May lose some sensation, become numb, stop moving, and become completely paralyzed. As soon as the patient’s condition has improved after drug treatment, rehabilitation procedures should immediately begin and the limb should be developed. If this is not done, the regeneration of nerve cells in the brain will not be complete, there will be a risk of another stroke, and the motor activity of the hand will not be fully restored.
Why doesn't my hand move?
During a stroke, the blood supply to the brain is disrupted. During an ischemic attack, blood does not flow to the tissues, and during an ischemic attack, hemorrhage occurs in the brain structures. Each of these pathologies can lead to impaired motor activity of the limbs. The hand does not react to external stimuli, does not feel anything, there are no reflexes. The paralyzed limb has weak muscle tone. Paresis or paralysis of the arm after a stroke occurs on the side opposite the brain hemisphere affected by the attack.
Immobility of a limb can occur due to blockage of a vessel by a blood clot or rupture of a blood artery in the brain. Paralysis of the arm as a result of a stroke is observed in patients suffering from hypertension, atherosclerosis, obesity, and high cholesterol. Blood circulation may be impaired in the vessels of the spinal cord. Such cases are very rare, but they can lead to paralysis of the limbs.
A hemorrhagic attack occurs most often during the day. In addition to paresis or paralysis of the arm, the patient may have speech impairment, the person often loses consciousness, he may have breathing problems, convulsions, hyperesthesia, and vomiting. The limb may be sore, swollen, swollen, and shaky.
Happens at any time of the day. It develops gradually. First, the patient's arm goes numb and loses consciousness, then his cheek, and then problems with speech are observed. A person becomes weak, tired, depressed, sleeps poorly, and his memory deteriorates.
Most often, the hand goes numb and stops listening when the right hemisphere of the brain and the cerebellum itself are affected. Here are the nerve centers responsible for the motor activity of the limb. Painful symptoms do not appear as intensely if the stroke occurred further away from the right side of the brain. Often the hand does not work well due to poor circulation after an attack. Impaired functioning of the heart muscle prevents the flow of blood to the tissues.
What to do with your hand
If after a stroke your right or left arm does not work, you should contact a specialist and undergo several physiotherapeutic procedures and special treatment. To restore the functionality of a paralyzed limb, it is necessary to carry out psychological and physical rehabilitation.
First of all, a person needs to develop a positive attitude towards life. The patient must hope for a positive result and believe in his healing. It is impossible to restore the functionality of your hand with positive thoughts alone. A complex of physiotherapeutic procedures, as well as drug treatment, is required.
In case of a right-sided stroke, it is better for a person to undergo a rehabilitation course in a hospital setting or a special center. The activity of the left limb can be restored with the help of drug therapy, massage, therapeutic exercises, hydrotherapy, acupuncture, clay modeling, dough and plasticine. If after a stroke your right arm does not work well, then you can develop it yourself at home under the supervision of a doctor using exactly the same methods.
After an attack, the left limb recovers over a long period of time - about six months. The situation is worse for older people. If a limb does not work for a long time, the muscles gradually atrophy. A person has to relearn how to use his hand. Restorative procedures must be started as soon as possible, otherwise the blood may stagnate. If oxygen and nutrients do not reach the tissues for some time, new hematomas and blood clots may appear.
Rehabilitation methods
As soon as the patient’s condition has stabilized, it is necessary to begin rehabilitation of the immobilized limb. Bedridden patients will need the help of nurses and physical therapists who know how to develop an arm after a stroke. An individual course is selected for each patient, which includes therapeutic exercises, reflexology, acupuncture, hydrotherapy, diet, modeling, medication, and treatment of chronic diseases.
How to restore an immobilized limb:
- stimulate the desire to move with the help of simple exercises (bend and straighten your fingers, clench a fist, take small objects, grab a hanging towel, raise your arms up, spread them to the sides, write, sculpt, draw);
- the patient should try to eat, cover himself, dress, wash himself;
- massage is performed to avoid blood stagnation and blockage of blood vessels (the procedure is combined with rubbing and various warming compresses);
- using special devices, acupuncture is performed to send electrical charges from the brain to the hand and make it move;
- in the morning, do exercises using exercise equipment to strengthen muscles and develop joints (lift dumbbells, bend your elbows with them), it is recommended to swim in the pool;
- conduct electrical stimulation to increase muscle tone, the procedure improves blood circulation and relieves pain.
