The sequelae of stroke are the most concerned and complicated problem that every stroke patient has to face. Every stroke patient wants to return to normal, but in fact the disability rate is quite high. Almost all of them are left with sequelae to varying degrees. The original textbook of Tui Na only has a short section on the treatment of post-stroke sequelae by Tui Na, compared to rehabilitation which is not a systematic treatment. In fact, the rehabilitation therapy of Western medicine currently dominates the treatment of post-stroke, and there is also the traditional acupuncture therapy, which has been applied to play its light in the clinic. After several years of clinical research, the author summarizes a set of massage and fire power therapy system for the treatment of post-stroke sequelae. As follows.
Tuina and fire power therapy applied to post-stroke sequelae has the following three main functions.
First, early tui na, point point stimulation meridians, there is the use of promoting the recovery of the spirit, language, limbs and senses.
Second, centering on the joints, preventing joint adhesions and restoring their normal flexion and extension and rotation functions, as well as restoring normal muscle tone.
Third, to prevent muscle atrophy and promote the recovery of urinary function and sexual function.
In order to facilitate clinical treatment and prevent the formation of joint adhesions, Tui Na fire power therapy is performed according to time periods
I. Push-up therapy can be performed about three weeks after the stroke is stabilized
The purpose and significance of Tui Na
1. It is an important period to prevent joint adhesions and the best period to prevent shoulder dislocation and subluxation. After a stroke, the blood circulation is not smooth, the meridians are not accessible, and because of the bedridden state, the joints begin to adhere to different degrees, and each bursa in the shoulder begins to loosen, which can easily cause subluxation. Tui na can promote blood circulation and enhance muscle strength, which can loosen the joints and prevent adhesions.
2. The sooner the stimulation and mental recovery, the sooner you can get out of bed. It is the best time for tui na intervention
Manual operation
1.Take the trapezius muscle of the neck, the front oblique foot muscle, the supraspinatus muscle, the infraspinatus muscle, the long and short head of the biceps muscle, the deltoid muscle, you can change the techniques such as pressing and kneading. Then press and knead the biceps and triceps stops at the elbow joint point, rotate the front round muscle, the internal and external epicondyles of the humerus, and the brachioradialis up to the wrist. The tendons of the fingers point press, wrist flexion and extension rotation, extraction and extension of the hand method.
2. Press the bilateral collateral ligaments of the knee joint with one hand, hold the calf flexion and extension of the knee joint with the other hand, and perform shaking, pressing, pulling and stretching, palm rubbing and other techniques on the ankle joint. Finally, return to the small rotor of the femur with point pressure techniques.
3.Press and knead on the diastasis, scapularis lingualis muscle.
4.After the end of tui na can alternate fire power at the ankle and shoulder joints.
Characteristics and precautions: Because the condition has just been stabilized, the technique should be gentle; the shoulder joint is easy to be semi-dislocated, so do not shake and turn drastically; the ankle joint can be loosened drastically; the diastasis muscle will be painful when treated.
While treating, communicate with and encourage the patient, tell the patient that the treatment can bring hope and results, and to cooperate with the treatment, and communicate according to the people, events and work environment around the patient to promote mental recovery.
II. After 4~6 weeks
Purpose and significance of massage To strengthen the recovery of muscle strength, restore joint function, reduce muscle tone, and prepare for getting out of bed and walking.
Manipulation
1.Shoulder and upper limb as above, and massage the large and small circular muscles, latissimus dorsi and back muscles.
2.Supine position Quadriceps, medial femoral muscle, bilateral collateral ligaments, press and knead, point press, take, poke and other techniques.
3.Lateral position Press the psoas major muscle, find the psoas major muscle groove, deep press and knead, and press at the point where the superior gluteal cutaneous nerve goes out of the mouth, point press and push at the gluteus maximus muscle, and push and press the iliotibial bundle to the stopping point.
4.Prone position The lumbar erector spinae, thigh biceps femoris, calf gastrocnemius, hallux valgus and tibialis anterior muscles are pressed, pushed, taken, kneaded and plucked mainly.
5.Ankle joint To shake mainly, and to the small tendons, ligaments thumb lightly press
6.Pointing points Lumbar Yangguan, Fengshi, Zhizhong, Foot Sanli, Yanglingquan and Chengshan are the main points.
7.Massage at Guan Yuan, Zhong Ji, with point, press, pressure, kneading and other techniques.
Technique characteristics
With heavy manipulation, strong stimulation is the main.
Third, after one year
The purpose and significance of tui na
Focus on loosening joints, correcting gait and reducing muscle tension.
Manipulation operations.
1.Mainly press the lumbar major muscle
2.Mainly shaking the joints
3.Gentle muscle tension high place
4, correct gait flexion of the hip and knee, that is to say, lifting the thigh, extending the calf, toes facing forward, the hip inward mainly
Characteristics of hand technique
The high muscle tone should be light, the joint should be heavy, and prevent the secondary injury caused by the fall.
After a stroke, the central damage will bring a series of damage to the organism, such as hemiplegia or loss of life, which will bring physical, mental and property disasters to the family. Therefore, how can thrombolysis be performed quickly to save lives and how can recovery be performed as soon as possible to reduce the rate of disability is an important issue in front of medical personnel and patients’ families. It is better to combine the two perfectly, but often the clinical focus on saving lives first, and then after a month, or three months, in the beginning of recovery, seems to be a good program, but the result is that most stroke patients have varying degrees of sequelae, and the number of those who cannot take care of themselves accounts for a considerable number. The harm it brings to the family is known to those who have experienced it, and whose experience is the deepest. The effect of massage treatment is fast, preventing the adhesion of joints and promoting the recovery of joints is obvious, and it can play a passive exercise and active recovery as well as point stimulation. After getting out of bed, it can be combined with a series of recovery techniques such as rehabilitation. This is a key, unique, and effective way to reduce the rate of self-harm and to promote self-care and even complete recovery.