脉冲枪脉冲治疗仪中英文版 严选材料

脉冲治疗仪TECHNIQUE,1,精编内容,ImpulseAdjustingTechnique脉冲调整技术,AChiropracticAnalysisofthespineReproductionofsymptomsunilaterallyconfirmsSIjointinvolvementTestbothsideswithUnilateralNachlasTest从受累侧开始(先测试有症状侧)单侧症状再现证实SI关节侵犯用单侧Nachlas测试法检查两侧,19,精编内容,Step2:UnilateralNachlasTest第2步：单侧Nachlas测试,20,精编内容,FlowchartforStep2第2步流程图,TestandAdjustInvolvedSIJ测试和调整受累的SIJ,TestandAdjustInvolvedLumbar测试和调整受累的腰椎,TestandLumbo-SacralJoint(DualStyluses)测试腰骶关节(双针),21,精编内容,TestandAdjustInvolvedSIJ测试和调整受累的SIJ,ConfirmwithSIJointCompressionTest通过SI关节压迫测试确认,22,精编内容,23,精编内容,LiteraturereviewofteststodiagnoseaSIlesion:用测试去诊断SI病变的相关文献综述：Binkley,etal,“Diagnosticclassificationofpatientswithlowbackpain:reportonasurveyofphysicaltherapyexperts,”PhysicalTherapy,1993:73,SymmetryTests:对称性测试：poorreliabilityandvalidity.信度和效度差PainProvocationTests:疼痛激发测试：evidencesupportsthevalidityofsomepainprovocationtests.证据支持某些疼痛激发测试的效度。,24,精编内容,ProneHipExtensionTest俯卧伸髋测试“SacralCup,”Dr.MajorDeJarnette,(TheAmericanChiropractor,May2007),“Pronehipextensiontest”(aka,“sacralcuptest”)“俯卧伸髋测试”（又名“骶杯测试”）TeststhestrengthofthemusclescrossingtheposterioraspectoftheSIjoint.测试横跨SI关节后端的肌肉力量。SIsprainreducespatientsabilitytoextendthehip.SI扭伤降低患者的伸髋能力。,25,精编内容,SIjointhorizontalsectionSI关节-水平横切位,SIcapsulecontainsadenseplexusofunmyelinatednervefibersindicativeofanociceptivereceptorsystem.SI关节囊含有密集的无髓鞘神经纤维丛，提示痛觉受体系统。Wyke,“Receptorsystemsinlumbosacraltissuesinrelationtotheproductionoflowbackpain,”AmericanAcademyofOrthopaedicSurgeonsSymposiumonIdiopathicLowBackPain,Mosby,1982,LocationofSIadjustmentSI调整部位,26,精编内容,27,精编内容,SacroiliacAdjustment骶髂调整,SacroiliacJointAdjustment骶髂关节调整SCP:Sacroiliacjoint,medialaspectofPSISLOD:Anterior-SuperiorSetting:HighorMediumSCP：骶髂关节，PSIS内侧LOD：前-上设置：高或中,28,精编内容,ImpulseiQAdjustingInstrumentAudibleIndicatorsupperC-spineusuallysuboccipitalspasminterferingwithnormaloccipitalglideandC1-C2movement.中-低段颈椎-通常是前凸弯曲消失，不能活动到前屈位，主要在C6C3上段颈椎-通常枕下痉挛，干扰正常的枕滑行和C1-C2运动。Alsotellsexaminerofpresenceofradicularpainindicatingpossiblespaceoccupyinglesion.还告诉检查者存在根性疼痛，表明可能有占位性病变。,77,精编内容,Cervicalcompressiontest:颈椎压迫测试：,PatientreportspaininupperneckorskullbeginwithC2analysis.Turnheadtorightandthenleft.AdjustC2onsideofrestriction,notsideofpain.患者报告颈部或颅骨疼痛-开始C2分析。头先转向右侧，然后向左。在束缚感的一侧调整C2，不痛。