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<span style="font-size:14px;line-height:2;"> <strong>(一)上肢假肢基本操作訓練</strong></span> </p> <p> <span style="font-size:14px;line-height:2;"> 訓練患者開閉假手時，先讓患者端坐于工作臺做簡單的開閉動作，然后慢慢訓練增加水平移位，在不同的高度上訓練直到截肢者能熟練為止。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 訓練假手開閉所使用的物體應當從最易抓握的東西開始，</span><span style="font-size:14px;line-height:2;">再逐漸變化形體大、不易抓握的物體。一般使用玻璃球、乒乓球、1cm見方的積木等來訓練手部的抓握熟練程度。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 采用插板訓練是一種有效的方法，改變不同大小、形狀(方桿、圓桿)的插樁，讓截肢者在訓練中不枯燥，通過玩具，積木有趣的游戲中達到訓練的目的。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 據本人經驗利用套圈訓練假手患者效果非常明顯，在患者伸肘的瞬間將假手張開，使手中的套圈摔出去，這樣訓練能使患者肘和手的協調能有明顯的提高。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 握取物件時，如何接近和緊握物體，是依據所握取物體的幾何形狀和所使用的機械假手的類型而定的，因為機械手有常開式和常閉式兩種。</span> </p> <p> <span style="font-size:14px;line-height:2;"> <strong>1、如何握緊物體的訓練</strong></span> </p> <p> <span style="font-size:14px;line-height:2;"> 對于拇指和四指同時作對掌運動的常開的機械假手來說有兩種方法：即兩邊接近法和單邊接近法。所謂兩邊接近法是指接近物體時兩組手指處于物體的兩邊，物體在拇指和四指中間，同時接近物體，握取玻璃杯就是用這種兩邊接近法。所謂一邊接近法是生活中常用的一種方法，也就是說當假手去取某個物體時，先有一組接觸物體。另一組再握取物體。在桌子上拾起硬幣就是采用這樣一種方法，對于常閉機械手來說握取物體握力的大小，完全由機械來決定的。</span> </p> <p> <span style="font-size:14px;line-height:2;"> <strong>2、訓練用道具及步驟</strong></span> </p> <p> <span style="font-size:14px;line-height:2;"> 為了使訓練具有實際意義，訓練用道具可以多樣化，多品種圓形的、方形的、長的、短的、厚的、薄的、硬的、軟的、輕的、重的等，如乒乓球、玻璃球、積木、火柴、小型金屬棒、硬幣等等，將這些大小，形狀各異的物體放在臺子上，讓患者去練習。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 第一階段可讓患者熟悉不同形狀物體如何取到手，只要練到能順利熟練地將物體取放就算完成。雖然開始階段動作笨拙，握取某件物體時要反復數十次才能成功，但這是一個訓練過程，必須鼓勵患者堅持，不要灰心，只要持之以恒一定會成功。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 第二階段則要計時，計時的目的就是要在規定的時間內做完各種物體的取放動作，同時也要糾正患者過分不雅的取物姿勢，熟練、快速動作接近常人是這個階段的最終目標。經過這個階段訓練的患者，對假手已經有了信心。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 第三階段則是要訓練生活起居中要碰到的穿衣、洗臉、刷牙、穿鞋襪等，讓患者真正感受到假手給他的生活帶來了方便，生活中的大部分事情能自主的完成(江新生錄像)。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 我們建議患者的衣褲最好用拉鏈，拉鏈頭上裝上一個圓形的鑰匙圈或者裝一個把。假手很容易捏住圈或將拉鏈拉上拉下。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 如果是肌電假手則應當加練開手和閉手的速度，即：快開、慢開、半開、停頓、快開慢閉、快閉慢開等動作。強力閉手，輕輕閉手、握取一次性杯和軟體物品而不變形的動作等。</span> </p> <p> <span style="font-size:14px;line-height:2;"> <strong>(二)假手的訓練標準</strong></span> </p> <p> <span style="font-size:14px;line-height:2;"> 訓練標準是為了評價訓練效果的優劣而制定的，只有在完全符合標準的要求下，在正常速度下完成基本的開手閉手項目，并且要重視訓練時的動作姿勢和技巧。