Rehabilitation exercises are carried out 2-3 times a day, physiotherapeutic procedures - once a day for 2-4 months. The duration of each rehabilitation session should be a minimum of 10 and a maximum of 60 minutes.
How to develop a paralyzed hand
If the mobility of the arm is completely lost, the patient needs the help of an outsider. At the very beginning, an assistant should smoothly bend and unbend the paralyzed limb. The hand, elbow and shoulder are developed. After a while, the patient should independently perform simple gymnastic exercises.
It is better to do physical exercises with your eyes closed. The patient needs to relax. Exercises are performed sitting or lying down.
During exercise, the patient must remember how he moved his arm before paralysis. Then you need to try to “impose” memories on the affected limb. The patient should try to move at least one finger.
If at first nothing works out, you should not despair and stop training. Each time the result will improve. It must be remembered that recovery of the hand after an attack is a very slow process that takes a long period of time.
How to deal with muscle spasticity:
- change the position of the sore arm every 60 minutes;
- do stretching exercises throughout the day and stretch your joints;
- monitor the air temperature in the room, it should be no lower than 23 degrees;
- constantly stroke your hand;
- Before starting classes, your fingers need to be stretched and rubbed for one minute.
Exercises can be passive, that is, performed with the help of strangers, or active - the patient does the exercises independently. You can only help at the very beginning of rehabilitation. All exercises are done while exhaling.
How to conduct recovery exercises:
- exercises should be started with a healthy arm in order to activate the areas responsible for the mobility of the limbs;
- if classes are conducted with the help of an assistant, the patient must mentally repeat all movements;
- exercises change every day;
- during training, you can use household items or special exercise equipment and devices;
- first, flexion and extension exercises are performed for large muscles, then fine motor skills are developed;
- the patient needs to develop the will and, despite the pain, do gymnastics daily and in full;
- After simple exercises, they move on to strength training and more complex exercises, during which coordination and memory are further developed.
How to give an effective massage:
- you need to start the procedure with a healthy hand, and then move on to the sick one;
- duration – from 12 to 60 minutes;
- massage is done 1-2 times a day;
- movements are smooth and rubbing;
- always move from the center to the edges;
- you need to work with your fingers to activate the nerves of the brain;
- each finger is kneaded separately;
- during the massage you can give the patient a bubble ball;
- during the procedure, a person can spread his fingers and clench them into a fist;
- The shoulder muscles are necessarily developed so that the patient can raise his arm up and down.
Simple exercises for every day:
- clenching your fingers into a fist and straightening them;
- flexion and extension of the limb at the elbow joint;
- rotation with a brush;
- clapping hands;
- pressing on fingers;
- pressing your palms to the table or to each other;
- grasping an object;
- rolling a ball on the table.
To perform movements with the hand, the hand must first rest on the table. When she gets stronger, you can do exercises without support.
After a month, you can do strength training every day to restore your arm. Rehabilitation exercises should involve the shoulder, elbow, hand, and wrist. Physical education is performed twice a day. Each exercise must be done 10 times. The patient can develop the affected arm simultaneously with the healthy one. You can do the exercises one by one. In this case, start training with a healthy hand. The objects used during physical education should not be too heavy. All exercises, like movements after a stroke, are done smoothly and slowly.
Shoulder and forearm workout:
- take dumbbells, bend your elbows, straighten and raise them up, bend them again at the elbow, lower them down;
- take dumbbells, raise your straight arms to shoulder height, move them in different directions, lower them down.
To develop your shoulders, you need to use horizontal bars in addition to dumbbells. It is recommended to rotate by hand. Muscles are best developed in the pool.
Exercise for elbows:
- lean forward, bend your elbows back;
- take dumbbells, raise your arms to shoulder height, spread them to the sides, bend them at the elbows, lift them up, bend them at the elbows again, lower them down.
