What are the common methods of rehabilitation training?
1.Passive activity: entirely by external forces, without any active muscle contraction. The external force can be generated by gravity, machinery, others or the action of another limb. It is often used when the child is unable to fully move his or her affected limb.
2. Active and active-assisted activities: The movement of the limb is accomplished by oneself or with the help of others. Since the coordination and control of limb movements are poor, the child must be trained to develop motor coordination and improve functional activity skills. Active assistance activities can provide enough help to produce the proper joint mobility. Wang Dong, Department of Neurosurgery, Aviation General Hospital of China Medical University
3. Traction activities: Increase joint movement by continuous traction on the joint, mainly used for contracted joints.
What should I pay attention to in rehabilitation training?
1.Either active or passive joint activities should not hinder the healing of damaged tissues and increase pain.
2, according to the tolerance of the child to adjust the amount of exercise, for poor tolerance of children should only do passive activities of large joints and active activities of small distal joints, and must be prudent and gentle.
3. Passive activities and distraction activities are different and should not be confused. However, distraction activities are more beneficial to help improve mobility.
4, no matter which joint activities should pay attention to soft, smooth, and rhythmic movements. Generally, each movement should be repeated 5 to 10 times, and the number of repetitions should be adjusted according to the purpose of treatment, the child’s condition and the response after training.
Methods of joint movement training at home.
Use the training method of hip abduction and external rotation.
①Let the child lie flat, bend his legs passively as close to his chest as possible, with his whole back in an arc, and slowly rock forward a few times until you feel some relief of muscle tone in the child’s legs. Separate the child’s knees slowly from side to side and keep them close to the bed for 2 to 3 minutes, while massaging the inner thighs on both sides to relax the tense adductor muscles. The child’s legs can also be slowly abducted and the hands pressed against the medial side of the knee on both sides for a period of time until the child is able to maintain this position on his or her own, then the parent’s hands can be slowly removed. Note that parents should not be anxious when doing the pulling for the first time, as this can cause great pain to the child. As long as the range of motion of the joint is expanded one at a time and is done daily, the range of motion of the joint will gradually approach normal. After each passive activity, let the child do active hip abduction and external rotation exercises, and parents can give some help at the end of each joint activity, so that the child can complete the full range of joint activities as much as possible.
② Active knee flexion training: with the child in the supine position, use both hands to hold both knees in your arms and shake them back and forth 10 times, then release one hand, let one leg straighten, and move the other hand from the outer side of the knee to the inner side, pull down hard to the maximum, and stay for 2-3 minutes. After doing this method, do the other leg, and after doing it 3 times in rotation, let the child actively flex the knee on one side and keep it for as long as possible, then the parents let the child extend the leg and apply resistance at the shin of the calf to improve the quadriceps muscle strength, about 30 times on each side in rotation.
③”Climbing” and “crawling” training: let the child stand in front of a small chair, sofa or bed, and take turns to reach the edge of the object with the foot, each side can do about 30 times. You can also let the child practice crawling on the carpet or bed, paying attention to the “frog” posture, which means that the legs should be spread out as far as possible.
④ “Horse-riding” exercise: let the child ride on a small rocking horse, roller, small chair and bedding roll to play or practice walking, which not only increases the fun of the training program, but also achieves the purpose of hip abduction.
⑤ During walking training, a spacer should be placed between the two feet as a way to induce the child to separate the feet and position them correctly during walking, so as to correct the crossed scissor step of both lower limbs.
(6) The best position for rest: When the child is in the supine position, a pillow or other soft object should be placed between the legs and the toes should be turned to the outside as much as possible. In the sitting position, the child should be encouraged to spread his legs apart.
Ankle joint
How to train inversion of the foot and pointed foot?
①Stretching of the Achilles tendon.
②Pulling on the forefoot: Parents hold the child’s heel with one hand and the child’s forefoot with the other hand, then slowly twist upward and outward with force for 15-30 seconds at a time.
③ Self-pulling method: let the child step on two kinds of inclined plates, hands on the edge of the table, bed rails, etc., and then the body upright, slowly squatting down, note that the two heels must not leave the inclined plate. In addition, the child can also stand facing the wall, and then slowly lean forward until the Achilles tendon feels the pull. After that, the toes can be turned to the outside (like Chaplin) to do the same action.
④ Parents can use their hands, ice, etc., to stimulate the skin of the affected child’s lateral calf from bottom to top, which can induce the appearance of active foot valgus action.
⑤ The usual best position: in the prone position, the child’s feet should be placed beyond the edge of the bed. Let the feet have a natural sagging force, so that over time, it can also prevent Achilles tendon contracture; when sitting, let the child try to put the feet flat, preferably barefoot. When walking, parents should also encourage their children to slow down and put their feet flat before walking. You can also take the method of padding the shoes from the inside out, etc.
In addition to the above methods, orthotics can now be worn to correct pronation and maintain the correct position of the foot, but the orthotics must be made by professionals and are more expensive.
Elbow joint
How to train the elbow joint in a flexed position?
1. Parents hold the child’s upper arm with one hand and his forearm with the other hand, then slowly extend the elbow joint. Be careful not to push too hard or too strong. Each time can last for half a minute to one minute.
2. Focus mainly on elbow extension training for the child, such as the arm weight training mentioned above. In addition to such methods, you can also let the child sit, hands straight, and push the parents’ hands or the mirror in front of them, or use the prone position hand support training, which can not only induce the child to gradually straighten the arm, but also improve the muscle strength of the elbow joint extensors (triceps).
3, the usual best position: when the child rests, parents can use cardboard as a splint, and then fixed with a bandage to prevent the elbow joint is further flexed position. In daily life actions, such as dressing, eating, going to the toilet, walking, etc., we should induce the child to keep the elbow joint extended as much as possible.