What Are the Benefits of Physiotherapy for Hemiplegia?

Hemiplegia, also known as hemiplegia, refers to movement disorders on the same side of the upper and lower limbs, the facial muscles and the lower part of the tongue muscles, and is a common symptom of acute cerebrovascular disease. Although patients with mild hemiplegia can still move, they often flex their upper limbs, straighten their lower limbs, and paralyzed lower limbs take a half-circle step. This special walking posture is called hemiplegia gait. Severe cases often cannot stay in bed and lose their ability to live. According to the degree of hemiplegia, it can be divided into paresis, incomplete paralysis and total paralysis. Paresis: manifested as weakening of muscle strength, muscle strength in grades 4 to 5, generally does not affect daily life, incomplete paralysis is heavier than paresis, a larger range, muscle strength of grades 2 to 4, total paralysis: muscle strength of 0 to At level 1, paralyzed limbs are completely immobile. You should see your doctor promptly to avoid delaying the optimal period of treatment.

Basic Information

nickname: Paraplegia
English name: hemiplegia
Visiting department: Neurology

Common causes: Increased blood lipids and blood viscosity
Common symptoms: Hemiplegia, flaccid hemiplegia, flaccid hemiplegia, unconscious hemiplegia

Causes of Hemiplegia

The causes of hemiplegia are diverse and complex. In general, they are inseparably related to diseases such as increased blood lipids and increased blood viscosity. In summary, there are the following points:

1. Atherosclerosis is the main cause of stroke. 70% of stroke patients suffer from arteriosclerosis, and hyperlipidemia is one of the main causes of arteriosclerosis.

2. Hypertension is the main and most common cause of stroke. 93% of patients with cerebral hemorrhage have a history of hypertension.

3. Cerebrovascular congenital abnormalities are common causes of subarachnoid hemorrhage and cerebral hemorrhage.

4. Heart disease, such as endocarditis, may cause mural thrombosis; bradycardia may cause insufficient blood supply to the brain.

5. Diabetes is most closely related to stroke in metabolic diseases, with 30% to 40% of stroke patients suffering from diabetes.

6. Poor mood (angry, excited).

7. Inadequate diet (overeating, inappropriate drinking).

8. Overwork; Excessive force; Excessive exercise; Suddenly sitting and getting up and other body changes.

9. Climate change; pregnancy; dry stools; watching TV for too long; improper use of the brain etc.

10. Improper medication, such as improper use of antihypertensive drugs.

11. Any cause of brain damage can cause hemiplegia. Cerebrovascular disease is the most common cause of hemiplegia. Hemiplegia can occur in craniocerebral trauma, cerebrovascular malformations, cerebral aneurysms, brain tumors, infections in the brain, cerebral degeneration and demyelinating disease.

Clinical manifestations of hemiplegia

There are four manifestations in the clinic:

Hemiplegia

In the case of very mild hemiplegia, such as in the early stages of progressive hemiplegia, or in the interstitial period of transient paroxysmal hemiplegia, the paralysis is mild, and it is easy to miss if not carefully examined.

2. Flaccid hemiplegia

It is manifested as a disorder of voluntary movement of one side of the upper and lower limbs accompanied by obvious hypotonia, and paralysis of the voluntary muscle is obvious without paralysis of the voluntary muscle, such as gastrointestinal movement, bladder muscle and so on.

3. Spastic Hemiplegia

It generally develops from flaccid hemiplegia and is characterized by markedly increased muscle tone. The extensor muscles of the upper limbs and the flexor muscles of the lower limbs are significantly paralyzed and the muscle tension is significantly increased. Therefore, the upper limbs are flexed, the lower limbs are straightened, the fingers are flexed, and the passively straightened hands have a stiff resistance.

4. Unconsciousness hemiplegia

It is manifested as sudden disturbance of consciousness, accompanied by hemiplegia, often with deflection of the head and sides of the eye.

Hemiplegia examination

The examination mainly includes imaging examination and rehabilitation assessment:

Imaging examination

(1) Cerebral angiography.

(2) CT.

(3) MRI.

