Njira yophunzitsira anthu kuchira kuphulika kwa tendon ya Achilles, mfundo yaikulu ya kuchira ndi iyi: chitetezo choyamba, kuchita masewera olimbitsa thupi molingana ndi momwe amadziwira okha.
Gawo loyamba pambuyo pa opaleshoni
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Chitetezo ndi nthawi yochira (masabata 1-6).
Zinthu zofunika kuziganizira: 1. Pewani kutambasula pang'onopang'ono kwa tendon ya Achilles; 2. Bondo logwira ntchito liyenera kupindidwa pa 90°, ndipo kupindika kwa bondo kuyenera kukhala kocheperako (0°); 3. Pewani kupsinjika kotentha; 4. Pewani kugwedezeka kwa nthawi yayitali.
Kuyenda koyambirira kwa mafupa ndi kunyamula zolemera zotetezedwa ndizofunikira kwambiri pa nthawi yoyamba ya opaleshoni. Chifukwa kunyamula zolemera ndi kuyenda kwa mafupa kumathandiza kuchiritsa ndi kulimbitsa tendon ya Achilles, ndipo kumatha kupewa zotsatira zoyipa za kulephera kuyenda (monga kutayika kwa minofu, kuuma kwa mafupa, nyamakazi yofooka, kupangika kwa ma adhesion, ndi thrombus ya ubongo).
Odwala adalangizidwa kuti azichita zinthu zingapo zolimbitsa thupicholumikiziraKusuntha kwa bondo tsiku lililonse, kuphatikizapo kusuntha kwa bondo, kupindika kwa plantar, varus, ndi valgus. Kusuntha kwa bondo mwamphamvu kuyenera kukhala 0° pa 90° ya kupindika kwa bondo. Kusuntha ndi kutambasula mafupa mopanda mphamvu kuyenera kupewedwa kuti muteteze tendon yochiritsa ya Achilles kuti isatambasulidwe kwambiri kapena kuphulika.
Wodwala akayamba kunyamula katundu wolemera pang'ono, masewera olimbitsa thupi a njinga osasuntha akhoza kuyamba panthawiyi. Wodwalayo ayenera kulangizidwa kuti agwiritse ntchito kumbuyo kwa phazi m'malo mwa phazi lakutsogolo pokwera njinga. Kupukuta chilonda ndi kuyenda pang'ono kwa mafupa kungathandize kuchiritsa ndikuletsa kuuma kwa mafupa.
Chithandizo cha chimfine ndi kukweza mwendo wokhudzidwa kungachepetse ululu ndi kutupa. Odwala ayenera kulangizidwa kuti akweze mwendo wokhudzidwa momwe angathere tsiku lonse komanso kupewa kunyamula kulemera kwa nthawi yayitali. Wodwalayo angalangizidwenso kuti agwiritse ntchito mapaketi a ayezi kangapo kwa mphindi 20 nthawi iliyonse.
Maseŵero olimbitsa thupi a m'chiuno ndi bondo lapafupi ayenera kugwiritsa ntchito njira yophunzitsira yolimbikitsira thupi. Maseŵero olimbitsa thupi otseguka ndi makina a isotonic angagwiritsidwe ntchito ndi odwala omwe ali ndi kulemera kochepa.
Njira zochiritsira: Mukagwiritsa ntchito ndodo kapena ndodo ya m'khwapa motsogozedwa ndi dokotala, valani chogwirira cholemera chokhazikika pansi pa nsapato zokhazikika zokhala ndi gudumu; active ankle dorsiflexion/plantar flexion/varus/valgus; massage scra; masssage leaving; proximal miscle practices; physiotherapy; cold therapy.
Masabata 0-2: Kuletsa kuyenda kwa chikwama cha mwendo waufupi, kakolo kakakhala pamalo osalowerera; kunyamula katundu wolemera pang'ono ndi ndodo ngati kuli koyenera; ayezi + chithandizo cha kupsinjika kwa m'deralo/kugunda kwa magnetic; kupindika kwa bondo ndi chitetezo cha kakolo Kupindika kwa plantar, varus, valgus; kukana kwa quadriceps, gluteal, ndi maphunziro ochotsa chiuno.
Masabata atatu: Thandizo la miyendo yaifupi losayenda bwino, bondo lili pamalo osalowerera. Kuyenda pang'ono konyamula zolemera pang'ono ndi ndodo; +- yothandiza kusinthasintha kwa bondo/bondo la varus, maphunziro a valgus ya phazi (+- yolimbitsa thupi); Imafulumizitsa kuyenda kwa mafupa ang'onoang'ono a bondo (intertarsal, subtalar, tibiotalar) pamalo osalowerera; imakana maphunziro a quadriceps, gluteal, ndi chiuno.
