Inqubo ejwayelekile yokuqeqeshwa kokuvuselelwa kokuqhekeka kwemisipha ye-Achilles, isisekelo esiyinhloko sokuvuselelwa yile: ukuphepha kuqala, ukuzivocavoca kokuvuselelwa ngokwendlela yabo yokutholwa.
Isigaba sokuqala ngemva kokuhlinzwa
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Isikhathi sokuvikela kanye nokuphulukiswa (amasonto 1-6).
Izinto ezidinga ukunakwa: 1. Gwema ukwelula okungenamsebenzi kwe-Achilles tendon; 2. Idolo elisebenzayo kufanele ligobe ku-90°, futhi ukugoba kweqakala kufanele kukhawulelwe endaweni engathathi hlangothi (0°); 3. Gwema ukucindezela okushisayo; 4. Gwema ukugoba isikhathi eside.
Ukuhamba kwamalunga kusenesikhathi kanye nokuthwala isisindo okuvikelwe yizinto ezibaluleke kakhulu esikhathini sokuqala ngemva kokuhlinzwa. Ngoba ukuthwala isisindo kanye nokuhamba kwamalunga kukhuthaza ukuphulukiswa kanye namandla e-Achilles tendon, futhi kungavimbela imiphumela emibi yokungakwazi ukunyakaza (isb., ukuphelelwa amandla kwemisipha, ukuqina kwamalunga, isifo samathambo esiwohlokayo, ukwakheka kokunamathela, kanye ne-deep cerebral thrombus).
Iziguli zatshelwa ukuthi zenze imisebenzi eminingana esebenzayoilungaukunyakaza ngosuku, okuhlanganisa i-ankle dorsiflexion, i-plantar flexion, i-varus, kanye ne-valgus. I-ankle dorsiflexion esebenzayo kufanele ikhawulelwe ku-0° ku-90° yokugoba kwedolo. Ukunyakaza kwamalunga okungenamsebenzi kanye nokwelula kufanele kugwenywe ukuze kuvikelwe i-Achilles tendon ephulukisayo ekunwebekeni noma ekuqhekekeni.
Uma isiguli siqala ukuthwala isisindo esiphelele, ukuvivinya umzimba ngebhayisikili okungaguquki kungenziwa ngalesi sikhathi. Isiguli kufanele siyalwe ukusebenzisa ingemuva lonyawo esikhundleni sonyawo lwangaphambili lapho sigibela ibhayisikili. Ukuhlikihla isilonda kanye nokunyakaza okulula kwamalunga kungakhuthaza ukuphulukiswa futhi kuvimbele ukunamathelana nokuqina kwamalunga.
Ukwelashwa ngomkhuhlane kanye nokuphakamisa isitho esithintekile kungalawula ubuhlungu kanye nokuvuvukala. Iziguli kufanele zifundiswe ukuphakamisa isitho esithintekile ngangokunokwenzeka usuku lonke futhi zigweme ukubamba isisindo isikhathi eside. Isiguli singase selulekwe nokuthi sisebenzise amaphakethe eqhwa izikhathi eziningana imizuzu engama-20 isikhathi ngasinye.
Ukuzivocavoca kwe-proximal hip kanye nedolo kufanele kusebenzise uhlelo lokuqeqeshwa kokumelana okuqhubekayo. Ukuzivocavoca okuhambisana ne-Open-chain kanye nemishini ye-isotonic kungasetshenziswa yiziguli ezinesisindo esilinganiselwe.
Izindlela zokwelapha: Uma usebenzisa induku noma udondolo lwe-axillary ngaphansi kwesiqondiso sikadokotela, gqoka i-progressive weight bearing ngaphansi kwamabhuzu aqinile anesondo; i-ankle dorsiflexion/plantar flexion/varus/valgus; ukubhucunga isilonda; ukukhulula amalunga; izivivinyo zamandla emisipha eseduze; ukwelashwa ngokomzimba; ukwelashwa ngokubanda.
Amaviki 0-2: Ukuqina kwe-brace yemilenze emifushane, iqakala lisesimweni sokungathathi hlangothi; i-bearing yesisindo esiyingxenye enezinduku zokusibekela uma ibekezelelwa; iqhwa + ukwelashwa kwamagnetic okucindezelwayo/ukushaya kwenhliziyo; ukugoba kwamadolo nokuvikela iqakala Ukugoba kwe-plantar okusebenzayo, i-varus, i-valgus; i-quadriceps yokumelana, ukuqeqeshwa kwe-gluteal, ukuthunjwa kwesinqe.
Amaviki ama-3: Ukusekelwa kwemilenze emifushane kunganyakazi, iqakala lisesimweni sokungathathi hlangothi. Ukuhamba okuhamba kancane okunesisindo ngezinduku zokusikeka; ukujiya kweqakala/i-varus yezinyawo okusebenzayo okusizwa yi-+-, ukuqeqeshwa kwe-valgus yezinyawo (+- ukuqeqeshwa kwebhodi lokulinganisela); Kusheshisa ukunyakaza kwamalunga amancane eqakala (i-intertarsal, i-subtalar, i-tibiotalar) esimweni sokungathathi hlangothi; kumelana nokuqeqeshwa kwe-quadriceps, i-gluteal, kanye ne-hip abduction.
