Inqubo evamile yokuqeqeshwa kokuvuselela i-Achilles tendon rupture, isisekelo esiyinhloko sokuvuselela: ukuphepha kuqala, ukuvuselela umsebenzi wokuvuselela ngokusho kobunikazi babo.
Isigaba sokuqala ngemva kokuhlinzwa
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Isikhathi sokuvikela kanye nokuphulukiswa (amasonto 1-6).
Izindaba ezidinga ukunakwa: 1. Gwema ukunwebeka kwe-Achilles tendon;2. Idolo elisebenzayo kufanele liguquguquke ku-90 °, futhi i-ankle dorsiflexion kufanele ikhawulelwe endaweni engathathi hlangothi (0 °);3. Gwema ukucindezela okushisayo;4. Gwema ukuwohloka isikhathi eside .
Ukuhamba kwamalunga kwangaphambi kwesikhathi kanye nesisindo esivikelwe yizinto ezibaluleke kakhulu esikhathini sokuqala sokuhlinzwa.Ngoba ukuthwala isisindo kanye nokuhamba kwamalungu kukhuthaza ukuphulukiswa namandla e-tendon ye-Achilles, futhi kungavimbela imiphumela emibi yokunganyakazi (isb., ukuwohloka kwemisipha, ukuqina kwamalunga, isifo samathambo esiwohlozayo, ukwakheka kokunamathela, kanye ne-thrombus ye-cerebral ejulile).
Iziguli zayalwa ukuba zenze eziningana ezisebenzayookuhlangeneukunyakaza ngosuku, okuhlanganisa i-ankle dorsiflexion, i-plantar flexion, i-varus, ne-valgus.I-ankle dorsiflexion esebenzayo kufanele ikhawulelwe ku-0° ku-90° wokugoba kwamadolo.Ukunyakaza okuhlangene okuhlangene kanye nokwelula kufanele kugwenywe ukuze kuvikelwe i-tendon ye-Achilles ephulukisayo ekunwetshweni ngokweqile noma ukuphuka.
Lapho isiguli siqala ukuthwala isisindo esiphelele, ukuzivocavoca kwebhayisikili okumile kungase kwethulwe ngalesi sikhathi.Isiguli kufanele siyalwe ukuthi sisebenzise ingemuva lonyawo esikhundleni sonyawo lwangaphambili lapho sihamba ngebhayisikili.Ukuhlikihla isibazi nokunyakaza okuhlangene okukhanyayo kungakhuthaza ukuphulukiswa futhi kuvimbele ukunamathela nokuqina kwamalunga.
Ukwelashwa okubandayo kanye nokuphakama kwesitho esithintekile kungalawula ubuhlungu kanye ne-edema.Iziguli kufanele zifundiswe ukuthi ziphakamise isitho esithintekile ngangokunokwenzeka usuku lonke futhi zigweme ukubamba isisindo isikhathi eside.Isiguli singase futhi selulekwe ukuthi sigcobe amaphakethe eqhwa izikhathi eziningana imizuzu engu-20 isikhathi ngasinye.
Ukuzivocavoca kwe-proximal hip kanye nedolo kufanele kusebenzise uhlelo lokuqeqeshwa lokumelana okuqhubekayo.Ukuzivocavoca kwe-Open-chain kanye nemishini ye-isotonic ingasetshenziswa iziguli ezinesisindo esilinganiselwe.
Izinyathelo zokwelashwa: Uma usebenzisa induku ye-axillary noma umoba ngaphansi kokuqondisa kukadokotela, gqoka isisindo esiqhubekayo ngaphansi kwamabhuzu angaguquki anesondo;i-ankle esebenzayo i-dorsiflexion/plantar flexion/varus/valgus;massage isibazi;ukuthukulula okuhlangene;ukuzivocavoca kwamandla emisipha esondelene;ukwelashwa ngokomzimba;ukwelashwa okubandayo.
Amaviki angu-0-2: Ukuqiniswa kwe-brace yemilenze emifushane, i-ankle endaweni engathathi hlangothi;ukuthwala isisindo ngezinduku uma kubekezelelwa;iqhwa + ukucindezela kwendawo/ukwelashwa kazibuthe kwepulse;ukugoba kwamadolo nokuvikelwa kweqakala Ukuguquguquka okusebenzayo kwe-plantar, i-varus, i-valgus;ukumelana ne-quadriceps, i-gluteal, ukuqeqeshwa kokuthunjwa kwe-hip.
