![假肢矫形器技术与临床应用](https://wfqqreader-1252317822.image.myqcloud.com/cover/841/31391841/b_31391841.jpg)
第三节 关节活动度评定
一、关节活动度的定义
关节活动度(range of motion,ROM)是指关节活动时可达到的最大弧度,是衡量一个关节运动量的尺度,常以度数表示,是肢体运动功能检查的最基本内容之一。
根据关节运动的动力来源可将关节活动度分为主动关节活动度和被动关节活动度。
1.主动关节活动度(active range of motion,AROM) AROM是人体自身的主动随意运动而产生的运动弧。测量某一关节的AROM实际上是评定受检者肌肉收缩力量对关节活动度的影响。
2.被动关节活动度(passive range of motion,PROM) PROM是通过外力如治疗师的帮助而产生的运动弧。正常情况下,被动运动至终末时会产生一种关节囊内的、不受随意运动控制的运动,因此,PROM略大于AROM。
二、主要ROM的测量方法
(一)脊柱ROM的测量方法(表6-3-1)
表6-3-1 脊柱ROM的测量方法
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_22.jpg?sign=1739313981-sDl04iRj3wt2UUKv5qJ7zf0THAOf0oFQ-0-7ec7944be16aee220db4426df5959586)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_23.jpg?sign=1739313981-eF4LKOWUeMyHd3sFUXRsvSuZE2lSoK2G-0-aba0f2e25e58172019c85a33e8049ede)
图6-3-1 颈椎前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_24.jpg?sign=1739313981-aqT5vG6iOAgTygOTFQ7UBQiysMfLHqBy-0-3e2de090c78d81c21d91ace342adaac9)
图6-3-2 颈椎左旋右旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_25.jpg?sign=1739313981-gBlOyWmRjmEtwuaJPaIDYv48uHlMphu7-0-dcefde131e4c27e5a360544ac75b5c54)
图6-3-3 颈椎左右侧屈
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_26.jpg?sign=1739313981-QJVZthOtFZ424tmUTo8DNhtMu0LQ7Hoz-0-e83d3cd9b08370a7ee04d3c7736e9dc8)
图6-3-4 胸椎腰椎前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_27.jpg?sign=1739313981-RVuyaDZdX0j9p3ICT1rZPLgFhSvQpBwE-0-28ca60d82507c3e29a36bc411d79e9e9)
图6-3-5 胸椎腰椎左旋右旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_28.jpg?sign=1739313981-rOvHS96h5PbPaw1cejjXocbzHn5eYvki-0-46bf3a9386a4cdca317f9bc89ade439f)
图6-3-6 胸椎腰椎左右侧屈
(二)上肢ROM的测量方法(表6-3-2)
表6-3-2 上肢ROM的测量方法
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_29.jpg?sign=1739313981-nEO2AFqrRecHOwVwAaDUlZzKHkPbWW3Z-0-66660873e3e6493dc2370ae0d285ea27)
续表6-3-2
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_30.jpg?sign=1739313981-aAvTQaDHagAal38yqQsUVKLMKTRIwpVq-0-56d648fadd724e4640e2a11767eae891)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_31.jpg?sign=1739313981-ADxS5j8JNPdJO22Qq5LEO7YZN5xoR7Sx-0-4b5ff52c9b3566f5cfc5d9c6dda97c4c)
图6-3-7 肩胛带前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_32.jpg?sign=1739313981-YNQiK2jHrs3nIYIxTYxzvo9Yu54YFjwe-0-fcaa0192f64ce1f9f6c6c39fd7e9ad8e)
图6-3-8 肩胛带上举下降
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_33.jpg?sign=1739313981-mM2P6d5KL59uraWO9BOUruLLSnJMMvgt-0-86ae7a301a07df6bde24560196381836)
图6-3-9 肩前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_34.jpg?sign=1739313981-Nm5Qcivc4vaJvHMAADjt1y4DXIvQS3hr-0-763ac141e760eee1295412876e0d7149)
图6-3-10 肩外展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_35.jpg?sign=1739313981-w8PZoczmOYaoVA3fs7hOtzyD81YzVEUY-0-0e7b62cf813bda392112aa986b305eef)
图6-3-11 肩内旋外旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_36.jpg?sign=1739313981-aHdvijxDCR6dNHexJ818N1GBcFqXyxWU-0-d48e379ac191bb44c7b9d6a567144af9)
图6-3-12 肩水平屈曲
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_37.jpg?sign=1739313981-GZmFv293RrhTyjKpVZZEs7EnxtolzJwp-0-91d72820bf5225f6cee24ab45c1ba13c)
图6-3-13 肘屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_38.jpg?sign=1739313981-NdDMDVvM9XXjbsCWtNXbvegfhGswX5Dr-0-d925df2d4ee675b7b7a53725174681ff)
图6-3-14 前臂旋前旋后
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_39.jpg?sign=1739313981-qc9712oCVK16ZU41aUGU0LGwGSGHjogI-0-3f9dc8b6d1ca345a68c372d7af38148a)
图6-3-15 腕屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_40.jpg?sign=1739313981-NdJS2ijYiyLJR35RykZVJme1LnVvGdeU-0-fd0e15d547ee90fe531ce65e2b3e2aab)
