腰椎骨盆疾病的诊断、生物力学分析（84页）2

1、稳定肌稳定肌运动肌运动肌StabilityPassive subsystemActive subsystemControl subsystemPanjabi 1994- Muscles- Tendons- CNS- Periferal nerves- Bony structures- Ligaments- Joint capsules- Intervertebral discsSpinal motor control dysfunctionPainRepeated microtrauma在所有上肢和下肢的快速运动中，腹在所有上肢和下肢的快速运动中，腹横肌先于所有主动肌收缩之前开始收横肌先于所有

2、主动肌收缩之前开始收缩缩Hodges et al 1997 & 1999掌握脊柱保健的知识掌握脊柱保健的知识培养正确的体态体姿培养正确的体态体姿养成良好的生活方式养成良好的生活方式改善和保持改善和保持CNSCNS对躯干肌肉的对躯干肌肉的运动控制功能运动控制功能改善和保持躯干肌肉的改善和保持躯干肌肉的功能水平功能水平腰背学校腰背学校心理社会康复心理社会康复主动康复训练主动康复训练腰椎稳定性整体解决方案腰椎稳定性整体解决方案内层运动控制内层运动控制学习节段学习节段内外层连接控制内外层连接控制训练节段训练节段功能能力功能能力训练节段训练节段学习和掌握独立控制腰椎稳定肌活动能力训练和建立稳定肌与运动肌

3、协同活动能力训练和改善腰椎节段稳定性控制功能 Hodges PW, Richardson CA (1996)Hodges PW, Richardson CA (1998) Hodges PW, Richardson CA (1996) Hodges PW, Richardson CA (1996)Hodges PW (2001)Hides JA et al. (1994)Roy SH et al. (1989)Rantanen, J. et al. (1993)Ford D et al (1983)Sihoven T et al. (1991)Radebold A et al. (2000)A

4、rendt-Nielsen et al (1995)Kaigle A et al. (1998)Shirado (1995)Walker & Engstrom (1996) Parkhurst and Burnett (1994)Gill and Callaghan (1998)Brumagne et al (2000)(Hides et al., 1996)C ontrolled respirationN eutral lordosisIsolate TA and m ultifidusStage 1:C ognitive stageLow load, high repititionsR e

5、training m ovem ent patternsStage 2:Associative stageSkilled activitiesH igh load activation of global m usclesD ynam ic stabilisationStage 3:Autonom ous stageLum bar spine dysfunctionOSullivan P, 2000掌握脊柱保健的知识掌握脊柱保健的知识培养正确的体态体姿培养正确的体态体姿养成良好的生活方式养成良好的生活方式改善和保持改善和保持CNSCNS对躯干肌肉的对躯干肌肉的运动控制功能运动控制功能改善和保持

6、躯干肌肉的改善和保持躯干肌肉的功能水平功能水平腰背学校腰背学校心理社会康复心理社会康复主动康复训练主动康复训练腰椎稳定性整体解决方案腰椎稳定性整体解决方案内层运动控制内层运动控制学习节段学习节段内外层连接控制内外层连接控制训练节段训练节段功能能力功能能力训练节段训练节段学习和掌握独立控制腰椎稳定肌活动能力训练和建立稳定肌与运动肌协同活动能力训练和改善腰椎节段稳定性控制功能Conclusion:An intervention with specific stabilizing exercises, integrated functionally, is effective in reducing

7、 pain, improving functional status and quality of life, in women with pregnancy related pelvic pain after pregnancy. This is the first study with a 2-year follow-up of patients receiving treatment for postpartum pelvic girdle pain. The significant differences between the groups in functional status, pain, quality of life, obtained during the the intervention period, were obtained 2 years after delivery.Stuge B, Veierd MB, Lrum E, Vllestad N. The efficacy of a treatment program focusing on specific stabilizing exercises