I. Acute phase (early bedridden phase) rehabilitation
Maintain good body position, carry out passive movement, bed exercise training and start activities of daily living (ADL) training. The training should be gradual and the basic procedures are as follows.
1. Correct lying posture.
Affected side lying position, healthy side lying position, supine position (transitional, time should not be too long).
2.Sitting position in bed.
First of all, the patient’s trunk should be kept upright, for which a large pillow can be used behind the body, by the joint flexion by 900, both upper limbs placed on a small mobile table to prevent the trunk from falling back, elbow and forearm under the pillow to prevent pressure on the elbow.
3. Training to maintain joint mobility.
It should be started early and can be implemented in the ward during the acute phase. Generally, do it twice a day for 1O–20 minutes each time. Do exercises for each joint and each direction 2 – 3 times.
4. Correct sitting position in chair and wheelchair.
Compared with bed rest, sitting is good for trunk extension and can promote the improvement of the whole body and mental state. Therefore, as soon as physical conditions allow, you should leave the bed and take a sitting position. However, the sitting position can only serve the purpose of treatment and training if the correct sitting posture is maintained. The therapist should always observe the sitting posture of the patient, find the bad sitting posture and correct it in time.
5.Transfer movement training.
It can be divided into bed transfer (lateral movement and turning in the supine position), bed sitting, transfer from bed to wheelchair, standing, etc.
6.Self-active training of upper limbs.
The mobility of the shoulder and shoulder joint largely affects the recovery of upper limb motor function, so measures must be taken at an early stage to protect the easily damaged shoulder joint and maintain its mobility. The Bobath grip is the main method of exercise.
7.Mobilization of the acromion.
Activities of the shoulder lunate nail bone can be performed in the supine and healthy-side minister|, position or sitting position.
II. Recovery period rehabilitation
1.Upper limb functional training.
In this stage, the motor functions involved in the exercise therapy should be fully applied to daily life through the combination of exercise therapy and occupational therapy, and the patient should be continuously trained and strengthened so that the recovered functions can be consolidated. Therefore, during this period, the exercise therapist and the occupational therapist should work closely together to identify the key problems that exist in the patient and fully understand the main purpose of the training content and program.
2.Lower limb functional training.
Lower limb functional training during the recovery period is mainly focused on improving gait. Specific training methods include: selective dorsiflexion and dorsiflexion of the heel joint, walking-like movement of both lower limbs, forward movement of the affected lower limb from a standing position, weight-bearing and balance ability of the affected lower limb, backward movement, rotation of the pelvis and shoulder lunar band.