等速肌力测定PPT课件

,UptoDateDynamometry肌力测定新进展:ClinicalApplicationsandResearch临床应用与研究,Dr.phil.SteffenMller,UniversityOutpatientClinic.SportsMedicineandSportsOrthopaedicsUniversityofPotsdam.Germany德国波茨坦大学运动医学与康复专业医院,1,-,Content目录introduction介绍clinicalapplication(patients/athletes)临床应用（病人/运动员）strengthdiagnostics力量诊断treatmentevaluation治疗评估rehabilitation康复strengthtraining力量训练research研究strengthdiagnostics力量诊断standardizedtestsituations标准测试方式standardizedstrengthtraining标准力量训练uptodate最新ballisticmode“弹道模式sensorimotor“testing感觉运动测试speedprofile“(+perturbation)速度情况扰动special/functionalmovementsituations特别的/功能性运动状况examples(videoclip)例子（视频剪辑）,J.Perrine1967,2,-,IsokineticsinLiterature等速文献PubMedsearch检索(isokinetic等速/torque力矩):1980:81990:482000:702010:11468knee膝11ankle踝9hip髋7trunk躯干9shoulder肩5elbow肘5other其他,3,-,感谢德国菲兹曼医用电子公司提供设备支持!,4,-,5,-,6,-,everydaypractice:patients每天训练：病人strengthdiagnostics力量诊断,femaleathlete女性运动员;8weeksaftertornmusclefibers在肌纤维损伤8周后(M.rectusfemoris,left左侧股直肌)fullrecovery?真的康复了吗？,isthereastrengthdeficit?有无力量缺失？sidedifferences;agonistvs.antagonist;conentricvs.eccentric;referencevalues?两侧差异；收缩肌，对抗肌；向心，离心；参考值？,decision:besttreatment/training?决定：最佳的治疗/训练,additionalexamples:举例LBP-patients下腰痛病人strokepatients中风病人,7,-,everydaypractice:athletes每天训练：运动员treatment/trainingevaluation治疗/训练评估,elitemaleathlete(nopain)优秀男性运动员（无疼痛）strengthgainaftertrainingintervention?在训练之后力量的增加,restorationofstrengthlevelaftertherapy?治疗之后力量水平的恢复情况？,everydaypractice:patients/athletes每天训练：病人/运动员rehabilitation(trainigmodebiofeedback)康复（训练模式-生物反馈）,8,-,everydaypractice:patients/athletes每天训练：病人/运动员diagnosticsandtreatmentevaluationandrehabilitation诊断治疗评估康复,maleathleteafterACLinjury男性运动员在前交叉韧带损伤之后3month,6month,9month3,6,9个月,restorationofstrengthlevelaftertherapy?治疗之后力量水平的恢复,EccentricIsoconcentric,9,-,Research研究:strengthdiagnostics力量诊断,forexample举例:differencesinstrengthoftheplantarflexorsbetweenhealthyrunnersandrunnerswithachillestendinopathy健康运动员与阿基里斯肌腱损伤运动员在跖屈力量上的差异shoulderstrengthcapacityandsupraspinatustendinopathy肩关节力量能力和冈上肌肌腱病istrunkstrengtharelevantfactorinlowbackpain躯干力量是下腰痛的一个相关因素,Bauretal.Trunkextensorandflexorstrengthoflongdistanceracecardriverscomparedtophysicallyactivecontrols.JSportsSci.(2010)长距离驾车驾驶员的躯干伸肌与屈肌力量身体主动控制对比,Bauretal.Reactivity,stability,andstrengthperformancecapacityinmotorsports.BrJSportsMed(2006)运动中的反应，稳定性，力量能力,10,-,Research研究:standardizedtestsituations标准测试状态,thicknessofAchilles/Patellatendonindifferentjointanglesandloadingsituations阿基里斯/髌骨肌腱在不同关节角度和负载状态下的厚度wellcontrolledposition,velocity,loading很好的控制姿势，速度，负载,Aryaetal.2009,objectivity/reliability客观性/可靠性themachinesareaccurate仪器准确性variabilitycomesfromthesubjectinthespecifictestsituation目标特殊测试状态下的可变性,Mlleretal.Reproducibilityofisokineticsingle-andmulti-jointstrengthmeasurementsinhealthyandinjuredathletes.IsokineticsandExerciseScience(2007)健康与