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- 您请求的操作仅限于组中的用户:==理疗管理==[[文件:关节炎疼痛时不要坐着不动[[文件:关节炎疼痛时不要坐着不动[[文件:关节炎疼痛时不要坐着不动[[文件:关节炎疼痛时不要坐着不动]]]OA会导致肌肉力量降低(尤其是影响关节周围的肌肉)、柔韧性下降、体重增加、adl活动能力受限,而且经常会损害活动能力。增强身体和心理功能,增强幸福感是综合锻炼计划的主要目标。增加关节运动,增强肌肉力量,增加有氧能力和最佳体重是当前的目标。McCarty DJ, Koopman WJ。关节炎及相关疾病。Lea和菲比格:费城,伦敦,1993年。[[跌倒|跌倒预防策略]]在老年患者的治疗中也起着重要作用。患有骨关节炎的人也更容易跌倒。研究发现,与非OA患者相比,OA患者跌倒的几率增加了30%,骨折的风险增加了20%。骨性关节炎患者有诸如功能下降、肌肉无力和平衡受损等危险因素,这些因素使他们更容易摔倒。 Side effects from medications used for pain relief can also contribute to falls. Narcotic pain relievers can cause people to feel dizzy and unbalanced. Physiotherapy is important part of OA management and will be instrumental in teaching people to: properly use joints; exercise correctly in both motion and flexibility exercises as well as cardiovascular exercises (e.g.[[Aquatherapy|hydrotherapy]], swimming), recommend [[Assistive Devices|assistive devices]], recommend use of modalities (eg. heat or cold therapies, [[Transcutaneous Electrical Nerve Stimulation (TENS)|TENS]]). === Typical Treatment Plans for OA === ==== Basic PhysiotherapyZhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M. [https://www.sciencedirect.com/science/article/pii/S1063458407003974 OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines.] Osteoarthritis and cartilage 2008;16(2):137-62.==== Not for patients with acute painful joint swelling and cardiovascular diseases. *Warm-up and range of motion *Strengthening (quad sets, supine straight leg raises, prone hip extensions, seated isometric knee extensions, single-leg leg presses, standing hamstring curls, and standing heel raises) *Aerobic program *Cooling down with muscle stretching (quadriceps femoris, [[Hamstrings|hamstring]], and calf muscle stretching) *Long-sitting knee flexion and extension range of motion, and treadmill walking *All lower-extremity exercises need to be performed bilaterally *Manual therapy can be used as a treatment tool for osteoarthritis. According to a systematic review, manual therapy (mobilisation with movement, passive joint mobilisation, patellar mobilisation therapy ) and exercises effectively reduce knee pain and increase functionality. However, further research is needed to determine the long-term effects of manual therapy on knee OA. Tsokanos A, Livieratou E, Billis E, Tsekoura M, Tatsios P, Tsepis E, Fousekis K. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304320/ The Efficacy of Manual Therapy in Patients with Knee Osteoarthritis: A Systematic Review.] Medicina. 2021 Jul;57(7):696.
==== Agility and Perturbation Training TechniquesFitzgerald GK, Piva SR, Gil AB, Wisniewski SR, Oddis CV, Irrgang JJ. [https://academic.oup.com/ptj/article/91/4/452/2734990 Agility and perturbation training techniques in exercise therapy for reducing pain and improving function in people with knee osteoarthritis: a randomized clinical trial.] Physical therapy 2011;91(4):452-69.==== Agility techniques: *Side stepping *Braiding (lateral stepping combined with forward and backward crossover steps) * Front crossover steps during forward ambulation * Back crossover steps during backward ambulation *Shuttle walking(forward and backward walking to and from designated markers) *A drill requiring multiple changes in direction *[[Perturbation-Based Balance Training|Perturbation techniques]] and [[Balance Boards|balance]] training '''Falls Prevention training [[Falls in elderly|see]] [[Falls in elderly|Falls in Elderly]]
''' The video below gives some sound basic physiotherapy exercises for all the major joints {{#ev:youtube|https://www.youtube.com/watch?v=FBqxjYvnUI8|width}}Nuffeild Health How to exercise safely with osteoarthritis. Available from: https://www.youtube.com/watch?v=FBqxjYvnUI8 (last accessed 28.5.2019)