![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=1739612384-AkNZvzE2fjK3IxrAkLqJF99urqz5CFLU-0-c66dc9555ccac2015cd84d5d44fd80f3)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_23.jpg?sign=1739612384-xtx34ox1rzOtNfrX8FscCLEx3iO3MYU0-0-8ece22bf443b24fa240140f2a6ac341f)
图6-3-1 颈椎前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_24.jpg?sign=1739612384-z40sc0GjJoeo4hcycv8BJRcGlpRXslpr-0-b1c76861218de3b7741e47a209f412ba)
图6-3-2 颈椎左旋右旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_25.jpg?sign=1739612384-Zet74VUnTz76k2NgPNHhBoAH790mhkwF-0-b4245509adf5fe6baa018ccdd452bf3a)
图6-3-3 颈椎左右侧屈
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_26.jpg?sign=1739612384-cshPpvOVvPabZqMuo36VNLTMwaLy2ZWQ-0-dcee68526b1fb858bcabc6ad01385435)
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=1739612384-mLHqFKPATPopIvDzv8DtiFNZviwz1DNe-0-b951e44cac27ba6dae479490296e212d)
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=1739612384-IqoOsHj0Z3Vw3r8KNjo1SxzzWOthEs7X-0-d011c4f62076e961bf1432aabae01352)
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=1739612384-bOeIhGLRpS0TvGYsvLSKcik7tAkkHPeH-0-1fd504c93fc2f0305733954705e77ba6)
续表6-3-2
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_30.jpg?sign=1739612384-mZmTFuRklOez6Ht5YokHq81hRaem1Kst-0-dd47ea695e4fd666d2a7e76b0d9d3c66)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_31.jpg?sign=1739612384-2PMYNExUIy65Oq5KIKKjEL2geiPUz1zh-0-682f3aa9b16fbf66f4d3fd9bed452242)
图6-3-7 肩胛带前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_32.jpg?sign=1739612384-rEV48gKhmVwXwN1Hquwg1RdHebbnBncj-0-9e0a9e3b3011740e43ab8616fc596d04)
图6-3-8 肩胛带上举下降
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_33.jpg?sign=1739612384-OYIlcJwIdKuGiGHyTONjTLqtN2W7LPVX-0-8e48cb56323205756115f2aff5c275ea)
图6-3-9 肩前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_34.jpg?sign=1739612384-McE7otxy8UO3FIsnf9UvvPPcCSsa5ojm-0-57367d0d2b3b550f12eaef693e20106b)
图6-3-10 肩外展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_35.jpg?sign=1739612384-8P6fNbZfdta5HDfBjivyhi7OF9K0doi6-0-646e5a3e01f8db35fb059998f7e28d40)
图6-3-11 肩内旋外旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_36.jpg?sign=1739612384-VLgjiKUPaPgkD8tjpFutrxKsUiBp9I60-0-902f38de2a06530ee288517605e1c038)
图6-3-12 肩水平屈曲
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_37.jpg?sign=1739612384-DSyhKNoyB6NjkTPyeuPRE8tRjjNXHV3u-0-e14035c7a9175fca11572bed915aa005)
图6-3-13 肘屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_38.jpg?sign=1739612384-AaF1k7IPhmXcjsvsCfsyT2rSqQk5xN0p-0-b29af22f1a3e119047ad12858a50e6bb)
图6-3-14 前臂旋前旋后
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_39.jpg?sign=1739612384-EbhS3OYh8xupdmy6zko5pq7pkxuuqG5I-0-beb74241d91b9253b3ccb709ea07e873)
图6-3-15 腕屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_40.jpg?sign=1739612384-KlMthc18RY4wuU88n7ou51pbpjwMDJgu-0-a775d7593f4137138ae888f0ae1c8074)
图6-3-16 腕尺偏桡偏
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_41.jpg?sign=1739612384-5pUUxJMsONThQBSjH0xaMt1br6PZcMMz-0-40c6c475adc3e49f8f6fb2dace3ca80e)