损伤运动员单与多关节等速力量诊断的再现等速与训练科学2007,11,-,Research研究:standardizedstrengthtraining标准的力量训练,RCT;6weekstrainingintervention随机对照实验：6周的训练standardizedtraining标准训练,12,-,ballisticmode“弹道模式”,probleminclassicmode“经典模式“的问题:realspeedmaynotreachpresetspeedlimits:不能达到预设的速度,reasons原因physics(Newtonslaws)物理性:patients/athleteshavetoovercometwofactorstoreachspeedlimit:病人和运动员必须克服两个因素达到预设的速度gravity(gravitationalforcethatoccursbetweenearthandotherbodies)重力（地球与身体之间的引力）,momentofinertia(dependingon:mass;radius)惯性（决定于：质量，半径）,13,-,ballisticmode“弹道模式”,Consequence(classicmode“)结论（经典模式）incorrectinterpretationofdata错误的数据解释:ameasuredvalueiscorrelatedtoawrongvelocity测量值与错误的速度相关联themeasuredvalueiseffectedthroughacceleration/decelerationmoments(noisokineticphase)诊断值受加速，减速运动的影响（无等速阶段）patients:reasonablevelocitiesinactivemovementsnotalwayspossible(especiallyintheinitialphaseofrehabilitation)病人：在主动运动中，合理的速度不总是存在（尤其在康复的初期）athletes:highspeed“testing/trainingisnotpossible运动员：”高速“测试与训练不可能,14,-,ballisticmode“”弹道模式“,naturalmovement自然运动,naturalmovementspeed自然运动速度:walking步行:膝关节knee140-320/srunning跑步:膝关节knee150-185/s(8,0km/h)(Li1999)pitching投掷:肩关节shoulder-8500/s(internalrotation内旋)(Murray1999)throwing投掷:肘关节elbow1000/s(McNaughton2004),ballisticmode“”弹道模式“:activecompensationofgravityandinertia重力和惯性主动补偿,15,-,ballisticmode“弹道模式,Method方法subjects目标:N=25(healthy)健康material材料:rotationalandlineardynamometer(Con-trexMJ/LP/TP/WS)旋转和线性测力计Protocol方式:max.strengthmeasurements最大力量诊断(5rep.5次;60secondsrest60秒休息)inclassicandballisticmode(randomized)经典和弹道模式（随机）4differentmovements4种不同的运动(knee,trunk,totallowerlimbandshoulder/armcomplex膝，躯干，下肢，肩/上肢复合)3velocities3种速度test-retestdesign(1weekinterval)测试-再测试设计（一周间隔）,M1,M2,1week1周,16,-,ballisticmode“弹道模式,Consequences结论newisokineticballistic“modeisrelevant新的等速”弹道模式“相关forhighmovementvelocities高速运动patientswithlowstrengthlevel力量低下病人complexjointmovements关节联合运动movementswithlargebodysegments身体的粗大运动earlierandwiderapplicationofdynamometryinrehabilitation(activemode)肌力测定法（主动模式）在康复中更早期、更广泛的应用applicationofdynamometryinhighperformanceathleteswithmorefunctionality肌力测定法在高体能运动员中有更多的应用,Mlleretal.Highervelocitiesinisokineticdynamometry:Apilotstudyofnewtestmodewithactivecompensationofinertia.IsokinExercSci19(2011)等速肌力测定中的更高速度：新的惯性主动补偿测试模式初步研究,17,-,Footplateunstable不稳定踏板,Footplatestable稳定踏板,TariPlriGmriVmriRfriTalePlleGmleVmleRfleTriggerN,sensorimotor“testing感觉运动测试Legpresstestwithstableandunstablefootplates带有稳定或不稳定踏板的下肢力量测试,malepatient;repetitiveanklesprains男性病人；反复踝关节扭伤strengthdeficitand/orsensorimotordeficit?力量缺失或感觉运动缺失,18,-,speedprofile(+perturbation)速度情况扰动simulationofvelocityprofileoffunctionalmovement(e.g.walkingknee)功能性运动的速度变化模拟Weuseisfor我们使用:compensationofperturbationatthetrunk(maximaltrunkextension;EMG)躯干扰动补偿（最大躯干伸展；EMG）,19,-,abdominalm.腹部,backm.背部,20,-,special/functionalmovementsituations特殊功能性运动状态Pilotstudy(inter