronic low back pain rehabilitation

Gender-specific Aspects in Chronic Low Back Pain Rehabilitation.Little is known about gender differences in utilisation, outcomes and evaluation of orthopaedic rehabilitation for chronic low back pain. The purpose of this article is to review and analyse the literature on rehabilitation and recovery of men and women with chronic back pain. In Western societies, chronic back pain is one of the most common causes for utilising medical rehabilitation services. In general no significant gender differences in the prevalences of back pain are found, but men are more sick-listed and early retired due to musculoskeletal diseases. Also, more men than women participate in medical rehabilitation programmes. National and international studies pinpoint the fact that differences exist between women and men with regard to participating in an orthopaedic rehabilitation programme. Additionally there is some evidence that different physical and psychological therapy services have different effects on health status of women and men. Mixed results are available regarding gender differences concerning the outcomes of rehabilitation programmes. Rehabilitation activities after discharge from in-patient programmes and these being performed within the home setting are primary indicators of recovery. Gender differences have been identified regarding various types of activities, apparently because especially family roles interfere with activity. Further research must be conducted so as to increase the understanding of women's and men's experiences relative to orthopaedic diseases and orthopaedic rehabilitation services.     

Adherence to rehabilitation in patients with low back pain

This study investigated adherence to low back pain rehabilitation in the clinical setting. Adherence was assessed in 105 (71 male and 34 female) patients attending private physiotherapy clinics for rehabilitation of low back pain. Three aspects of adherence were measured over the 4-week study period: attendance at clinic-based rehabilitation sessions, adherence to a home exercise component of rehabilitation, and adherence to activities and advice during clinic-based rehabilitation. Rehabilitation outcome was measured using the Patients' Measure of Perceived Rehabilitation (McDonald & Hardy 1990) and the Physiotherapists' Measure of Perceived Rehabilitation (McDonald & Hardy 1990). It was found that patients attended 87.7% of their scheduled physiotherapy rehabilitation appointments and reported completing 71.6% of their prescribed home exercises. In relation to adherence to clinic-based rehabilitation activities (as measured by the Sport Injury Rehabilitation Adherence Scale, Brewer et al. 2000), patients scored an average of 11.6/15. Although no gender differences were found, compensable patients adhered significantly less to clinic-based rehabilitation activities than did their non-compensable counterparts. Further, it was found that higher levels of adherence to clinic-based activities significantly predicted both the patients' and physiotherapists' perception of degree of rehabilitation at the end of the 4-week rehabilitation period. These findings are discussed in relation to rehabilitation strategies for physiotherapists.     

Comprehensive rehabilitation of patients having chronic low back pain.

Seventy-two patients having chronic back pain, representative of high-risk demographic and personality populations, received a broad range of therapeutic modalities designed around the theme of self-regulation. The self-regulation principle was used in: (1) biofeedback training for teaching self-regulated muscle relaxation; (2) psychological counseling emphasizing self-control techniques for the management of stress and anxiety, including assertion training; (3) patient-regulated medication program; (4) patient involved case conferences; (5) physical therapy program emphasizing reconditoning; (6) comprehensive vocational rehabilitation services; (7) a series of educational lectures; (8) a therapeutic milieu designed for relaxation, recreation and socialization. Utilizing a success criteria of functional physical activity at discharge (average length of stay, 45 days) and levels of vocational restoration (employable, in training, or employed at 30 days postdischarge), 57 of the patients demonstrated unimpaired physical functioning levels and 59 of the patients were at success levels of vocational restoration.     

The effects of a back rehabilitation programme for patients with chronic low back pain

AIM: The aim of this paper was to perform a pragmatic before-after analysis of a back rehabilitation programme (BRP) for patients with chronic low back pain (LBP). A total of 877 patients were recruited onto the BRP, which were carried out at four centres within the Wrightington, Wigan and Leigh NHS Trust. The BRP consisted of nine 2-hour group sessions of therapy run over 5 weeks and included 1 hour of exercise and 1 hour of education, advice problem solving and goal setting. METHOD: Using the Wilcoxen signed rank tests and paired t-tests levels of pain, disability, anxiety and depression were significantly reduced pre-post programme (P < 0.001). In addition, the levels of fitness and perceived control improved significantly (P < 0.001) suggesting that participants were better able to manage their LBP. CONCLUSION: Overall, the BRP proved to be effective in reducing pain, disability, anxiety and depression levels for people with chronic LBP. However, despite significant improvements in outcome measures only 50% of the patients completed the BRP and questionnaires post BRP. The implications of the findings are discussed with respect to modified programmes and alternative management for patients within different subgroups of LBP.     