,78,精编内容,RightCervicalRotationTest(forC2):右颈旋转测试（C2）：,79,精编内容,C2adjustment(TP):C2调整（TP）：,80,精编内容,-SCP:C2LPJ-LOD:Anterior-Superior-Setting:Low-Thrust(s):Single-SCP：C2LPJ-LOD：前上-设置：低-推力：单个,CervicalSpine颈椎,81,精编内容,Occiputadjustment:(singlestylus)枕部调整：（单针）,82,精编内容,C1adjustment:C1调整：,83,精编内容,-SCP:C1TP-LOD:Medial-Setting:Low-Thrust(s):Single-SCP：C1TP-LOD：内侧-设置：低-推力：单个,84,精编内容,-SCP:Occiput-LOD:Anterior-Superior-Setting:LoworMedium-Thrust(s):Single-Doublestylus-SCP：枕部-LOD：前-上-设置：低或中-推力：单个-双针,85,精编内容,-SCP:C2BilateralLPJ-LOD:Anterior-Superior-Setting:MediumorLow-Thrust(s):SingleorMultiple-Doublestylus-SCP：C2双边LPJ-LOD：前-上-设置：“中”或“低”-推力：单个或多重-双针,86,精编内容,Ifcervicalcompressiontestproducespaininmidtolowercervicalspine,proceedtolateralflexiontest.BeginatC3onsideofrestriction,notpain.如果颈椎压迫试验造成中下段颈椎疼痛，则开始侧屈试验。开始在C3束缚感侧，不痛。,87,精编内容,RightCervicallateralbendingtestforC3-C7:C3-C7颈右侧弯测试：,88,精编内容,RightC3-7TPadjustment:右侧C3-7TP调整：,89,精编内容,-SCP:CervicalLPJ-LOD:Anterior-Superior-Setting:MediumorLow-Thrust(s):Multiple-SCP：颈椎LPJ-LOD：前-上-设置：“中”或“低”-推力：多重,CervicalSpine颈椎,90,精编内容,Cervicaldualstylusadjustmenttorestorelordosis:颈椎双针调整恢复前凸：,91,精编内容,-SCP:CervicalBilateralLPJ-LOD:Anterior-Superior-Setting:MediumorLow-Thrust(s):SingleorMultiple-SCP：颈部双侧LPJ-LOD：前-上-设置：“中”或“低”-推力：单个或多重,92,精编内容,93,精编内容,94,精编内容,MusclesthathinderOcciput-C7correction:阻碍枕部-C7肌肉的矫正：,ScalenesUpperTrapeziusLevatorscapulaeSpleniuscapitis斜角肌上斜方肌肩胛提肌夹肌,95,精编内容,Scalenes:斜角肌O:TPsofC2-7I:1st&2ndribsO：C2-7的TPsI：第1、2肋骨,Muscles,TestingandFunctionwithPostureandPain,Kendalletal,2005,LippincottWilliams&Wilkins,96,精编内容,Kulkarnietal.QuantitativeStudyofMuscleSpindlesinSuboccipitalMusclesofHumanFoetuses.胎儿枕下肌肉肌梭的定量研究NeurologyIndia,49,December2001:355-9.,Thedensity,distributionandmorphologyofmusclespindleswerestudiedintheuppercervicalspineDensityofMuscleSpindlesPerGramOfMuscle:研究了上颈椎肌梭的密度、分布和形态每克肌肉中的肌梭密度：-InferiorOblique242-下斜肌242-SuperiorOblique190-上斜肌190-RectusCapitisPosteriorMajor98-头后大直肌98-RectusCapitisPosteriorMinor98-头后小直肌98-LateralPterygoid20.3-翼状肌20.3-OpponnensPollicis17.3-对掌拇肌17.3-FirstLumbrical16.5-第一蚓状肌16.5-Trapezius2.2-斜方肌2.2-LatissimusDorsi1.4-背阔肌1.4,97,精编内容,98,精编内容,“Adistinctpatternofmyofascialfindingsinpatientsafterwhiplashinjury,”Murphy,ArchivesofPhysicalMedicineandRehabilitation,89:7,July,2008“颈部扭伤伤后患者肌筋膜检查发现的不同模式，”Murphy，物理医学与康复档案，89:2008年7月7日,85.1%hadpositivetriggerpointsinthesemispinaliscapitismuscle.ReducedcervicalROMisaprominentfinding.Myofascialtensionofthescalenemusclescausesafunctionalthoracicoutletsyndromethatmayexplainbrachialgia.Patientswithwhiplashdisplaymoretriggerpointsinthesemispinaliscapitismuscle,whichislocalizedintheupperneck,consistentwithaC1-2facetinjury.85.1的人在头半棘肌有触发点。颈椎ROM减少是一个突出的发现。斜角肌的肌筋膜紧张引起功能性胸廓出口综合征，这可能解释臂痛的原因。颈部扭伤患者在头半棘肌具有更多的触发点，位于上颈段，与C1-2关节突损伤一致。