To develop your elbows, you need to lift dumbbells and rotate your arms. It is recommended to use exercise machines and horizontal bars. It is useful to alternately tense and relax your hand. During physical education, you should not overdo it, otherwise you can stretch the ligaments.
Wrist workout:
- take dumbbells, bend your elbows at an angle of 90 degrees in front of you, twist your hands up and down;
- take dumbbells, keep your arms straight and motionless, raise your wrists up and down.
There are many muscles and joints in the wrist area. The development of this part of the hand is very long and complex. To strengthen your wrist, you need to draw, write, sculpt, do gymnastics with dumbbells, or a rubber exercise machine.
Exercises for the whole arm after a stroke:
- kneading, stroking and rubbing fingers;
- swing your arms, twist your body;
- put your palms on your knees, spread your fingers, move them, clench them into a fist, turn your palms up, spread your fingers, move them, clench them into a fist;
- rotation with all fingers in turn;
- clasp your hands together, try to tear all your fingers off your hands one by one;
- take a rubber band, raise your arms in front of you to shoulder height and try to stretch the band.
Limb development equipment:
- Rubik's cube - stretches fingers, strengthens hand muscles, improves fine motor skills;
- plasticine, clay, construction set - develop fingers, wrist, contribute to faster recovery of the hand;
- chess, checkers - develop memory, activate brain cells, improve attention;
- dumbbells, tourniquets, rubber exercise machines, pimply balls - strengthen and develop muscles;
- picking up scattered buttons and matches improves finger motor skills.
Rehabilitation takes a long time. To fully restore a hand, a person needs to be persistent and not lose heart during the first failure. If you follow the recommendations of a specialist and regularly do gymnastics, the activity of the paralyzed limb will soon be restored. Rehabilitation of the hand after an attack is carried out at the Nekrasovka hospital.
Drug treatment
Treatment of an immobilized hand after an attack is carried out under the supervision of a doctor and in accordance with his recommendations. He prescribes medications to the patient individually and sets the dosage. Self-medication is prohibited.
How to restore a paralyzed arm after a stroke with the help of medications:
- Baclofen – relieves spasms, relaxes muscles, relieves pain, makes limbs mobile;
- Tizanidin-Teva – relieves pain, relieves spasms;
- Klonopin, Valium - relax muscles, reduce spasticity;
- Phenol – relieves pain, spasms, relaxes muscles.
The patient is also prescribed antibiotics, painkillers, blood purifiers, vitamins, coagulants, neurostimulants, nootropics, and general restoratives. The following drugs are popular: Glycine, Aspirin, Actovegin, Papaverine, Pirocetam, Neuromidin, Vinpocetine. First, it is necessary to treat the damaged area of the brain, after which the motor activity of the hand is normalized.
Most women spend a lot of time and products caring for the skin of their face, around the eyes, and neck. And unfortunately, almost no attention is paid to the hands. But it is precisely this part of the body that is more polluted than the rest. Washing, washing dishes, wet cleaning, gardening beds - all this has a bad effect on their condition. Of course, if you take care of them or at least regularly pamper them with nourishing cream and wear gloves when performing work, then the influence of negative factors could be minimized. But without receiving proper attention, the skin of the hands becomes rough, dry, and cracks and peeling appear on it. As a result, you have to forget about a beautiful manicure and rings for an indefinite period of time.
We will try to tell you how to restore the skin of your hands using products that can be found in every home.
