开链运动与闭链运动康复中心—张廷峰目录概念比较在康复中的应用运动特点1234总结5运动链人体若干环节借助关节按一定顺序衔接起来,称运动链。在人体上,上肢由肩带、上臂、肘关节、前臂、腕关节、手等形成上肢运动链;下肢由髋关节、大腿、膝关节、小腿、踝关节、足等形成下肢运动链。人们通常将一侧上下肢视为一条长链，每个关节均为链扣。Inopenkineticchain(OKC)exercise,theterminalsegmentoftheextremitymovesfreelywithoutanyexternalresistance.ThesequentialactivationofmusclesinOKCexercisefromproximaltodistalallowsrapidaccelerationandspeedofthedistalsegment.Inclosedkineticchain(CKC)exercise,thedistalsegmentoftheextremityisfixed,andproximalmotiontakesplaceinmultipleplanes.Acommonerrorindevelopinganexerciseprogramisfailuretoassesstheproximalanddistalsegmentsoftheentireextremity,orkineticchain.Akinematicchainisaseriesofinterrelatedjointsthatconstituteacomplexmotorunit,constructedsothatmotionatonejointwillproducemotionattheotherjointsinapredictablemanner.Whereaskinematicsdescribestheappearanceofmotion,kineticsinvolvestheforces,whetherinternal(e.g.,musclecontractionsorconnectivetissuerestraints)orexternal(e.g.,gravity,inertia,orsegmentalmasses)thataffectmotion.Initially,aclosedkineticchain(CKC)wascharacterizedasthedistalsegmentoftheextremityinanerect,weight-bearingposition,suchasthelowerextremitywhenapersonisweightbearing.Subsequently,whenthedistalsegmentoftheextremityisfreetomovewithoutcausingmotionatanotherjoint,suchaswhennon-weightbearing,thesystemwasreferredtoasanopenkineticchain(OKC).Whenforceisapplied,thedistalsegmentmayfunctionindependentlyorinunisonwiththeotherjoints.MovementsofthemoreproximaljointsareaffectedbyOKCandCKCpositions.Forexample,therotationalcomponentsoftheankle,knee,andhipreversedirectionwhenmovingfromanOKCtoCKCposition.Becauseofincongruitiesbetweenthelowerandupperextremity,particularlyintheshoulderregion,severalauthorshavechallengedthetraditionaldefinitionofOKCandCKCpositions.StabilizingmusclesinthescapulothoracicregionproducesajointcompressionforcethatstabilizestheglenohumeraljointmuchinthesamemannerasaCKCinthelowerextremity.AlthoughdebatecontinuesondefiningCKCandOKCrelativetotheupperextremity,thereremainsgeneralagreementthatbothCKCandOKCexercisesshouldbeincorporatedintoanupperandlowerextremityrehabilitationprogram.Injuryandsubsequentimmobilizationcanaffecttheproprioceptorsintheskeletalmuscles,tendons,andjoints.Inrehabilitation,itiscriticalthatCKCactivitiesbeusedtoretrainjointsandmuscleproprioceptorstorespondtosensoryinput.Closedkineticchainexercisesarerecommendedforseveralreasons.Closedkineticchainexercisesstimulatetheproprioceptors,increasejointstability,increasemusclecoactivation,allowbetterutilizationoftheSAID(SpecificAdaptationstoImposedDemands)principle,andpermitmorefunctionalpatternsofmovementandgreaterspecificityforathleticactivities.Incontrast,OKCexercisescanisolateaspecificmusclegroupforintensestrengthandenduranceexercises.Inaddition,theycandevelopstrengthinveryweakmusclesthatmaynotfunctionproperlyinaCKCsystembecauseofmusclesubstitution.AlthoughOKCexercisesmayproducegreatgainsinpeakforceproduction,theexercisesareusuallylimitedtoonejointinasingleplane(uniplanar),havegreaterpotentialforjointshear,havelimitedfunctionalapplication,andhavelimitedeccentricandproprioceptiveretraining.However,OKCexercisescanassistindevelopingapatient-athletictrainerrapportthroughuniplanarandmultip...