Masabata 4: Maphunziro olimbitsa thupi a dorsiflexion a akakolo; kulimba kwa plantar flexion, varus, ndi eversion pogwiritsa ntchito zingwe za rabara zotanuka; maphunziro olimbitsa thupi oyenda pang'ono - kulimba kwa isokinetic low resistance (>30 degrees/sec); kukhala pansi motsika kwambiri Kulimbitsa thupi mopitirira muyeso ...
Masabata 5: Chotsani chogwirira cha akakolo, ndipo odwala ena amatha kupita ku masewera olimbitsa thupi akunja; masewera olimbitsa thupi okweza miyendo iwiri; masewera olimbitsa thupi oyenda pang'ono komanso olemera - masewera olimbitsa thupi olimbana ndi kutopa (madigiri 20-30 pa sekondi); masewera olimbitsa thupi ochepetsa chidendene; masewera olimbitsa thupi othamanga (chitetezo panthawi yochira).
Masabata 6: Odwala onse anachotsa zomangira ndipo anachita maphunziro oyenda panja; maphunziro achikhalidwe a Achilles tendon extension atakhala pansi; maphunziro ochepa olimbana (osachitapo kanthu) a mphamvu ya minofu yozungulira (kukana varus, kukana valgus) magulu awiri; maphunziro a mwendo umodzi (Mbali yathanzi --- mbali yokhudzidwayo imasintha pang'onopang'ono); kusanthula kuyenda.
Zofunikira pakukweza: ululu ndi kutupa zimayendetsedwa; kunyamula kulemera kumatha kuchitika motsogozedwa ndi dokotala; kupindika kwa bondo kumafika pamalo osalowerera; mphamvu ya minofu ya m'munsi mwa mwendo imafika pa giredi 5/5.
Gawo lachiwiri pambuyo pa opaleshoni
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Mu gawo lachiwiri, panali kusintha koonekeratu pamlingo wonyamula kulemera, kuwonjezeka kwa ROM ya mwendo wokhudzidwa ndi kulimbitsa mphamvu ya minofu.
Cholinga chachikulu: Kubwezeretsa mphamvu yogwira ntchito bwino kuti munthu ayende bwino komanso kukwera masitepe. Kubwezeretsa mphamvu ya dorsiflexion, varus, ndi valgus pa bondo kufika pa giredi 5/5. Kubwerera ku giredi yabwinobwino.
Njira zochizira:
Potetezedwa, imatha kupirira kuyenda bwino ngati ikunyamula zolemera, ndipo imatha kuchotsa ndodo pamene palibe ululu; kuyendetsa bwino pansi pa madzi; chidendene cha nsapato chimathandiza kubwezeretsa kuyenda bwino; kuchita masewera olimbitsa thupi a ankle dorsiflexion/plantar flexion / varus / valgus; kuchita masewera olimbitsa thupi; kuchita masewera olimbitsa thupi a isometric / isotonic: kusintha kwa ankle / valgus.
Maseŵero olimbitsa thupi oyambirira a mitsempha ndi mafupa kuti athandize kubwezeretsa kuzindikira kwa ziwalo, minofu ndi kukhazikika bwino. Pamene mphamvu ndi kukhazikika bwino zikubwezeretsedwa, machitidwe olimbitsa thupi amasinthanso kuchokera ku miyendo yonse ya m'munsi kupita ku miyendo yonse ya m'munsi. Kutikita minofu ya zipsera, kuchiritsa thupi, ndi kusuntha mafupa pang'ono kuyenera kupitilira ngati pakufunika kutero.
Masabata 7-8: Wodwalayo ayenera kuvala choyamba chothandizira mwendo pansi pa chitetezo cha ndodo kuti amalize kunyamula thupi lonse la mwendo wokhudzidwa, kenako achotse ndodozo ndikuvala nsapato kuti anyamule thupi lonse. Chophimba chidendene chikhoza kuyikidwa mu nsapato panthawi yosintha kuchokera ku chothandizira phazi kupita ku nsapato.
Kutalika kwa chidendene cha chidendene kuyenera kuchepa pamene kuchuluka kwa kayendetsedwe ka chidendene kukuwonjezeka. Pamene kuyenda kwa wodwalayo kwabwerera mwakale, chidendene cha chidendene chikhoza kuchotsedwa.
