Hemiplegic standing balance training

  1.Balanced standing includes the ability to maintain relatively stationary standing without excessive muscle activity, to move back and forth in the standing position to perform various activities, to move out, move in, and stride, etc.  2. The basic components of standing balance are: (1) The feet are separated basically by the same width as the shoulders so that the legs are vertical.  (2) Both shoulders are perpendicular to both hips, and both hips are in front of both ankles. The alignment is an effective work for the patient to be able to move back and forth.  (3) The hips and knees are extended and the trunk is erect.  (4) Both shoulders horizontal position, head neutral position.  (3) Common problems (1) Increased support surface, such as too much spacing between the feet or external rotation of one (or both) hip joints.  (2) Restricted random motion.  (3) The patient moves the foot in lieu of postural adjustment. When the center of gravity is moved, the patient strides.  (4) When the center of gravity is slightly shifted, the patient reaches forward or laterally for support.  4.Standing balance exercises (1) Training hip joint (forward extension).  A take the supine position, the affected leg on the side of the bed, the affected foot on the ground, the patient practice a small range of hip extension; B take the standing position, both feet weight bearing, hip extension.  (2) Prevent hyperextension of the knee joint in flexion.  (3) Induce contraction of the quadriceps.  A take a sitting position, support and extend the knee joint, practice contracting the quadriceps and hold it for as long as possible, then relax; B take a sitting position, the therapist holds the affected knee in an extended position with his or her hand, then remove the hand and instruct to maintain it for a period of time or let it fall slowly.  5.Adjust the posture when the center of gravity is shifted.  (1) Take a standing position with the feet separated by the same width as the shoulders, and ask the patient to raise the head.  (2) take the standing position as above, instruct the patient to turn his head, shift his trunk to the left and right, and then return to the neutral position; (3) take the standing position, reach his hands to the front, side and rear respectively to take items from the table; (4) take the standing position with the weight of the lower limb on the affected side, instruct the patient to take a step forward with the healthy leg, then return to the neutral position, and then take a step backward; 6. increase the difficulty.  (1) reach forward, laterally and downward to grab the thrown ball and step forward to grab the ball; (2) pick up different objects from the floor with one or both hands; (3) step in different directions (forward, backward, left and right) with the healthy leg or the affected leg, as well as practice stepping over objects, etc.