Amaviki ama-4: Ukuqeqeshwa kwe-ankle dorsiflexion okusebenzayo; ukumelana nokujiya kwe-plantar okusebenzayo, i-varus, kanye ne-eversion ngezintambo zerabha ezinwebekayo; ukuqeqeshwa kokuhamba ngezinyawo okunesisindo esingaphansi - ukuqeqeshwa kokumelana okuphansi kwe-isokinetic (>30 degrees/sec); ukuqeqeshwa kwe-treadmill yokuvuselela isithende esiqinile.
Amaviki ama-5: Susa i-brace yeqakala, bese ezinye iziguli zingaya ekuqeqeshweni kwangaphandle; ukuqeqeshwa kokuphakamisa imilenze emibili; ukuqeqeshwa kokuhamba ngezinyawo okunesisindo esingaphelele-ukuqeqeshwa kokumelana okuphakathi kwe-isokinetic (20-30 degrees/isekhondi); ukuqeqeshwa kwe-treadmill yokuvuselela isithende esiphansi; Ukuqeqeshwa kokushayela (ukuvikela ngesikhathi sokululama).
Amaviki ayi-6: Zonke iziguli zasusa ama-braces futhi zenza ukuqeqeshwa kokuhamba endaweni engaphandle eyisicaba; ukuqeqeshwa kokwandiswa kwemisipha ye-Achilles evamile endaweni yokuhlala; ukuqeqeshwa kwamandla emisipha okujikelezayo okuphansi (okungashukumi) (ukumelana ne-varus, ukumelana ne-valgus) amaqembu amabili; ukuqeqeshwa kokulinganisela umlenze owodwa (Uhlangothi olunempilo --- uhlangothi oluthintekile luyashintsha kancane kancane); ukuhlaziywa kokuhamba ngezinyawo.
Izindlela zokukhushulwa: ubuhlungu kanye nokuvuvukala kuyalawulwa; ukuthwala isisindo kungenziwa ngaphansi kwesiqondiso sikadokotela; ukugoba kweqakala kufinyelela endaweni engathathi hlangothi; amandla emisipha yemilenze engezansi eseduze afinyelela ibanga lesi-5/5.
Isigaba sesibili ngemva kokuhlinzwa
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Esigabeni sesibili, kube nezinguquko ezisobala ezingeni lokuthwala isisindo, ukwanda kwe-ROM yesitho esithintekile kanye nokuthuthukiswa kwamandla emisipha.
Umgomo oyinhloko: Ukubuyisela ububanzi obanele bokunyakaza ukuze kuhambe kahle futhi kukhuphuke izitebhisi. Buyisela i-ankle dorsiflexion, varus, kanye namandla e-valgus ezingeni elijwayelekile elingu-5/5. Buyela endleleni evamile yokuhamba.
Izindlela zokwelapha:
Ngaphansi kokuvikelwa, ingamelana nokuthwala isisindo kuze kube yilapho iqhubeka nokuzijwayeza ukuthwala isisindo ngokugcwele, futhi ingakhumula izinduku zokuzibopha uma kungekho buhlungu; uhlelo lokuzijwayeza ukunyakaza ngaphansi kwamanzi; isithende esisezicathulweni sisiza ukubuyisela ukuhamba okuvamile; ukujima kwe-ankle okusebenzayo/ukujima kwe-plantar / ukuzivocavoca kwe-varus / i-valgus; ukuqeqeshwa kobunikazi; izivivinyo zamandla ze-isometric / isotonic: ukuguqulwa kwe-ankle / i-valgus.
Uhla lokuqala lwezivivinyo zokunyakaza zemisipha ye-neuro kanye ne-joint ukukhuthaza ukubuyiselwa kokutholwa kwe-proprioception, imisipha ye-neuro kanye ne-balance. Njengoba amandla kanye ne-balance kubuyiselwa, iphethini yokuzivocavoca nayo iyashintsha kusukela emilenzeni yomibili engezansi iye emilenzeni engezansi ehlangothini olulodwa. Ukubhucungwa kwezibazi, ukwelashwa ngokomzimba, kanye nokunyakaza okuncane kwamalunga kufanele kuqhubeke njengoba kudingeka.
Amaviki angu-7-8: Isiguli kufanele siqale sigqoke i-brace ngaphansi kwesivikelo sezinduku zokusibekela ukuze siqedele ukuthwala isisindo esiphelele somlenze othintekile, bese silahla izinduku zokusibekela bese sigqoka izicathulo ukuze sithwale isisindo ngokugcwele. Iphedi lesithende lingafakwa esicathulweni ngesikhathi sokushintsha kusuka esicathulweni sokusibekela izinyawo kuya esicathulweni.