Coffee
The coffee grounds left at the bottom of the cup can be used as a scrub. Better than any expensive cosmetic product, it will help remove the top layer of dead skin cells and improve the color and condition of your hands. To do this, you just need to rub the remaining coffee into the skin. After they dry, they can be washed off with water, and then apply a nourishing cream to the skin.Vegetable masks
In order for the skin of your hands to receive a sufficient amount of nutrients and vitamins, you can pamper it with vegetable masks, for example, cucumber-carrot masks. You just need to grate these two ingredients on a fine grater and add a few drops of olive oil to the resulting slurry. The mixture should be left on your hands for ten minutes and then washed off. And, of course, don’t forget to treat your fingers with a nourishing or moisturizing cream.Lemon
This representative of the citrus family is versatile and is used in the production of many cosmetics. It will also help rejuvenate the skin of your hands. To do this, add a few drops of its juice to a mixture of egg yolk and olive oil. The mask should be applied to the skin and left for a few minutes.Honey and oats
Take a spoonful of olive oil, milk and honey. Stir. Add three tablespoons of oatmeal. Leave on your hands for three hours. This mask perfectly nourishes the skin.Any of the selected cosmetic procedures should be done twice a week. And after a short period of time, we will notice that the skin of our hands has recovered and become soft and smooth.
Baths
In order to restore the skin of your hands to its former beauty, you can prepare special baths for it.Oil
Lightly heat olive or sunflower oil and soak your hands in it for 15 minutes. Then put on cotton gloves overnight. This procedure will help not only rejuvenate the skin, but also strengthen the nails.Ammonia and glycerin
Add a spoonful of the above ingredients to the heated water. Dip your hands there and after 15 minutes also go to bed wearing gloves. And the next day you will forget about dry skin.Potato
You can also dip your hands in the broth in which the potatoes were boiled.It happens that homemade cosmetics do not help. Modern beauty salons can offer a wide range of services designed to restore the skin of your hands.
Chemical peeling
This procedure is usually used by women under forty who want to tighten the skin of their hands. In addition, it is also a way to restore collagen balance. To obtain visible results, various oils containing vitamin A and glycolic acid are used.Mechanical peeling
It is intended for older women. The technique for performing it is as follows: the surface of the hands is polished using crystals contained in magnesium oxide.Birevitation
This name was given to the complex process of injecting hyaluronic acid under the skin. This procedure is not cheap, but the result is worth it: the skin of your hands becomes elastic and firm, and wrinkles disappear.Laser rejuvenation
Gives the same effect as previous procedures. In addition, it can tighten the skin and refresh it.Exercises for hands
Good day, friends. Often, after a spinal injury or stroke, a person’s hand and steering wheel are partially or completely paralyzed, which, as you understand, does not allow you to carry out your usual activities and is extremely disruptive.
Exercises for the hands I won’t describe it in detail, everything is shown in detail below in the video (it’s better to see it once), I’ll just add that in addition to exercises for the hands, you should definitely do exercises for finger motor skills that help restore movements, sensitivity and certain areas of the brain.
Also, with paralysis of the hand, it is not possible to simply tie shoelaces; to train this skill, there is a special sneaker with lacing on which you need to learn these movements.
Must be fulfilled previously familiar movements such as turning the light on and off, closing the door, tightening the nuts and much more. In hospitals, as a rule, there are special stands with imitation of these exercises for the hands. where you can hone these actions, and in rehabilitation centers there are robotic mechanotherapy simulators, such as in the center of Sestroretsk.
In principle these exercises for hands enough, the main thing is to do them regularly. Let me remind you once again about the video at the end of the article, which shows in detail how, for example, to perform a set of exercises.
I would like to add something: if you live in Moscow and have problems with your teeth, I recommend you a good dentistry on Serpukhovskaya.
Restoring hand movements after a stroke
It is possible to return to normal life - you just need patience and work on yourself
The consequences of a stroke depend on the individual case. One may lose speech, another may lose memory, and so on. These processes can be restored using special techniques. In this article we will look at what can be done if problems with the arm begin after a stroke.
Before this, it is worth noting that the correct instructions regarding activities related to the restoration of the arm must be obtained from a physiotherapist, because it is he who will be able to select the most suitable complex for a particular person. Also, you should not think that the result will be instantaneous. Sooner or later, it will happen, the main thing is not to give up. It is possible that the functionality of the hand will be fully restored, but before that you need to try very hard.
In total, restoration of hand movements after a stroke is aimed at eliminating the following problems:
- muscle spasticity;
- paralysis;
- contracture;
- atrophy;
- circulatory disorders.