2. Rehabilitation assessment

Muscle strength, muscle tone, balance function, daily living ability assessment, Brinell staging, psychological function assessment, etc.

Differential diagnosis of hemiplegia

1. Cortex and subcortical hemiplegia

In cortical hemiplegia, paralysis of the upper extremity is obvious, and the distal end is. Seizures if cortical irritation occur. When parietal lobe lesions are present, there is cortical sensory disturbance, which is characterized by shallow sensations, that is, tactile sensations, warm and painful sensations, and physical, position, and two-point discrimination sensations. The sensory disturbance is apparent at the distal end. Right-sided cortical hemiplegia is often accompanied by aphasia, apraxia, and loss of identity (right-handedness), and bilateral subcortical hemiplegia is accompanied by disturbance of consciousness and mental symptoms. Cerebral cortical hemiplegia generally does not have muscle atrophy, and there may be disused muscle atrophy in the later stages; but hemiplegia caused by parietal tumors may have significant muscle atrophy. Hypercortical or subcortical hemiplegia tendon hyperreflexia, but other pyramidal tract signs are not obvious. Cortical and subcortical hemiplegia is the most common cause of middle cerebral artery disease, followed by trauma, tumor, occlusive vascular disease, syphilitic vascular disease or cerebral embolism caused by heart disease.

2. Endocystic Hemiplegia

After the cone bundle was injured in the internal capsule, internal cystic hemiplegia occurred. The internal cystic hemiplegia was manifested as paralysis of the upper and lower limbs including the lower facial muscle and tongue muscle on the opposite side of the lesion.

3. Brainstem hemiplegia (also known as cross hemiplegia)

Hemiplegia caused by brainstem lesions mostly manifests as cross hemiplegia, that is, paralysis of one side of the cranial nerve and paralysis of the opposite upper and lower limbs. Its etiology is more common in vascularity, inflammation and tumors.

Hemiplegia treatment

Drug treatment

Repair damaged glial cells, nerve cell axons and microvessels, increase the nutritional support of damaged brain tissue, increase the repair potential of brain tissue, and perform comprehensive and in-depth brain repair. In addition to the necessary medical treatment, early rehabilitation must be provided.

2. Physical therapy

Including functional point stimulation, electronic bio-feedback, joint mobility training, muscle stretch training, strength training, transfer training, gait training, etc.

3. Occupational Therapy

Including basic daily movements of clothing, food, housing, and transportation, occupational labor movements, and craft labor movement training. It mainly trains upper limb function and improves patients' daily activities. The purpose is to make patients gradually adapt to the needs of personal life, family life, social life.

4. Traditional rehabilitation treatment

Including acupuncture, massage and traditional Chinese medicine fumigation, light therapy, hydrotherapy, wax therapy and ultrasound therapy, acupoint magnetic therapy, Chinese and Western medicine direct current introduction therapy, etc.

5. Nursing

Hemiplegia has a long treatment time and needs to be persistent. It is necessary to pay attention to daily care and provide nutritious and digestible food to meet the supply of protein, inorganic salts and total heat energy. Language training for aphasia patients can restore their speaking ability to a certain extent ; Listening to music, practicing musical instruments, sewing, painting, etc. to stimulate the spirit and emotions of patients, and use psychological therapy to promote patients' psychological and physiological recovery.

Hemiplegia prevention and prognosis

1. Regular physical examination is an important measure to prevent stroke and hemiplegia. For people over 40 years of age, especially those with a family history of hypertension, diabetes, or stroke, regular physical examinations and early detection and early treatment of the risk factors for stroke can prevent the occurrence of stroke.

2. Physical exercise helps recovery of hemiplegia; it can strengthen physique, improve disease resistance and delay aging; it can enhance heart function, improve vascular elasticity, promote blood circulation throughout the body, and increase blood flow in the brain; can reduce blood pressure and dilate blood vessels, Accelerate blood flow and reduce blood viscosity and platelet aggregation, which can reduce thrombosis; promote lipid metabolism, increase the content of high density lipoprotein in the blood, and thus prevent arteriosclerosis. Long-term exercise can reduce weight and prevent obesity. Therefore, physical exercise is an important measure to prevent hemiplegia.