Rehabilitation of Hemiplegia
Rehabilitation of Hemiplegia
Rehabilitation of Hemiplegia
The rehabilitation of hemiplegia depends on the degree of the damage to the cerebral neural cells and the pathological changes of the cerebral vessels on the one hand, and rehabilitative treatment on the other. Delayed rehabilitative treatment or incorrect functional exercises will affect the rehabilitation of limb functions, and even lead to disability, such as transverse walking, swinging the hip and drooping foot.
The rehabilitation of hemiplegia usually goes through the following stages:
(1) Complete paralysis stage (stage I): Two weeks from the occurrence, 0 degree of the myodynamia, inability of the affected limbs to contract. At this stage passive functional exercise can be done.
(2) Combined reaction and involuntary contraction stage (stage II): The myodynamia is 1-2 degrees, the function of the affected limbs begins to return, with slight voluntary movement, spasm of the muscles and some low degree of involuntary movement. Passive functional exercise can be done with the help of doctors and nurses. The patient also can do passive functional exercise, unaided, or self massage.
1)Combined reaction: At the early stage of hemiplegia, when the affected limbs are unable to contract, strong exercise of the muscles on the healthy side may cause atrophy of the muscles on the affected side, such as contraction of the greater pectoral muscle, sternocleidomastoid muscle and adductive muscle groups on the hip joint. It aggravates, with an increase in the muscular spasms on the affected side and attenuates, with the improvement of the pathological conditions. Thus, it is not physiological activity, but a kind of primitive moving model in the rehabilitative course of the affected limbs.
2)Voluntary contraction: It can produce the smallest voluntary movement but cannot stimulate the movement of.the joints.
(3) Common movement stage (stage III): The myodynamia is 3 degrees and there is obvious contraction of the muscles on the affected limbs that propels the movement of the joints. But this is a kind of fixed movement. For example, the contraction of the flexors on the upper limbs is certainly the combined contraction of the muscles on the shoulder, elbow, wrist and finger, that is, common movement. And the spasm of the muscles gradually aggravates. Incorrect treatment at this stage will easily cause spasms and stiffness of the joints. So, doctors and nurses should help the patients correctly perform functional exercise with Tuina (massage) therapy so as to enable each joint to separate from the combined movement and reduce the spasms. Proper sitting exercise is also applicable at this stage.
(4) Separated movement stage (stages IV and V): The myodynamia is 3-4 degrees. The affected limbs are bent and extended to move the muscles on the joints separately, such as simple bending and extending the elbow and wrist joints. The muscular spasms will be alleviated and the patient can sit or stand. Sitting and standing exercises can be done actively at this stage with the combined use of Tuina therapy for smoothing the joints and strengthening the myodynamia.
(5) Voluntary movement stage (stage VI): The myodynamia is 4-5 degrees. The affected limbs can stand and walk freely with high speed. The coordination and acrobatic movement are obviously improved, and the symptoms of muscle spasm have basically disappeared. The functional exercises of standing, walking forwards and backwards, and going up and down stairs can be done with the combined use of Tuina therapy. The patients may do some other exercises, such as writing and picking up small glass beads.
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