After a stroke, a person whose arm mobility is impaired first faces a problem such as muscle spasticity. Due to the fact that the muscles were immobile for a long time, they lost their elasticity and shortened slightly. Muscle tone increases due to paralysis. And because of this, spasticity occurs, manifested in stiffness and limitation of movements. There are several recommendations that, if followed, will help combat this problem.
Need to change hand position frequently
You should not allow your hand to remain in one position for a long time.
Start
Rehabilitation needs to start with someone's help
The first movements will most likely be performed with an assistant. He needs to carefully and smoothly bend and straighten his arm at the shoulder, then at the elbow and hand. He will also bend his arm back and forth, side to side, and in other ways. The assistant should be told to perform the movements with the patient's hand that he would perform himself. At this time, the patient himself should try to begin to control his hand, mentally helping the assistant. Thanks to this, after a certain period of time, the feeling that the hand can be controlled will begin to appear. Even if you only manage to pull your hand, it will already be a small victory.
There is an exercise for you to do on your own. To do this, you need to lie down or sit down, relax and close your eyes. It is advisable to imagine that the hand is obedient. It’s easier to do this if you remember the feelings before the stroke. It is advisable to imagine a mental picture of how the hand is freely controlled. Then this picture should be, figuratively speaking, “superimposed” on a real hand and try to feel control. If even one finger moves, it is already a success. But you shouldn’t stop, you need to move on, and then two fingers will move, then the hand, and so on.
It must be remembered that these are just examples of the first movements of the hand. They depend on the type of stroke, its severity, and other factors. Recovery of the arm is slower than recovery of the leg because the latter occurs somewhat unnoticed. This is explained by the fact that the affected leg is used in one way or another to make necessary movements, for example, walking around the kitchen, to the toilet, and so on. In comparison, the affected hand is freed from work, which is completely transferred to the healthy hand.
Additional exercises
Massage is an integral part of rehabilitation
Additionally, you can do a massage. The main thing is that it brings pleasant sensations, not pain. You can start the massage with a healthy hand, after which you can move on to the paralyzed hand. Let the movements be fast, but not forceful. It is better to perform massage twice a day - in the evening and in the morning, lasting from ten to thirty minutes.
After the hand begins to feel, it is advised to continue exercises with the fingers, because their activities are connected with the brain. Again, you should remember how they moved before the attack, and then you should try to move them. At first the movement will be very small, but gradually it will increase.
After the result is more obvious, you can begin to stretch your fingers. This can be done using massage movements on each finger separately. Then it is advised to do the following exercise: the fingers in the hands are spread wide, and then clenched into a fist. This must be repeated several times, gradually increasing the load.
Then you can move on to training the muscles of the shoulder girdle, since that is where they are the most developed. They are responsible for raising the arm and lowering it. During training, it is important to learn new movements without concentrating only on raising your arm. For example, you can imitate the flight of birds. Even if some exercises look funny, the main thing is that they give the expected result.
It is recommended to use a swing to strengthen the shoulder girdle. For example, you can push off from a pillar with your hand. If you change the angle of bend of the arm, different muscle groups will be loaded.
ethnoscience
You can use traditional medicine methods. However, you should also consult your doctor about this. Here are examples of some popular recovery methods.
- Royal jelly and honey.
- An ointment based on pine needles and bay leaves, which is rubbed into the affected hand.
- Tincture of mountain arnica flowers.
- Medicine based on Sophora japonica.
- Collection of herbs from motherwort, mint, St. John's wort and so on.
A recovery course in a sanatorium would be a good idea
It may not be possible to return your hand to its previous state of activity at home. Then it is best to undergo a recovery course in a specialized sanatorium, where good care and all necessary procedures will be provided. In addition, you can sign up for special massage courses, which will be conducted by specialists in their field. Let us remember that one of the goals of the hand restoration process is precisely the restoration of blood circulation. Massage helps with this. Thanks to good blood circulation, arm activity will be restored much faster.
Under the supervision of an experienced doctor, recovery will be much more effective. Of course, you need to look for and ask for new methods of restoration, but it is best to discuss all your actions with your attending physician, who, taking into account the characteristics of his patient, will choose the best ways to restore motor activity of the hand.
