本帖最后由 苹果丫丫 于 2013-4-24 19:49 编辑
NECK
Neckmuscle weakness in ALS makes it hard to turn or hold up the head, leading todecreased mobility and — if untreated — pain, especially when turning the head,raising and lowering into bed, or rolling over. Poor neck posture also canimpair breathing, swallowing and communication. Effective management of neckweakness can prevent or treat pain and injury. The key is to find the bestmethods of supporting the head.
Be awarethat neck weakness makes the person more vulnerable to injury during transfersand when riding in a vehicle. If the head suddenly flops down, back or to theside, muscles and ligaments in the neck can tear, or the cervical spinal cord orneck vertebrae can be seriously injured. For some, even a slight jerk is all ittakes to tear muscles.
Encourageand assist neck-stretching exercises (after consulting a physical therapist).
Twosimple exercises:
1. Slowly turn the head to each side as far aspossible without pain, hold and return to the center.
2. Tilt the head sideways on each side, so theear points down toward the shoulder; hold and return to center.
Use alumbar roll or cushion behind the lower back to prevent slumping when sitting,and to prevent the head and shoulders from tipping forward. Pillows under eacharm also promote upright head position when sitting.
Workwith a physical therapist to investigate different types of soft collars, neckbraces and head supports such as a band around the forehead that attaches to aheadrest. Alternating the use of collars and head support systems helps reducepressure points and skin breakdown. Thin-cushioned skin dressings (e.g.,Duoderm) also protect the skin.
Ensurethe person’s bed pillow isn’t too thick, as that can cause neck strain. Tryplacing a rolled towel under the back of the neck, coupled with a thin pillowfor the head.
颈部
ALS使患者颈部肌肉无力，这也使患者难以转头或抬头，导致颈部活动性下降。如果不及时治疗，会导致颈部疼痛，特别是转头、从床上起来或者躺到床上，或翻身时。颈部姿势不良也会妨害患者的呼吸、吞咽和言语沟通。颈部无力的有效管理，可以预防或治疗痛苦和伤害。关键是要找到最好的支撑头部的方法。
要意识到颈部无力会让患者在转移过程中和乘车时颈部更容易受伤。如果头部突然落下、到背面或落向一侧，可能会导致脖子上背面的肌肉和韧带的撕裂，或引发脊髓型颈椎病或颈椎严重受伤。一些人认为，即使是一个轻微的抖动也可能会导致肌肉撕裂。
鼓励和协助颈部伸展运动（在咨询物理治疗师后）。
两个简单的练习：
1. 在不引起疼痛的情况下，尽可能多地慢慢向两侧转动头部，保持住并返回到中心位置。
2. 将脑袋向两侧倾斜，以至耳朵向下直至碰到肩膀，保持住并返回到中心位置。
用一个腰椎环枕或者靠垫放在背部靠下的位置，以防止坐着的时候陷落进去，并且防止头和肩膀往前倾斜。两条胳膊下面垫上枕头也可在坐着的时候帮助头部保持直立的姿势。
在物理治疗师的帮助下调查不同种类的软项圈、颈部支撑器、头部支撑器，例如把额头绑在头枕上的绷带。交替使用项圈和头部支撑器，有助于减少受压点并防止皮肤破裂。皮肤薄垫敷料（例如，DUODERM）也可保护皮肤。
确认患者的床上的枕头不要太厚，太厚可能会导致颈部劳损。试着在脖子后面放一条卷起来的毛巾下，再在头部加上一个薄枕头。
狗仔卡
发表于 2013-4-24 19:42:42
提升卡
置顶卡
沉默卡
喧嚣卡
变色卡
抢沙发
千斤顶
显身卡
发表于 2013-4-25 06:50:31
