常見康復治療技術操作規(guī)范

第一篇物理治療....................................................................................................................7一章功能評估..............................................................................................................................7第一節(jié)身體形態(tài)評估..................................................................................................................7一、姿勢........................................................................................................................................7二、身高與體重............................................................................................................................8三、肢體長度和圍度....................................................................................................................8第二節(jié)關節(jié)活動范圍測量........................................................................................................9一、四肢關節(jié)..............................................................................................................................9二、脊柱關節(jié)..............................................................................................................................9第三節(jié)肌力評估........................................................................................................................10一、徒手肌力評估......................................................................................................................10二、等速肌力評估......................................................................................................................12三、其他器械肌力評估..............................................................................................................13四、肌肉耐力評估......................................................................................................................13第四節(jié)肌張力評估....................................................................................................................14一、手法評估..............................................................................................................................14二、儀器評估..............................................................................................................................16第五節(jié)感覺評估........................................................................................................................17一、淺感覺..................................................................................................................................17二、深感覺..................................................................................................................................17三、復合感覺..............................................................................................................................18第六節(jié)平衡評估........................................................................................................................18一、臨床觀測..............................................................................................................................18二、量表評估..............................................................................................................................19三、儀器評估..............................................................................................................................21第七節(jié)協(xié)調評估........................................................................................................................21一、上肢......................................................................................................................................21二、下肢......................................................................................................................................22第八節(jié)步行評估........................................................................................................................22一、步行能力..............................................................................................................................22二、步態(tài)分析..............................................................................................................................23第九節(jié)心血管評估....................................................................................................................24一、心率......................................................................................................................................24二、血壓......................................................................................................................................25三、心電分級運動試驗..............................................................................................................26四、簡易運動試驗技術..............................................................................................................27第十節(jié)呼吸評估........................................................................................................................27一、通氣功能..............................................................................................................................27二、代謝當量..............................................................................................................................29三、心肺聯(lián)合運動試驗..............................................................................................................29第十一節(jié)疼痛評估....................................................................................................................30一、壓力測痛法..........................................................................................................................30二、視覺模擬評分法..................................................................................................................31三、疼痛問卷..............................................................................................................................31附錄..............................................................................................................................................32附表1-2-1上肢關節(jié)活動范圍測量.........................................................................................32附表1-2-2下肢關節(jié)活動范圍測量.........................................................................................32附表1-2-3脊柱關節(jié)活動范圍測量.........................................................................................33附表1-3-1上肢肌肉徒手肌力檢查.........................................................................................34附表1-3-2下肢肌肉徒手肌力檢查.........................................................................................46附表1-3-3軀干肌肉徒手肌力檢查.........................................................................................53第二章運動治療........................................................................................................................57第一節(jié)關節(jié)活動范圍訓練........................................................................................................57一、被動關節(jié)活動范圍訓練......................................................................................................57二、積極-助力關節(jié)活動訓練.....................................................................................................58三、積極運動..............................................................................................................................58第二節(jié)關節(jié)松動技術................................................................................................................59一、上肢......................................................................................................................................59二、下肢......................................................................................................................................60三、脊柱......................................................................................................................................61第三節(jié)牽伸技術........................................................................................................................62一、上肢......................................................................................................................................62二、下肢......................................................................................................................................62三、軀干......................................................................................................................................63第四節(jié)肌力訓練........................................................................................................................63一、徒手肌力訓練......................................................................................................................63二、等長肌力訓練......................................................................................................................64三、等張肌力訓練......................................................................................................................64四、等速肌力訓練......................................................................................................................65第五節(jié)步行訓練........................................................................................................................65一、步行前訓練..........................................................................................................................66二、步行訓練..............................................................................................................................66第六節(jié)呼吸訓練........................................................................................................................67一、腹式呼吸訓練......................................................................................................................67二、抗阻呼氣訓練......................................................................................................................68三、深呼吸訓練..........................................................................................................................68四、局部呼吸訓練......................................................................................................................68五、排痰訓練..............................................................................................................................69六、呼吸肌訓練..........................................................................................................................69第七節(jié)平衡與協(xié)調訓練............................................................................................................70一、無器械平衡訓練..................................................................................................................70二、簡易設備平衡訓練..............................................................................................................71三、儀器平衡訓練......................................................................................................................71四、協(xié)調訓練..............................................................................................................................71第八節(jié)有氧訓練........................................................................................................................72一、器械有氧訓練......................................................................................................................72二、無器械有氧訓練..................................................................................................................73第九節(jié)神經(jīng)發(fā)育療法................................................................................................................73一、Brunnstrom技術..................................................................................................................73二、Bobath技術..........................................................................................................................75三、PNF技術..............................................................................................................................76第十節(jié)運動再學習....................................................................................................................80一、上肢功能訓練......................................................................................................................81二、口面部功能訓練..................................................................................................................82三、臥位到床邊坐起及坐位平衡訓練......................................................................................82四、站起與坐下訓練..................................................................................................................83五、站立平衡訓練......................................................................................................................83六、行走訓練..............................................................................................................................84第十一節(jié)醫(yī)療體操....................................................................................................................84一、偏癱......................................................................................................................................84二、頸椎病................................................................................................................................86三、腰椎間盤突出癥................................................................................................................87四、肩周炎................................................................................................................................88五、膝關節(jié)骨關節(jié)炎................................................................................................................89六、脊柱側凸............................................................