Inkqubo eqhelekileyo yoqeqesho lokuvuselela i-Achilles tendon rupture, eyona nto iphambili yokubuyisela: ukhuseleko lokuqala, ukuvuselela umsebenzi ngokuhambelana nobunikazi babo.
Inqanaba lokuqala emva kotyando
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Ukukhuselwa kunye nexesha lokuphilisa (iiveki 1-6).
Imiba efuna ingqwalasela: 1. Gwema ukolula kwe-Achilles tendon;2. Idolo elisebenzayo kufuneka liguqulwe kwi-90 °, kwaye i-ankle dorsiflexion kufuneka ikhawulelwe kwindawo engathathi hlangothi (0 °);3. Kuphephe ukucinezela ezishushu;4. Kuphephe ukuwohloka ixesha elide .
Ukuhamba okuhlangeneyo kwangaphambili kunye nokukhuselwa kobunzima zizinto ezibaluleke kakhulu kwixesha lokuqala emva kokusebenza.Ngenxa yokuba ubunzima kunye nokuhamba ngokubambisana kukhuthaza ukuphulukiswa kunye namandla e-tendon ye-Achilles, kwaye kunokuthintela imiphumo emibi ye-immobilization (umzekelo, ukuchithwa kwemisipha, ukuqina kwamalungu, i-arthritis ephazamisayo, ukubunjwa kwe-adhesion, kunye ne-thrombus enzulu ye-cerebral).
Izigulane zayalelwa ukuba zenze ezininzi ezisebenzayongokubambisanaiintshukumo ngosuku, kubandakanywa i-ankle dorsiflexion, i-plantar flexion, i-varus, kunye ne-valgus.I-ankle dorsiflexion esebenzayo kufuneka ikhawulelwe kwi-0 ° kwi-90 ° yokuguqa kwamadolo.Ukunyakaza okuhlangeneyo kunye nokwelula kufuneka kugwenywe ukukhusela i-tendon ye-Achilles yokuphulukisa ekugqithiseni okanye ukuphuka.
Xa isigulana siqala ukuthwala ubunzima obupheleleyo, umthambo webhayisekile omileyo unokwaziswa ngeli xesha.Isigulana kufuneka siyalelwe ukuba sisebenzise umva wonyawo endaweni yeenyawo zangaphambili xa uhamba ngebhayisikili.Ukuphulula isiva kunye nentshukumo edibeneyo yokukhanya kunokukhuthaza ukuphilisa kunye nokuthintela ukunamathela kunye nokuqina.
Unyango olubandayo kunye nokuphakama kwelungu elichaphazelekayo kunokulawula intlungu kunye ne-edema.Izigulane kufuneka zifundiswe ukuba ziphakamise umlenze ochaphazelekayo kangangoko kunokwenzeka yonke imini kwaye ugweme ukubamba ubunzima ixesha elide.Isigulana sinokucetyiswa ukuba sisebenzise iipakethe zomkhenkce izihlandlo ezininzi kangangemizuzu engama-20 ngexesha ngalinye.
Ukuzivocavoca kwe-hip proximal kunye nedolo kufuneka kusebenzise irejimeni yoqeqesho oluqhubekayo.Ukuzivocavoca okuvulekileyo kunye noomatshini be-isotonic bangasetyenziswa zizigulane ezinobunzima obuthintelweyo.
Amanyathelo onyango: Xa usebenzisa i-axillary stick okanye i-cane phantsi kwesikhokelo sikagqirha, nxiba ubunzima obuqhubekayo phantsi kweebhuthi ezisisigxina kunye nevili;i-ankle esebenzayo i-dorsiflexion/plantar flexion/varus/valgus;isiva sokuphulula;ukukhulula ngokubambisana;ukuzilolonga ukomelela kwezihlunu ezisondele;ulungiso lwenyama ;unyango olubandayo.
Iiveki ze-0-2: Immobilization ye-brace yomlenze omfutshane, i-ankle kwindawo engathathi hlangothi;ukuthwala ubunzima obungaphelelanga ngeentonga ukuba kunyanyezelwe;umkhenkce + ukunyanzeliswa kwendawo / unyango lwemagnethi lwepulse;ukuguqa kwedolo kunye nokukhuselwa kwe-ankle I-flexion plantar esebenzayo, i-varus, i-valgus;ukuxhathisa i-quadriceps, i-gluteal, uqeqesho lokuthunjwa kwe-hip.
Iiveki ze-3: Inkxaso yomlenze omfutshane ingenakunyakaziswa, i-ankle kwindawo engathathi hlangothi.Ukuhamba ngeentonga zokuthwala ubunzima;esebenzayo +- incedise i-ankle plantar flexion/foot varus, i-foot valgus training (+- ukuqeqeshwa kwebhodi yokulinganisela);Ukukhawuleza ukunyakaza kwe-ankle encinci (i-intertarsal, i-subtalar, i-tibiotalar) kwindawo engathathi hlangothi;ixhathisa i-quadriceps, i-gluteal, kunye noqeqesho lokuthunjwa kwe-hip.
