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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
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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
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① full-circle manual universal goniometer most versatile &popular ② Gonoimeters for single joint motion
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③ fluid inclinometer ④ pendulum inclinometer ⑤ electrogoniometer
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Upper Ext. Lower Ext. Spine
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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)
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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)
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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)
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Goniometer Alignment Axis – center of humeral head near acromion process Stationary arm – parallel to sternum Moving arm – aligned with midline of humerus
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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)
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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)
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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)
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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)
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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
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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
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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
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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
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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
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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
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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)
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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)
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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)
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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)
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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)
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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)
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Test Position Subject standing Flex thoracic and lumbar spines Tape Measure Alignment Spinous processes of C7 and S1
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Test Position Subject standing Extend thoracic and lumbar spines Tape Measure Alignment Spinous processes of C7 and S1
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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
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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
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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
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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
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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.
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