Muscle activation changes after exercise rehabilitation for chronic low back pain

Marshall PW, Murphy BA. Muscle activation changes after exercise rehabilitation for chronic low back pain.

Objective

To investigate the changes in 2 electromyographic measures, flexion relaxation (FR) response and feed-forward activation of the deep abdominals, associated with low back pain (LBP) after different rehabilitation interventions.

Design

A 2×2 factorial design with subjects' self-selecting treatment with randomization after 4 weeks to either the specific exercise group or exercise advice group for a further 12-week period.

Setting

General community practitioners and university training center.

Participants

Subjects with chronic nonspecific LBP were recruited for this study. A total of 112 people were initially screened, and 60 were recruited for the study, with 50 being available for long-term follow-up.

Intervention

Four weeks of treatment (manipulative or nonmanipulation) and 12 weeks of subsequent exercise (supervised Swiss ball training or exercise advice).

Main Outcome Measures

The Oswestry Disability Index, FR response measured at T12-L1 and L4-5, and feed-forward activation of the deep abdominal muscles.

Results

More rapid improvements in disability were identified for subjects who received the supervised exercise program. The FR response at L4-5 also increased more for those who received directly supervised exercise. Long-term follow-up showed that there was still a between-group difference in the FR response, despite no difference in self-rated disability. Long-term changes were observed for the feed-forward activation of the deep abdominals; however, no exercise or treatment effects were identified.

Conclusions

Supervised exercise rehabilitation leads to more rapid improvements in self-rated disability, which were associated with greater improvement in the low back FR response.     

定量有氧运动早期干预对非特异性下腰痛的康复作用

背景非特异性下腰痛的临床治疗方法较多,但多为被动对症治疗,有关主动运动早期干预治疗的报道较少.目的研究定量有氧运动早期干预加功能重建对非特异性下腰痛的治疗效果.设计临床随机对照试验设计.地点和对象资料收集于阿曼首都马斯喀特亚洲医学中心1996-01/1998-12门诊收治非特异性下腰痛(nonspecific low back pain,NLBP)患者189例,其中男112例,女77例(均为阿拉伯人和欧洲人).干预189例非特异性下腰痛患者按就诊顺序随机分成两组A组(137例)主动运动早期干预加推拿治疗,B组(52例)推拿治疗;用视觉模拟量表(VAS)和腰痛问卷调查量表(OSW),对两组患者进行治疗前后分析评估.主要观察指标治疗前后VAS和OSW评分指数变化.结果两组VAS和OSW指数都有下降,A组指数下降明显大于B组[A组VAS治疗前后的值分别为(59.64±1.19),(28.98±0.95),B组为(63.33±1.91),(36.86±1.47),t=36.644,19.785,P＜0.01;A组OSW治疗前后的值分别为(26.781±0.492),(11.649±0.357),B组为(27.098±0.756),(15.625±0.570)(t=42.216,18.202,P＜0.01).6个月～2年随访表明A组复发率(15.08%,19/126)低于B组(35.42%,17/48).结论运动疗法早期介入治疗非特异性下腰痛,可缓解疼痛,改善和重建腰部功能,预防机体功能下降,提高日常生活活动能力.     

肌力训练对下背痛患者胸腰椎生物力学的影响

目的 探讨肌力训练对下背痛患者胸腰椎生物力学的影响.方法 分为观察组与对照组2组,观察组为2008年9月～2010年8月间本院门诊的50例下背痛患者,其中男24例,女26例,年龄50～70岁,平均(59.7±5.7)岁.对照组为50～70岁的正常人群,其中男23例,女27例,平均(61.1±5.6)岁.观察组进行肌力训...