![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=1739417127-yHPfUcjMIc1QHWU7utW2nRZzYdvVSUvA-0-d440176c7e615c8cfc3f118d1f54c630)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_23.jpg?sign=1739417127-eCMXK0v8Xc3iqGJ3fhexLqKE1wCIFojt-0-85a38e4fe5ffab2f3c59084893cff0bc)
图6-3-1 颈椎前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_24.jpg?sign=1739417127-eyuKJSM6wSAdf2dus2K0dCvwywtdVuGN-0-97b92d3a20014d78f1fbe890a06e9224)
图6-3-2 颈椎左旋右旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_25.jpg?sign=1739417127-084ldcBe7JUKvmjYCkQKuMSO0Mg7nnPW-0-d6be8ff939ae2bb535bac1d8f644d1d3)
图6-3-3 颈椎左右侧屈
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_26.jpg?sign=1739417127-nprhAeD5Bp5Xl2rw9v8rWDwP9Y92vEtE-0-896074e84f6b27cee37f25cd924dd2ff)
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=1739417127-jiCRVxsxt8ZTgQA21RZLLb66iGpoAW3b-0-0e7612a9ed024ace17104a822db74232)
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=1739417127-KM6HHDuELDW31O09lZSV9dp1duZ09Eld-0-3ee3c9c34606b7cf0b2346b54cfd95c7)
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=1739417127-nBhgQAt9s0GTRlHF72JGlEEgshI1AKJ4-0-60f8fcd66e4398f072b63a86027a5e7e)
续表6-3-2
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_30.jpg?sign=1739417127-o2uwqHDqL011KRQ8zRaIs1zkMH5rPN57-0-a3d1b7f121c93e6339de89bd1441d3f6)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_31.jpg?sign=1739417127-FZTW136aDwnGXJwOrhxgJZ7DqDsgaCOQ-0-d17a740a0534a197fd98dbcbc4688fbf)
图6-3-7 肩胛带前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_32.jpg?sign=1739417127-h7IcjBVrJUYYlyWRCzzx4EGNeZBqjAMR-0-11f129857a0b81b87387ccc1bf83f345)
图6-3-8 肩胛带上举下降
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_33.jpg?sign=1739417127-wIXkFgmDXbTbyEV9w8PsbDp5JGcyHl4v-0-9fcd1e095b3b61faa411f7ddab9923ba)
图6-3-9 肩前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_34.jpg?sign=1739417127-auCYHPLXIql7t0SGHX8b5iPmP9CfdG29-0-095ef008d882e421642e1f75c4edef9f)
图6-3-10 肩外展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_35.jpg?sign=1739417127-EFc8YLaS4aTTXh3KaNb3URYmpOLPr2Li-0-8f522c79ea17ebe760f5171cdf5c50b1)
图6-3-11 肩内旋外旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_36.jpg?sign=1739417127-EJMjkAO6p8Xdyxwp7szf57h9URm8Tg6D-0-19c742aee4ba1870838e2e69122e8e5c)
图6-3-12 肩水平屈曲
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_37.jpg?sign=1739417127-3tgEIfmdPPx2b3AKsuTqtmkgxjqUYDlv-0-41b82fff1f63385d0772baafd42ed80a)
图6-3-13 肘屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_38.jpg?sign=1739417127-im7JVbEVTCJQRyDfh4JKyorKYmE2TebV-0-c6f48d12b97e400003afa8ee4178c5c6)
图6-3-14 前臂旋前旋后
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_39.jpg?sign=1739417127-gfJYdOwS2LYfXEkGeLC7LqX6zAVHgURt-0-ca2bd3d08dd0260bdc156e0f1a3b40b6)
图6-3-15 腕屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_40.jpg?sign=1739417127-YWbByWxHvrWfDPMt6TiCFeqPsNEaWfIu-0-c84bb010e14a791568860bea649dc3a5)
图6-3-16 腕尺偏桡偏
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_41.jpg?sign=1739417127-mqcEgYoBviuV4hfcW3QDLM8GFWKjSJnm-0-c7b0e5c872c2ac42a8380ec6c960a6bc)
