I. Rehabilitation to prevent or improve contracture
Purpose: maintain the length of the lengthened, improve skin contracture and increase ligament flexibility
1, and knee flexion hip flexion knee (or squat) exercise there are two kinds of active exercise and passive exercise; passive flexion hip flexion knee for can not understand the purpose and method of exercise, can not actively cooperate with the conservative treatment of patients under 6 years old and early postoperative (after 12 hours) need to exercise to assist drainage but because of pain can not be well exercise in place patients.
Specific method: after the knees are fixed together, the operator lifts the patient’s feet up and the soles of both feet are in contact with the operator’s chest, hands hold the patient’s calf on the ankle, hands and chest slowly exert force and ask the patient to breathe deeply to make the hip and knee fully flexed, 3-4 groups of each, 6-8 groups for conservative treatment patients and 3-4 groups for postoperative patients on the same day. Passive exercise pain if reduced, then active forging. Both knees together and fixed, hands grasp firm support for squat training, the number of requirements with passive.
2, double lower limbs cross overlap hip flexion knee exercise (sitting crossed legs), active and passive operation requirements and knee exercise, but the start time than the knee exercise 1-2 days later, and each time the first practice and then practice cross knee, in order to reduce pain increase adaptability.
3, the whole cross-legged (also known as the devil’s movement): two hands to hold firmly (or pull firmly) after cross-legged single-legged squat stand up, each leg 5 times, alternating between the two legs once for a group. Remember that the action can be practiced only after 3 weeks.
4, hold the knee touch shoulder method: C2 patients must practice action! After sitting down, hold the right calf knee joint with both hands to approach the left shoulder, about as close as possible until contact; then hold the left calf knee joint with both hands to approach the right shoulder, repeatedly alternating training, hold the knee joint in the process of knee joint always internal rotation.
Second, to prevent residual blood accumulation
Patients in supine prone position alternate every 2 hours, especially early exercise after each group should be exchanged once, the interval of about 15 minutes. During minimally invasive surgery, because the working cavity is located in front of the incision, it is not necessary to be in the prone position, but only to exercise on time to increase the pressure of the working cavity to squeeze out the accumulated blood.
III. Rehabilitation of the adductor muscle group
Purpose: To increase the strength of the adductor and abductor muscles
The patient should bend slightly, grasp the fixation with both hands, and practice swinging the lower limbs left and right after the standing lower limbs are moved back slightly, especially the higher the swinging of the adductor, remembering that the trunk must be neutral and stable during the swinging process, and no rotation should occur. After 10 swings on one side, the other lower limb should be swung similarly. The exercise should be started 1 week after surgery for those who have sutures, and 2 days after surgery for 3-4 groups per day.
Fourth, the rehabilitation of gait and posture
Objective: to change the original “outward-looking” and “frog-legged” gait
Head up and look at the marker two meters high in front of you, walk with one step forward (i.e. model step), swing both upper limbs and coordinate with the step generation, exercise at least 3 times a day from the first day after surgery, at least 200 meters each time, and ask to use this pace as long as you get out of bed and walk. Pre-operative scoliosis and hip tilt must be made daily to the convex side of the lateral flexion exercise and double upper limbs hanging down traction, starting from the third day after surgery, daily 3 groups of lateral flexion 10-20, hanging 5-10 minutes, deep breathing exercise when hanging.
V. Rehabilitation of internal rotation anterior flexor muscle group
Purpose: To increase the strength of the adductor and abductor muscles
The body is standing vertically with the arms down and elbows flexed forward to extend the forearms and hands, and the lower limbs are internally rotated to lift the thighs with force, requiring the knees to be naturally flexed when lifting the thighs, and the thighs should be lifted to touch the palms of the same side as far as possible, starting on the third day after surgery, 3 groups per day, and each group can be practiced until the muscles are slightly sore.
Rehabilitation of gluteus maximus
Objective: to plump up the buttocks to change the deflated and concave buttocks
Grasp the fixed object with both hands, deviate from the fixed object on the side of the trained lower limb, swing the lower limb back and forth, and lift as high as possible each time when extending back; start on the third day after surgery, no less than 3 groups per day, and practice each group until the muscles are slightly sore, with an interval of at least 2 hours to let them recover.
VII. Rehabilitation of the low back muscles
Purpose: to make the low back muscles strong and powerful to correct the hunchback and buttocks
Lie on the bed (prone position) head and limbs all slowly up out of bed, limbs straight out of bed the higher the better only the stomach (abdomen) contact bed, and then slowly back to the bed flat; each time the back extension force lifting the higher the better; exercise from the first day after surgery, no less than 3 groups per day, each group practice until the muscle slightly sore, interval of at least 2 hours, let it recover. Continue for at least 3 months, better if adhered to for life to protect the stability of the spine and prevent and treat low back pain.
VIII. Rehabilitation of pelvic tilt (only for patients with double lower limbs of unequal length)
Purpose: Correction of pseudo bilateral lower limb inequality
Action 1: lifting method: put the body weight on the short leg standing straight, straighten the long leg vertically and keep the foot off the ground for 2 minutes; repeat 20 times each time.
Action 2: back pump method: knees together always keep flush slowly squat to the end, then keep knees together flush slowly stand up.
Action 3: Knee touch shoulder method: sit down and hold the knee joint of the long leg with both hands to approach the shoulder of the short leg, about as close as possible until contact, repeated training, knee joint always inwardly rotated during the knee holding process.
IX. Rapid rehabilitation of body balance (six months after surgery)
Purpose: Rapid recovery of body balance
1, 2 seconds in situ high lift leg run: 2 seconds of maximum speed in situ high lift leg run, interval rest for more than 15 minutes and then complete two 2 seconds in situ high lift leg run; daily exercise 3 groups, each group interval of more than 2 hours. The requirement is that there should be no gap between the knee joints in the process of running in place. Remember that the action surgery 3 weeks after the start of practice.
2, 30 meters sprint run: with standard running posture to the maximum speed sprint run 30 meters, interval rest for more than 15 minutes and then complete two 30-meter sprint run; daily exercise 3 groups, each group interval of more than 2 hours. The requirement is that there should be no gap between the knee joints during the sprint run. Remember the action 3 weeks after surgery to start practicing.
Remember: before exercising 30 meters sprint run first practice high legged in situ running, can be comfortable and then practice 30 meters sprint run.