脉冲治疗仪使用教程

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“俯卧wk.baidu.com髋测试”（又名“骶杯测试”）
Tests the strength of the muscles crossing the posterior aspect of the SI joint. 测试横跨SI关节后端的肌肉力量。 SI sprain reduces patient’s ability to extend the hip.
脉冲治疗仪
TECHNIQUE®
Impulse Adjusting Technique 脉冲调整技术
• A Chiropractic Analysis of the spine & pelvis that incorporates findings from:
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从下列方面整脊分析脊椎与盆骨的结果：
– – – – – – – – History (signs & symptoms, pattern recognition): Exam Findings: Orthopedic tests (tests that have high sensitivity & specificity) Joint alignment Joint movement (symmetry with opposite side) Pain over bone Pain over soft tissue Muscle and nerve reaction to movement and pressure
Unilateral Pain Above Waist 腰部以上 单侧疼痛
Central Low Back Pain 中间腰背疼痛
Proceed to Unilateral Nachlas Test 开始单侧Nachlas测试
SI Joint Involvement SI关节侵犯
Lumbar Involvement 腰椎侵犯
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Symmetry Tests: 对称性测试： poor reliability and validity. 可靠性和有效性差
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Pain Provocation Tests:
疼痛激发测试： evidence supports the validity of some pain provocation tests. 证据支持疼痛激发检查的有效性。
SI Joint Involvement SI关节侵犯
Lumbar Involvement 腰椎侵犯
Lumbo-Sacral Involvement 腰骶侵犯
Test and LumboTest and Adjust Test and Adjust Sacral Joint Involved SIJ Involved Lumbar (Dual Styluses) 测试和调整受侵犯的SIJ 测试和调整受侵犯的腰椎 测试腰骶关节(双针)
•单侧症状再现证实SI关节侵犯
•通过单侧Nachlas测试法检查两端
Step 2: Unilateral Nachlas Test 第2步：单侧Nachlas测试
Flowchart for Step 2 第2步流程图 Unilateral Nachlas Test 单侧Nachlas测试
Positive 阳性
SI扭伤降低患者的伸髋能力。
SI joint – horizontal section SI关节 - 水平段
Location of SI adjustment
SI调整部位
SI capsule contains a dense plexus of unmyelinated nerve fibers indicative of a nociceptive receptor system. SI囊含有密集的无髓鞘神经纤维丛，提示痛觉受体系统。 Wyke, “Receptor systems in lumbosacral tissues in relation to the production of low back pain,” American Academy of Orthopaedic Surgeons Symposium on Idiopathic Low Back Pain, Mosby, 1982
Lumbo-Sacral Involvement 腰骶侵犯
Test and LumboTest and Adjust Test and Adjust Sacral Joint Involved SIJ Involved Lumbar (Dual Styluses) 测试和调整受侵犯的SIJ 测试和调整受侵犯的腰椎 测试和调整腰骶关
Test and Adjust Involved SIJ 测试和调整受侵犯的SIJ
Literature review of tests to diagnose a SI lesion: 测试相关的文献综述确诊SI病变： Binkley, et al, “Diagnostic classification of patients with low back pain: report on a survey of physical therapy experts,” Physical Therapy, 1993:73
Unilateral Nachlas Test 单侧Nachlas测试
Positive 阳性
Confirm with SI Joint Compression Test 通过SI关节压迫测试确认
Unilateral Pain Below Waist 腰部以下单侧疼痛
SI Joint Involvement SI关节侵犯
Step 1: Bilateral Nachlas Test 第1步：双侧Nachlas测试
Step 2: Unilateral Nachlas Test 第2步：单侧Nachlas测试
Step 3: Hip Rotation Tests 第3步：髋关节旋转测试
Step 4: Lower Extremity Compression Tests 第4步：下肢压迫测试
Yes是
No否
Acceleration Response Maximized 加速反应最大化
SCP：骶髂关节，PSIS内侧 LOD：前-上 设置：高或中
Impulse iQ® Adjusting Instrument Audible Indicators & Clinical Decision Making 脉冲IQ®调整仪器的发声指示及临床判断
Single Beep 单声
Significant Improvement in at Least 2 Components of PART Documentation in Re-Assessment of Clinical Indicators 在重新评估临床指标的PART文件中至少有2部分有明显改善
Step 1: Bilateral Nachlas Neuromechanical Innovations Slides Test Test
第1步：双侧Nachlas测试
Step 1: Bilateral Nachlas Test 第1步：双侧Nachlas测试
Clinical Considerations: 临床注意事项： •Ask, “Does this cause any pain anywhere?” •Do both legs flex the same?
