Ko te tukanga whānui o te whakangungu whakaora mō te pakaru o te uaua Achilles, ko te kaupapa matua o te whakaora ko: te haumaru tuatahi, te whakangungu whakaora i runga i tō rātou ake whakaaro.
Te wāhanga tuatahi i muri i te pokanga
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Te wā tiaki me te wā whakaora (wiki 1-6).
Ngā take hei aro atu: 1. Āraia te totoro koretake o te uaua Achilles; 2. Me piko te turi kaha ki te 90°, ā, me whakawhāiti te piko o te pona ki te tūnga koretake (0°); 3. Āraia te whakamahi i ngā kōpeke wera; 4. Āraia te whakaheke roa.
Ko te nekehanga wawe o ngā hononga me te pupuri taumaha te mea nui rawa atu i te wā tuatahi i muri i te pokanga. Nā te mea ka whakatairanga te pupuri taumaha me te nekeneke o ngā hononga i te whakaora me te kaha o te uaua Achilles, ā, ka taea te ārai i ngā pānga kino o te kore e neke (hei tauira, te ngoikore o te uaua, te pakari o ngā hononga, te mate rumatiki pirau, te hanganga piri, me te thrombus roro hohonu).
I tohutohuhia ngā tūroro kia mahi i ētahi mahi whakakori tinanahonongangā nekehanga ia rā, tae atu ki te piko o te pona waewae, te piko o te plantar, te varus, me te valgus. Me whakawhāiti te piko o te pona waewae ki te 0° i te 90° o te piko o te turi. Me karo i te nekehanga me te totoro o ngā hononga kore mahi hei tiaki i te uaua Achilles e ora ana mai i te totoro nui, te pakaru rānei.
Ina tīmata te tūroro ki te pikau i te taumaha katoa, ka taea te whakauru i ngā mahi whakakorikori pahikara tū i tēnei wā. Me ako te tūroro ki te whakamahi i te tuara o te waewae hei utu mō te waewae o mua i te wā e eke pahikara ana. Mā te mirimiri i te koha me te nekehanga māmā o te hononga ka taea te whakatairanga i te whakaora me te ārai i te piri me te pakari o ngā hononga.
Mā te rongoā makariri me te hiki i te peka e pāngia ana ka taea te whakahaere i te mamae me te pupuhi. Me ako ki ngā tūroro kia hiki ake i te peka e pāngia ana i te roanga o te rā, kia kaua hoki e pupuri i te taumaha mō te wā roa. Tērā pea ka tohutohuhia te tūroro kia pania he putea hukapapa kia maha ngā wā mō te 20 meneti i ia wā.
Me whakamahi i tētahi tikanga whakangungu ātete matatau ngā mahi whakakorikori o te hope me te turi tata. Ka taea te whakamahi i ngā whakakorikori mekameka tuwhera me ngā mīhini isotonic e ngā tūroro he iti te taumaha e hiki ana.
Ngā tikanga maimoatanga: I te wā e whakamahi ana i te rākau, i te tokotoko rānei o te tuaka i raro i te arataki a te tākuta, mauria he pūtu tautoko taumaha i raro i ngā pūtu pumau me te wira; te piko o te pona waewae/te piko o te waewae/te varus/te valgus; te mirimiri i te koha; te wetekina o ngā hononga; ngā mahi whakapakari uaua tata; te whakaora tinana; te whakaora makariri.
Wiki 0-2: Whakaūngia te waewae poto ki te tautoko i te taura, te pona i te tūnga kūpapa; te pupuri i te taumaha wāhanga me te tokotoko mēnā e whakaaetia ana; te huka + te pēhitanga ā-rohe/te pākia o te uaua; te piko o te turi me te tiaki i te pona. Te piko o te plantar, te varus, te valgus; te ātete o te quadriceps, te gluteal, te whakangungu tango hope.
