1、Neuromuscular strength assessment and training神经肌肉力量的测试、评定神经肌肉力量的测试、评定 Dr.Oliver Kieffer,PhD 奥利弗奥利弗 基弗基弗 博士博士 OrthoTrain Rehabilitation Center,Berlin,Germany 德国柏林德国柏林OrthoTrain康复中心院长康复中心院长 Soreha China CEO 玖瑞德康复技术（北京）有限公司玖瑞德康复技术（北京）有限公司 总裁总裁 Muscular decrease after immobilization and bedrest 固定和卧床后肌
2、肉力量的下降固定和卧床后肌肉力量的下降 0%50%100%after 1 weekafter 2 weeksafter 3 weeksafter 4 weeksWearing a cast after operations lead to a decrease of muscle strength of 20%and more within 2 weeks.The decrease of strength works 4 times faster than the rebuild of muscular strength.在手术后的2周内导致肌肉力量下降20%或以上。肌肉力量下降的速度比重建的
3、速度快4倍 Research studies show that 1 week bedrest reduce the muscular mass by 13%.4 weeks immobilization result in a strength decrease of 30-50%.Mainly the type I fibers decrease in the first period of immobilization.。研究结果表明，1周的卧床休息使肌肉重量降低13%。4周的固定导致力量下降30-50%。在制动的第一阶段大部分减少的是1型肌纤维。Assessment 诊断、测试 Ass
4、ignment 评价、计划 Intervention 干预、治疗 Evaluation 再测试、评估 ICF-The Rehab circle ICF-康复治疗周期康复治疗周期 Assessment 测试、诊断测试、诊断 Medical examination 医学检查 PT Assessment PT 检查 Functional work specific Assessment 功能检查 Generic questionnaires 一般问卷 Indication Specific questionnaires 适应症的 特殊问卷 Pain rating 疼痛指数 Neuromuscular
5、 testing 神经肌肉测试 Psychological tests Attendance Concentration 心理测试 MTT neuromuscular assessment MTT神经肌肉诊断神经肌肉诊断 Questions:问题问题 Pain?疼痛？Flexibility?柔韧性？Strength?力量？Ratios 比率 Dysbalances 失衡 Strength in particular positions 特定姿势的力量 Bilateral comparison 双侧比较 Strength endurance?力量耐力？EMG activity?肌电活动性？MTT
6、 assessment 诊断诊断 Flexibility柔韧性柔韧性 Muscle function testing 肌肉功能测试肌肉功能测试 Lower extremities 下肢 Calf testing 小腿后群测试 Stretching test:拉伸测试 Dorsal extension in 背伸 full knee extension (m.gastrocnemius and mm.soleus)完全伸膝（腓肠肌和比目鱼肌）90 knee flexion(mm.soleus)90屈膝（比目鱼肌）Flexibility Muscle function testing 柔韧性肌肉功
7、能测试柔韧性肌肉功能测试 Lower extremities 下肢 Result:结果结果 Knee flexion 90 +屈膝大于90 Knee 80-90flexion O 屈膝80-90之间 Knee flexion KeyPalmarTip 报告的选择报告的选择 Report Options Assessment 诊断、测试 Assignment 评价、计划 Intervention 干预、治疗 Evaluation 再测试、评估 ICF-The Rehab circle ICF-康复治疗周期康复治疗周期 Assignment 分析、计划 Treatment planning 治疗计
8、划 Definition of treatment goals 确定治疗目标 Multidisciplinary treatment program 全方位综合治疗方案 Assessment Assignment Intervention Evaluation Intervention 干预、治疗 Multidisciplinary treatment program 多学科综合治疗方案多学科综合治疗方案 Assessment Assignment Intervention Evaluation Strength training on medical strength machines 应用医用力量训练器械进行力量训练 Leg Press closed kinetic chain 下肢蹬踏训练（闭链）Inner and outer hip and leg muscles(Ab-Adduction)髋关节内收外展训练 Leg extension open kinetic chain 膝关节伸训练（开链，活动范围 Thank you for your attendance!谢谢！谢谢！