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=1739417127-loT6WFyGruvhgD0tAqGoy2FvsZvT19RV-0-346dbac00f085da18c003827191a4b8a)
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=1739417127-ACpVrZoZub9thZqaid0P1dKJO0yazkZC-0-3b78f7b6e72ac03254cb0b8f03d072ea)
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=1739417127-Dxwu9OM96Njy6Ywpp9INEb5m4S43lRQ6-0-7b2dc21415496d906057eca8ddf3ac70)
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=1739417127-iLF8TDylyHeRrHkKJGCaQ8YDfXmnF5ZA-0-51ba72bc787529bd73f98448f5c641f8)
图6-3-21 拇指对掌
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_46.jpg?sign=1739417127-keM4REmHYTr5e6nxFQzD9C5QJezlHNew-0-54de802516eb8f0813b6ab0ebcd3fc36)
图6-3-22 指掌指关节屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_47.jpg?sign=1739417127-9Nb7pdlCzlFNdF8ErECukReOGaQJcvaC-0-848d6db6fd1fd0192e1c246ca55fa357)
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=1739417127-SbuVc5IYIPeT8zk7tnJku6uV5CToWToZ-0-5e8ddd80df0a2a1b4e2e9e2ec38789ee)
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=1739417127-lFx9H5okIFaywktI72lAmeVxZCv2I2uf-0-bf77242a3c294ff0c7ad7315c75504bb)
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=1739417127-eBZluU0e6nYUJwmVyF8NzpTb4E6VFECM-0-2952212372212bdfd51be973f24a76e9)
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_51.jpg?sign=1739417127-ZNVqmadEDZvXPkFtEiutAfjsYk3csWrJ-0-49d13a62667def1e3525c23e588bedf1)
图6-3-26 髋前屈后伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_52.jpg?sign=1739417127-osvqld6ZvMBrioID4m36JCqElKgRtRK8-0-6c6dd0f59ac9395a75871cae4f91f18f)
图6-3-27 髋外展内收
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_53.jpg?sign=1739417127-qNPjL6HLgMnJ3wjyeuQWNf8t46oLS8Bv-0-abd88d828aec2988641d8097dd7d919a)
图6-3-28 髋内旋、外旋
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_54.jpg?sign=1739417127-HuEboZicbhhyhfykblICKi4iWLW6ODtP-0-1e07febdfbfca6294237cc5ce7f19d31)
图6-3-29 膝屈伸
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_55.jpg?sign=1739417127-QRiVFz4CEXv3CnJOW6HamZPv5fnsxomq-0-a5e2a649cac426fc4494554209fd641f)
图6-3-30 踝背伸跖屈
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_56.jpg?sign=1739417127-FnyBxmBkjGdrLECzQougjTOs0XdfgGNt-0-96f84b1fba3d8e5f5c5b4b528051dfa3)
图6-3-31 踝内翻、外翻
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_57.jpg?sign=1739417127-VvDptEcPqWnLorS7yEF7BLixrWKGuMBm-0-cd19292cc1f77b8ff3351680408cdee4)
图6-3-32 趾MP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_59.jpg?sign=1739417127-KGdHMKUHNQWJocUFpZjMWIXsNboJOBXb-0-2f7c8fd423f37d809e27d15e57fc6789)
图6-3-33 趾IP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_61.jpg?sign=1739417127-D4otkOXBpHh7IZh0nf8IALxmsfaxW7MX-0-bdb6d1b025d700cca6ef00168245cebc)
图6-3-34 趾MP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_62.jpg?sign=1739417127-gUs95pPStOTmRATf2XSB2YRWPHS7db6K-0-00e8126b523e7c7da34bf739dbdd99bf)
图6-3-35 趾PIP屈曲伸展
![](https://epubservercos.yuewen.com/28B8A2/16992237105825206/epubprivate/OEBPS/Images/txt006_63.jpg?sign=1739417127-gTMPuAKtPCjU4jjTrkiVUsRJRgaCzjh9-0-27808c31785b68a243134e4a08493f89)
图6-3-36 趾DIP屈曲伸展
(何建华)