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第三节 关节活动度评定
一、关节活动度的定义
关节活动度(range of motion,ROM)是指关节活动时可达到的最大弧度,是衡量一个关节运动量的尺度,常以度数表示,是肢体运动功能检查的最基本内容之一。
根据关节运动的动力来源可将关节活动度分为主动关节活动度和被动关节活动度。
1.主动关节活动度(active range of motion,AROM) AROM是人体自身的主动随意运动而产生的运动弧。测量某一关节的AROM实际上是评定受检者肌肉收缩力量对关节活动度的影响。
2.被动关节活动度(passive range of motion,PROM) PROM是通过外力如治疗师的帮助而产生的运动弧。正常情况下,被动运动至终末时会产生一种关节囊内的、不受随意运动控制的运动,因此,PROM略大于AROM。
二、主要ROM的测量方法
(一)脊柱ROM的测量方法(表6-3-1)
表6-3-1 脊柱ROM的测量方法
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图6-3-1 颈椎前屈后伸
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图6-3-2 颈椎左旋右旋
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图6-3-3 颈椎左右侧屈
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图6-3-4 胸椎腰椎前屈后伸
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图6-3-5 胸椎腰椎左旋右旋
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图6-3-6 胸椎腰椎左右侧屈
(二)上肢ROM的测量方法(表6-3-2)
表6-3-2 上肢ROM的测量方法
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续表6-3-2
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图6-3-7 肩胛带前屈后伸
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图6-3-8 肩胛带上举下降
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图6-3-9 肩前屈后伸
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图6-3-10 肩外展
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图6-3-11 肩内旋外旋
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图6-3-12 肩水平屈曲
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图6-3-13 肘屈伸
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图6-3-14 前臂旋前旋后
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图6-3-15 腕屈伸
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图6-3-16 腕尺偏桡偏
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图6-3-17 拇指桡侧外展尺侧内收
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图6-3-18 拇指掌侧外展掌侧内收
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图6-3-19 拇指掌指关节屈伸
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图6-3-20 拇指指间关节屈伸
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图6-3-21 拇指对掌
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图6-3-22 指掌指关节屈伸
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图6-3-23 指近端指间关节屈伸
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图6-3-24 指远端指间关节屈伸
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图6-3-25 指外展内收
(三)下肢ROM的测量方法(表6-3-3)
表6-3-3 下肢ROM的测量方法
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图6-3-26 髋前屈后伸
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图6-3-27 髋外展内收
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图6-3-28 髋内旋、外旋
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图6-3-29 膝屈伸
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图6-3-30 踝背伸跖屈
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图6-3-31 踝内翻、外翻
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图6-3-32 趾MP屈曲伸展
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图6-3-33 趾IP屈曲伸展
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图6-3-34 趾MP屈曲伸展
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图6-3-35 趾PIP屈曲伸展
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图6-3-36 趾DIP屈曲伸展
(何建华)