运动治疗计划

null运动计划的评论 Critical Analysis of Exercise Programs运动计划的评论分析 Critical Analysis of Exercise Programs付 奕 中山大学附属第三医院康复医学科 Email: sundy_fy@tom.comDesigning an exercise program: why exercise ?Designing an exercise program: why exercise ?Common aims： Improve and keep health General aims： ↑muscle strength ↑endurance ↑flexibility ↑skill Establishing a baseline by which improvement can be measured Establishing a baseline by which improvement can be measured To test strength To test flexibility To test endurance To test skillTo test strengthTo test strength治疗师常用的方法： MMT、测力计、等速仪等 在一般的运动计划中： Abdominal muscles Sit-ups, straight-leg lifts Muscles of the upper limb Push-ups, chin-ups, throw ball Back muscles Prone-lying chest and leg lifts Muscles of the lower limb Jumping To test strength ——Abdominal musclesTo test strength ——Abdominal musclesSit-ups Feet unsupported is more effective than the full sit-up with feet supported. Start position to 45°-- primarily performed by rectus abdomins. 45°to sitting position-- primarily performed by iliacus muscle Half curl-up is used to test abdominal muscle strengthTo test strength ——Abdominal musclesTo test strength ——Abdominal musclesTo test strength ——Abdominal musclesTo test strength ——Abdominal musclesTo test strength ——Abdominal musclesTo test strength ——Abdominal musclesStraight-leg lifts 背部保持平直，不能弓背。 弓背意味着腹肌力量不足以对抗髂腰肌的拉力 髂腰肌只是完成高举和放下双腿的动作 对于有腰部活动过度或不稳定的患者此法不安全 下肢保持屈曲90度，做骨盆前倾的次数。To test strength ——Abdominal musclesTo test strength ——Abdominal musclesⅢ : 90° - 75 ° Ⅲ+ : 74 °- 60 ° Ⅳ - : 59 °- 45 ° Ⅳ : 44 °- 30 ° Ⅳ+ : 29 °- 15 ° Ⅴ : 14 °- 0 °To test strength ——Muscles of the upper limbTo test strength ——Muscles of the upper limbPush-ups Muscles of the trunk, hip and knee joints; triceps brachii; pectoralis major. It is hard for someone. The position of the hands and shoulder joint can affect the difficulty. To test strength ——Muscles of the upper limbTo test strength ——Muscles of the upper limblatissimuc dorsi muscles, biceps brachii, brachialis. Pull-ups (pronated grip ) Palms facing away. Less biceps, more back. Harder. Chin-ups (supinated grip ) Palms facing you. Work your biceps more. Easier. a difficult exercise to master Throw ball To test strength ——Back musclesTo test strength ——Back musclesProne-lying chest liftsTo test strength ——Muscles of the lower limbTo test strength ——Muscles of the lower limbLong/high jump Calf raises Gastrocnemius: with knee extended Soleus: with knee flexed Ⅴ: more than 6 repetitions Ⅳ: 3-5 repetitions Ⅲ:1-2 repetitionsTo test flexibility To test flexibility Hamstring Back Between the spinous processes of C7 and S2Toe-touch testTo test flexibility To test flexibility Pectoralis major Short upper neck extensors Trunk and hip flexors Ankle plantarflexors Quadriceps Triceps brachii DeltoidTo test endurance To test endurance Local muscle endurance Cardiovascular endurance To test skillCoordination Agility Balance Timing Velocity To test skillTo test skillTai Chi has been shown to improve balance and co-ordination Agility Figure of 8 Zigzags (Z字型) Shuttle runs (快速的往返跑) Cariocas Retrorunning Sport specific drills Establishing realistic goalsEstablishing realistic goalsExercise to increase strength Exercise to increase flexibility Exercise to increase endurance Exercise to increase skillExercise to increase strengthExercise to increase strengthHigher intensity lower repetition Increase the torque or the arm of force Exercise to increase strengthExercise to increase strengthThe common mistake Hard to performance Isometric ex. for the stabilizers Isotonic ex. for the prime movers Cause strain Exercise to increase strengthExercise to increase strengthThe common mistake Bilateral straight-leg raising tilts the pelvis anteriorly, cause the back strain Start at 90°, movement is stopped when no longer maintain the posterior pelvic tilit. Knee to chest ex. Scissors Curl-ups Increase the intervertebral disk pressure Exercise to increase strengthExercise to increase strengthOveruse cause poor posture Flexion exercise Keep balance Combine with extension exercise Did not identify the discomfort caused by the strain and fatigue Strain tearing (part or all) of the muscle fibers and the tendons usually occur during activities that require the muscle to tighten forcefully feel a burning sensation, muscle looks bruised or swells Fatigue is a weakness caused by exertion Soreness Exercise to increase strengthExercise to increase strengthMovement of the original design was altered or exaggerated Fire hydrant Strengthen the gluteus maximus 必须有良好的骨盆稳定性，保持骨盆中立位，hip完成其范围内的位置时，停止伸直及外转的动作 抬起大腿范围过大，会造成SIJ及腰椎的额外压力 有潜在的危险性 Side-lying abduction Strengthen the gluteus medius/minimus 底下的腿屈曲以固定，上面的腿必须与躯干呈一直线，外展角度大约30°-45°。 夸大这个动作，会伴随过多的屈曲及转动，造成tensor fasciae latea 张力增加及knee pain。 Exercise to increase strengthExercise to increase strengthThe insecurity of biomechanical view Bridging 传统的姿势会造成颈椎过度受压，使椎间盘受伤 改良为双脚及上背上推 Duck waddle / deep-knee bends 深蹲会造成knee的结构损伤 改为半蹲，0-60°。 Exercise to increase strengthExercise to increase strengthMuscles strength training program, a set of safety recommendations. P723 8 pointsExercises to increase flexibilityExercises to increase flexibilityThe common mistake Emphasize inappropriate Unbalance of the flexibility Ballistic stretch Pain Mistake biomechanicsExercises to increase flexibilityExercises to increase flexibilityMistake biomechanics Toe-touch/ push-ups Knee or elbow must keep a slight flexion Genu recurvatum Gastrocsoleus stretch 避免脚掌向外，尽量使脚掌朝内，可卡住足部，稳定足弓。 Exercises to increase flexibilityExercises to increase flexibilityMuscles flexibility training program, a set of safety recommendations. P724 6 points Exercise to increase enduranceExercise to increase enduranceMuscle endurance Cardiovascular enduranceExercise to increase skillnullRe-evaluate at frequent intervals to see if the baseline has changed.null