Exercises to restore finger mobility
A stroke is usually accompanied by paralysis (paresis) of one side of the body. Accordingly, in addition to the classification of strokes according to other criteria, for example, causes: ischemic and hemorrhagic, there is a difference in strokes according to the side of the body that was affected by paralysis: right-sided and left-sided strokes.
In most cases, paralysis of body parts is temporary and after a certain, usually short time, their mobility and functions can be restored. Human rehabilitation activities after a stroke are devoted to restoring the functions of body parts.
To restore the functions of the hands after a stroke, there are exercises that I would like to offer to your attention. These exercises are quite effective. With their help, I restored the mobility of my left (I have a left-sided stroke) arm, by a subjective estimate of 80-90 percent.
I received the list and type of these exercises from a doctor who did physical therapy in the hospital where he was treated immediately after a stroke.
The pictures describing exercises for the fingers after a stroke did not seem very informative to me, so I took photographs of these exercises.
—The main question: when and where should one begin to restore movements of the arm(s) after a stroke?
—Answer: rehabilitation must begin on the first day after a stroke.
For example, in Western countries (Germany, Switzerland, etc.), intensive care units operate a highly specialized service that provides rehabilitation at the earliest possible stage after neurological diseases. This rehabilitation also concerns the restoration of mobility of the upper limb.
This example was given to remove confidence and fear of working with a patient in the early stages. There is a German study that proves that the risk of spasticity is much lower in those patients who received early rehabilitation measures and, very importantly, used correct moving techniques patient in bed.
As a rule, in the first day after a stroke there is very little active movement in the upper limb. It may not exist at all. Therefore, passive, joint gymnastics are often performed first.
So, what guides us in restoring movement in the upper limb and rehabilitation in general?
- orientation towards “normal movement”
- normalization of muscle tone
- stimulating body awareness
"Normal" movement.
Normal movement is a coordinated and adapted response of the central nervous system to sensorimotor stimulation to achieve a goal.
Knowledge of normal movement allows one to detect pathological (abnormal) movement and facilitate assistance to the patient in assisting in initiating movement.
If the patient is not able to perform a movement in a normal “economical mode,” then the task of the instructor (relative, assistant) is to find out why? The instructor must analyze which component of the movement is preventing the patient from performing the desired movement. Instructors evaluate the patient, identify missing and pathological movements or elements of movements, and select techniques that allow the patient to feel normal movement and achieve the desired result.
A patient with hemiplegia (hemiparesis) develops typical movement patterns due to the interaction of abnormal muscle tone and the appearance of primitive movement patterns. They form various adaptive postural strategies to ensure postural stability.
Normal movement depends on:
- functional state of the sensory organ
- understanding of the task at hand
- motivation
- individual movement experience
- differentiated muscle activity
- coordination
- joint mobility
Criteria for normal movement
1. focus
2. profitability
3. adaptability
4. automaticity
5. smoothness
To carry out proper therapy, it is necessary to clearly understand the anatomy of the upper limb.
Shoulder girdle.
Brachial The belt is a complex system that combines several joints:
- Shoulder joint
- Acromio - clavicular joint
- Sternoclavicular
- Pseudojoint of the scapula
- Suprahumeral pseudojoint
The shoulder joint is the most mobile joint of the human body, movements in which are possible in three planes (flexion-extension, abduction-adduction, external and internal rotation).
Stability of the joint during movements, especially abduction, is provided by the tendons of the deep muscles of the shoulder joint - supraspinatus, infraspinatus, teres minor and subscapularis. Based on its functional characteristics, this muscle group is called the “rotational cuff.”
The tendons of these muscles, as well as the tendon of the long head of the biceps brachii muscle, prevent upward displacement of the head of the humerus when the powerful superficial muscles of the shoulder region work.
The scapula plays an important role in shoulder movements. Its articular surface serves as a platform for the head of the humerus during movements. During shoulder movements, the scapula slides along the chest. Scapular abduction provides functional elevation of the humeral head and contact of the rotator cuff tendons with dense structures. In addition, by restricting scapular motion, the length/tension ratio of the deltoid muscle is impaired and its force to abduct the shoulder is reduced.
