Hemiplegia

Hemiplegia - the complete absence of voluntary movements of the muscles on one side of the body. In case of incomplete or partial paralysis - side hemiparesis reduced muscle strength and limited movement. Hemiplegia occurs when organic brain damage. Distinguish between left-and right hemiplegia.
The sudden development of hemiplegia more likely to occur when the stroke (see), gradually (over several weeks, months) if a brain tumor. In the acute period of the disease is observed hypotension muscles paralyzed limbs.
Important features (described N. K. Bogolepova), can detect hemiplegia in a coma (see), are the following: a symptom rejected the outside of the foot (the rotation of the foot); symptom spread thighs when thigh because of the loss of a tone of muscles become flabby and wide; symptom hypotension century - patient raise both century-side hemiplegia eyelids lowered slowly and incompletely covers the eyeball. Recovering in a paralyzed limb starts to raise the tonus of muscles in the hand-in flexion and causes the muscles in the leg in the extensor muscles). Due to the irregular increase muscle tone occurs characteristic posture of the hand is given to the body is bent at the elbow and wrist joints, leg straightened in all joints (pose Wernicke - Mann). Tendon reflexes in the acute period hemiplegia initially lowered or are not called. While improving muscle tone in paralyzed limbs increase of the tendon reflexes. Skin reflexes decreased, there protective reflexes, clonus foot and kneecap, friendly movement (for example, curl into a fist healthy hand causes involuntary bending paralyzed hands and others).
Treatment. It is necessary to treat the underlying disease.
Restoration of impaired motor function should be undertaken with the early period of development hemiplegia. Appoint neostigmine, which helps to restore normal tone and movements (subcutaneously 0,05% solution of 1 ml a day, the course of 10 to 15 injections, or inside on 0,01-0,015 g 2 times a day).
From the funds, reduces muscle tone, use of melittin (0.02 g 3 times a day, the course is 30 days). To improve the General condition prescribe vitamins (C, B1, B6, B12), means improving cardiovascular activity, etc. To conduct active treatment start (by prescription) when they are beginning to show signs of recovery tone, and reflex movements.
From the first days it is necessary to periodically change the position paralyzed limbs, to prevent the development of contractures. Physical therapy begins with 7-10 days after onset of the disease; massage with 10-20 days. We should strive to make the patient systematically to use a paralyzed limb. After 3 weeks (with good recovery functions sometimes earlier) the patient can be gathered by creating a comfortable position (to give the chance to lean back on the pillow, and resting his back to the wall). In 3-4 weeks after a stroke patient allow to sit on the bed with bowed legs.
In 1-2 weeks after the patient began to sit, he is allowed to stand with assistance (initially for a short time, gradually extending it), then use 1-2 step beside the bed. At that, the patient should be supported. After some time it begins to teach walking.
Physiotherapy is first on the bed, to which fasten a special frame with pendants on the straps to exercise paralyzed limbs; studies are conducted under the supervision of nurses with regard breathing and pulse. Is passive, then active gymnastic exercises for paralyzed limbs. Start with elementary complexes and gradually move to more complex (Fig. 1-15). Patient compress and decompress the fingers and follows the movement of the arms and increase strength. For hands applied exercises for compressing hand in a fist and extension, exercises with the ball and other
More complex exercises for arms and legs are shown on the picture.
With good recovery functions, if the General condition of use water treatment, underwater massage therapy. With good recovery of motor function of patients are attracted to work. Cm. also Paralysis, paresis.

Fig. Commit stop an angle of 90 degrees when it stops at a special stand (to prevent contractures). Fig. 2. Exercises for paralyzed hands with the help of a special device. Fig. 3. Extension and the abduction of paretic hands in the shoulder joint (held by the instructor). Fig. 4. Exercise for the muscles of the forearm and hand (held by the instructor). Fig. 5. Exercise for paretic feet (held by the instructor). Fig. 6. Exercise for hands and fingers with the help of the device. Fig. 7. Exercise for brush paretic hands: the extension of the hand. Fig. 8. Exercise in the wrist joint to brush paretic hands using tool (held by the instructor). Fig. 9. Exercise with a ball. Fig. 10. Walking with the help of the apparatus. Fig. 11. Develop the correct techniques walk with the support of a healthy hand and help from the instructor. Fig. 12. Walking with the help of the instructor. Fig. 13. Exercise for hands: the raising of the stick. Fig. 14. Exercise for shoulder girdle and hands with a stick. Fig. 15. Exercise for hands with a rotating circle.