1) 근 골격계 사정 (1) 관절 가동범위 측정 시진 : 양쪽 대칭, 상 하지 비교, 위축 관절과 뼈의 변형, 근육 모양, 크기 촉진 : 경련, 근육의 긴장도, 압통 관절 각도계 : 객관적

 대상자의 현재 상태  주 장애는 무엇인가 ?  대상자가 할 수 있는 것은 무엇인가 ?  대상자가 할 수 없는 것은 무엇인가 ?  대상자가 기능적으로 독립하기 위해 할 수 있는 일은 무엇 이며, 대상자 본인과 가족에게 가장 중요한 것은 무엇인가 ?  기능을 수행할 수 없는 이유가 무엇인가 ? ex) 운동능력의 소실, 감각인지의 소실, 부조화, 경직, 근육 허약등

① full-circle manual universal goniometer most versatile &popular ② Gonoimeters for single joint motion

③ fluid inclinometer ④ pendulum inclinometer ⑤ electrogoniometer

 Upper Ext.  Lower Ext.  Spine

Test Position  Subject supine  Flatten lumbar spine (flex knees)  Shoulder no abduction, adduction or rotation  (note: to measure gleno- humeral motion, stabilize scapula) Shoulder flexion(0~180°) Goniometer Alignment  Axis – center of humeral head near acromion process  Stationary arm – parallel mid-axillary line  Moving arm – aligned with midline of humerus (lateral epicondyle)

Test Position  Subject prone  Shoulder no abduction, adduction or rotation  (note: to measure gleno-humeral motion, stabilize scapula) Goniometer Alignment  Axis – center of humeral head near acromion process  Stationary arm – parallel mid-axillary line  Moving arm – aligned with midline of humerus (lateral epicondyle)

Test Position  Subject supine  Shoulder 0o flexion and extension  Shoulder laterally (externally) rotated  Shoulder abducted  Stabilize thorax (note: to measure gleno-humeral motion, stabilize scapula)

Goniometer Alignment  Axis – center of humeral head near acromion process  Stationary arm – parallel to sternum  Moving arm – aligned with midline of humerus

Test Position  Subject supine  Shoulder 90o abduction  Forearm neutral  Elbow flexed 90o  Stabilize arm Goniometer Alignment  Axis – olecranon process of ulna  Stationary arm – aligned vertically  Moving arm – aligned with ulna (styloid process)

Test Position  Subject supine  Shoulder 90o abduction  Forearm neutral  Elbow flexed 90o  Stabilize arm Goniometer Alignment  Axis – olecranon process of ulna  Stationary arm – aligned vertically  Moving arm – aligned with ulna (styloid process)

Test Position  Subject supine  Shoulder neutral (arm at side)  Forearm supinated  Elbow flexed  Stabilize arm Goniometer Alignment  Axis – lateral epicondyle of humerus  Stationary arm – aligned with humerus (center of acromion process)  Moving arm – aligned with radius (styloid process)

Test Position  Subject supine  Shoulder neutral (arm at side)  Forearm supinated  Elbow extended  Stabilize arm Goniometer Alignment  Axis – lateral epicondyle of humerus  Stationary arm – aligned with humerus (center of acromion process)  Moving arm – aligned with radius (styloid process)

Test Position  Subject sitting  Shoulder neutral (arm at side)  Elbow flexed to 90o  Stabilize arm  Pronate forearm Goniometer Alignment  Axis – lateral to ulnar styloid  Stationary arm – parallel to humerus  Moving arm – aligned with dorsum of radius

Test Position  Subject sitting  Shoulder neutral (arm at side)  Elbow flexed to 90o  Stabilize arm  Supinate forearm Goniometer Alignment  Axis – medial to ulnar styloid  Stationary arm – parallel to humerus  Moving arm – aligned with ventral aspect of radius

Test Position  Subject seated  Forearm stabilized on table  Flex wrist (fingers relaxed) Goniometer Alignment  Axis – lateral wrist (triquetrum)  Stationary arm – aligned with ulna  Moving arm – aligned with fifth metacarpal

Test Position  Subject seated  Forearm stabilized on table  Extend wrist (fingers relaxed) Goniometer Alignment  Axis – lateral wrist (triquetrum)  Stationary arm – aligned with ulna  Moving arm – aligned with fifth metacarpal

Test Position  Subject sitting with forearm resting on table  Stabilize forearm to prevent pronation or supination Goniometer Alignment  Axis – capitate  Stationary arm – aligned with forearm (lateral epicondyle)  Moving arm – aligned with metacarpal of middle finger

Test Position  Subject sitting with forearm resting on table  Stabilize forearm to prevent pronation or supination Goniometer Alignment  Axis – capitate  Stationary arm – aligned with forearm (lateral epicondyle)  Moving arm – aligned with metacarpal of middle finger

Test Position  Subject supine  Allow knee to flex (to avoid limitation by tight hamstrings)  Stabilize pelvis to prevent rotation, Hip flex. Hip flexion(0~120°)  Goniometer Alignment  Axis – greater trochanter  Stationary arm – aligned with midline of plevis  Moving arm – aligned with femur (lateral epicondyle)

Test Position  Subject prone  Stabilize pelvis to prevent rotation  Extend hip Goniometer Alignment  Axis – greater trochanter  Stationary arm – aligned with midline of plevis  Moving arm – aligned with femur (lateral epicondyle)

Test Position  Subject supine  Stabilize pelvis to prevent pelvic list  Abduct hip Goniometer Alignment  Axis – anterior superior iliac spine (ASIS)  Stationary arm – aligned with opposite ASIS  Moving arm – aligned with femur (center of patella)