In terms of function, the shoulder joint is characterized by four main features: mobility, stability, strength and smoothness. The structure of the shoulder joint is unique, due to the participation of soft tissues in ensuring its mobility and stability
Painful shoulder syndrome
The main role in the occurrence is played by:
- Subluxation- prolapse of the humeral head from the glenoid cavity due to stretching of the joint capsule, which occurs under the influence of the weight of the paretic arm, as well as due to muscles. Shoulder pain may appear in the first days after a stroke; the greatest pain occurs during rotation and abduction of the arm. Moreover, subluxation as such does not cause pain. But due to instability, the shoulder is easily susceptible to injury.
- Trophic disorders ( arthropathy )
Principles of arm treatment (→ also to improve forward function)
Torso - core, base, center
achieving dynamic stability
increase in activity
reduction of resistance
Scapula - proximal support
reduction of spasticity
increase in dynamic stability
increased range of motion in the shoulder girdle
improved balance
prevention of sore shoulder syndrome
telescope
- reduction of spasticity
- involvement existing activity
- improved sensitivity
- improvement of body structure, perception, concentration
- <уменьшение ассоциативных реакций
- improved aesthetics
- facilitating patient care
Brush- executive body, working body
- reduction of spasticity
- improved blood circulation
- reduction of swelling
- use of existing activity
- improvement of the vegetative situation
- improved sensitivity
- prevention of painful hand syndrome
- facilitating patient care.
Basic principles of manipulation of the affected arm and hand (primarily for inactive arms and for fear of shoulder pain)
10 commandments for restoring movement in the hand
- Be careful when moving your arms passively against gravity.
- With all movements of the patient, it is better to first clasp your hands and release them only when the therapist can take on the weight of the injured hand.
- A greater range of movement is achieved when the injured arm is punctum fixum (eg supported by the therapist, or positioned in a neutral position) and the torso is punctum mobile.
- Passive movements of the arm are made only when the head of the humerus is centered in the socket.
- As the arm moves upward, the humerus should move with outward rotation. Please do not confuse forearm supination with humeral external rotation.
- When passively moving the arm, the elbow is first straightened, and only then is flexion or abduction carried out at the shoulder joint.
- Elbow extension is achieved better and more safely by pushing the proximal part of the elbow in the direction of extension.
- When moving, the best inhibition of spasticity is from the proximal point to the distal point (together with the hand and fingers). If necessary, the instructor's hands help himself with other parts of the body. Hold carefully but confidently!
- Pain in the shoulder and arm is a ban on movement.
- Hand movements are performed slowly, sensitively, with possible breaks.
Brush functions
F. Engels: “The brush is the educator of consciousness, the builder of the brain in the process of human evolution.”
The territory of the projection of the hand in the central gyrus of the cerebral cortex has almost the same extent as the rest of the body. This is not surprising if we remember that in all types of diverse human activities and everyday life, the main role belongs to the brush.
The brush performs static, dynamic and sensory functions.
The human hand is an amazing tool, capable of performing countless actions thanks to the important function of gripping.
Capture methods can be grouped into three large groups:
- Actually grippers, which can be called clamps
- Gravity grips
- Grips-plus-action.
Capture + action. The grips or clamps themselves are divided into three groups:
- finger
- palmar
- centered.
Finger grips or clamps are divided into two subgroups:
- Two-finger clamps
- Multi-finger clamps.
In palm grips In addition to the fingers, the palm of the hand is involved. They can be of two types depending on whether the thumb is involved or not.
- In a finger-palm grip, the palm is opposed to the last four fingers. This is an auxiliary grip, but is often used when operating a lever or steering wheel of a car.
- The "whole hand" or "whole palm" palm grip ("grip") is a power grip for heavy and relatively large objects.
Centered grips
Centered grips create symmetry around a longitudinal axis, which usually coincides with the axis of the forearm.
This is evident in the case of the conductor's baton, which in this example is merely an extension of the hand and represents an extrapolation of the index finger in its pointing role.