Ukuphakama kwe-heel pad kufanele kwehle njengoba ububanzi bokunyakaza kwejoyinti bukhula. Lapho ukuhamba kwesiguli kubuyela esimweni esijwayelekile, i-heel pad ingasuswa.
Ukuhamba okuvamile kuyimfuneko yokuhamba ngaphandle kokubanjwa. Amaphampu eqakala afaka phakathi ukujiya kwe-plantar kanye nokwandiswa kwe-dorsi. Ukujiya kwe-Dorsi kusho ukuthi izinzwane ziboshwe emuva ngamandla ngangokunokwenzeka, okungukuthi, unyawo luphoqeleka ukubuyela endaweni enqunyelwe;
Kulesi sigaba, kungaqalwa izivivinyo zamandla emisipha ezisebenzisa i-inversion kanye ne-inversion isometric, futhi amabhande enjoloba angasetshenziswa ukuzijwayeza esigabeni esilandelayo. Yakha amandla emisipha ngokudweba ukuma kwezinhlamvu ngeqakala lakho kudivayisi ene-axis eminingi. Uma sekufinyelelwe ibanga elanele lokunyakaza.
Ungaqala ukuzijwayeza imisipha emibili eyinhloko yokujiya kwethole nge-plantar. Ukuzivocavoca kokumelana ne-plantar flexion okunokuguquguquka kwedolo kufike ku-90° kungaqalwa emavikini ayi-6 ngemuva kokuhlinzwa. Ukuzivocavoca kokumelana ne-plantar flexion ngedolo elinwetshiwe kungaqalwa ngesonto lesi-8.
Ukujiya kwe-Plantar kungenziwa kulesi sigaba kusetshenziswa idivayisi yokujiya enwetshiwe ngamadolo kanye nomshini wokugoba imilenze. Ngalesi sikhathi, ukuzivocavoca kwebhayisikili okuhleliwe kufanele kwenziwe nge-forefoot, futhi inani kufanele lenyuswe kancane kancane. Ukuhamba emuva nge-treadmill kuthuthukisa ukulawula ukujiya kwe-plantar okungavamile. Lezi ziguli zivame ukuthola ukuhamba emuva kukhululekile ngoba kunciphisa isidingo sokuzilungiselela. Kungenzeka futhi ukwethula ukuzivocavoca kwesinyathelo sokuya phambili. Ukuphakama kwezinyathelo kungakhushulwa kancane kancane.
I-Micro-squat enokuvikelwa kweqakala (i-Achilles tendon inwetshwa ngaphansi kwesisekelo sobuhlungu obubekezelelekayo); amaqembu amathathu okuqeqeshwa kwemisipha yokujikeleza okulinganiselwe (okungashukumi) (ukumelana ne-varus, ukumelana ne-valgus); Ukuphakamisa izinzwane (ukuqeqeshwa kwe-soleus okunamandla); ukuphakamisa izinzwane ngamadolo aqonde endaweni yokuhlala (ukuqeqeshwa kwe-gastrocnemius okunamandla).
Sekela isisindo somzimba kubha yokulinganisela ukuze uqinise ukuqeqeshwa kokuhamba okuzenzakalelayo; yenza ukuqeqeshwa kokuphakamisa ithole +- EMG ekumeni; yenza ukufundisa kabusha ukuhamba ngaphansi kwe-treadmill; yenza ukuqeqeshwa kokuvuselela i-treadmill nge-forefoot (cishe imizuzu eyi-15); ukuqeqeshwa kokulinganisela (ibhodi yokulinganisela).
Amaviki angu-9-12: ukuqeqeshwa kokwelula kwe-triceps yethole elimile; ukuqeqeshwa kokuphakamisa ukumelana kwethole elimile (izinzwane zithinta phansi, uma kudingeka, kungangezwa ukuvuselelwa kwemisipha kagesi); ukuqeqeshwa kokukhuthazela kwe-treadmill yokuvuselela izinyawo zangaphambili (cishe imizuzu engama-30); ukuphakamisa izinyawo, ukuqeqeshwa kokuhamba kokufika, isinyathelo ngasinye siqhelelene ngamasentimitha angu-12, ngokulawula okugxilile nokungavamile; ukuhamba phambili ukhuphuka intaba, ukuhamba uhlehla ubuyela emuva; ukuqeqeshwa kwebhalansi ye-trampoline.
Ukuvuselelwa ngemva kokuvuselelwa
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Isonto 16: Ukuqeqeshwa kokuguquguquka (i-Tai Chi); uhlelo lokuqalisa luqala; ukuqeqeshwa kwe-isometric okunamaphoyinti amaningi.
Izinyanga eziyi-6: Ukuqhathaniswa kwemilenze engezansi; ukuhlolwa kokuzilolonga kwe-isokinetic; ucwaningo lokuhlaziya ukuhamba; ukuphakanyiswa kwethole lomlenze owodwa imizuzwana engama-30.
I-Sichuan CAH
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Email: liuyaoyao@medtechcah.com
Isikhathi sokuthunyelwe: Novemba-25-2022
