等速肌力测定学习教案

1、会计学1等速肌力等速肌力(j l)测定测定第一页，共22页。Content目录目录 introduction介绍介绍 clinical application (patients / athletes)临床应用（病临床应用（病人人/运动员）运动员） strength diagnostics力量力量(l ling)诊断诊断 treatment evaluation治疗评估治疗评估 rehabilitation康复康复 strength training力量力量(l ling)训练训练 research研究研究 strength diagnostics力量力量(l ling)诊断诊断 standa

2、rdized test situations标准测试方式标准测试方式 standardized strength training标准力量标准力量(l ling)训练训练 up to date最新最新 ballistic mode“弹道模式弹道模式 sensorimotor“ testing感觉运动测试感觉运动测试 speed profile“ (+ perturbation)速度情况速度情况 扰动扰动 special/functional movement situations特别的特别的/功能性功能性运动状况运动状况 examples (video clip) 例子例子 （视频剪辑）（视频

3、剪辑）J.Perrine 1967第1页/共23页第二页，共22页。Isokinetics in Literature等速文献 PubMed search检索(jin su) (isokinetic 等速/ torque力矩): 1980: 8 1990: 48 2000: 70 2010: 114 68 knee 膝 11 ankle踝 9 hip髋 7 trunk躯干 9 shoulder肩 5 elbow肘 5 other其他第2页/共23页第三页，共22页。感谢德国菲兹曼医用电子感谢德国菲兹曼医用电子(dinz)公司提供设备支持公司提供设备支持!第3页/共23页第四页，共22页。第4页

4、/共23页第五页，共22页。第5页/共23页第六页，共22页。everyday practice: patients每天训练：病人 strength diagnostics力量(l ling)诊断female athlete女性运动员; 8 weeks after torn muscle fibers 在肌纤维损伤8周后(M. rectus femoris, left左侧 股直肌) full recovery?真的(zhn de)康复了吗？ is there a strength deficit?有无力量缺失？side differences; agonist vs. antagonist;

5、conentric vs. eccentric; reference values?两侧(lin c)差异；收缩肌，对抗肌；向心，离心；参考值？ decision: best treatment / training?决定：最佳的治疗/训练 additional examples:举例LBP-patients下腰痛病人stroke patients中风病人第6页/共23页第七页，共22页。everyday practice: athletes每天训练：运动员 treatment / training evaluation治疗(zhlio)/训练评估elite male athlete (no

6、pain)优秀男性运动员（无疼痛(tngtng)） strength gain after training intervention?在训练之后力量的增加 restoration of strength level after therapy?治疗之后(zhhu)力量水平的恢复情况？everyday practice: patients / athletes每天训练：病人/运动员 rehabilitation (trainig mode biofeedback)康复（训练模式-生物反馈）第7页/共23页第八页，共22页。everyday practice: patients / athlet

7、es每天训练：病人/运动员 diagnostics and treatment evaluation and rehabilitation 诊断(zhndun) 治疗 评估 康复male athlete after ACL injury男性运动员在前交叉韧带损伤(snshng)之后 3 month, 6 month, 9 month 3,6,9个月 restoration of strength level after therapy?治疗之后(zhhu)力量水平的恢复Flex reFlex liExt reExt liEccentric Iso concentric 第8页/共23页第九页，

8、共22页。Research研究(ynji): strength diagnostics力量诊断for example举例:differences in strength of the plantarflexors between healthy runners and runners with achilles tendinopathy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shoulder strength capacity and supraspinatus tendinopathy 肩关节力量能力和冈上肌肌腱病is trunk strength a relevant fact

9、or in low back pain躯干力量是下腰(xi yo)痛的一个相关因素 Baur et al. Trunk extensor and flexor strength of long distance race car drivers compared to physically active controls. J Sports Sci. (2010)长距离驾车驾驶员的躯干伸肌与屈肌力量身体主动(zhdng)控制对比Baur et al. Reactivity, stability, and strength performance capacity in motor sports

10、. Br J Sports Med (2006) 运动中的反应，稳定性，力量能力第9页/共23页第十页，共22页。Research研究(ynji): standardized test situations标准测试状态thickness of Achilles / Patella tendon in different joint angles and loading situations阿基里斯/髌骨 肌腱在不同关节(gunji)角度和负载状态下的厚度 well controlled position, velocity, loading很好的控制姿势，速度，负载Arya et al. 20