,99,精编内容,ScaleneAdjustment:斜角肌调整：,100,精编内容,Uppertrapezius:上斜方肌：O:occiput&cervicalsI:Lateral1/3ofclavicle&acromialprocessO：枕部&颈部I：锁骨&肩峰外侧1/3,Muscles,TestingandFunctionwithPostureandPain,Kendalletal,2005,LippincottWilliams&Wilkins,101,精编内容,UpperTrapAdjustment:斜方肌上部调整：,102,精编内容,Levatorscapulae:肩胛提肌：O:C1-4TPsI:medial-upperborderofscapulaI：肩胛骨内侧上缘,Muscles,TestingandFunctionwithPostureandPain,Kendalletal,2005,LippincottWilliams&Wilkins,103,精编内容,LevatorScapulaeAdjustment:肩胛提肌调整：,104,精编内容,Spleniuscervicis&capitis:颈夹肌和头夹肌：O:Ligamentumnuchae&TPsofC7&T1-6O：颈背韧带C7&T1-6之TPsI:OcciputtoC3I：枕部至C3,Muscles,TestingandFunctionwithPostureandPain,Kendalletal,2005,LippincottWilliams&Wilkins,105,精编内容,Spleniustestandadjustment:夹肌测试和调整：,Upperthoraciccompressiontestandadjustment上胸椎压缩测试和调整,106,精编内容,Posteriorneck“glide:”颈后“滑动”：,107,精编内容,Againstresistance:抗阻力：,108,精编内容,Fromhorizontal:水平角度：,correct正确,incorrect不正确,109,精编内容,ThoracicSpine胸椎,脉冲调整TECHNIQUE,110,精编内容,Thoraciccompressiontest:胸椎压迫测试：,111,精编内容,“Thoraciccostotransversejointpainpatterns:astudyinnormalvolunteers,”Youngetal,BMCMusculoskeletalDisorders,2008:9“胸肋横突关节疼痛模式：一项正常志愿者的研究”，Young等人，BMC肌肉骨骼疾病，2008:9,Intra-articularinjectionsin21CTjointsof8pain-freevolunteersproduced:在8名无疼痛志愿者的21个CT关节处进行关节腔内注射，产生：Adeepdullache,andpressuresensation.Painpatternsweresuperficialtotheinjectedjoint.Noproductionofchestwall,upperextremity,orpseudovisceralpain.OnlyT2referredpain2segmentscaudallyandcranially.一种深刻的隐痛和压迫感。疼痛模式为注射关节的浅表。没有产生胸壁、上肢或假性内脏疼痛。只有T2的尾端和颅端2段牵涉痛。,112,精编内容,-SCP:ThoracicTP-LOD:Anterior-Superior-Setting:MediumorLow-Thrust(s):Single-SCP：胸TP-LOD：前-上-设置：“中”或“低”-推力：单个,ThoracicPain胸痛,113,精编内容,-SCP:MedialPosteriorRibHead-LOD:Lateral-Inferior-Setting:MediumorLow-Thrust(s):SingleorMultiple-SCP：内侧后肋头-LOD：横向-下-设置：“中”或“低”-推力：单个或多个,ThoracicPain胸痛,114,精编内容,Thoracicdualstylusadjustment:胸部双针调整：,115,精编内容,-SCP:AnteriorRib-LOD:Lateral-Inferior-Setting:LoworMedium-Thrust(s):Single-SCP：前肋骨-LOD：横向-下-设置：低或中-推力：单一,ChestPain胸痛,116,精编内容,LowerExtremity下肢,Foot/Ankle足/踝关节Knee膝关节Hip髋关节,TheNeuromechanicalSystem,脉冲调整TECHNIQUE,117,精编内容,CommonConditionsoftheLowerExtremity:下肢的常见疾病：,Foot/Ankle足/踝PlantarFascitis/HeelPainAchillesTendonitisInversionAnkleSprainEversionAnkleSprainInstepPainMetatarsalgia足底筋膜炎/足跟痛跟腱炎内翻踝关节扭伤外翻踝关节扭伤脚背疼痛跖骨痛,118,精编内容,119,精编内容,Combinationofeversion,abduction,anddorsiflexion外翻、外展和背屈结合,Normalcalcanealeversionis4to8degrees.正常跟骨外翻是4至8度。,120,精编内容,PlantarFascitis足底筋膜炎,121,精编内容,CommonAssociatedFootSubluxations常见相关的足半脱位MedialCalcaneusInferior-medialTalusInferior-medialNavicularInferiorMedialCuneiformInferior1stMetatarsalInferiorLateralCuneiform内侧跟骨下内侧距骨下内侧舟骨下内侧楔形骨下第一跖骨下侧向楔形骨,PlantarFascitis足底筋膜炎,122,精编内容,PlantarFascitis足底筋膜炎,MedialCalcaneus-LO