Amaviki angu-3: Ukusekelwa komlenze omfushane akunyakazi, iqakala lisesimweni sokungathathi hlangothi.Ukuhamba okunesisindo esiyingxenye okuqhubekayo ngezinduku;esebenzayo +- isizwa i-ankle plantar flexion/foot varus, ukuqeqeshwa kwe-valgus yonyawo (+- ukuqeqeshwa kwebhodi lebhalansi);Isheshisa ukunyakaza kwama-ankle amancane (intertarsal, subtalar, tibiotalar) endaweni engathathi hlangothi;imelana ne-quadriceps, i-gluteal, nokuqeqeshwa kokuthunjwa kwe-hip.
Amaviki angu-4: Ukuqeqeshwa kwe-ankle dorsiflexion esebenzayo;ukumelana ne-plantar flexion esebenzayo, i-varus, ne-eversion enezintambo zokunwebeka zenjoloba;ukuqeqeshwa kwe-gait enesisindo esiyingxenye-i-isokinetic ukuqeqeshwa kokumelana okuphansi (>30 degrees/sec);ukuhlala okuphezulu okuphansi Ukuqeqeshwa kwe-treadmill yokuvuselela isithende.
Amaviki angu-5: Susa i-brace ye-ankle, futhi ezinye iziguli zingaya ekuqeqesheni ngaphandle;ukuqeqeshwa kwethole lomlenze ophindwe kabili;ukuqeqeshwa kwe-gait enesisindo esiyingxenye-i-isokinetic ukuqeqeshwa kokumelana okumaphakathi (ama-20-30 degrees/isekhondi);Ukuqeqeshwa kwe-treadmill yokuvuselela isithende esiphansi;Ukuqeqeshwa kokudonsa (ukuvikela ngesikhathi sokululama).
Amaviki angu-6: Zonke iziguli zasusa izintambo futhi zenza ukuqeqeshwa kokuhamba endaweni eyisicaba yangaphandle;ukuqeqeshwa okujwayelekile kwe-tendon ye-Achilles endaweni yokuhlala;ukumelana okuphansi (okungenzi lutho) ukuqeqeshwa kwamandla okujikeleza kwemisipha (ukumelana ne-varus, ukumelana ne-valgus) amaqembu amabili;ukuqeqeshwa kwebhalansi yomlenze owodwa (Uhlangothi olunempilo --- uhlangothi oluthintekile luyashintsha kancane kancane);ukuhlaziywa kwe-gait yokuhamba.
Izindlela zokuphromotha: ubuhlungu kanye ne-edema kulawulwa;ukuthwala isisindo kungenziwa ngaphansi kokuqondiswa udokotela;i-ankle dorsiflexion ifinyelela endaweni engathathi hlangothi;amandla emisipha esondelene aphansi afinyelela ebangeni 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 uhla lokusebenza olwanele lokunyakaza kokuhamba okuvamile nokukhuphuka izitebhisi.Buyisela i-ankle dorsiflexion, i-varus, namandla e-valgus ebangeni elijwayelekile elingu-5/5.Buyela ekuhambeni okuvamile.
Izinyathelo zokwelashwa:
Ngaphansi kokuvikelwa, ingakwazi ukumelana nokuthwala isisindo kuya ekuzilolongeni okugcwele kwesisindo, futhi ingakwazi ukukhumula izinduku lapho kungekho buhlungu;i-underwater treadmill system practice gait;in-shoe isithende pad isiza ukubuyisela ukuhamba okujwayelekile;ukuzivocavoca kwe-ankle dorsiflexion/plantar flexion / varus / valgus;ukuqeqeshwa okufanele;izivivinyo zamandla e-isometric / isotonic: i-ankle inversion / valgus.
Uhlu lokuqala lwe-neuromuscular kanye nohlobo oluhlangene lokuzivocavoca ukukhuthaza ukubuyiselwa kwe-proprioception, neuromuscular kanye nokulinganisela.Njengoba amandla nokulinganisela kubuyiselwa, iphethini yokuzivocavoca iphinde ishintshe isuka kokubili ephansi iye emaphethelweni aphansi ahlangene.Ukubhucungwa kwesibazi, ukwelapha ngokomzimba, kanye nokuhlanganisa amalungu amancane kufanele kuqhubeke njengoba kudingeka.
Amaviki angu-7-8: Isiguli kufanele siqale sigqoke i-brace ngaphansi kokuvikelwa kwezinduku ukuze siqedele ukuthwala isisindo esiphelele sesitho esithintekile, bese silahla izinduku futhi sigqoke izicathulo ukuze sithwale isisindo ngokugcwele.Iphedi lesithende lingafakwa esicathulweni ngesikhathi soguquko ukusuka kubhande lonyawo kuya esicathulweni.
Ukuphakama kwephedi lesithende kufanele kunciphe njengoba ububanzi bokunyakaza kokujoyina kukhula.Lapho ukuhamba kwesiguli kubuyela esimweni esijwayelekile, isithende sesithende singakhishwa.
