Causes of stroke can be atherosclerosis, hypertension, thrombosis or embolism. The severity of stroke depend on the extent of the damage. Symptoms are: loss of consciousness, cardiovascular activity, breathing, motor function of the limbs. Localization and depth of hemorrhage or thrombosis depends on the extensiveness of the defeat of the extremities: monopoles or monoplegia, hemiparesis or hemiplegia, prepares or paraplegia, etc.
After a stroke marked disorders of the movements of the individual characteristics. Most often in spastic paresis or paralysis are violated or no movement in the shoulder joint: the lead, the extension, flexion - shoulder given to the body and rathrowan inside (pose Wernicke-Mann); arm is bent at the elbow joint, or (in rare cases) hangs; no supination, straightening (if the hand does not hanging) forearm and fingers of the hand, and lead her and thumb, fingers usually bent into a fist; increased tone extensor femur, tibia and flexor tendons of the foot, and therefore leg folded in three joints, sock drawn or hangs, and so patient while walking makes leg forward circular motion over the side. These lesions often have a mental illness (sick cries or laughs, malcontented), many phenomena of synkinesia (friendly involuntary movements)arising simultaneously with arbitrary or passive movements in the extremities as with the sick and the healthy side.
Treatment of such patients is complex. Patient is placed in the supine position. Under the knee outstretched legs enclose the platen diameter 20-60 cm (depending on the growth of the patient), and under the foot - mounting box (corner of dorsiflexion equal to 90 degrees). The length of the thigh, and sometimes tibia have bags with sand, so that the whole leg was turned outwards. In order to prevent contractures of the upper limb of her stack on the pillow stuffed with cotton wool with chips or sawdust in the position of a lead in the shoulder at the right angle and supination with upturned palm, straightened and bent fingers. To maintain this position from fingertips to elbow impose Paris splint is placed, and on the forearm put a bag of sand. After 2-3 hours to change the position of the hand - laying straightened his hand along the trunk. During physiotherapy sessions these latches off.
Despite the difficult condition of the patient on 2-3rd day appointed medical physical culture. Passive movements are performed in the direction from the center to the periphery in all joints. Each movement is repeated 2-4 times. The shoulder joint are, lead, flexion, extension, circular motion, supination with the hand bent at the elbow joint right angle. Exercises for fingers (if they are bent into a fist) are in the position of maximum bending in the wrist joint. Exercise for hip, and for the foot and toes run in all directions in the position bent knee leg. With the improvement of the General condition of the patient, the dosage of each exercise increases by 8-10 times. The exercises are done not only from the center to the periphery, but also from the periphery to the center. With flaccid paralysis hand hung on the headscarf (to avoid stretching ligaments and shoulder joint capsule, and subsequent subluxation of the head of the humerus), in spastic paralysis - placed Paris splint is placed in a special (arm elbow extended, thumb allocated, the remaining fingers straightened and fixed with a special mount).
Translation into a sitting position is only paralyzed limbs, otherwise, the patient may fall.
To transfer the patient in the standing position only if you have orthopaedic shoes or Longuet in a paralyzed foot, on top of which is put on any shoes.
To walk the patient is taught with a stick or a "walk-around", which he holds in his hand. The stairs down first leg, put it well; while climbing the ladder first rearrange healthy leg, her tighten sick. Turn on the spot or in the walk is only in the direction of the patient's legs.
Therapeutic gymnastics in the water appointed after the patient in the standing position. As it becomes active at sessions include exercises with objects and devices for the development of fingers and toes. Special attention should be paid to the development grip first large items, then fine.
The asymmetry of the face from the first days appoint facial exercises with the pronunciation of sounds on the methodology used in the paresis of the facial nerve and massage: effleurage, petrissage, friction, vibration. The back massage spend massage of extremities in the direction from the center to the periphery.