图6-3-16 腕尺偏桡偏
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_41.jpg?sign=1739313981-7bSLt1UFad3x3JG5A7Uw59XKc2upnTnQ-0-fa28aaa356d9928bbb1675ac9e6861c6)
图6-3-17 拇指桡侧外展尺侧内收
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_42.jpg?sign=1739313981-0yZCssw2zs0EtqAgcpqHMtI4RtchCzHC-0-bbe0b8a35188ea4ae17b929b7bce4340)
图6-3-18 拇指掌侧外展掌侧内收
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_43.jpg?sign=1739313981-a140q6WjtYCjm6sXrzIvCtp1d2xRN3vy-0-4a75df19c257901d8a13ec283776d425)
图6-3-19 拇指掌指关节屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_44.jpg?sign=1739313981-7pXuwXfX8TCyVs0sLPPMhSFx4s8Mtrrg-0-3c3ecc876ce89d87b14228728a0aae1f)
图6-3-20 拇指指间关节屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_45.jpg?sign=1739313981-bZV8LWpx1EWCTwgMqWHQDEuC3dOxFDcp-0-02d6b803902df2ea512bf5a6100b964c)
图6-3-21 拇指对掌
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_46.jpg?sign=1739313981-0vnAc5WNokopqzP14eVIxOcsqg6p4iJy-0-7e927d13280a81ccdd7718ec5f8fd82a)
图6-3-22 指掌指关节屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_47.jpg?sign=1739313981-iyGfMPJ0bZF6maDIKCN1r6MAGSa43s32-0-f9ab26d72923c32542531ad8222e0797)
图6-3-23 指近端指间关节屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_48.jpg?sign=1739313981-Y4ct1QJrlJHpnmhp7YKwiJJRkyctALFq-0-e97ed0298105e6d88bc54be2f2caac7c)
图6-3-24 指远端指间关节屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_49.jpg?sign=1739313981-H4QVVLtHq9FQeNMsA1pipnDmoL8RbuK4-0-f41176de6e0c81159d662c2beb91a8c5)
图6-3-25 指外展内收
(三)下肢ROM的测量方法(表6-3-3)
表6-3-3 下肢ROM的测量方法
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_50.jpg?sign=1739313981-N3pkxp0ANri6J3uLE7IL5y1obgO6T7Yi-0-6a1a7cda6b8baf4b0823fcbe0cea37b2)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_51.jpg?sign=1739313981-piotG8VRCJnrToWxVitdanRb4tco6hl6-0-01d94b5a575a5cbd0705530480f29e03)
图6-3-26 髋前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_52.jpg?sign=1739313981-ze6pV9dbxnZyPQJMrceL0md4BPbwFJCb-0-4059913deab5b04579faa0cbfd2bf810)
图6-3-27 髋外展内收
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_53.jpg?sign=1739313981-o0z0cKg8hPOaAKIEw6okCbAoMiMDmQTt-0-fc90f73d629598de89611309a73848e5)
图6-3-28 髋内旋、外旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_54.jpg?sign=1739313981-9eS59RCrfJcLsTyWz9rNz3B9twQDj49S-0-313b8041a5b281e5507d3580d1deea28)
图6-3-29 膝屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_55.jpg?sign=1739313981-I0guDhdxn752NdOcUK9ccygbkOoWHA2O-0-3333feb83144c2ff165156e395460a6f)
图6-3-30 踝背伸跖屈
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_56.jpg?sign=1739313981-GrsVj2xjj7SmEOkTy9XuvJwYolpYF87K-0-a7ddc49259e4c68a4d0ea74fb61710ce)
图6-3-31 踝内翻、外翻
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_57.jpg?sign=1739313981-OVfoBvWxOBTyS8msEbZtiNOLUYhIsfBK-0-e2c5fa00e68f057e7e4a79356afcecc8)
图6-3-32 趾MP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_59.jpg?sign=1739313981-ugnNmJayve1fAWXzivPWZxKv6A3O6Yyt-0-b87065537999101bb63c794ab55f6750)
图6-3-33 趾IP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_61.jpg?sign=1739313981-XUQcudGTKIIOTsrG76ZDquamViNElQKw-0-09fd8c4bd82ee851bda07b8541cc276e)
图6-3-34 趾MP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_62.jpg?sign=1739313981-0y9QjWCLP5Ux4DLWPPhPYUgAuYqzSXCy-0-1565297015e937a39bd68821d95163cf)
图6-3-35 趾PIP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_63.jpg?sign=1739313981-QaUS1R9uonnQnm9q4wvFVaJ3vb1TV8Hh-0-14a013447da0480df9adfb8a0cf876ea)
图6-3-36 趾DIP屈曲伸展
(何建华)