Rehabilitation of hemiplegia

  In addition to the necessary drug interventions, the main rehabilitation training methods for hemiplegia include: movement therapy, occupational therapy, speech therapy, psychotherapy, cultural and physical therapy, traditional physical therapy, and traditional Chinese medicine.  Movement therapy: It is a general term for the treatment methods to improve movement disorders through active and passive movements. The main contents include joint mobility training, muscle strength enhancement training, posture correction training and neurophysiological therapy, etc. Approximately 80% of patients with cerebrovascular disease are left with movement disorders of varying degrees, mainly the hemiplegic spastic pattern, which is the spastic pattern we often see with the upper limbs flexed and lower limbs straightened. During the ambulatory period of cerebrovascular disease, the main exercises are position change, passive movement, maintaining good limb position and sitting training to reduce complications such as pressure sores and joint contractures, and to lay a good foundation for future rehabilitation training; during the out-of-bed period, sitting training, balance training and rising training should be carried out to promote the improvement of limb function; during the walking period, walking training is mainly used to improve gait. In order to improve motor function, motor training often uses a combination of therapeutic techniques and motor relearning therapy to achieve the purpose of restoring limb movement.  Occupational therapy: It is a method to improve and subsidize the patient’s function by using purposeful and selected occupational activities as a treatment tool, and its purpose is to maximize the patient’s ability of self-care, work, leisure and other daily life, and to improve the quality of life, which is an ideal method to facilitate the patient’s return to family and society. It mainly includes evaluation and training of dysfunction, cognitive and perceptual training, evaluation and training of daily living ability, selection and production of self-help tools, design and guidance of environmental modification, prescription of wheelchair, etc. It is the same as the theoretical principles of movement therapy, but differs in that it designs the movement needed for the limbs as a work activity, such as using pottery making to train fine finger movements, which not only improves the patient’s interest but also improves the patient’s ability to live.  Speech therapy: About 22%-32% of hemiplegics have speech and language disorders, so speech training is essential. The language trainer should first diagnose the type of impairment according to the patient’s language condition and lesion area, and then use different methods to trigger and reinforce the correct language response through multiple stimuli such as auditory, visual and tactile.  Psychotherapy: Physical disability and functional impairment often cause anxiety, depression and other psychological disorders, and the disease itself can cause cognitive impairment in memory, attention and orientation. Effective psychotherapy can enhance the patient’s learning ability and active participation, mainly through supportive psychotherapy, rational emotion therapy and behavioral therapy.  Sports and recreational therapy: It is a method of training patients with sports and recreational programs to improve and enhance their physical functions and to improve their poor psychological status. This has an undervalued role in improving physical movement, enhancing physical fitness and creating a good psychological state. Wheelchair skills, hemiplegic gymnastics and various ball games are the main components.  Traditional physiotherapy: It also has a special role in the rehabilitation of hemiplegia. In particular, aquatic exercise therapy is to make it easier for the patient’s limbs to complete the correct movement in water through the buoyancy of water and other effects.  Traditional Chinese medicine has long been used for the treatment of hemiplegia, especially the use of acupuncture with limb movement has unique features.