Iiveki ezi-4: Uqeqesho olusebenzayo lwe-ankle dorsiflexion;ukuxhathisa okusebenzayo kwi-plantar flexion, i-varus, kunye ne-eversion ngeentambo zerabha elastiki;Uqeqesho lwe-gait ethwele ubunzima obungaphelelanga-isokinetic uqeqesho oluphantsi lokumelana (> 30 degrees / sec);ukuhlala okuphezulu okuphantsi Ukumelana nesithende sokuvuselela uqeqesho lwe-treadmill.
Iiveki ze-5: Susa i-ankle brace, kwaye ezinye izigulane zinokuya kuqeqesho lwangaphandle;uqeqesho lokunyusa ithole lomlenze ombini;Uqeqesho lwe-gait-bearing weight-bearing-isokinetic moderate resistance training (20-30 degrees / second);isihlalo esisezantsi sokuvuselela isithende Uqeqesho;Uqeqesho lokuqhuba (ukukhusela ngexesha lokubuyisela).
Iiveki ze-6: Zonke izigulane zasusa iibrayisi kwaye zenza uqeqesho lokuhamba kwindawo engaphandle;uqeqesho oluqhelekileyo lwe-tendon ye-Achilles kwindawo yokuhlala;ukuchasana okuphantsi (okungahambiyo) ukuqeqeshwa kwamandla okujikelezayo kwemisipha (i-varus resistance, i-valgus resistance) amaqela amabini;uqeqesho lokulinganisa umlenze omnye (Icala eliphilileyo --- icala elichaphazelekayo litshintsha kancinci);uhlalutyo lokuhamba.
Iinqobo zokukhuthaza: intlungu kunye ne-edema zilawulwa;ukuthwala ubunzima kunokuqhutywa phantsi kwesikhokelo sikagqirha;i-ankle dorsiflexion ifikelela kwindawo engathathi hlangothi;amandla asezantsi asezantsi afikelela kwibakala lesi-5/5.
Inqanaba lesibini emva kotyando
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Kwinqanaba lesibini, kukho utshintsho olucacileyo kwiqondo lokuthwala ubunzima, ukwanda kweROM yelungu elichaphazelekayo kunye nokwandiswa kwamandla emisipha.
Injongo ephambili: Ukubuyisela uluhlu olwaneleyo lokusebenza lwentshukumo yokuhamba ngokuqhelekileyo kunye nokunyuka kwezitebhisi.Buyisela i-ankle dorsiflexion, i-varus, kunye namandla e-valgus kwibakala eliqhelekileyo lesi-5/5.Buyela kwindlela eqhelekileyo yokuhamba.
Amanyathelo onyango:
Ngaphantsi kokhuseleko, inokumelana nokuthwala ubunzima ukuya kwi-gait epheleleyo yokuthwala ubunzima, kwaye inokukhulula iintonga xa kungekho ntlungu;indlela yokuziqhelanisa nenkqubo yokunyathela phantsi kwamanzi;kwisihlangu isithende pad inceda ukubuyisela ukuhamba okuqhelekileyo;i-ankle esebenzayo i-dorsiflexion/plantar flexion / varus / valgus exercises;uqeqesho olufanelekileyo;isometric / isotonic umthambo amandla: iqakala inversion / valgus.
Uluhlu lokuqala lwe-neuromuscular kunye noluhlu oludibeneyo lokuzivocavoca ukukhuthaza ukubuyiswa kwe-proprioception, neuromuscular kunye nokulinganisela.Njengoko amandla kunye nokulinganisela kubuyiselwa, ipateni yokuzivocavoca iphinda iguqule ukusuka kwimibini ephantsi ukuya kwi-unilateral ephantsi.I-massage ye-scar, unyango lomzimba, kunye nokuhlanganisana okuncinci kufuneka kuqhubeke njengoko kufuneka.
Iiveki ze-7-8: Isigulane kufuneka siqale sigqoke i-brace phantsi kokhuseleko lwee-crutches ukugqiba ubunzima obupheleleyo bomzimba ochaphazelekayo, kwaye emva koko ulahle iintambo kwaye ugqoke izicathulo ukuze uthwale ubunzima ngokupheleleyo.Isithende sesithende sinokufakwa kwisihlangu ngexesha lokutshintsha ukusuka kwintambo yeenyawo ukuya kwisihlangu.
