[臨床思考] 代償的種類(三) Different Types of Compensation(3)

在相同動作的肌肉代償模式以外
另一種肌肉的可能產生的問題是動作鍊上的代償
Other than the same movement compensation,
muscles can compensate others on the same kinetic chain.

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上面的是除了呼吸核心之外的四個基礎動作的次系統
當然動作鍊不是只有這些
但這可以當作一個很好的評估開端
之後我們會再針對每個次系統談一些臨床的評估治療應用
Above is the simple version of four basic subsystem
Of course there's more kinetic chains, but those can be a good start.
I'll discuss further about the evaluation and treatment base on subsystem in the future post

在動力鍊的概念之下
任何一條肌肉的異常反應都會造成連鎖的效果
跟關節相依理論其實有點相似
但更重視動態動作下的整體表現
Under the concept of the subsystem, any dysfunction on this chain can cause others problem.
It's kind of like the joint dependence theory, but not only the adjacent tissues.
It has big picture about the dynamic performance.

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舉例來說:
深縱次系統(Deep Longitudinal Subsystem)控制了矢狀面上的活動
單側多裂肌的失能可能會有
對側腓骨肌/股二頭
同側豎脊肌/頸伸肌
以及在對側的次系統上產生代償
而我們會在步態的擺盪期看到失能現像
For example:
Deep longitudinal subsystem dominate the movement on sagittal plane.
The multifidus dysfunction on side can have the result of:
contralateral peroneus/bicep femoris compensation
unilateral erector spinae/neck extensor compensation
contralateral subsystem compensation
And we can see the movement dysfunction while they swing their leg.

與單純動作協同相比, 是一個更整體的概念
也顯示了多關節/動態動作評估的重要性
Compare to simple synergistic muscle, this concept shows more details when we move.
It indicates the importance of multi-joint/movement assessment.

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。