How to degrade elevated muscle tone in hemiplegia of stroke

  As a rehabilitation physician, from the concept of rehabilitation treatment: I. Physical therapy 1. Remove factors that contribute to the worsening of spasticity (such as cold, pain, urinary tract infection, constipation, joint contracture, excessive force during passive activities, etc.). Adopt appropriate body position to avoid the occurrence of muscle tension. Early adoption of appropriate position in bed or wheelchair is an important measure to control spasticity.  2, joint range of motion training This is the most basic method to deal with spasticity. It should be performed at least 2 times a day for about 20 min each time. Either active or passive joint range of motion training can prevent joint contracture and limitation of movement. The activity process should be gentle, slow, stable, and reach the full range of joint.  3.Standing weight training can produce good static tension on hip flexors, knee flexors and ankle plantarflexors, which can reverse the early contracture and reduce the excitability of the tension reflex, thus relieving the muscle spasm. Standing training is performed at least twice a day for 30-45 min each time. 4.Water therapy includes full-body electric bathtub, Hubbard bath, walking bath, water exercise pool training, water walking training, etc.  5, cold therapy according to the different parts of the treatment, you can choose to apply cold water, ice packs and other methods, the role of time to last 10 ~ 30min, once the muscle is cooled enough to release the spastic state, this effect can last 1 ~ 1.5h. 6, heat therapy clinically common methods are: wax therapy, hot steam therapy, moist heat therapy, etc.. For patients with dull sensation or sensory loss, special protection is needed during treatment to prevent burns.  7, functional electrical stimulation (FES) FES can relieve muscle spasm and enhance muscle strength. Commonly used FES are therapeutic electrical stimulation, spinal cord electrical stimulation, low circumference, intermittent electrical and various low frequency pulse currents. The commonly used stimulation intensity is usually 20-50Hz, 20min each time, 2 times/d. Second, drug therapy clinically available for anti-spasticity drugs, can be divided into the following categories: (1) neurotransmitter inhibitors, such as baclofen, piracetam, glycine, etc.; (2) benzodiazepines, such as Valium, clonidine, etc.; (3) drugs that affect ion flow, such as dantrolene sodium, dalantin, etc.  (4) drugs that act on monoamines, such as tizanidine, colistin, etc.; (5) others, such as cyclobenzaprine, myclobutanil, etc. (5) Other drugs, such as cyclobenzaprine and colistin, are commonly used in clinical practice, including the skeletal muscle relaxant Myona and the neurotransmitter inhibitor baclofen.  According to traditional Chinese medicine, spasticity is a lesion formed by the loss of moistening of the tendons and veins.  Damage to the Directing Vessel and internal stagnation of blood stasis prevent Yang Qi from distributing to the limbs to nourish the tendons. Therefore, it is mostly believed that spasticity after spinal cord injury is mainly caused by damage to the Directing Vessel. Traditional prescriptions include: antispasmodic combination, antispasmodic soup, etc., which can be added or subtracted according to the principle of evidence-based treatment, thus providing better antispasmodic effect. In addition, according to the principle of meridians, acupuncture and moxibustion are used to treat spasticity in patients with traumatic spinal cord injury. Traditional tui-na and massage techniques can relax the muscles by relaxing the muscles, thus effectively relieving spasticity.