Kuyenda bwino nthawi zonse ndi chinthu chofunikira kuti munthu ayende popanda kugwidwa. Mapampu a akakolo amaphatikizapo kupindika kwa plantar ndi dorsi extension. Kupindika kwa dorsi kumatanthauza kuti zala za mapazi zimakokedwa kumbuyo mwamphamvu momwe zingathere, ndiko kuti, phazi limakakamizidwa kubwerera pamalo oletsedwa;
Pa gawo ili, maseŵera olimbitsa thupi olimbitsa thupi pang'ono komanso osinthasintha amatha kuyamba, ndipo mipiringidzo ya rabara ingagwiritsidwe ntchito pochita maseŵera olimbitsa thupi pambuyo pake. Pangani mphamvu ya minofu mwa kujambula mawonekedwe a zilembo ndi bondo lanu pa chipangizo chokhala ndi axis yambiri. Mukatha kuyenda mokwanira.
Mukhoza kuyamba kuchita masewera olimbitsa thupi awiri akuluakulu a minofu ya plantar flexion ya ng'ombe. Masewera olimbitsa thupi olimbitsa thupi olimbitsa thupi olimbitsa thupi okhala ndi mawondo opindika kufika pa 90° angayambe milungu 6 mutachita opaleshoni. Masewera olimbitsa thupi olimbitsa thupi olimbitsa thupi okhala ndi bondo lotambasulidwa angayambe pofika sabata ya 8.
Kupindika kwa Plantar kungathenso kuchitidwa pagawoli pogwiritsa ntchito chipangizo chopondera mawondo ndi makina opindika miyendo. Panthawiyi, masewera olimbitsa thupi a njinga ayenera kuchitika ndi phazi la kutsogolo, ndipo kuchuluka kwake kuyenera kuwonjezeredwa pang'onopang'ono. Kuyenda kumbuyo pa treadmill kumathandizira kuwongolera kupindika kwa plantar. Odwalawa nthawi zambiri amapeza kuyenda chammbuyo kukhala kosavuta chifukwa kumachepetsa kufunikira kopaka primer. Ndizothekanso kuyambitsa masewera olimbitsa thupi opita patsogolo. Kutalika kwa masitepe kumatha kuwonjezeredwa pang'onopang'ono.
Kulimbitsa minofu yaing'ono yokhala ndi chitetezo cha akakolo (minofu ya Achilles imatambasulidwa chifukwa cha ululu wovomerezeka); magulu atatu a kuphunzitsa minofu yozungulira (yosasinthasintha) (kukana kwa varus, kukana kwa valgus); Kukweza zala (kukana kwamphamvu kwa soleus); kukweza zala ndi mawondo molunjika mutakhala (kukana kwamphamvu kwa gastrocnemius).
Thandizani kulemera kwa thupi pa balance bar kuti mulimbikitse maphunziro oyenda okha; chitani maphunziro okweza mwana wa ng'ombe +- EMG mutayimirira; chitani maphunziro obwerezabwereza a kuyenda pansi pa treadmill; chitani maphunziro obwezeretsa treadmill ndi phazi la kutsogolo (pafupifupi mphindi 15); maphunziro olinganiza bwino (balance board).
Masabata 9-12: maphunziro owonjezera a ng'ombe yamphongo yoyimirira; maphunziro okweza mphamvu ya ng'ombe yoyimirira (zala zala zakhudza pansi, ngati kuli kofunikira, kulimbitsa minofu yamagetsi kungawonjezedwe); maphunziro opirira a treadmill obwezeretsa phazi lakutsogolo (pafupifupi mphindi 30); kukweza mapazi, maphunziro oyenda pansi, sitepe iliyonse ili ndi mainchesi 12, ndi kuwongolera kozungulira komanso kosiyana; kuyenda patsogolo kukwera phiri, kuyenda mobwerera m'mbuyo kutsika phiri; maphunziro olimbitsa thupi a trampoline.
Kuchira pambuyo pa kuchira
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Sabata 16: Maphunziro osinthasintha (Tai Chi); pulogalamu yoyendetsa imayamba; maphunziro a isometric a mfundo zambiri.
Miyezi 6: Kuyerekeza miyendo ndi miyendo; mayeso ochita masewera olimbitsa thupi a isokinetic; kuphunzira kusanthula kayendedwe ka thupi; kukweza mwendo umodzi kwa ng'ombe kwa masekondi 30.
Sichuan CAH
WhatsApp/Wechat: +8615682071283
Email: liuyaoyao@medtechcah.com
Nthawi yotumizira: Novembala-25-2022
