脉冲枪(中英文)

Unilateral Pain Below Waist 腰部以下单侧疼痛
SI Joint Involvement SI关节受累
Test and Adjust Involved SIJ 测试和调整受累的SIJ
Literature review of tests to diagnose a SI lesion: 用测试去诊断SI病变的相关文献综述： Binkley, et al, “Diagnostic classification of patients with low back pain: report on a survey of physical therapy experts,” Physical Therapy, 1993:73
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 腰背部中间疼痛
Proceed to Hip Rotation Tests 开始髋关节旋转测试
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 受累下肢的压迫测试
3. Hip Rotation Tests 髋关节旋转测试
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关节受累
Lumbar Involvement 腰椎受累
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“俯卧伸髋测试”（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.
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 腰背部中间疼痛
Proceed to Hip Rotation Tests 开始髋关节旋转测试
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Yes是
No否
SI扭伤降低患者的伸髋能力。
SI joint – horizontal section SI关节 - 水平横切位
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关节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
•单侧症状再现证实SI关节侵犯
•用单侧Nachlas测试法检查两侧
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 Joint Involvement 骶髂关节受累
Lumbar Involvement 腰椎受累
Lumbo-Sacral Involvement 腰骶受累
Test and Adjust Involved SIJ 测试和调整受累的SIJ
Test and Adjust Involved Lumbar 测试和调整受累的腰椎
病史（体征和症状，模式识别）： 检查结果： 骨科测试（具有较高的灵敏度和特 异性的测试） 关节对位对线 关节运动（双侧对称） 骨疼痛 软组织疼痛 肌肉和神经对运动和压力的反应
脉冲治疗仪
TECHNIQUE®
The Sacroiliac, Pubic, and Hip joints 骶骨关节，耻骨，髋关节
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?
•Is one leg heavier than the other?
•How does the pelvis move during the test? •问诊“这会引起任何部位的疼痛吗？” •两条腿屈曲程度相同吗？ •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
Test and LumboSacral Joint (Dual Styluses) 测试腰骶关节(双针)
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 •从受累侧开始(先测试有症状侧)
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
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®调整仪器的发声指标及临床决策
Single Beep 单声
Significant Improvement in at Least 2 Components of PART Documentation in Re-Assessment of Clinical Indicators 在临床指标再评估中，PART文件中至少有2部分有明显改善
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
Prone Hip Extension Test 俯卧伸髋测试 “Sacral Cup,” Dr. Major DeJarnette, (The American Chiropractor, May 2007)
•
“Prone hip extension test” (aka, “sacral cup test”)
Test and LumboSacral Joint (Dual Styluses) 测试腰骶关节(双针)
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
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
Lumbo-Sacral Involvement 腰骶受累
Test and Adjust Involved SIJ 测试和调整受累的SIJ
Test and Adjust Involved Lumbar 测试和调整受累的腰椎
Test and LumboSacral Joint (Dual Styluses) 测SI关节受累
Lumbar Involvement 腰椎受累
Lumbo-Sacral Involvement 腰骶受累
Test and Adjust Involved SIJ 测试和调整受累
Test and Adjust Involved Lumbar 测试和调整受累的腰椎
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: • 整脊疗法结合下列的检查对脊椎和骨盆 进行分析 – 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
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 受累盆骨上端的压迫测试
• •
Symmetry Tests: 对称性测试： poor reliability and validity. 信度和效度差
•
• •
Pain Provocation Tests:
疼痛激发测试： evidence supports the validity of some pain provocation tests. 证据支持某些疼痛激发测试的效度。