下面的標準時對較理想殘肢的條件提出來的：</span> </p> <p> <span style="font-size:14px;line-height:2;"> 1、每一項所需時間：</span> </p> <p> <span style="font-size:14px;line-height:2;"> 穿脫假肢5分鐘;</span> </p> <p> <span style="font-size:14px;line-height:2;"> 在一分鐘內開手次數不得少于12次;</span> </p> <p> <span style="font-size:14px;line-height:2;"> 在一分鐘內旋腕次數不少于4次;</span> </p> <p> <span style="font-size:14px;line-height:2;"> 在一分鐘內掌屈、背伸不少于4次;</span> </p> <p> <span style="font-size:14px;line-height:2;"> 2、在標準時間內應完成規定的訓練項目，即：穿脫假肢屈臂開手，屈肩開手，旋腕和伸屈腕等。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 3、操縱假手時，盡量做到：姿勢要自然，不應出現笨拙姿勢。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 4、操縱假手既能緩慢又能迅速的開手，也能隨意控制手指張開的大小。(視物體大小而決定開手大小)。</span> </p> <p> <span style="font-size:14px;line-height:2;"> <strong>訓練所需時間：</strong></span> </p> <p> <span style="font-size:14px;line-height:2;"> 一般第一次安裝單側前臂假手患者10-20小時，雙側前臂假手患者約需20-30小時。訓練時應當分期進行，每天訓練二次，每次約一小時，中間休息十分鐘，以免造成過度疲勞。如一旦在疲勞和精力不集中的情況下繼續訓練，患者容易出現錯誤動作，特別是對上臂截肢患者，屈肘握著的杯子會打碎等。</span> </p> <p> <span style="font-size:14px;line-height:2;"> <strong>(三)患者的生活自己訓練</strong></span> </p> <p> <span style="font-size:14px;line-height:2;"> 經過上述的各種訓練患者在掌握基本的開手、閉手、屈肘、伸肘等訓練后，最終將回到他自己的生活環境中去，那么對于患者生活是否能自理，那要看患者的年齡、性別、殘肢情況。假手的類別多種因素的制約，但是有一條是至關重要的，那就是患者自信心和毅力，如果患者缺乏自己的信心，飯來張口，什么都想依賴別人為他服務的話，我想再好的假手也是起不了多大作用的，所以我們的訓練師一定要幫助患者樹立堅定地信心，只要通過自身的不斷努力，一定能實現目標。</span> </p> <p> <span style="font-size:14px;line-height:2;"> 一天的生活，患者所碰的需要他用自己的雙手去實現的動作太多了，洗臉、刷牙、穿衣服、吃飯、看書、看報、喝水、抽煙、大小便，不同的物體，不同的形狀，就得用不同的方法，不同的角度，不同的時間去適應，對患者來說這是一個漫長艱苦枯燥現實又必須去實踐的過程，但他更是一個不斷積累、不斷熟練、不斷完善和擴大的過程，我這里也就無法提供更多的訓練，只能依靠患者自己去努力。</span> </p></div></div><div class="news_detail_divice_line"></div><div class="my-news-footer news-footer-1 my-news-footer-mb"><div class="news_content_footer"><div class="news_info_footer_line"><div class="news_info_soruece_detail news_flex_add"></div><div class="g-share-render-box j-share-render-box"><div class="news_share_info jz_share_info large-click-btn" data-device="pc"><span class="jz_share_text news_share_text faisco-icons-S000258 j-share"><i class="u-icon iconfont icon-fenxiang"></i><span class="u-share_title">分享</span></span><div class="jz_share_wrap"><div class="jz_share_layout"></div><div class="jz_share_list"><a hidefocus="true" title="分享到微信" href="javascript:void(0);" class="jz_share_icon jz_share_Weixin j-btn-weixin"><div class="jz_share_name">微信</div><i class="u-icon iconfont 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