肌腱轉移術後物理治療介入對頸髓損傷患者功能之改善情形－一病例報告

第六節頸髓完全損傷造成四肢全癱的患者在受傷一年後，藉由後三角肌肌腱轉移手術來重建手肘伸直動作及力量。物理治療師於手術前四周即閉始對患者進行衛教及積極介入物理治療，內容包括加強要被轉移之後三角肌之訓練，目的在於增進肌力並使肌肉增大肥厚。術後經石膏固定六週後患者開始接受達五個月的術後物理治療，內容包括以漸進方式牽張肘關節，以回復肘關節因制動而受限的肘屈曲角度，及運用肌電回饋方式配合本體感覺神經誘發技術來達到被轉移之肌肉功能再教育並加強手肘伸直動作，進而訓練其肌力。此外亦加強各項轉位的功能性訓練。術後五個月評估病患結果右側仲肘肌力及功能表現有明顯進步；床上活動均可獨立完成，在旁人監督保護不需輔助用具可獨立完成輪椅與床之間的轉位，使用輔助轉位板可獨立完成輪椅與車之間的轉位。

關鍵字

脊髓損傷；肌腱轉移；肘伸直肌；物理治療

並列摘要

After posterior deltoid tendon transfer, a C6 tetraplegia caused by complete destruction of C6 level regained strength and the ability to extend the elbow one-year post injury. Patient received aggressive physical therapy intervention four weeks before surgery which included strengthening the muscle marked for transplantation to increase muscular strength and muscle mass. Patient was immobilized by a plaster cast for six weeks affer sungery. Physical therapy programs included gradual straightening of the elbow to increase the limited ROM caused by prolonged immobilization, and EMG biofeedback training accompanying proprioceptive neuromuscular facilitation to allow the transplanted muscle function and to increase the extension of the elbow. Additionally, the patient received functional training for the transplanted muscle. Five months after surgery, the patient showed marked improvement in muscle strength of the right elbow. The patient was able to accomplish all movements on his own in bed and was able to transfer between bed and wheelchair without assistive devices under supervision and between wheelchair and car independently with a transfer board.

並列關鍵字

Spinal cord injury ； Tendon transfer ； Elbow extensor ； Physical therapy

國際替代計量

肌腱轉移術後物理治療介入對頸髓損傷患者功能之改善情形－一病例報告

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