The good limb position is a therapeutic position designed to prevent or counteract the onset of spasticity patterns, to protect the shoulder joint and to induce early detachment movements.
Purpose
1.Protect the shoulder joint and prevent subluxation.
2.Prevent posterior pelvic tilt and hip abduction and external rotation.
3.Prevent and relieve spasm.
4.Early induction of separation movement.
Important points
1.To prevent upper limb inversion, internal rotation, contracture and hand puffiness, place the affected upper limb on the pillow in the supine position to keep it in a mild external booth, with the hand slightly above the heart position.
2.To prevent shoulder joint subluxation, a small pillow should be placed under the shoulder joint on the affected side in the supine position for patients in the flaccid stage, which can play a role in preventing shoulder joint prolapse and retraction.
3.To prevent forward rotation of the pelvis, flexion and external rotation of the hip joint and hyperextension of the knee joint, a large pillow should be placed on the affected hip in the supine position to make the pelvis tilt backward, and support objects such as pillows, sandbags and towel rolls should be placed on the outer thighs at the N fossa respectively to make the hip joint extend and be in a neutral position, and the knee joint should be mildly flexed.
4.To prevent the occurrence and development of upper limb flexion spasm pattern, the upper limb should be stretched forward as much as possible when the patient is in the lateral position and placed on the pillow.
5. To prevent the occurrence and development of extensor spasm pattern of the lower limbs, the lower limbs should be placed on the pillow with the hip and knee joints flexed in the lateral recumbent position.
Methods
1, supine position: the head is placed on the pillow with the face facing the affected side, the height of the pillow should be appropriate, and the thoracic spine should not be flexed. Put a pillow under the affected hip to make the affected pelvis protrude forward and prevent the hip joint from flexion and external rotation. A pillow should be placed under the shoulder joint of the affected side to make the scapula protrude forward. The elbow joint of the upper extremity is extended and placed on a pillow, the wrist joint is dorsally extended, and the fingers are extended. A sandbag is placed in the middle of each thigh and calf of the lower limb to prevent hip extension and external rotation.
2. Lateral position with the affected side underneath: the scapular band of the affected side is extended forward, the shoulder joint is flexed, the elbow joint is extended, the forearm is rotated backward, the wrist joint is dorsally extended, and the fingers are extended. The lower extremity of the affected side is extended and the knee joint is mildly flexed. The hip and knee joint of the lower limb on the healthy side is flexed, a pillow is placed underneath, a pillow is squeezed on the back, the trunk can be relied on, and a relaxed position is taken.
3.Side lying position with the affected side above: the upper limb of the affected side is stretched out to the front, the shoulder joint is flexed about 90 degrees, supported by a pillow underneath, and the upper limb of the healthy side can be placed freely. The hip and knee joint of the lower limb on the affected side is flexed and placed on the pillow. The hip joint of the lower limb on the healthy side is extended and the knee joint is mildly flexed, and a pillow is squeezed behind the back to make the trunk relaxed.
Caution
1.The good limb position is a temporary position designed from a therapeutic point of view. In order to prevent the joint contracture from affecting the motor function, the position must be changed regularly.
2.Supine position can cause postural abnormalities due to the influence of tense neck reflex and tense vagus reflex. In addition, decubitus ulcers are likely to occur in the sacral area, lateral heel and external ankle. Therefore, the time of supine position should be reduced as much as possible.
3. When the affected side is in the lateral position below, the head and upper cervical vertebrae are flexed and the jaw is inwardly folded. The upper limb of the affected side is stretched out to the front and the shoulder joint is flexed at an angle of less than 90 degrees. The medial edge of the scapula and the plane of the thorax are in contact with the bed to prevent pain from the shoulder joint due to pressure.
4. When the affected side is in the lateral position above, the upper limb of the affected side is extended as far forward as possible. The ankle joint is in a neutral position to prevent plantarflexion and inversion. Place the hand on the pillow and maintain the thumb abduction and four-finger extension position.