Presence of Pain Range of Motion Asymmetry Strength 存在疼痛 运动范围 不对称性 强度
4. Compression Tests for Lower Ext. Involvement 下肢侵犯的压迫测试
3. Hip Rotation Tests 髋关节旋转测试
Positive 阳性
Negative 阴性
Unilateral Pain Below Waist 腰部以下单侧疼痛
Unilateral Pain Above Waist 腰部以上单侧疼痛
Central Low Back Pain 中间腰背部疼痛
Proceed to Hip Rotation Tests 开始髋关节旋转测试
•Is one leg heavier than the other?
•How does the pelvis move during the test? •问题“这会引起任何部位的疼痛吗？” •两腿感觉相同吗？ •一条腿比另一条腿重吗？ •检查过程中盆骨如何移动？
Flowchart for Step 2 第2步流程图 Unilateral Nachlas Test 单侧Nachlas测试
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病史（体征和症状，模式识别）：
检查结果： 骨科测试（测试具有较高的灵敏度和特异性） 关节对齐 关节运动（对面对称）
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骨疼痛
软组织疼痛 肌肉和神经的运动和压力反应
脉冲治疗仪
TECHNIQUE®
The Sacroiliac, Pubic, and Hip joints 骶髂，耻骨，髋关节
Step 2: Unilateral Nachlas Test 第2步：单侧Nachlas测试
•Begin with side of involvement (symptomatic side first); •Reproduction of symptoms unilaterally confirms SI joint involvement •Test both sides with Unilateral Nachlas Test •侵犯端开始(症状端开始)
5 Step Lumbo-Pelvic Analysis Flowchart 5步腰腹骨盆分析流程图
1. Bilateral Nachlas Test 1.双侧Nachlas测试 2. Unilateral Nachlas Test 单侧Nachlas测试
5. Compression Tests for Supra-Pelvic Involvement 盆骨上端侵犯的压迫测试
Step 5: Supra-Pelvic Compression Test 第5步：盆腔上端压迫测试
Flowchart for Step 1 第1步流程图 Bilateral Nachlas Test 双侧Nachlas测试
Positive 阳性
Negative 阴性
Unilateral Pain Below Waist 腰部以下 单侧疼痛
Sacroiliac Adjustment 骶髂调整
Sacroiliac Joint Adjustment 骶髂关节调整 SCP: Sacroiliac joint, medial aspect of PSIS LOD: Anterior-Superior Setting: High or Medium
Negative 阴性
Unilateral Pain Below Waist 腰部以下单侧疼痛
Unilateral Pain Above Waist 腰部以上单侧疼痛
Central Low Back Pain 中间腰背部疼痛
Proceed to Hip Rotation Tests 开始髋关节旋转测试
Prone Hip Extension Test 俯卧伸髋测试 “Sacral Cup,” Dr. Major DeJarnette, (The American Chiropractor, May 2007)
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“Prone hip extension test” (aka, “sacral cup test”)
SI Joint Involvement SI关节侵犯
Lumbar Involvement 腰椎侵犯
Lumbo-Sacral Involvement 腰骶侵犯
Test and LumboTest and Adjust Test and Adjust Sacral Joint Involved SIJ Involved Lumbar (Dual Styluses) 测试和调整受侵犯的SIJ 测试和调整受侵犯的腰椎 测试腰骶关节(双针)