3 wiki: Tautoko waewae poto kua kore e nekeneke, pona kei te tūnga koretake. Hīkoi haere whakamua me te tautoko i te taumaha ā-wāhanga me ngā tokotoko; whakangungu piko pona/varus waewae āwhina +- kaha, whakangungu valgus waewae (whakangungu papa taurite +-); Whakateretere i ngā nekehanga pona iti (intertarsal, subtalar, tibiotalar) i te tūnga koretake; ātete ki te whakangungu tango hope, te quadriceps, me te gluteal.
4 wiki: Whakangungu piko pona waewae kaha; ātete piko plantar kaha, varus, me te hurihanga me ngā taura rapa rapa; whakangungu hikoi hapa-maumaha-whakangungu ātete iti (>30 nekehanga/hekona); noho teitei iti whakangungu whakaora rekereke ātete.
5 wiki: Tangohia te whitiki pona waewae, ā, ka taea e ētahi tūroro te haere ki te whakangungu o waho; te whakangungu hiki waewae takirua; te whakangungu hikoi hapa-taumaha-whakangungu ātete ā-waenga (20-30 nekehanga/hekona); te whakangungu whakaora rekereke nohoanga-iti; te whakangungu oma-ringa (te tiaki i te wā e ora ana).
6 wiki: I tangohia e ngā tūroro katoa ngā whitiki tautoko, ā, i whakahaerehia he whakangungu hikoi i runga i te mata papatahi o waho; he whakangungu toronga uaua Achilles tikanga i te tūranga noho; he whakangungu kaha uaua hurihuri ātete iti (koretake) (ātete varus, ātete valgus) e rua ngā rōpū; he whakangungu taurite waewae kotahi (Ko te taha hauora --- ko te taha e pāngia ana ka neke haere); he tātaritanga hikoi.
Ngā paearu whakatairanga: kua whakahaeretia te mamae me te pupuhi; ka taea te kawe i te taumaha i raro i te arataki a te tākuta; ka tae te piko o te pona waewae ki te tūranga kūpapa; ka eke te kaha o te uaua o te pito o raro ki te taumata 5/5.
Te wāhanga tuarua i muri i te pokanga
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I te wāhanga tuarua, i kitea ngā huringa mārama o te nui o te pikaunga taumaha, te pikinga o te ROM o te peka kua pāngia, me te whakanui ake i te kaha o te uaua.
Whāinga matua: Kia whakahokia mai te whānuitanga o te nekehanga e tika ana mō te haere noa me te piki arawhata. Kia whakahokia te kaha o te piko o te pona waewae, te varus, me te valgus ki te taumata noa 5/5. Kia hoki ki te haere noa.
Ngā mahi maimoatanga:
I raro i te tiakitanga, ka taea e ia te tu atu i te hāpai taumaha ki te haere whakaharatau pikau taumaha katoa, ā, ka taea te tango i ngā tokotoko ina kore he mamae; te haere whakaharatau pūnaha oma i raro i te wai; ka āwhina te papa rekereke i roto i te hū ki te whakahoki mai i te haere noa; ngā mahi whakakorikori pona waewae/piko plantar / varus / valgus; te whakangungu proprioceptive; ngā mahi whakakorikori kaha isometric / isotonic: hurihanga pona waewae / valgus.
Ngā mahi whakakori tinana me ngā hononga hei whakaora i te tirohanga ā-tinana, te neuromuscular me te taurite. I te hokinga mai o te kaha me te taurite, ka huri anō te tauira whakakori tinana mai i ngā pito o raro e rua ki ngā pito o raro kotahi. Me haere tonu te mirimiri i ngā koha, te whakaora tinana, me te nekenekehanga iti o ngā hononga mēnā e tika ana.
7-8 wiki: Me mau tuatahi te tūroro i tētahi whitiki tautoko i raro i te maru o ngā tokotoko hei whakaoti i te pikaunga taumaha o te waewae e pāngia ana, kātahi ka tangohia ngā tokotoko tautoko ka mau hu hei pikaunga taumaha. Ka taea te whakanoho i tētahi papa rekereke ki roto i te hu i te wā e neke ana mai i te whitiki tautoko waewae ki te hu.