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=1739612384-uyOhEa1pYkuBX6nrKdusYbqh2JMS8OTW-0-e30bfac04cd500fc2a88a9c17feb0466)
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=1739612384-SFKV53fGRhnTeFOhx8WPUlBsGp91FEmS-0-aed09df3043162714dbaafa0ffdf4eb5)
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=1739612384-sL5vnt1p1TxbGt506YyV1RH2VdSu5wqR-0-4ae9a65f20f7330f1909851804a6443a)
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=1739612384-adp6SK2GtmhZWHcGbDwBucLZcbLWb5A3-0-fabee7391bd18f3dc8d72f5ac62ee916)
图6-3-21 拇指对掌
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_46.jpg?sign=1739612384-PV2XEuyHzCGsTvhQmQh2lArBBS2u8HBk-0-dd5981cea53d2e4547efffc28ae3a876)
图6-3-22 指掌指关节屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_47.jpg?sign=1739612384-1rQurmSSGT0w1G0C0Qy9BnvQbN8QPiN0-0-713797286de4f9f303f3ffde3a4cfa4a)
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=1739612384-2prWH0fpTAXIzBsCE6ORw1nDdTrgvrDc-0-e34b53771163b0a2a06a06d3589c54f8)
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=1739612384-h2UZisvjxslgRXtabv5zlgIiVOhBzXmR-0-8f677a55d83ea14b9be629420d048c30)
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=1739612384-tFBFlin8yLp25S82roKa2AzLw82Lt0GC-0-bf770fa769b08c778c8dcd7c37a52636)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_51.jpg?sign=1739612384-aH7K9HloDKq4n38vR89iIIi2XZWmfzH8-0-7fd9878b98fda3f30dd2ca624c77ffe8)
图6-3-26 髋前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_52.jpg?sign=1739612384-VrUqcF8oBb9f6AvyrdA7EFv0QA8PmaPX-0-57fa3c57312b56b4c9958db0009e8a32)
图6-3-27 髋外展内收
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_53.jpg?sign=1739612384-NFbQ26iyiEm1lcUguIbZkpGzdY8a6yyD-0-a09a2bec82b168399173d886444fc651)
图6-3-28 髋内旋、外旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_54.jpg?sign=1739612384-jSr1tM89VH9lIJOOBUyciNGjHtEEfem5-0-109e5619a27e7193acad5826e9cb3182)
图6-3-29 膝屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_55.jpg?sign=1739612384-iZ55aO4Te2SVfLivSqXnUs6DjoAlCtUI-0-7bbc8e579113182b5f6bdd86a516dbeb)
图6-3-30 踝背伸跖屈
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_56.jpg?sign=1739612384-oPFAqK2OslByPEGbmgANgkrqsxkVa0uz-0-a9423b0430ed64ddb17e859f3a9e30a3)
图6-3-31 踝内翻、外翻
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_57.jpg?sign=1739612384-GH0UrwEeSrYNR8bQbUngWaSclP8VYC6v-0-4bea37fd71d6fa105bf011703d6fd938)
图6-3-32 趾MP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_59.jpg?sign=1739612384-9YDLCDIY0IWAKqV445aLxhROM2JI2lgR-0-c1c5894736790f3c28c87565ad496e11)
图6-3-33 趾IP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_61.jpg?sign=1739612384-fJN4zdwlpT7Wgsx9CLcvowCguhEGvIZT-0-f82f8fdecbe5396b95e48c1cb1b2c87c)
图6-3-34 趾MP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_62.jpg?sign=1739612384-kurKV4dC2y9Jzz2FQ0WIBeNSC86Bv6cC-0-43d0103d286e32665c411b1bc47e04ad)
图6-3-35 趾PIP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_63.jpg?sign=1739612384-IfM6imsvGHkaqRLPw2wkW3v9nuvFaK9k-0-e1ac40dbc8e39d4840aea98396f272a8)
图6-3-36 趾DIP屈曲伸展
(何建华)