Test Position  Subject supine  Stabilize pelvis to prevent pelvic list  Abduct opposite hip (to allow room for tested limb to adduct)  Adduct hip Goniometer Alignment  Axis – anterior superior iliac spine (ASIS)  Stationary arm – aligned with opposite ASIS  Moving arm – aligned with femur (center of patella)

Test Position  Subject sitting on table  knee flexed  Stabilize distal thigh  medially (internally) rotate hip Goniometer Alignment  Axis – center of patella  Stationary arm – aligned vertically  Moving arm – aligned with leg (crest of tibia)

 Test Position  Subject sitting on table  knee flexed  Stabilize distal thigh  hip laterally (externally) rotated  Goniometer Alignment  Axis – center of patella  Stationary arm – aligned vertically  Moving arm – aligned with leg (crest of tibia)

 Test Position  Subject supine  Allow hip to flex  Flex knee  Goniometer Alignment  Axis – lateral epicondyle of femur  Stationary arm – aligned with greater trochanter  Moving arm – aligned with lateral malleolus

 Test Position  Subject prone  Stabilize femur  Extend Knee  Goniometer Alignment  Axis – lateral epicondyle of femur  Stationary arm – aligned with greater trochanter  Moving arm – aligned with lateral malleolus

 Test Position  Subject supine  Extend knee  Stabilize leg  Plantarflex ankle  Goniometer Alignment  Axis – lateral malleolus  Stationary arm – aligned with fibular head  Moving arm – aligned with fifth metatarsal

 Test Position  Subject prone  Flex knee  Stabilize sub-talar in neutral  Dorsiflex ankle by pushing through 5th metatarsal head  Goniometer Alignment  Axis – lateral malleolus  Stationary arm – aligned with fibular head  Moving arm – aligned with fifth metatarsal

 Test Position  Subject prone  Stabilize tibia in sagittal plane (rotate hip or pelvis to align tibia)  Invert calcaneus  Goniometer Alignment  Axis – automatically positioned by alignment of goniometer arms  Stationary arm – aligned with midline of leg  Moving arm – aligned with midline of calcaneus

 Test Position  Subject supine  Stabilize calcaneus and talus  Evert forefoot  Goniometer Alignment  Axis – automatically positioned by alignment of goniometer arms  Stationary arm – aligned with midline of leg  Moving arm – aligned with plantar aspect of metatarsal heads

Test Position  Subject sitting with lumbar and thoracic spines supported  Stabilize lumbar and thoracic spines  Flex cervical spine  Goniometer Alignment  Axis – external auditory meatus  Stationary arm – vertical  Moving arm – aligned with nostrils

 Test Position  Subject sitting with lumbar and thoracic spines supported  Stabilize lumbar and thoracic spines  Mouth relaxed and slightly open  Extend cervical spine  Goniometer Alignment  Axis – external auditory meatus  Stationary arm – vertical  Moving arm – aligned with nostrils

 Test Position  Subject sitting with lumbar and thoracic spines supported  Stabilize lumbar and thoracic spines  Sidebend cervical spine  Goniometer Alignment  Axis – spinous process of C7  Stationary arm – spinous processes of thoracic spine  Moving arm – posterior midline of head at occipital protuberance

 Test Position  Subject sitting with lumbar and thoracic spines supported  Stabilize lumbar and thoracic spines  Rotate cervical spine  Goniometer Alignment  Axis – center of superior aspect of head  Stationary arm – aligned with acromion processes  Moving arm – aligned with tip of nose

 Test Position  Subject standing  Flex thoracic and lumbar spines  Tape Measure Alignment  Spinous processes of C7 and S1

 Test Position  Subject standing  Extend thoracic and lumbar spines  Tape Measure Alignment  Spinous processes of C7 and S1

 Test Position  Subject standing  Stabilize pelvis  Sidebend thoracic and lumbar spines  Goniometer Alignment  Axis - S1 spinous process  Stationary arm - vertical  Moving arm - C7 spinous process

 Test Position  Subject sitting  Stabilize pelvis  Do not allow sidebending, forward bending or backward bending  Rotate thoracic and lumbar spines  Goniometer Alignment  Axis - center of superior aspect of head  Stationary arm - aligned with anterior superior iliac spines  Moving arm - aligned with acromion processes

1) 치료의 기본선을 설정하고 근력이용 정도를 결정한다 2) 근력약화 정도를 판별하여 일상생활동작 수행능력을 조절 3) 근력 불균형으로 인한 변형을 예방한다 4) 보조 장구 즉 보조기의 필요성을 결정 5) 환자의 능력내에서 수행 가능한 활동을 선택한다 6) 효과적인 치료법 여부를 평가하여 가장 정확한 치료방법을 선 택한다

유발전위 검사란 시각, 청각, 후각, 촉각 등의 자극을 인위적으로 주었을 때 이 자 극들을 담당하는 뇌 부위의 전기적 반응 을 측정하는 것으로 중추신경계 이상을 체크하는 검사방법 적응증 : 청력 이상, 어지러움, 몸의 균 형을 잡지 못할 때, 시력 이상, 시야 협 소, 척수 뇌 기능 측정 감각 경로 이상, 다발성 경화증

유발 전위검사방법 두피와 사지 등에 전극을 부착하여 시각, 청각, 후각, 촉각 등에 자 극을 주면서 검사가 진행됩니다. 검사 시간은 약 30 분 ~ 1 시간 검사 전날 목욕하시고 로션이나 크림을 바르지 마시고 편안한 마음 으로 검사 받으러 오시면 됩니다.