Ukuhamba okuvamile kuyisidingo sokuhamba ngaphandle kokuthunjwa.Amaphampu e-ankle ahlanganisa i-plantar flexion kanye nesandiso se-dorsi.I-Dorsiflexion isho ukuthi izinzwane ziboshwe emuva kanzima ngangokunokwenzeka, okungukuthi, unyawo luphoqeleka ukuba lubuyele endaweni elinganiselwe;
Kulesi sigaba, ukuguqulwa okuncane kanye nokuguqulwa kokuzivocavoca kwamandla emisipha ye-isometric kungaqalwa, futhi amabhande enjoloba angasetshenziswa ukuzijwayeza esigabeni sakamuva.Yakha amandla emisipha ngokudweba umumo wezinhlamvu ngeqakala lakho kudivayisi enama-eksisi amaningi.Lapho sekuzuzwe uhla olwanele lokunyakaza.
Ungaqala ukuzijwayeza imisipha emibili eyinhloko yokugoba kwe-plantar yethole.Ukuzivocavoca kwe-Plantar flexion nge-knee flexion kuya ku-90 ° kungaqalwa amaviki angu-6 ngemva kokuhlinzwa.Ukuzivocavoca kwe-Plantar flexion ngedolo elinwetshiwe kungaqalwa ngeviki lesi-8.
I-Plantar flexion ingenziwa futhi kulesi sigaba ngokusebenzisa idivayisi yokudonsa idolo kanye nomshini wokugoba umlenze.Ngalesi sikhathi, ukuzivocavoca kwebhayisikili okuhleliwe kufanele kwenziwe nge-forefoot, futhi inani kufanele landa kancane kancane.Ukubuyela emuva ku-treadmill kuthuthukisa i-eccentric plantar flexion control.Lezi ziguli zivame ukuthola ukuhamba emuva kunethezekile ngoba kunciphisa isidingo sokuthosa.Kungenzeka futhi ukwethula izivivinyo zokuya phambili.Ukuphakama kwezinyathelo kungandiswa kancane kancane.
I-Micro-squat enokuvikelwa kwe-ankle (i-tendon ye-Achilles inwetshiwe ngaphansi kwesisekelo sobuhlungu obubekezeleleka);amaqembu amathathu okumelana nokulinganisela (okungatholakali) ukuqeqeshwa kwemisipha ejikelezayo (ukumelana ne-varus, ukumelana ne-valgus);Ukuphakamisa uzwane (ukuqeqeshwa kwe-soleus ephezulu yokumelana);uzwane uphakamisa ngamadolo aqonde endaweni ehlezi (high resistance gastrocnemius training).
Sekela isisindo somzimba kubha yebhalansi ukuze uqinise ukuqeqeshwa kwe-autonomous gait;yenza ukuqeqeshwa kokukhulisa inkonyane +- Ukukhuthazwa kwe-EMG endaweni yokuma;funda kabusha i-gait ngaphansi kwe-treadmill;yenza ukuqeqeshwa kwe-treadmill yokuvuselela nge-forefoot (cishe imizuzu eyi-15);ukuqeqeshwa kwebhalansi (ibhodi lebhalansi).
Amaviki angu-9-12: ukuqeqeshwa kokwandisa ithole le-triceps;ithole elimile liphakamisa ukuqeqeshwa kokumelana (izinzwane zithinta phansi, uma kunesidingo, ukukhuthazwa kwemisipha kagesi kunganezelwa);ukuqeqeshwa kwe-treadmill yokuvuselela i-forefoot (cishe imizuzu engama-30);ukuphakamisa unyawo , Ukuqeqeshwa kokuhamba kwe-Landing, isinyathelo ngasinye siqhelelene ngamasentimitha angu-12, sinokulawula okugxilile kanye ne-eccentric;ukuya phambili umqansa ukuhamba, ukuhlehlisa ukwehla;ukuqeqeshwa kwebhalansi ye-trampoline.
Ngemuva kokuvuselelwa
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Isonto le-16: Ukuqeqeshwa kokuguquguquka (i-Tai Chi);uhlelo olusebenzayo luqala;ukuqeqeshwa kwe-isometric enamaphuzu amaningi.
Izinyanga ezingu-6: Ukuqhathaniswa kwamaphethelo aphansi;ukuhlolwa kokuzivocavoca kwe-isokinetic;isifundo sokuhlaziya ukuhamba;ithole lomlenze owodwa liphakamisa imizuzwana engama-30.
Sichuan CAH
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Email: liuyaoyao@medtechcah.com
Isikhathi sokuthumela: Nov-25-2022
