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1、康复医学基础上海市第六人民医院康复医学科董薇红康复医学基础 定义 分类 分级 残疾预防 颈椎病的康复 腰椎间盘突出症的康复 肩关节周炎的康复定 义 残疾：是指外伤、疾病、发育缺陷或精神因素造成的明显的身心功能障碍，以致不同程度地丧失正常生活、工作和学习的一种状态。广义残疾包括残损、残障在内，成为人体身心功能障碍的总称定 义（续）残疾人：是指心理、生理、人体结构上某种组织、功能丧失或者不正常，使得部分或全部失去以正常方式从事个人或社会生活的人。包括视力、听力、语言、肢体、智力、精神残疾及多重残疾和其他残疾的人定 义（续）残疾学：一门研究残疾的各种原因、流行、表现特点、发展规律、后果及评定康复与预
2、防的学科；是自然科学与社会科学相结合的产物分 类 WHO 分类法：1 残损 是指心理上、生理上或解剖结构上或功能上任何丧失或异常，是生物器官系统水平上的残损。2 残疾 由于残损使能力受限或缺乏以致不能按正常的方式、范围内进行活动。是个体水平上的残疾。3 残障 由于残损或残疾限制或阻碍一个人在正常的情况下应能完成的社会作用，是社会水平的残疾。分 类（续）中国分类法：1 视力残疾 2 听力语言残疾 3 智力残疾 4 肢体残疾 5 精神残疾。分 级 残疾分级：根据残疾对身心主要能力即日常生活活动、行动，排泄功能，交流能力及智力和适应性能力的影响程度分成三级：一级重度 二级中度 三级轻度残疾预防 一级
3、预防：减少和损害发生 二级预防：限制或逆转由损害造成的残疾 三级预防：防止残疾转化为残障（废）颈椎病的康复 颈椎病的康复一 概论二 临床表现和诊断分型三 康复治疗 一 概 论 颈椎病亦称颈椎综合症多见于老年人，主要是由于颈椎间盘退变和突出，导致周围组织和结构继发性改变，而引起一系列临床表现 二 临床表现和诊断1 神 经 根 型2 脊 椎 型3 椎 动 脉 型4 交 感 神 经 型5 混 合 型 三 康复治疗1 颈 部 牵 引2 推 拿 按 摩3 物 理 疗 法4 运 动 疗 法5 保 健 腰椎间盘突出症的康复腰椎间盘突出症的康复一 概论二 临床表现和诊断分型三 康复治疗 一 概 述 腰椎间盘突
4、出症是常见的腰、腿疼疾病，多见于青壮年。其发病主要是在椎间盘退变的基础上，受到相应的损伤或应力作用所致。造成纤维环破裂和髓核组织突出。发病部位以腰四、五和骨5、骶1椎间盘为最多见。其他腰椎间盘亦可发生。可以单节或多节段发病。突出方向以向后外侧突出压迫神经根为最多见，亦可向后方突出压迫硬膜囊甚至马尾神经 二 临床表现和诊断 主要表现为腰腿痛。一般先有腰痛，以后出现坐骨神经痛，少数病人出现股神经痛。症状常反复发作，或呈慢性过程。体症：压疼和放散痛 在腿抬高试验和加强试验呈 阳性 脊柱侧凸 感觉肌力和腱反射改变 三 康复治疗 卧硬板床休息和制动 腰部牵引 推拿按摩 物理疗法 运动疗法 自我保健疗法肩
5、关节周围炎的康复 肩关节周围炎的康复 一 概论 二 临床表现和诊断分型 三 康复治疗一 概 述 肩关节周围炎又称肩周炎，亦称粘连性关节囊炎；俗称：凝肩、冻结肩、五十肩等。病因至今未明，一般认为是随年龄的增长，软组织发生退行性变，加上反复的细微损伤和肩部缺乏活动而发病 二 临床表现和诊断1 病程长、起病隐蔽2 早 期：疼痛为主3 冻结期：肩部活动功能逐渐受限，直至盂月厷关节活动范围 完全丧失，形成冻结肩4 恢复期：半年至二年后，病变缓解，盂月厷关节活动功能逐渐 好转 三 康复治疗1物理疗法2推拿按摩3运动疗法4保健+euK#6mCS-euKZ5lBR)dtJZ5lAQ(csIY4kAQ*brHX
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