Ukuphakama kwesithende sesithende kufuneka kunciphe njengoko uluhlu lwentshukumo ye-joint joint.Xa i-gait yesigulane ibuyela kwisiqhelo, isithende sesithende sinokukhutshwa.
I-gait eqhelekileyo iyimfuneko yokuhamba ngaphandle kokubanjwa.Iimpompo ze-Ankle ziquka i-plantar flexion kunye ne-dorsi extension.I-Dorsiflexion ithetha ukuba iinzwane ziboshwe ngasemva kangangoko kunokwenzeka, oko kukuthi, unyawo lunyanzeliswa ukuba lubuyele kwindawo elinganiselweyo;
Ngeli nqanaba, ukuguqulwa okuncinci kunye nokuguqulwa kwamandla e-isometric amandla omzimba angaqalwa, kwaye iibhendi zerabha zingasetyenziselwa ukuziqhelanisa kwinqanaba elilandelayo.Yakha ukomelela kwezihlunu ngokuzoba imilo yoonobumba ngeqatha lakho kwisixhobo esinamacala amaninzi.Xa uluhlu olwaneleyo lwesindululo luphunyeziwe.
Unokuqala ukuziqhelanisa nezihlunu ezibini eziphambili ze-plantar flexion yethole.I-Plantar flexion resistance exercises with knee flexion to 90 ° inokuqaliswa kwiiveki ezi-6 emva kokuhlinzwa.I-Plantar flexion resistance exercises kunye nedolo elongeziweyo inokuqaliswa ngeveki ye-8.
I-Plantar flexion inokuphinda isetyenziswe kweli nqanaba usebenzisa i-knee-extended pedaling device kunye nomshini wokugoba umlenze.Ngeli xesha, ukuqeqeshwa kwebhayisikili emiselweyo kufuneka kuqhutywe nge-forefoot, kwaye isixa kufuneka sandiswe ngokuthe ngcembe.Ukuhamba ngasemva kwi-treadmill kuphucula ulawulo lwe-eccentric plantar flexion.Ezi zigulana zihlala zifumana ukuhamba ngasemva zikhululekile ngakumbi kuba kunciphisa imfuno yokuqalisa.Kwakhona kunokwenzeka ukwazisa imithambo yokuya phambili.Ukuphakama kwamanyathelo kunokunyuswa ngokuthe ngcembe.
I-Micro-squat kunye nokukhusela i-ankle (i-tendon ye-Achilles yandiswa phantsi kweentlungu ezibekekileyo);amaqela amathathu okumelana nomlinganiselo (passive) ukuqeqeshwa kwemisipha ejikelezayo (ukumelana ne-varus, ukuxhathisa kwe-valgus);Ukunyuswa kweenzwane (uqeqesho oluphezulu lwe-soleus);inzwane iphakamisa ngamadolo ngokuthe ngqo kwindawo ehleliyo (uqeqesho oluphezulu lwe-gastrocnemius).
Ukuxhasa ubunzima bomzimba kwi-balance bar ukomeleza uqeqesho lwe-autonomous gait;yenza uqeqesho lokunyusa ithole +- ukuvuselela kwe-EMG kwindawo yokuma;ukwenza i-gait re-mfundo phantsi kwe-treadmill;ukwenza uqeqesho lokubuyisela kwi-treadmill kunye ne-forefoot (malunga nemizuzu eyi-15);uqeqesho lokulinganisela (ibhodi yokulinganisa).
Iiveki ze-9-12: ithole elimileyo i-triceps yokwandisa uqeqesho;ithole elimileyo liphakamisa uqeqesho lokumelana (iinzwane zichukumisa umhlaba, ukuba kuyimfuneko, ukuvuselela imisipha yombane kunokongezwa);i-forefoot rehabilitation treadmill uqeqesho lokunyamezela (malunga nemizuzu engama-30);ukuphakamisa unyawo , Ukuqeqeshwa kokuhamba kwe-Landing, inyathelo ngalinye li-12 intshi ngaphandle, kunye nolawulo olugxininisiweyo kunye ne-eccentric;ukuya phambili ukuya phezulu, ukuhamba umva ukuhla;uqeqesho lwe-trampoline balance.
Emva kokuvuselelwa
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Iveki ye-16: Uqeqesho lokuguquguquka (i-Tai Chi);inkqubo esebenzayo iqala;Uqeqesho lwe-isometric olunamanqaku amaninzi.
Iinyanga ze-6: Ukuthelekiswa kweziphelo ezisezantsi;uvavanyo lokuzilolonga lwe-isokinetic;isifundo sohlalutyo lokuhamba;ithole lomlenze omnye liphakamisa imizuzwana engama-30.
Sichuan CAH
WhatsApp/Wechat: +8615682071283
Email: liuyaoyao@medtechcah.com
Ixesha lokuposa: Nov-25-2022