................................................................89第十二節(jié)牽引治療..................................................................................................................90一、腰椎牽引............................................................................................................................90二、頸椎牽引............................................................................................................................91三章物理因子治療..................................................................................................................92第一節(jié)電療法..........................................................................................................................92一、直流電療法........................................................................................................................92二、直流電藥物離子導入療法................................................................................................92三、低頻電療法........................................................................................................................93四、中頻電療法........................................................................................................................94五、高頻電療法........................................................................................................................94第二節(jié)光療法..........................................................................................................................98一、紅外線療法........................................................................................................................98二、紫外線療法........................................................................................................................98三、激光療法............................................................................................................................100第三節(jié)磁療法..........................................................................................................................100一、靜磁場療法........................................................................................................................100二、動磁場療法........................................................................................................................101第四節(jié)超聲波療法...................................................................................................................101一、超聲波療法........................................................................................................................101二、超聲藥物透入療法............................................................................................................102第五節(jié)冷療法...........................................................................................................................103一、冷療法................................................................................................................................103二、冷凍療法............................................................................................................................103第六節(jié)熱療法..........................................................................................................................104一、石蠟療法............................................................................................................................104二、濕熱袋敷療法....................................................................................................................105三、泥療法................................................................................................................................105第七節(jié)壓力療法......................................................................................................................106一、正負壓療法........................................................................................................................106二、負壓療法............................................................................................................................107三、正壓次序循環(huán)療法............................................................................................................107第八節(jié)肌電生物反饋療法......................................................................................................108第二篇作業(yè)治療.....................................................................................................................108一章作業(yè)評估..........................................................................................................................108第一節(jié)作業(yè)體現(xiàn)層次..............................................................................................................108一、作業(yè)需求............................................................................................................................108二、平常生活活動....................................................................................................................109三、工作....................................................................................................................................110四、生存質量............................................................................................................................111第二節(jié)作業(yè)構成層次..............................................................................................................112一、手功能................................................................................................................................112二、知覺功能............................................................................................................................114三、認知功能............................................................................................................................120第三節(jié)物理環(huán)境......................................................................................................................123一、家居和小區(qū)環(huán)境................................................................................................................123二、工作環(huán)境............................................................................................................................123二章作業(yè)治療..........................................................................................................................124第一節(jié)作業(yè)體現(xiàn)層次..............................................................................................................124一、平常生活活動....................................................................................................................124二、娛樂與休閑活動................................................................................................................127三、職業(yè)康復............................................................................................................................129第二節(jié)作業(yè)構成層次..............................................................................................................133一、功能性作業(yè)活動................................................................................................................133二、手功能................................................................................................................................137三、知覺功能............................................................................................................................141四、認知功能............................................................................................................................144第三節(jié)環(huán)境改造與輔助..........................................................................................................145一、自助具適配........................................................................................................................145二、助行器使用........................................................................................................................146三、輪椅選擇與使用................................................................................................................147四、環(huán)境適應與改造................................................................................................................150第四節(jié)矯形器制作與使用......................................................................................................150一、矯形器制作........................................................................................................................150二、矯形器使用........................................................................................................................151三、壓力衣制作與使用............................................................................................................152第三篇言語治療....................................................................................................................153第一章聽力障礙......................................................................................................................153第一節(jié)評估技術......................................................................................................................153一、主觀測聽............................................................................................................................153二、客觀測聽............................................................................................................................154第二節(jié)治療技術......................................................................................................................154一、聲音察覺訓練....................................................................................................................154二、聲音辨別訓練....................................................................................................................155三、聲音識別訓練....................................................................................................................155四、聲音理解訓練....................................................................................................................155五、助聽器和電子耳蝸應用技術............................................................................................155二章失語癥..............................................................................................................................156第一節(jié)評估技術......................................................................................................................156一、失語癥................................................................................................................................156二、口面失用癥........................................................................................................................159三、言語失用癥........................................................................................................................160第二節(jié)治療技術......................................................................................................................160一、聽理解治療技術................................................................................................................160二、閱讀理解治療技術............................................................................................................161三、言語體現(xiàn)治療技術............................................................................................................162四、書寫體現(xiàn)治療技術............................................................................................................164五、實用交流能力技術............................................................................................................164六、輔助交流技術....................................................................................................................165第三章構音障礙......................................................................................................................166第一節(jié)評估技術......................................................................................................................166一、呼吸評估............................................................................................................................166二、喉功能評估........................................................................................................................167三、口唇評估............................................................................................................................168四、下頜評估............................................................................................................................169五、軟腭評估............................................................................................................................169六、舌評估................................................................................................................................170七、反射評估............................................................................................................................171八、言語評估............................................................................................................................172第二節(jié)治療技術......................................................................................................................174一、舌感覺運動技術................................................................................................................174二、口唇感覺運動技術............................................................................................................174三、下頜運動技術....................................................................................................................175四、軟腭感覺運動技術............................................................................................................176五、聲帶運動技術....................................................................................................................176六、呼吸訓練技術................................................