Me heke te teitei o te papa rekereke i te pikinga ake o te whānuitanga o te nekehanga o te hononga. Ina hoki te haere o te tūroro ki te āhua noa, ka taea te tango atu i te papa rekereke.
Ko te hikoi noa te mea nui mō te hikoi me te kore e taea te tango i te waewae. Ko ngā mahi whakapakari pona waewae ko te piko o te waewae me te toronga o te tuara. Ko te tikanga o te piko o te waewae ko te mau o ngā matimati ki muri kia kaha rawa, arā, ka akiakihia te waewae ki muri ki te tūranga mutunga;
I tēnei wāhanga, ka taea te tīmata i ngā mahi whakakorikori uaua whakahurihuri ngawari me te whakahurihuri, ā, ka taea te whakamahi i ngā here rapa hei whakaharatau i te wāhanga o muri mai. Hangaia te kaha o te uaua mā te tuhi i te āhua o ngā reta me tō pona waewae ki runga i tētahi taputapu tuaka-maha. Ina tutuki te whānuitanga o te nekehanga e ranea ana.
Ka taea e koe te tīmata ki te whakaharatau i ngā uaua matua e rua o te piko o te waewae. Ka taea te tīmata i ngā mahi ātete piko o te waewae me te piko o te turi ki te 90° i ngā wiki e 6 i muri i te pokanga. Ka taea te tīmata i ngā mahi ātete piko o te waewae me te turi e toro ana i te wiki 8.
Ka taea hoki te whakaharatau i te piko o te waewae i tēnei wā mā te whakamahi i te taputapu takahuri turi-toro me te mīhini piko waewae. I tēnei wā, me mahi te whakaharatau pahikara pumau me te waewae o mua, ā, me whakanui haere i te nui. Mā te hikoi whakamuri i runga i te mīhini oma ka whakarei ake i te mana o te piko o te waewae tauhou. He maha ngā wā ka kitea e ēnei tūroro he pai ake te hikoi whakamuri nā te mea ka whakaitihia te hiahia mō te whakareri. Ka taea hoki te whakauru i ngā whakaharatau hikoi whakamua. Ka taea te whakanui haere i te teitei o ngā hikoi.
Te tūpeke iti me te tiaki i te pona waewae (ka toro te uaua Achilles i raro i te whakaaro o te mamae e taea te manawanui); e toru ngā rōpū whakangungu uaua hurihuri ātete ngawari (koretake) (ātete varus, ātete valgus); Te hiki o ngā matimati (whakangungu soleus ātete teitei); Te hiki o ngā matimati me ngā turi tika i te tūranga noho (whakangungu gastrocnemius ātete teitei).
Tautokona te taumaha o te tinana ki runga i te pae taurite hei whakapakari i te whakangungu hikoi motuhake; mahihia te whakangungu hiki i te kōpū waewae +- whakaohooho EMG i a koe e tū ana; mahihia te ako anō i te hikoi i raro i te mīhini oma; mahihia te whakangungu mīhini oma whakaora me te waewae o mua (mō te 15 meneti); whakangungu taurite (papa taurite).
9-12 wiki: whakangungu toronga triceps o te kuao kau tū; whakangungu ātete hiki i te kuao kau tū (ka pā ngā matimati ki te whenua, ki te tika, ka taea te tāpiri i te whakaohooho uaua hiko); whakangungu manawanui whakaora waewae i mua (mō te 30 meneti); hiki waewae, whakangungu hikoi taunga, kia 12 inihi te wehenga o ia hikoinga, me te whakahaere porowhita me te rerekē; hikoi piki whakamua, hikoi heke whakamuri; whakangungu taurite trampoline.
I muri i te whakaoranga
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Wiki 16: Whakangungu ngāwari (Tai Chi); tīmata te kaupapa oma; whakangungu isometric maha-ira.
6 marama: Whakataurite i ngā pito o raro; whakamātautau whakakori tinana isokinetic; rangahau tātari haere; hiki i te waewae kotahi mō te 30 hēkona.
Sichuan CAH
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Email: liuyaoyao@medtechcah.com
Wā tuku: Whiringa-ā-rangi 25-2022
