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| 題 名 | 痙攣型雙邊麻痺兒童粗動作型態之發展及玻巴斯治療方法 |
|---|---|
| 作 者 | 廖華芳; | 書刊名 | 中華民國物理治療學會雜誌 |
| 卷 期 | 15 1990.09[民79.09] |
| 頁 次 | 頁63-71 |
| 分類號 | 418.92 |
| 關鍵詞 | 兒童; 玻巴斯治療; 粗動作型態; 痙攣型雙邊麻痺; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 本文以神經生理與生物力學之角度來描述痙攣型雙邊麻痺兒童粗動作 之發展。大部份患童早期沒有異常動作型態,僅是生理性屈曲姿勢佔優勢之時期 較正常兒童長,到後期,由於活動量增加,過份出力引發聯合反應(associated reaction),使下肢伸肌痙攣愈來愈明顯。然後在爬及坐之發展階段,下肢即呈現 屈肌和伸肌同時收縮之半伸半屈姿勢,即使是到能站能走的階段,也維持此一特 性。根據步態分析實驗室之研究顯示,患童由於缺乏足夠的平衡反應,加上痙攣 的影響,痙攣型雙邊麻痺兒童於步行時所使用之代償方式之變異性相當大。接受 過跟腱延長術之患童,如果跟腱過份延長,行走時常因膝屈曲力矩增加,以致造 成進行性屈膝步態(progressive crouch gait)。另一種在痙攣型雙邊麻痺兒童常見的 異常步態,則因犢肌(calfm.)痙攣太強,使其在步行之站立期(stance phase)初期脛 骨便無法前移,以致造成膝關節後頂步態(hyperextended knee)。著者並根據玻巴 斯(Bobath)治療概念,分析異常動作之成因及治療原則,並介紹在不同發展階段 之運動治療方法。 |
| 英文摘要 | The development of gross motor patternin spastic diplegics is presented in this articlein view of neurophysiology and biomechanics.The child usually showed physiological flexionposture in the early infancy, then extensorspasticity gradually appeared with the increasingactivities. In the later stage, because of the flexionpositions in sitting and crawling, the semiflexionposture gradually developed with the co-contrac-tion of flexor and extensor. This semiflexionposture usually remained through the standingand walking stage. The two most commongait deviations are described as follows. Oneis the progressive crouch gait of spastic diplegicchild which was caused by the increasing flexiontorque of knee joint and the deformity of patellaalta. The other is the hyperextended knee during early stance phase which was usually in duced by the decreased forward advancement of thetibia affected by the strong calf muscle activities. The treatment principles and methodsintroduced in this paper were based on theBobath's concepts. Such as using active inhibiting pattern rather than the passive or staticreflex inhibiting pattern to reduce the hypertonus; using key point control to facilitatethe normal postural reactions and to inhibitthe abnormal movement patterns; facilitatingthe movement patterns that deviating fromsynergic pattern; avoiding effort during treatment; weight shifting training in weight bearingposture; using proper sensory stimulation tonormalize muscle tone; to prevent the development of contracture or deformities. |
本系統中英文摘要資訊取自各篇刊載內容。