课件分析文案

课课程目标／内Reviewtheclinicalpresentation,clinicalanatomy,pathology,clinicalkinesiology,andclinicalbiomechanicsofNeckReviewtheexercisesforindividualswhoarereportingsymptomsconsistentwithNeckPainwithRadiatingAnyAnyPonders,Concerns,orQuestion DescribeQuestion DescribeakeyclinicalfindingthatyourclientwithNeckPainwithMovementCoordinationImpairmentswouldtellyouabouthis/hersymptomsthatwouldincreasethelikelihoodyourclienthasNeckPainwithMovementCoordinationImpairmentsratherthananothertypeofneckNeckPainNeckPainwithMovementCoordination(alsocommonlyknownas"cervicalClinicalNeckpainandassociated(referred)upperextremitySymptomsareoftenlinkedtoaprecipitatingtrauma/whiplashandmaybepresentforanextendedperiodofDiminisheddeepneckflexormusclestrengthandenduranceisusuallyMuscleflexibilitydeficitsinselectedshouldergirdlemusclesandMobilitydeficitsintheupperthoracicspineandribsarecommonly颈痛伴运动协调性障颈痛，伴牵涉上肢症状经常与突然的外伤／鞭甩动作有关，并可能已持续了一段时常见深层颈屈肌力量与耐力减常见肩带肌肉柔韧性不足与上胸段及肋骨活动度不Question DescribeQuestion DescribeakeyclinicalfindingthatyourclientwithNeckPainwithMobilityDeficitswouldtellyouabouthis/hersymptomsthatwouldincreasethelikelihoodthatyourclienthasNeckPainwithMobilityDeficitsratheranothertypeofneck2.NeckPainwithMobilityNeckPainwithMobilityClinicalUnilateralneckpainNeckmotionlimitationsOnsetofsymptomsisoftenlinkedtoarecentunguarded/awkwardmovementorAssociated(referred)upperextremitypainmaybeOftenhaveobservable,orreported,stiffness/motionlimitationsReportpainatthelimit(endranges)oftheavailablemotion单侧颈颈部活动受症状初现时与最近的无防备／不自然运动或者姿势有可能伴有上肢牵涉Question DescribeQuestion DescribeakeyclinicalfindingthatyourclientwithNeckPainwithRadiatingPainwouldtellyouabouthis/hersymptomsthatwhatwouldincreasethelikelihoodthatyourclienthasNeckPainwithRadiatingratherthananothertypeofneck3.NeckPainwithRadiatingNeckPainwithRadiatingClinicalFindingsNeckpainwithassociatedradiating(narrowbandoflancinating)painintheinvolvedupperextremityUpperextremityparesthesias,numbness,andweaknessmaybepresent•••Positionsormovementsthatputtensiononnervesaggravatethe颈痛伴放射临床表颈痛伴上肢有放射痛（窄条状刺痛上肢感觉异常、麻木、无增加神经张力的姿势或者运动会加重症 Describea DescribeakeyclinicalfindingthatyourclientwithNeckPainwithHeadachewouldtellyouabouthis/hersymptomsthatwhatwouldincreasethelikelihoodthatyourclienthasNeckPainHeadacheratherthanMigraineHeadachesorheadachesfromanother4.NeckPainwithNeckPainwithClinical••Noncontinuous,unilateralneckpainandassociated(referred)Headacheisprecipitatedoraggravatedbyneckmovementsofsustained••LimitedcervicalrangeofmotionisusuallyStrengthandendurancedeficitsofthedeepneckflexormusclesis非持续性、单侧颈痛伴（牵涉性）5.5.ReportsofanarrowbandoflancinatingpainintheupperextremitiesismostcommoninindividualswhohaveclinicalfindingsmostconsistentNeckPainwithMovementCoordinationImpairmentsNeckPainwithMobilityDeficitsNeckPainwithRadiatingD.NeckPainwith5.主诉上肢窄条状刺痛，更常见于哪种疼痛颈痛伴运动协调性障颈痛伴活动度不颈痛伴放射颈痛伴头5.5.ReportsofanarrowbandoflancinatingpainintheupperextremitiesismostcommoninindividualswhohaveclinicalfindingsmostconsistentNeckPainwithMovementCoordinationImpairmentsNeckPainwithMobilityDeficitsNeckPainwithRadiatingD.NeckPainwith5.