Treatment of paralysis

Paralysis is only the symptom, not the disease itself. Treatment should be directed at the underlying disease, however, needed and symptomatic treatment.
The leading role is played by physiotherapy - massage and medical gymnastics, contributing to the restoration movement, warning the occurrence of deformations and contractions.

Laying hands (Fig. 1) and legs (Fig. 2) under the Central paralysis to prevent contractures.

The complex consists of the following elements: 1) laying paralyzed limbs in the correct position; 2) massage; 3) passive movements; 4) active movement. At the Central paralysis of the limbs should be given a special position, which prevents the formation of contractures (Fig. 1 and 2). Since the beginning of the second week begin massage. The muscles, which elevated tone, lightly stroke, other muscles massaged conventional techniques depending on the condition of the patient. Along with this is done gymnastics, including passive and active exercise (Fig. 3-17). Passive movements should begin possibly earlier, it is better in the end of the first week (depending on the condition of the patient). First, they can be limited to a few minutes. They need to produce at a slow pace, but in full in all joints paralyzed limbs. These exercises also try to prevent the incorrect position of the limbs (excessive bending, coercion or extension).treatment gymnastics under the Central paralysis

Fig. 3-17. Therapeutic exercises in the Central paralysis: Fig. 3 - passive movement of the shoulder; picture 4 - passive abduction of the shoulder forward, up and away; Fig. 5 and 6 - extension of the arm in the elbow joint diverting extended arms to the side; Fig. 7 - extension of the elbow joint in position supination and arm rotation outwards; Fig. 8 - supination and pronation of the forearm; Fig. 9 - hip rotation in the hip joint; Fig. 10 - bringing and disposal hips; Fig. 11 - flexion of the knee joint with a straightened hip lying on your side; Fig. 12 - passive bending and straightening of the legs at the knee; Fig. 13 - passive movements in the ankle joint; Fig. 14 - hold affected brush in the position given to it; Fig. 15 keeping the affected foot in the position given to it; Fig. 16 - light weight lifting and lowering of the affected hand with his good arm by means of a cord and a block (exercise can be combined with the abduction and coercion hands in the raised position); Fig. 17 - light weight lifting and lowering of the affected leg by hand by means of a cord and a block.

When voluntary movements should explain to the patient the need for active and frequent repetition. The choice of active exercises in each individual case depends on the group of the affected muscles. 2-3 weeks (for the aged and weak patients, this should be made more gradually) the patient should take poluciaetsea position for 1-2 hours a day. By the end of 3-4 weeks you can spend most of the day in a comfortable chair. When learning how to walk the patient should first be taught to step on a paralyzed leg. Thus it is necessary to pay attention to correct abnormal posture flexor tendons and muscles, turning leg outwards. When walking raise high paralyzed leg due to the muscles of the pelvis, so as not to hurt toe floor. Initially the patient is able to walk with assistance, and then leaning on a stick.
In peripheral paralysis in the first days of the trunk and extremities also give a provision barring further development of contractures. You may begin before a massage, which should also have selective; paretic muscles massaged all receptions and antagonists only stroke. Simultaneously with massage begin passive movement. When movements are added to active exercise. Useful exercises in the bath, pool with warm water.
Drug treatment is performed by a doctor-neurologist. Of medicines paralysis used neostigmine inside 0,01-0,015 g 3 times a day or subcutaneously to 1 ml of 0.05% solution every day, Dibazol 0.015 g 3 times a day, intramuscular injections thiamine chloride 5% solution of 1 ml daily. Paralysis, with increase of a tone of muscles, mellitin 0.02 g 3 times a day before meals.
  • Orthopaedic treatment of paralysis