醫療運動的探討

A Study on the Therapeutic Exercise

陳在頤

《體育學報》 3期 (1981/12) Pp. 25-41

https://doi.org/10.6222/pej.0003.198112.1903

摘要

本文旨在探討目前利用運動在醫學治療上的情況，以及說明透過治療運動技巧獲致實質成效的科學工作。所討論的基本問題在應用運動去治療病人的效果，如同一般運動和競技對常人的效果一樣。
治療運動的方式有兩種：主動和被動的。對某一特殊的病人，給予何種方式的運動處方是沒有一成不變的視則可循的。主動的或被動的運動計畫可自行操作，機械操作、或人工操作。被動運動最主要治療價値之一就是可促進和維護“關節的正常運動”。主動運動包括靜態或動態的運動，是應用運動作為治療作用最重要和最有效的方式之一。利用主動運動作治療，可改善肌力、耐力和神經肌肉再教育。
運動處方是根據患者的身體狀況，且必需與內、外科治療配合運用。每一種運動方式在生理學上有其一致性的效果，它可應用在不同的治療目的上。不過，所採用的運動操作方法會影響到生理上的反應和獲得治療上的目的。運動處方可應用在肢體殘障、神經障碍及一般內、外科病症方面，它的治療目的包括：維護或（和）增強肌力、動力、張力、運動範圍以及協調能力；同時維護和改善身體和肌肉的耐力。
過去所使用的技巧在治療運動的操作上，一直是藝術的氣氛超過科學的。未來的運動作為治療病人的方法應發展下列兩點：(1)運用科學方法研究運動技巧的應用和評價；(2)增加證明運動的確有其醫療價値的研究。一旦吾人擁有每種運動方式所產生的效果知識後，就會明白怎樣獲得這種效果，以及有能力去評價所獲得的治療效果，這樣運動在醫學上將成為一種治療的科學，亦是一種藝術。

並列摘要

This study is intended to provide a brief analysis of some present day uses of exercise in medicine and to take into account the scientific work being done to determine quantitatively the outcomes achieved through clinical exercise techniques. The fundamental question as to the effects of exercise apply in relation to therapeutic exercise as they do to exercise and sports generally.
There are two types of exercise: active and passive. There is no rigid rule employed in prescribing the type of exercise for a specific clinical entity. The exercise program active and/or passive may be administered autonomously, mechanically, or manually. One of the chief therapeutic values of passive exercise is the promotion and a maintenance of ”normal joint motion.” Active exercise, static or kinetic, is one of the most important and effective modalities in the clinical application of exercise. Some of the major therapeutic uses of active exercise are improvement of strength, endurance, and neuromuscular reeducation.
The prescription for exercise is based upon the knowledge of the patient's condition as a whole and is used in conjunction with whatever medical and surgical measures are necessary. Each type of exercise has unique physiological effect which gives to it a different therapeutic objective. Then, too, the method used in administering the exercise affects the physiological responses and derived therapeutic objectives. The therapeutic objectives for which exercise is prescribed in the clinical fields of orthopedics, neurological, and general medical and surgical conditions generally include: maintaining and/or augmenting strength, power, tone, range of motion, and coordination; and maintaining and/or improving general body and muscular endurance.
In the past the techniques used for administering exercises clinically have been more an art than a science. Two developments--(1) a more scientific approach to the application and evaluation of exercise techniques and (2) an increase of basic research concerned with determining the values of exercise--suggest the future role of exercise in total patient care. When we have acquired sufficient knowledge of the range of effects each form of exercise is capable of producing, and understanding of how these effects are brought about, and an ability to make a quantitative clinical evaluation of the results obtained, exercise will acquire full stature in medicine as a clinical science as well as an art.