Problem description:
I have ankylosing spondylitis, and the doctor said that the development of the disease can be controlled through exercise.
I have inflammation in my hips and waist now. What exercise programs can you do?
It is best to stay at home without any equipment.
I have a pair of dumbbells.
Analysis:
How to carry out self-care for patients with ankylosing spondylitis?
Dysfunction caused by spinal deformity and stiffness will cause great pain to patients and difficulties in bending, expanding chest and bending neck. In order to reduce or prevent these adverse consequences, patients should learn to take care of themselves, such as careful and long-term exercise (initially under the guidance of physiotherapists), in order to obtain and maintain the best position of the spine, enhance paravertebral muscle strength and increase vital capacity. When resting, first of all, keep proper * * *, sleep on a hard bed, and take a supine position to avoid * * * that promotes flexion deformity. Once the lesion invades the upper thoracic and cervical vertebrae, the pillow should be stopped. Physical activity that can cause persistent pain should be avoided: measuring height regularly; Recording height is a good measure to prevent early spinal curvature that is not easy to find. Chest wall lesions are common, and patients should understand the harm of smoking and give up smoking.
Rehabilitation exercise of ankylosing spondylitis
Ankylosing spondylitis is a systemic disease with unknown causes, mainly chronic inflammation of axial joints, mainly involving sacroiliac joints, hip joints, intercostal joints and intercostal joints, especially sacroiliac magnetic joints. About13 patients can see peripheral joint symptoms.
Its treatment methods mainly include drug therapy, physical therapy, surgery and so on. After the condition improves, you should pay attention to exercise during the recovery period:
1. Daily posture training
1) Standing: Keep the head in the middle position, lower the stool slightly, and naturally relax when hanging down; The abdomen is slightly adducted, the feet are the same width as the ankles, and the joints such as ankles, knees and hips are kept in a natural posture, and the center of gravity should not be shifted;
2) Sitting posture: Sit on a right-angle hardwood chair during the day with a straight back. When you are tired, you can lean your hips back and rest on the chair with a tight towel.
3) Lying position: Sleeping on a hard bed during the day should be done alternately on your back and on your side to avoid keeping a posture for a long time. The pillow should not be too high or not show your pillow. In addition, you can lie prone for 5 minutes every morning or before going to bed.
2. Exercise of achievement method
1) achievement method 1: Lie on your back with your feet disturbed, with your toes up, put your hands on your sides naturally, and hold your breath for about 3 minutes, then inhale first, send your breath into the lower abdomen with your mind, and arch your waist and buttocks upward at the same time, concentrate your strength on your waist, shoulders and back, and exhale with your waist and buttocks down, and so on 10 times.
2) Exercise 2: Stand with your legs together (toes are aligned with your heels), with your hands akimbo, turn your waist back and forth from left to right, 50 times forward and 50 times backward;
3) Exercise 3: Hands akimbo and walk backwards 10 minutes.
The above techniques are gentle and the activity is small. To increase the activity, you can choose Yijinjing, Wuqinxi, Crane xiang zhu or Tai Ji Chuan.
Nursing care of patients with ankylosing spondylitis
The purpose of treatment and nursing of ankylosing spondylitis is to delay the course of disease and reduce the occurrence of deformity.
Psychological nursing: This disease is a potential chronic progressive arthropathy. Educate patients to know diseases, understand prevention and treatment methods, treat and exercise as required, and master the methods of self-care. This is especially important for reducing joint dysfunction, delaying the course of disease and participating in normal work and study.
Basic principle of exercise: Early proper exercise can reduce the deformity of spine and joints. Flexion and extension of the spine and hip joint are carried out twice a day, and the amount of activity each time is limited to not causing aggravation of joint symptoms the next day. Relax paraspinal muscles before exercise, which can relieve pain and prevent muscle injury. At the same time, physical therapy such as hydrotherapy and ultrashort wave can relieve muscle spasm, improve blood circulation, diminish inflammation and relieve pain. Nursing care of delaying ideological deformity: keeping upright posture and normal height. Sleep on a low pillow to reduce cervical lordosis. Sleep on a hard bed. Usually pay attention to reduce the load on the spine and avoid bending over for a long time. Obese patients should lose weight, thus reducing the burden on joints.
Prevention of infection: Because of chest involvement, lung infection is easy to occur. Patients should be encouraged to do chest expansion exercises and take deep breaths every day. For patients who can't take care of themselves, turn over and pat their backs to encourage coughing. At the same time, pay attention to supplement nutrition and enhance the body's resistance.
When complicated with uveitis, wash the eye secretions regularly, keep the conjunctival sac clean, and do not cover your eyes to avoid infection.
Medication nursing: During the application of sulfasalazine, the hemogram should be checked regularly, and protective isolation measures should be taken for those with granulocytopenia. At the same time, check the liver and kidney function regularly to strengthen the protection of liver and kidney function.
