Clinical Methodology / 01/臨床方法論/01

Treat what the examination reveals./按檢查結果制定治療。

The Two-Phase Neuro-Mechanical Triage separates centralised pain from localised mechanical limitation before rehabilitation is prescribed./在制定復康計劃前,兩階段神經機械評估會先分辨中樞敏感性疼痛與局部機械性限制。

Phase 01 / Centralisation pain/第一階段/中樞敏感性疼痛

Down-regulate the central nervous system signal./降低中樞神經系統的過度訊號。

Down-regulate the central nervous system signal.

Before loading a defensive joint, precise micro-system dry needling is used to reduce central hypersensitivity and protective guarding./在為防禦性關節增加負荷前,會先以精準微系統針刺減少中樞過敏及保護性肌肉緊張。

Observable re-test/可觀察的覆檢

Spurling&neural tension test/Spurling 與神經張力測試

Spurling&neural tension test

The immediate centralisation response is observed before local load is introduced./在加入局部負荷前,會先觀察中樞敏感性是否即時下降。

Phase 02 / Localised pain/第二階段/局部疼痛

Restore localised load tolerance./重建局部組織負荷耐受度。

Once central neural noise clears, the structural lesion can be isolated with local orthopaedic testing and treated with targeted loading./當中樞神經干擾減少後,可透過局部骨科測試找出結構性病灶,並以針對性負荷治療。

01 / Local orthopaedic testing/01/局部骨科測試

The Neer test, Empty Can, and other local tests identify the actual movement-limiting structure./Neer 測試、Empty Can 測試及其他局部檢查,有助找出真正限制動作的結構。

02 / Targeted tissue loading/02/針對性組織負荷訓練

Progressive eccentric exercise and local manual therapy are directed to the measured pain point./漸進式離心訓練與局部手法治療會針對已量測的疼痛點進行。

03 / Clinical specificity/03/臨床針對性

Examples include articular supraspinatus lesions and radial tunnel PIN entrapment beneath the Arcade of Frohse./例子包括岡上肌關節面病變,以及 Frohse 弓下的橈神經隧道後骨間神經受壓。

Clinical endpoint/臨床終點

Pain location alone is not a diagnosis./疼痛位置本身並不能構成診斷。

The rehabilitation path follows a reproducible change in the examination, not a presumed pathology from where it hurts./復康路徑以檢查中可重複觀察到的變化為依據,而非只憑疼痛位置推測病因。

Manus Physiotherapy/麥納斯物理治療

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