Internationally, it is believed that patients with limb dyskinesia caused by subarachnoid hemorrhage can obviously reduce or alleviate the sequelae of paralysis through formal rehabilitation training. Some people regard rehabilitation as particularly simple, and even equate it with "exercise". They are eager for success, and often get twice the result with half the effort, which leads to joint muscle injury, fracture, shoulder and hip pain, aggravated spasm, abnormal spasm pattern and gait, foot drop and varus, which is called "misuse syndrome".
Improper muscle strength training will aggravate spasm, and proper rehabilitation training can alleviate this spasm, thus making limb movements tend to be coordinated. Once the wrong training method is adopted, such as repeatedly practicing hard grasping with the affected hand, it will strengthen the coordination of the flexor muscles of the affected upper limb, aggravate the muscle spasm responsible for joint flexion, cause elbow flexion, wrist flexion and flexion, and make the recovery of hand function more difficult. In fact, limb dyskinesia is not only a problem of muscle weakness, but also an important cause of motor dysfunction due to uncoordinated muscle contraction. So don't mistake rehabilitation training for strength training.
The purpose of convalescence treatment is to improve symptoms such as dizziness, headache, numbness of limbs, and unfavorable language, so as to achieve the best state; Reduce the high recurrence rate of subarachnoid hemorrhage.
In the daily home care and rehabilitation treatment, our country often uses the limb movement rehabilitation instrument to restore the damaged limb movement. It is based on neural facilitation techniques. After low-frequency pulse electrical stimulation, muscle groups can simulate normal movement in a certain order. It not only exercises muscle strength directly, but also coordinates and dominates the functional state of limbs by simulating the passive antagonism of exercise, thus restoring its dynamic balance. At the same time, repeated exercise can feed back facilitation information to the brain, so that it can realize functional reconstruction as soon as possible, break the spastic mode and restore independent motor control, especially at home. This therapy can make the paralyzed limbs simulate normal movement, enhance the self-confidence of patients in rehabilitation, and restore the muscle tension and limb movement of patients to the maximum extent.
1, scientific and accurate medication to prevent recurrence of cerebral infarction.
Subarachnoid hemorrhage is an acute cerebrovascular accident with high recurrence rate and irreversibility. After discharge, patients still need to take medicine according to the doctor's advice, control the basic diseases of arteriosclerosis such as hypertension, hyperlipidemia and diabetes, and go to the hospital for regular review.
2. Actively start rehabilitation as soon as possible.
As mentioned above, subarachnoid hemorrhage will leave many sequelae, such as paralysis, hemiplegia and aphasia. And the effect of drugs on these sequelae is very limited. Through active and regular rehabilitation treatment, most patients can take care of themselves and some can return to work. If conditions permit, it is best to go to a regular rehabilitation hospital for systematic rehabilitation. If you can't go to a rehabilitation hospital for various reasons, you can buy some books and videos about it and do them at home. Rehabilitation treatment should be carried out as soon as possible. 6- 12 months after illness is the best recovery time. After half a year, it is difficult to recover because of muscle atrophy and joint contracture, but it will also help.
3. Daily life training After getting sick, many previous living habits were broken. In addition to training the affected limb as soon as possible and formally, we should also pay attention to developing the potential of healthy limbs. Right hemiplegic patients who are used to using their right hand (right-handed) should train their left hand to do things at this time. Clothes should be made loose and soft, and special styles can be sewn according to special needs. For example, you can install a zipper on the sleeve of the affected limb and measure your blood pressure when you go to see a doctor. Wear the paralyzed side first and then the healthy side when dressing; When undressing, take off the healthy side first and then the affected side.
4, face the reality, adjust the mood As the saying goes: "Illness comes like a mountain, and illness goes like reeling." This is more suitable for people with cerebrovascular diseases. Facing the fait accompli, we should adjust our emotions and actively carry out rehabilitation treatment in order to return to society as soon as possible. Patients with severe emotional disorders can seek help from doctors and use antidepressants, such as Prozac, which has a good effect on depression and anxiety after cerebrovascular disease.
5. Functional rehabilitation nursing of sequela
(1) Patients with language disorders are more anxious and miserable. Medical staff should contact patients more, understand their pain, make them happy and eliminate their nervousness. We must induce and encourage patients to speak as soon as possible, patiently correct their pronunciation, from simple to complex, such as "E", "Ah" and "Song", and keep practicing repeatedly. Combining acupuncture at Dumen, Tongli and Li 'an points is beneficial to improve and restore the language function.
(2) In the acute nursing of limb dysfunction, we should pay attention to the functional position of paralyzed limbs to prevent limb contracture deformity, and adopt supine position and lateral position. When the patient's condition is stable, use the home limb movement rehabilitation instrument to guide and assist him in functional exercise. Starting from simple flexion and extension, we should exercise fully, reasonably and moderately to avoid damaging muscles and joints, 2-4 times a day for 5-30 minutes each time. Combined with drug therapy, massage the affected limb and acupuncture Quchi, Hegu and Zusanli. Patients are required to soak their affected limbs with hot water frequently to promote their blood circulation.
(3) oblique mouth. The common diseases in clinic include incomplete eyelid closure, drooping mouth, wrinkle-free forehead, closed eyes, protruding cheeks, whistling and so on. Patients often have negative emotions and lose confidence in treatment. Nurses should sympathize with and care for patients and give spiritual encouragement to gain trust and relax their emotions. Diet should be digestible and nutritious liquid or semi-liquid diet. With acupuncture cheek car, ground warehouse, welcome incense and four whites. Encourage patients to do more eye, mouth and face exercises and often massage local areas.