Principles of medication for ankylosing spondylitis
How to use indomethacin suppository?
Indomethacin suppository is a dosage form of indomethacin, which has anti-inflammatory, analgesic and antipyretic effects. The advantages of suppository are as follows: ① It gradually dissolves in rectum, is absorbed into blood through intestinal mucosa, and then circulates to the whole body through blood. ② Drugs will not stay in the stomach and small intestine through the oral cavity, thus reducing the * * * and possible adverse reactions to the upper digestive tract. ③ Putting 1 suppository before going to bed at night can supplement and continue the curative effect of taking medicine during the day, and can obviously relieve or alleviate the pain at night, difficulty in turning over and morning stiffness. ④ For patients who need indomethacin and have active gastric or duodenal ulcer, suppository administration can reduce the influence on ulcer.
The commercially available indomethacin suppository is shaped like a small bullet, and there are two doses of 50 mg and 100 mg. Adult patients can use 100 mg every night, which can be reduced to 50 mg after the symptoms are relieved. Drugs should be stored in a cool place, taken out before use, and the outer packaging should be removed. The patient is lying on his side, and the suppository is delivered by himself or with the assistance of others for indwelling. Patients should exclude stool during the day or before taking medicine.
How to treat ankylosing spondylitis with sulfasalazine?
Sulfasalazine has been used to treat ulcerative colitis and rheumatoid arthritis for more than 40 years. In recent years, many cases abroad have found that the drug has obvious therapeutic effects on peripheral arthritis, low back pain, stiffness, erythrocyte sedimentation rate, C-reactive protein changes and X-ray lesions of sacroiliac joints in patients with ankylosing spondylitis. Many hospitals in China have also carried out this treatment.
Sulfasalazine is a tablet, 0.25g per tablet, which is convenient and safe to take. In order to reduce adverse reactions and facilitate tolerance, the method of gradually increasing dosage is adopted at home and abroad. The specific administration method is as follows: 0.25g in the first week, 3 times a day; 0.5g in the second week, twice a day; 0.5g in the third week, three times a day, and 1.0g in the fourth week, twice a day. Maintain this dose for about 1 year. Take medicine after meals. Usually, the adult dose does not exceed 2.0 grams per day, otherwise the side effects may increase.
In the first 3 ~ 6 months of sulfasalazine treatment, another anti-inflammatory drug, such as indomethacin or voltarin or naproxen, can be used at the same time. After the symptoms improve, it can be gradually reduced to stop using anti-inflammatory drugs and maintained by sulfasalazine alone. According to literature reports, the side effects of sulfasalazine include nausea, vomiting, headache, rash, anemia, decreased white blood cell or platelet count, abnormal liver function or kidney injury. According to our clinical observation, as long as we refer to the above medication methods, the total daily dose does not exceed 2.0 grams, and pay attention to regular blood tests and liver and kidney functions, there are few serious side effects. If there are serious side effects, the drug should be stopped in time.
Several auxiliary treatment methods of ankylosing spondylitis
Push back: the patient takes a prone position, with his thumb flat or his fingers pushing back on both sides of the spine. Massage repeatedly from top to bottom for several times, with heavy force, making patients feel sore, each time 10min. Its function is to relieve the soft tissue spasm of intervertebral joint and spinal-costal joint, promote blood circulation, and thus relieve pain.
Acupoint selection * * *: Acupoints can be selected according to symptoms and symptoms. For example, pressing the bladder meridian on both sides and the acupoints such as jumping, ranking and staying on the buttocks with your fingers can relieve the stiffness and rigidity of the spine and buttocks. Taking the wind pool and both sides of the cervical spine to the shoulder can relieve the muscle spasm of the neck and shoulder.
Shake joint method: according to the different degree of joint dysfunction, adopt the shaken method with appropriate strength. In this method, the patient should be placed in a suitable position according to the treatment site and the degree of lesion. For example, the lower back and upper limbs generally take a prone position or supine position, such as the neck and upper limbs, and can take a sitting position or a lying position. In the treatment method, generally, the muscles can be relaxed by light manipulation first, and then the joints with dysfunction can be treated by passive manipulation. For example, the back can be pressed elastically, and the upper limbs can pull the joints with mobility disorders and the deformed joints. For example, you can shake the joints of lower limbs with mobility disorders, or do stretching.
Of course, passive manipulation should be done with light, fast and elastic movements according to anatomical and physiological characteristics, that is, the range of motion of each joint axis and the specific situation of the diseased joint. Avoid violence so as not to aggravate the pain. Rushing for success is often self-defeating. If the inflammation is serious, it is advisable to do more back pushing and acupoint selection first, and shake the joints less or not. The diseased joints must be treated first in stages. For example, hip joint stiffness is the main factor, and spinal stiffness exists at the same time, then the hip joint can be treated first, and then the spinal joint can be treated.