Welcome to PMR

R1 林威廷
weitinglin1204@gmail.com
About Me 關於我
• 台北榮總復健科住院醫師 PMR, Taipei Veterans General Hospital
• UCL, MSc Sports Medicine, Exercise and Health
• 台灣⼤學醫學系 National Taiwan University, Doctor of Medicine

• SFMA Lv 1 FMS Lv 1 KPM

• Be Activated Lv 1-2. RPR Lv 1-2
• Redcord 紅繩訓練 Neurac 1
• NSCA CSCS NASM CES
• 中華⺠國肌內效協會B級貼紮課程認證
• ⽇本筑波⼤學Tsukuba University 運動科學中⼼參訪
你聽過 Fiterix 嗎？

• 降低發炎指標 (anti-TNF, CRP, IL-6)

• 增加抗氧化物並降低氧化壓力
• 刺激染色體端粒酶以延長細胞壽命
• 降低心血管風險因子
• 促進神經細胞恢復與再生
你聽過走路嗎？

• 降低發炎指標 (anti-TNF, CRP, IL-6)

• 增加抗氧化物並降低氧化壓力
• 刺激染色體端粒酶以延長細胞壽命
• 降低心血管風險因子
• 促進神經細胞恢復與再生
REALLY?
REALLY?
REALLY?
PARAMOL
REALLY?
PARAMOL
• 500mg
• Q6HPRN
• If BT >38
• Liver toxicity
REALLY?
REALLY?

80% of doctors are not familiar

with physical activity
REALLY?
REALLY?

Only 16% of physios know all the

component of physical activity
REALLY?
REALLY?
Physical Activity and Exercise: Disease Modification
從疾病的角度出發看待身體活動與運動
Smoking vs Inactivity
抽煙 vs 活動不⾜
Physical Activity and Exercise: Disease Modification
從疾病的角度出發看待身體活動與運動

抽煙 vs 身體活動

Wen CP, Wu X. Stressing harms of physical inactivity to promote exercise. 2012.

Physical Activity and Exercise: Disease Modification
從疾病的角度出發看待身體活動與運動
Physical Activity and Exercise: Disease Modification
從疾病的角度出發看待身體活動與運動
Physical Activity and Exercise: Disease Modification
從疾病的角度出發看待身體活動與運動
Physical Activity and Exercise: Disease Modification
從疾病的角度出發看待身體活動與運動

最大心跳：220 – 年齡
保留心跳：最大心跳 – 休息心跳
最大心跳比率 vs 保留心跳比率
40 歲 休息心跳 80 強度 70% >> 150
Physical Activity and Exercise: Disease Modification
從疾病的角度出發看待身體活動與運動

時間越多效果越好，每⼀分鐘都會有成效

每週 150 分鐘中等程度
或是
75 分鐘⾼強度⾝體活動

每週⾄少兩次的阻⼒運動 盡量減少坐式⽣活
Dose
Dependent
PA Guideline
UK
PA
Guideline
USA
PA Guideline
Canada
Start with Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance

⼀種透過外在阻⼒刺激肌⾁以增進肌⾁適能的⾝體活動
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
• Function 功能性
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
• Function 功能性
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
• Function 功能性
• Progression 漸進性
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
• Function 功能性
• Progression 漸進性
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
• Function 功能性
• Progression 漸進性
• Multi-joint vs Single-joint
多關節 vs 單關節
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
• Function 功能性
• Progression 漸進性
• Multi-joint vs Single-joint
多關節 vs 單關節
Resistance Training 阻⼒訓練
• Resistance training is a form of physical activity that is
designed to improve muscular fitness by exercising a
muscle or a muscle group against external resistance
• Pearls of Resistance training 阻⼒訓練的重點
• Physical Ability 身體能力
• Function 功能性
• Progression 漸進性
• Multi-joint vs Single-joint
多關節 vs 單關節
• Open chain vs Close chain
開放鍊 vs 閉鎖鍊
What is Sports Medicine?
什麼是運動醫學？
Multidiscipline 多專業合作
Sports Science

Sports Medicine Training

Injection Surgery Strength and Conditioning

Screening
Sports specific

Rehabilitation Optimisation
Medication Screening
Sports medicine is a branch
of medicine that deals
with physical fitness and the
treatment and prevention
of injuries related
to sports and exercise
所有有在進⾏運動的⼈都是受眾
Athlete 運動員
Athlete 運動員
Athlete 運動員

General population
⼀般⼈
Athlete 運動員

General population
⼀般⼈
 Athlete 運動員

Special
Specialpopulation
population
特殊族群
特殊族群 General population
⼀般⼈
23 歲男性
先天性結締組織疾病
小時候脊椎側彎開過刀

接受背架評估，核心肌力尚可
不需要背架但需要運動
83 歲男性
慢性腎臟病洗腎
高血壓、糖尿病
15 年前小中風

兩個月前肺炎住院
住院期間右腳疼痛
骨科診斷椎間盤突出

出院後因腳痛坐輪椅代步
Who in Sports Medicine Team?
運動醫學團隊裡面有哪些角色？
Credit to 林頌凱醫師
Credit to 林頌凱醫師
Credit to 林頌凱醫師
As a PMR Doc
A 26 y/o basketball player suffered from Achilles tendon rupture
Goal: Return to competition ASAP
An 80 y/o male with history of HTN, DM suffered from right MCA infarction
Goal: Independent ADL
My Way
To Sports
Medicine
Tsukuba University
UCL SMEH
Pure Sports Medicine
Summary 總結

• Physical Activity ⾝體活動

• Resistance Training 阻⼒運動

• Sports Medicine for every human beings

• Society and technology are improving but

how about you?
社會或科技⼀直在進步，那你呢？
Questions 問題