高速低幅(HVLA)操作对静态和动态姿势参数的影响 – 颅枕过渡受阻患者的病例研究

Przemysław Malich, Aleksandra Bitenc-Jasieńko, Agata Pasternak, Adrian Westfal, Helena Gronwald, Karina Kijak, Krzysztof Gronwald, Krzysztof Konior, Danuta Lietz-Kijak

Przemysław Malich, Aleksandra Bitenc-Jasieńko, Agata Pasternak, Adrian Westfal, Helena Gronwald, Karina Kijak, Krzysztof Gronwald, Krzysztof Konior, Danuta Lietz-Kijak – The effect of HVLA manipulation on static and dynamic postural parameters – a case study of a patient with a blocked atlanto-occipital transition –  Fizjoterapia Polska 2024; 24(1); 215-225

DOI: https://doi.org/10.56984/8ZG2EF8t5I

摘要
目的。本研究旨在评估高速低幅(HVLA)操作对患有颅枕阻塞个体的力分布、压力和平衡的影响,重点关注治疗后的改善。
研究方法。通过诊断测试(颈椎压迫、斯普林、德克莱因测试)和足底压力测量(使用EPS/R2垫和BIOMECH STUDIO软件)评估HVLA治疗前后的功能性和姿势参数。
结果。初步诊断显示力分布、平衡和步态有显著干扰。HVLA治疗后的改善包括:
  1. 站立时前足负荷平衡,后跟负荷百分比降低。
  2. 全身压力分布改善,左侧身体压力显著减少。
  3. 前后和侧向身体摆动范围增强,极端偏转距离与偏转表面的比率减少,位移平均速度降低。
  4. 右脚外展角度正常化,左脚访视角度无显著变化。
  5. 足弓指数(AI)和步态平均足压轻微改善,步态最大足压变化微小。
    结论。HVLA操作显著改善静态平衡参数,但在步态参数上的改善有限。这表明颅枕阻塞与姿势障碍之间存在复杂的关系,暗示需要进一步研究探索姿势缺陷与颅枕过渡阻塞之间的联系,以及这些阻塞对姿势变化的影响。
关键词
颅枕阻塞,HVLA操作,姿势障碍,平衡改善,足底压力测量
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Postural problems of children with CP based on hemiparesis

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny

Małgorzata Domagalska, Krzysztof Czupryna, Andrzej Szopa, Janusz Nowotny – Postural problems of children with CP based on hemiparesis. Fizjoterapia Polska 2008; 8(3); 253-259

Abstract
Background. Injury to the immature brain leads to impaired development of the antigravity mechanism. The adoption of progressively higher body positions is only possible due to compensatory mechanisms. The aim of the study was to diagnose postural disorders in children with CP with respect to the adopted compensatory mechanisms. Material and methods. Eighteen children with advanced hemiparesis, aged from 5 to 14, took part in the study. Objective posturometric measurements were taken while the patients maintained a standing position without assistance. Photogrammetric measurements was used to evaluate the spatial arrangement of individual body segments, with pressure forces on the support base being assessed simultaneously using a baroresistive platform. Results. Patients demonstrated two types of postural patterns: a progravity pattern and an antigravity pattern, which differed mainly in terms of the patient habitually overloading or unloading one of the lower limbs, changing the position of the centre of gravity projection on the support base and a characteristic relation of the shoulder and pelvic lines. Conclusions. The nature of postural disorders in CP children depends on the anti- or progravitational nature of the paresis. The development of postural disorders in CP children is predictable and should therefore be taken into account from the very beginning of rehabilitation
Key words:
cerebral palsy, compensatory antigravity mechanism, postural problems
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