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[康复中的部分负重。指导策略与限制因素]

[Partial weight-bearing in rehabilitation. Strategies for instruction and limitations].

作者信息

Klöpfer-Krämer I, Augat P

机构信息

Institut für Biomechanik, BG Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418 Murnau am Staffelsee.

出版信息

Unfallchirurg. 2010 Jan;113(1):14-20. doi: 10.1007/s00113-009-1717-8.

Abstract

Following trauma or surgery on the musculoskeletal system the primary aim is always as complete a restitution of mobility as possible. By mobilization with partial weight-bearing this is possible. The preferred way of teaching partial weight-bearing is the use of conventional bathroom scales. This method proves to be simple as well as time and cost-saving, but the transferability to the patient's daily life is questionable. Training and control of partial weight-bearing under dynamic conditions, such as normal walking, and walking up and down stairs seem to be very important. Different investigations have shown that the minority of subjects recruited could manage to maintain the given load of partial weight-bearing. Furthermore, the actual resulting moments within the joints, caused by muscles, fascia and tendons, are not considered in presets of partial weight-bearing, as only external forces (ground reaction forces) are measured. However, the problems in teaching partial weight-bearing have to be contrasted with the as yet unexplained issue of postoperative partial versus full weight-bearing.

摘要

在肌肉骨骼系统遭受创伤或手术后,首要目标始终是尽可能完全恢复活动能力。通过部分负重的活动可以实现这一目标。教授部分负重的首选方法是使用传统的浴室秤。这种方法被证明既简单又节省时间和成本,但它在患者日常生活中的可转移性值得怀疑。在动态条件下,如正常行走以及上下楼梯时,对部分负重进行训练和控制似乎非常重要。不同的研究表明,招募的受试者中少数人能够设法维持给定的部分负重负荷。此外,在部分负重的预设中,并未考虑由肌肉、筋膜和肌腱在关节内产生的实际力矩,因为仅测量了外力(地面反作用力)。然而,教授部分负重时存在的问题必须与术后部分负重与完全负重这一尚未得到解释的问题相权衡。

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