主诉上肢窄条状刺痛，更常见于哪种疼痛颈痛伴运动协调性障颈痛伴活动度不颈痛伴放射颈痛伴头Patterns,Patterns,orcategories,ofindividualswithNeckCategoriesarehelpfulbecausetherearedifferentexerciseandcounselingstrategiesforthedifferentsubAnyAnyQuestionsAbouttheOraboutNeckBreakBreakConsidertakingaBreaknow-ifthepreviousdiscussionsaboutNeckPainwerelong-otherwise-continuewithoutaYourYourclientswithwhattype,orpattern,ofneckpaininmostneedofnervemobility什么类别的颈痛患者最需要神经活动度NeckPainwithNeckPainwithRadiatingClinicalNeckpainwithassociatedradiating(narrowbandoflancinating)painintheinvolvedupperUpperextremityparesthesias,numbness,andweaknessmaybe•••Positionsormovementsthatputtensiononnervesaggravatethe颈痛伴放射临床表增加神经张力的姿势或者运动会加重症TherearethreemainnervesthatgofromyournecktoyourMedianTherearethreemainnervesthatgofromyournecktoyourMedianRadialUlnarCourseofMedianCourseofMedianInfrontof/anteriortoInfrontof/anteriortoInfrontof/anteriortoPutyourPutyourarminapositionthatputstheMedianNerveonThensidebendthe(remembertokeeptheshoulderblade/scapula（保持肩胛下降AnyAnyquestionsaboutMedianNerveandpositionsthatwouldputitonCourseofRadialInbackofCourseofRadialInbackof/posteriortoshoulderInfrontof/anteriortoInbackof/posteriortoPutyourarmPutyourarminapositionthatputstheRadialNerveonThensidebendthe(remembertokeeptheshoulderblade/scapula（保持肩胛下降AnyAnyquestionsaboutRadialNerveandpositionsthatwouldputitonSlideSlideInsertanimageoftheUlnarAnddescribethecourseofthatCourseofUlnarCourseofUlnarInfrontof/anteriortoInbackof/posteriortoInfrontof/anteriortoPutyourPutyourarminapositionthatputstheUlnarNerveonThensidebendthe(remembertokeeptheshoulderblade/scapula（保持肩胛下降AnyAnyquestionsaboutUlnarNerveandpositionsthatwouldputitonWhenWhenyouweredoingtheexercises,didyounoticeanyoddsensations,suchaspinsandneedlesinyourforearm,wrist,orNoteNotethattheproblemwithnervesintheupperlimb-similartothelowerlimb-isthatthenervesgetcompressedor"entrapped"attheycoursethoughtunnelsaroundbonesandthroughmusclesand与下肢类-神经在走行中穿过骨附近的管道、And,And,themobilityofthenervesthroughthesetunnelsandthecirculationtothenervescanbeimprovedwithmovingthenervebackandforththoughthoseanatomicaltofreeupthe"entrapment"andimprovecirculationtonervesthatwerepreviouslywereexperiencingsomeThus,Thus,thefocusforexercisesforthenervesis(andnot因此，神经练习注重的是活动度（而不是拉伸And,And,asyoucansuspect,puttingtensiononnervesthathavehadsomerecentirritationcanbepainful,sothegoalistoimprovethemovementandcirculationbutincreasetheSo,So,dosageofthemobilityexercisesisIfthereispainpriortofeelingtissueIfthereispainpriortofeelingtissueDothenervemobilityexercisespriortothepointofIftissueresistanceandIftissueresistanceandpainarefeltatthesameDothenervemobilityexercisesintothefirsttissueresistanceandbarelyproduceThereshouldbenoincreaseinthepre-exerciselevelofpainafterthemobilityexercisesetisIftissueIftissueresistanceisfeltnoticeablypriortotheonsetofDothenervemobilityexercisesintothetissueresistanceanditisoktoproduceasmallaboutpainforashortperiod(afewAgain,thereshouldbenoincreaseinthepre-exerciselevelofpainafterthemobilityexercisesetis如果组织阻力在疼痛出现之前出现神经活动度练习至出现阻抗，可以出现段时间（几秒钟）的疼同样，完成神经活动度练习后疼痛不应超过练习前水AnyAnyquestionsaboutKeepthosedosagesuggestionsaswepracticethedifferentmobilityexercisesforthemedian,radialandulnarWeWewillstartwithmobilityexercisesfortheMedianMedianMedianNerveMobility(Level1):Mid-range正中神经活动度（1级）：MedianNerveMobilityMedianNerveMobility(Level1):Mid-range正中神经活动度（1级）：•LieonyourbackwithasmalltowelsupportingyourheadthatwillallowyournecktoThestartingpositionfortheinvolvedarmistohavetheshoulderrelaxed(armpitpressedslightlydownwardstowardsyourtoes),elbowstraight,palmrotateduptowardstheceiling,armawayyour下降），Rotateyourheadtowardstheinvolvedsidewhilebendingthewristback.Thenlookawaywhileyoubendthewristforward(bringingthefingersclosertothepalm-sideofyour手腕向后伸时头部向患侧旋转。然后手腕向前伸（••前臂掌侧靠近）MedianMedianNerveMobility(Level2):End-range正中神经活动度（2级）：MedianNerveMobilityMedianNerveMobility(Level2):End-range正中神经活动度（2级）：•LieonyourbackwithasmalltowelsupportingyourheadthatwillallowyournecktoThestartingpositionfortheinvolvedarmistohavetheshoulderrelaxed(armpitpressedslightlydownwardstowardsyourtoes),elbowstraight,palmrotateduptowardstheceiling,armawayfromyourInthis‘tensioning’maneuver,tiltyourheadawayfromtheinvolvedarm(eartowardstheuninvolvedshoulder).Asyoutiltyourheadawayfromtheinvolvedarm,bendthewristoftheinvolvedarmSlideyourheadbacktomidlineasyourelaxthewristbacktoamid-range•••MedianMedianNerveMobility(Level3):End-rangemotions/using正中神经活动度（3级）：MedianNerveMobilityMedianNerveMobility(Level3):End-rangemotions/using正中神经活动度（3级）：•Lieonyourbackwithasmalltowelsupportingyourheadthatwillallowyournecktomove.Drapeabeltaroundtheshoulderyouplantostretchandaroundtheoppositeshin.Thebeltshouldbeatsufficientlengthtoallowtheuninvolvedlegtopressthebeltdownwards(towardsyourThestartingpositionforthearmisshoulderrelaxed(armpitpressedslightlydownwardstowardsyourtoes),elbowstraight,palmrotateduptowardstheceiling,armawayfromyourInthis‘tensioning’maneuver,tiltyourheadawayfromthestrap,towardtheoppositeshoulder.Whiletheheadismovingawayfromthestrap,bendthewristoftheinvolvedarmbackwards.Atthetime,gentlyusethelegthattoputpressureonthestrapinadownwarddirection–movingtheshoulderdownwardstowardsyourfeet.Thiswillprovidepressureontheinvolvedshoulderandprovideagreaterstretch.Slideyourheadbacktomidlineandeliminatetensiononthebeltasyourelaxthewristbacktoamid-rangeposition.••MedianMedianNerveMobility(Level3):End-rangemotions/using正中神经活动度（3级）：AnyquestionsorAnyquestionsorcommentsMedianNerveMobilityKeepKeepinmindthattheseexercisereallyonlycreateabiastomovingonenervemorethantheOnecannottotallyisolatethemovementofonenervebecausetheyareallinter-WejustmoveonenerverelativelymorethanNow,Now,let’smovetomovingtheRadialRadialRadialNerveMobility(Level1):Mid-range桡神经活动度（1级）：RadialNerveMobility(LevelRadialNerveMobility(Level1):Mid-range桡神经活动度（1级）：•LieonyourSupportyourheadwithalayeroftowelunderyourheadtoalloweasyneckmovementsfromside-to-sideandtolimitneckfrombendingThestartingpositionfortheinvolvedarmistohavetheinvolvedshoulderrelaxed(armpitpressedslightlydownwardstowardsyourtoes),elbowstraight,palmrotateddownwardsandoutwards(thumbbepointeddowntowardstheground),andarmawayfromyoursideapproximately12-18Inthis‘gliding’maneuver,rotateyourheadtowardstheinvolvedarmasthatarmisbendingthewristtowardtheground.Then,rotatingyourheadawayfromtheinvolvedsideasyoubendthebackwards(towardtheceiling).Alternatethesetwomotionsslowlyand••••••板）RadialRadialNerveMobility(Level1):Mid-range桡神经活动度（1级）：RadialRadialNerveMobility(Level2):End-range桡神经活动度（2级）：RadialNerveMobility(Level2):RadialNerveMobility(Level2):End-range桡神经活动度（2级）：•LieonyourSupportyourheadwithalayeroftowelunderyourheadtoalloweasyneckmovementsfromside-to-sideandtolimitneckfrombendingThestartingpositionfortheinvolvedarmistohavetheinvolvedshoulderrelaxed(armpitpressedslightlydownwardstowardsyourtoes),elbowstraight,palmrotateddownwardsoutwards(thumbwillbepointeddowntowardstheground),andarmawayfromyoursideapproximately12-18Inthis‘tensioning’maneuver,tiltyourheadawayfromtheinvolvedarmwhilethatarmisbendingthewristtowardfloor.Slideyourheadbacktoneutralasyoubendthewristbackwardstowardthe••••••RadialRadialNerveMobility(Level2):End-range桡神经活动度（2级）：RadialRadialNerveMobility(Level3):End-rangemotions/using桡神经活动度（3级）：RadialNerveMobility(Level3):End-rangeRadialNerveMobility(Level3):End-rangemotions/using桡神经活动度（3级）：•LieonyourLieonyourbackwithalayerofafoldedtoweltosupportyourheadtoalloweasyneckmovementsfromside-to-sideandtolimitneckfrombendingbackwards.Drapeabeltaroundtheshoulderandaroundtheoppositeshin.Thebeltshouldbeatasufficientlengthtoallowthelegtopressthebeltdownwards(towardsyourStartwithyourheadbenttowardtheinvolvedarm,armstraight,andwristinarelaxedThe“tensioning”positionfortheinvolvedarmistohavetheinvolvedshoulderpressedslightlydownwardsbythebelt(towardyourfeet),elbowstraight,palmrotateddownwardsandoutwardswillbepointeddowntowardstheground),andarmawayfromyoursideapproximately12-18Inthis‘tensioning’maneuver,tiltyourheadawayfromtheinvolvedarmwhilethatarmisbendingthewristtoward••••••••在此“拉伸”RadialRadialNerveMobility(Level3):End-rangemotions/using桡神经活动度（3级）：AnyAnyquestionsorcommentsRadialNerveMobilityNow,Now,let’smovetomovingtheUlnarUlnarUlnarNerveMobility(Level1):Mid-range尺神经活动度（1级）：UlnarNerveMobility(LevelUlnarNerveMobility(Level1):Mid-range尺神经活动度（1级）：•LieonyourbackwithasmalltowelsupportingyourheadthatwillstillallowyournecktoThestartingpositionfortheinvolvedarmistohavethearmouttotheside,elbowextended,palmawayfromthebody,andwristandfingerswillbebentawayfromyourRotateyourheadtowardstheinvolvedsidewhilebendingtheelbow,wristandfingersSlowlyreversethemotionandreturntothestart••••••UlnarUlnarNerveMobility(Level1):Mid-range尺神经活动度（1级）：UlnarUlnarNerveMobility(Level2):End-range尺神经活动度（2级）：UlnarNerveMobility(LevelUlnarNerveMobility(Level2):