I. Activity period
In the acute stage, due to inflammation, edema and fluid exudation will occur in the affected joint, which will lead to joint swelling, stiffness and pain. At this time, the patient can't make a fist or lift heavy objects. Patients with joint swelling, stiffness and severe pain should stay in bed. When patients are in bed, they should not sleep on soft mattresses and pillows. The purpose of this is to relieve joint pain and prevent the spread of inflammation through joint rest and no load on limbs. However, patients should not stay in bed absolutely. Patients can carry out passive or active limb stretching exercises within the maximum tolerance range, such as elbow flexion and extension, wrist flexion and extension, to prevent joint disuse. Patients with the above activities can practice many times a day. In addition, the joints should be kept in a functional position during the patient's bed rest.
1. Shoulder joint should not be in external rotation position. Pillows and other items can be placed on both sides of the shoulders, and pillows can be placed between the arms to maintain the shoulder joint.
You can hold a small scroll in the palm of your hand to keep your knuckles stretched.
3. Place cushions on both sides of the hip joint to prevent external rotation of the medullary joint.
4. Put a flat pillow under the knee of the person lying flat to keep the knee straight.
5. Put a soft pillow under your feet and do regular massage and passive exercise to prevent your feet from sagging.
6. Prone at least 2~3 times a day for half an hour each time to prevent hip flexion contracture.
7. Because it is difficult to maintain the functional position of joints such as knees, wrists, fingers and toes, they can be fixed with plastic splints, especially at night, because muscles are in a relaxed state, which is easy to aggravate deformity. Tie the splint when you sleep every night, remove the splint first in the morning, exercise properly in bed, and tie the splint after grooming and breakfast every day. But release it 2~3 times a day to make the joints move normally.
Second, the stable period:
Generally, it is recommended to do joint exercises with little or no load. At this stage, the joint activity should be changed from passive movement to active movement, and finally to resistance movement. Suitable exercise methods in this period are: joint exercises, Tai Ji Chuan, aerobics, swimming, etc. But it should be noted that all kinds of exercises should be done step by step. In order to be beneficial to exercise, we should relieve muscle spasm and enhance stretching ability by hot compress or other means before each exercise.
1. Finger joint movement: one hand holds the other hand and gradually flexes and rotates from the distal finger joint to the proximal finger joint and metacarpophalangeal joint.
2. Toe joint action: Lift the heel of both feet, stand on tiptoe for 3s and then put it down.
3. Wrist joint movement: Hands and fingers are gently pinched together for wrist joint left and right, back and forth and rotation.
4. Elbow joint movement: make the elbow joint flex, rotate, adduction, abduction and supination; Stretching elbow actively contracts triceps brachii; Put your hands together, bend your elbows, swing up and down or left and right along the midline of your body, or lift your hands forward and upward, and put your hands on the opposite shoulders alternately.
5. Foot-metatarsal joint movement: stand with both feet, support the table with both hands, and then lift one leg to do ankle extension and turn around, alternating legs.
6. Hip and knee joint movement: relax hip and knee joint and do hip adduction, abduction, internal rotation and external rotation; Take the supine position, help one leg bend its knees with your hands, keep the heel as close to the hip as possible, stay straight for 30 seconds, and alternate your legs.
7. Exercise of activities of daily living: Patients can independently comb their hair, wash, dress, unbutton their buttons, write, eat, take a bath and go to the toilet. , so as to establish the confidence of independent life.