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关于颈胸臂丛神经出口综合征康复的思考

[Considerations on rehabilitation of cervicothoracobrachial outlet syndrome].

作者信息

Berthe A

出版信息

Chir Main. 2000 Sep;19(4):218-22. doi: 10.1016/s1297-3203(00)73483-4.

Abstract

The conservative treatment of the thoracic outlet syndrome (TOS) as proposed by Peet in 1956 prevailed a long time and still remains, for many physiotherapists, the technique of reference. However, during these last 20 years, many authors have published improvements to this technique. The Walsh program, published in 1996, is advantageous on the one hand because it utilizes all the evaluation data, and on the other hand, it separates compressive TOS from entrapment TOS, with the latter limiting plexus mobility in proportion to extraneural and/or intraneural fibrosis. The treatment program includes three stages. The goal of the first stage is to control the symptomatology and to obtain comfort. The second stage concerns more directly the pathological tissues: musculoskeletal surroundings for compressive components and mobilization of the nervous system according to Butler, Totten and Hunter protocols for entrapment components. The third stage aims to condition and strengthen the postural muscles. A home rehabilitation program is also addressed. The patient's ability to tolerate daily living and professional activities depends on the pursuit of the home program in accordance with evolution.

摘要

1956年由皮特提出的胸廓出口综合征(TOS)保守治疗方法长期占据主导地位,并且对于许多物理治疗师而言,仍是参考技术。然而,在过去20年中,许多作者发表了对该技术的改进方法。1996年发布的沃尔什方案具有优势,一方面它利用了所有评估数据,另一方面,它将压迫性TOS与卡压性TOS区分开来,后者会根据神经外和/或神经内纤维化程度限制神经丛活动。治疗方案包括三个阶段。第一阶段的目标是控制症状并获得舒适感。第二阶段更直接针对病变组织:对于压迫性成分,处理肌肉骨骼周围组织;对于卡压性成分,根据巴特勒、托滕和亨特方案对神经系统进行松动。第三阶段旨在调整和强化姿势肌。还提到了家庭康复计划。患者耐受日常生活和职业活动的能力取决于能否根据病情进展坚持家庭康复计划。

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