The article was written by Dr. Le Thu Huong – Rehabilitation Doctor, High-Technical Unit for The Treatment of Cerebral Palsy and Autism – Share99 Times City International Health Hub.
Features of motor paralysis in this pathology are hec halves paralysis opposite the damaged brain area, including the hands (upper limbs), legs (lower limbs) and body muscles. In the emergency stage, patients often present with soft paralysis (i.e., decreased muscle tone), after transitioning to the recovery stage, soft paralysis will turn into stiffness, the patient will have increased muscle tone, which can lead to a pattern of spasms – hardening of the upper extum, hardening of the lower extum, causing pain and making movement even more difficult.
1. Consequences of motor paralysis in patients with accidents
Motor paralysis not only reduces or loses the mobility of the person, it also entails a lot of problems that affect the health and recovery of these subjects, such as:
- Semi-dislocated shoulder: 84% of patients suffer from pain and limit shoulder joint movement after a vascular accident caused by semi-dislocation of the shoulder, spasms – stiffness of the shoulder joint, inflammation around the shoulder joint. In which semi-dislocation of the shoulder is the most common condition in the group of shoulder joint pathology in patients with accidents.
Normally, the shoulder joint has a greater range than other joints on the body, so to ensure the flexibility and stability of the joint, requires a good combination of the bone system, ligaments, and muscles. When the patient has an accident, especially during the soft paralysis, the muscles around the shoulder joint and the upper limbs system are weakened, accompanied by the weight of the upper limbs, causing the shoulder joint to be loose and dislocated outside the joint socket or completely, thereby causing pain, limiting joint mobility and slowing hand movement recovery.
To prevent semi-dislocation of the shoulder after the accident, the patient should be wearing a shoulder strap when not in a lying position, and when care is not pulled, the hand is paralyzed. At the rehabilitation unit, patients will be assessed for the risk of semi-dislocation, exercise according to the range of joint movement, accompanied by physical and therapeutic methods to relieve shoulder pain, strengthen the ural area around the joint, stimulate muscles around the joints to enhance muscle strength as an ultrasound of the joints. , electric impulse stimulates muscle, pulse electricity relieves pain …
- Pneumonia: The incidence of pneumonia in accident patients can be between 6-22%, often associated with problems with swallowing disorders, choking. However, in patients with motor paralysis, lying down for a long time, weak respiratory muscles can lead to pneumonia or worsen pneumonia, slow the recovery time, increase the risk of death.
- Vein thrombosis: Normally, the lower vein system wants to function well thanks to the movement of muscles in the legs, helping to push blood in the vein system to the heart better. In patients with motor paralysis, this activity is not performed normally due to weak muscles or loss of movement, increasing the risk of blood clots in the vein system, causing a blockage of the limbs, which in turn leads to leg edema, pain, or can lead to pulmonary embolism and death.
This is a dangerous complications, which should be detected and treated early. Therefore, in order to reduce the risk of embolitis and reduce the risk of death from embolitis, increased lateral movement is one of the mandatory factors, even when the patient is in the emergency unit.
In addition, patients may also have muscle atrophy, stiffness of the joints, osteoporosis due to motor paralysis after a stroke of the cerebral vessels. These minor injuries are not life-threatening but slow down the patient's ability to recover, and increase the risk of disability in people with accidents.
2. Rehabilitation for people with motor paralysis after a stroke
It is the most necessary treatment for patients with motor paralysis from the first days after an accident while in resuscitation and emergency units to prevent paralyzing diseases that are potentially life-threatening such as pneumonia, chi embolism, pulmonary embolism, shortening the duration of treatment and reducing associated conditions.
Depending on the degree of paralysis, type of paralysis, the coordination ability of the patient, the patient is planned to be treated with various motor exercises:
- Exercise according to the range of joint movement: active or passive.
- Exercise hard.
- Practice shifting in a lying position, from lying down to sitting, from sitting to standing, shifting to a wheelchair, moving in the toilet.
- Moving exercises: when the patient's body is guaranteed to be able to meet the needs of movement, the patient will be able to practice walking and gaits with the supporting walking exercises of leg braces, sticks, walking frames, climbing stairs, complex terrain …
- Balancing exercises when sitting, when standing.
- Exercises to inhibit spasmodic samples: since patients with post-stage paralysis will begin to contract, when severe, it will make it difficult for patients with spade feet to move and easily fall. Therefore, exercises to inhibit spasmodic samples will help patients reduce stiffness and exercise more easily.
2.2 Therapeutic activities
While motor therapy pays attention to movement problems in the legs, mobility, mobility, and body motor problems to limit complications, therapeutic activity focuses on hand motor problems, especially the delicate mobility of the hand, and restores independence in daily life for paralyzed patients.
At the therapeutic activity unit, patients will be given exercises to inhibit upper dysm spasms, grip exercises with objects from large to small, from mild to severe, sensory stimulation exercises.
Practice daily activities: dressing exercises, personal hygiene exercises (brushing teeth, washing your face, combing your head …), practicing using chopsticks – spoons – forks, cooking exercises, toilet exercises …
2.3 Physical therapy
Electrotherapism, thermothermia and hydrotherm therapy in the physical therapy group are all very valuable for paralyzed patients to relieve neurological pain, relieve joint pain, strengthen muscle strength, limit complications caused by paralysis.
3. Home rehabilitation
Patients can practice motor therapy methods and therapeutic activities at home with the guidance of a technician or with the help and supervision of a guardian.
Some notes before conducting rehabilitation at home:
- It should be thoroughly assessed for the condition and paralysis by specialist doctors. Because patients have many complex health problems such as cardiovascular diseases, cosy disorders, and many complications, especially dangerous during exercise such as stiffness, osteoporosis, embolism of the veins … if not detected early, it will lead to serious consequences such as fractures, pulmonary embolism …
- Specific exercises should be guided by a professional health worker: regular therapeutic exercises and therapeutic activities must change according to the route to suit the patient's motor level and physical condition. Therefore, patients and trainees or supervisors must be regularly updated and guided in detail
- Need supervision and help during training: due to limited mobility because of muscle weakness, muscle spasms, balance disorders, coordination, in addition, it can be accompanied by co aware disorders, neglect of the paralyzed side, vision disorders … patients with accidents are very likely to fall even during exercise or during daily activities. Therefore, patients need supervision and assistance during rehabilitation at home.
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