11、09objectivity / reliability 客观性/可靠性the machines are accurate 仪器准确性variability comes from the subject in the specific test situation目标(mbio)特殊测试状态下的可变性Mller et al. Reproducibility of isokinetic single- and multi-joint strength measurements in healthy and injured athletes. Isokinetics and Exercise Sci

12、ence (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第10页/共23页第十一页，共22页。Research研究: standardized strength training标准(biozhn)的力量训练RCT; 6 weeks training intervention随机对照实验(shyn)：6 周的训练 standardized training 标准训练第11页/共23页第十二页，共22页。ballistic mode“弹道(dndo)模式”flexionextension0 problem in classic mode“经典模式“的问题(wn

13、t): real speed may not reach preset speed limits:不能达到预设的速度 reasons原因 physics (Newtons laws)物理(wl)性: patients/athletes have to overcome two factors to reach speed limit: 病人和运动员必须克服两个因素达到预设的速度 gravity (gravitational force that occurs between earth and other bodies)重力（地球与身体之间的引力） moment of inertia (dep

14、ending on: mass; radius)惯性（决定于：质量，半径）第12页/共23页第十三页，共22页。ballistic mode“弹道(dndo)模式”Consequence (classic mode“)结论（经典模式） incorrect interpretation of data错误的数据解释: a measured value is correlated to a wrong velocity 测量值与错误的速度相关联 the measured value is effected through acceleration/deceleration moments (no

15、isokinetic phase)诊断值受加速，减速运动的影响（无等速阶段） patients: reasonable velocities in active movements not always possible (especially in the initial phase of rehabilitation)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(chq)） athletes: high speed“ testing/training is not possible 运动员：”高速“测试与训练不可能flexionextension1801800/s0Nm第13

16、页/共23页第十四页，共22页。ballistic mode“”弹道(dndo)模式“natural movement自然(zrn)运动natural movement自然运动isokinetic movement等速运动 natural movement speed自然运动(yndng)速度: walking步行: 膝关节knee 140-320/s running跑步: 膝关节knee 150-185/s (8,0 km/h) (Li 1999) pitching投掷: 肩关节shoulder -8500/s (internal rotation内旋) (Murray 1999) thro

17、wing投掷: 肘关节elbow 1000/s(McNaughton 2004)ballistic mode“”弹道模式“: active compensation of gravity and inertia重力和惯性主动补偿第14页/共23页第十五页，共22页。ballistic mode“弹道(dndo)模式Method方法 subjects目标: N=25 (healthy)健康 material材料: rotational and linear dynamometer (Con-trex MJ/LP/TP/WS)旋转和线性测力计 Protocol方式: max. strength m

18、easurements 最大力量诊断(5 rep.5次; 60 seconds rest60秒休息) in classic and ballistic mode (randomized)经典和弹道(dndo)模式（随机） 4 different movements 4种不同的运动(knee, trunk, total lower limb and shoulder/ arm complex膝，躯干，下肢，肩/上肢 复合) 3 velocities 3 种速度 test-retest design (1 week interval)测试-再测试 设计（一周间隔）M1M21 week 1周第15页

19、/共23页第十六页，共22页。ballistic mode“弹道(dndo)模式Consequences结论 new isokinetic ballistic“ mode is relevant新的等速”弹道模式“相关 for high movement velocities高速运动 patients with low strength level力量低下病人 complex joint movements关节联合运动 movements with large body segments身体的粗大运动 earlier and wider application of dynamometry i

20、n rehabilitation (active mode)肌力测定法（主动(zhdng)模式）在康复中更早期、更广泛的应用 application of dynamometry in high performance athletes with more functionality肌力测定法在高体能运动员中有更多的应用Mller et al. Higher velocities in isokinetic dynamometry: A pilot study of new test mode with active compensation of inertia. Isokin Exerc

21、Sci 19(2011) 等速肌力测定中的更高速度：新的惯性主动补偿(bchng)测试模式初步研究第16页/共23页第十七页，共22页。Footplate unstable不稳定(wndng)踏板Footplate stable稳定(wndng)踏板Ta riPl riGm riVm riRf riTa lePl leGm leVm leRf leTriggerNsensorimotor“ testing感觉运动测试 Legpress test with stable and unstable footplates带有稳定(wndng)或不稳定(wndng)踏板的下肢力量测试male patient; repetitive ankle sprains男性病人；反复踝关节扭伤 strength defici