In gravity-assisted grips, the hand serves as a stand, as if it were supporting a tray, suggesting its ability to become flat with the palm facing upward, horizontal, i.e. we have complete supination and no curled fingers.
Thanks to gravity, the hand can also behave like a spoon, i.e. as if grain or flour were poured into it or liquid was poured into it.
Hook grips involving one or more fingers, used, for example, when carrying a bucket or suitcase or to grip uneven rocky surfaces, also use gravity.
Grips-plus-action
The hand's grasping ability is called grip-plus-action or simply grip-action. Some of these actions are simple, such as spinning a top or throwing a ball.
Other grips are more difficult, since the hand performs an action directed at itself. In this case, an object supported by one part of the palm is affected by the other part.
- Lighting a lighter
- Pressing the button of an aerosol can
- Cutting with scissors
- Eating with Chinese chopsticks
- Tying knots with one hand
Strikes - touch - gesture
The hand is used not only for grasping, it can also serve as a percussion instrument, for example:
- for working on a typewriter, calculator, computer or playing the piano
- when snapping your fingers, when the middle finger slides forcefully from the surface of the thumb to its base.
The touch of the hand can be very light, as, for example, during caresses, which play a major role in social and especially emotional relationships. It should also be noted that both the caressing hand and the object being caressed require impeccable skin sensitivity.
Gesticulation is an indispensable attribute of the hand.
Shoulder-hand syndrome
The sudden development of shoulder-hand syndrome (reflex sympathetic dystrophy syndrome), which is characterized by swelling, cyanosis and burning pain in the hand, complicates rehabilitation. But what’s even worse: without special therapy, the disease leads to deformation of the hand and fingers, and the impossibility of functional use of the hand.
Early stage:
- sudden swelling predominant on the back of the hand
- wrinkles on the hand disappear
- the tumor is soft, swollen, ends at the wrist joint
- skin takes on a red or purple color
- brush hot, wet
- Movement disorders:
- impossibility: - supination, with passive supination pain
- wrist elevation, pain with passive movement
- finger flexion
- abduction of fingers is difficult
- flexion in the middle joint of the fingers and at the same time extension in the end joint
Late stage
Without proper treatment and care, the pain intensifies and the swelling increases.
Final station
Deformation of the hand. Pain and swelling disappear, movement is impaired.
Causes:
- Holding the hand for a long time in a bent state:
- problems arise at 2-3 months, patients pay little attention to the hand.
- The tone of the flexors is already quite high, the extensors are hypotonic
- Most patients experience negligence
- Incorrect hand positioning
2. Overextension of the joints of the hand can cause inflammation, swelling and pain.
- Minor hand injuries.
Therapy:
Better results can be achieved if therapy is started at the first signs of the disease.
- Correct positioning in any position
- It is unacceptable to position the hand in a bent state
- Orthosis
- Manual lymphatic drainage
- Ice bath
- Kinesio Taping
- Active movements
- Mobilization of the nervous system
09.09.2017
Most people who have suffered a cerebral circulatory disorder recommend restoring their arm after a stroke using various exercises. Performing gymnastics for the hands, or rather for the fingers, activates the work of the brain - this is of significant importance for patients in a post-stroke state. The success of recovery depends on the extent of brain damage.
How is mobility and sensitivity impaired?
Impaired hand functionality provokes an inflammatory process in the left hemisphere. This area is directly responsible for traffic.
Such disruptions manifest themselves in the form of an absolute or fragmented lack of motor activity, weakening of muscles, tremors, or an unsatisfactory response to the identification of external stimuli.
Paralysis resulting from a stroke or cerebral hemorrhage is divided into the following types:
- peripheral – individual nerve endings are damaged;
- central - pathology extends to the activity of the nervous system as a whole.
A stroke caused by blood clots or swelling of the extremities can cause arm paresis. The patient has a chance for recovery if he completes a full course of medication and rehabilitation therapy. You will need to perform special gymnastics.
Probably numbness of the hand is a condition when pain receptors do not respond to irritation, as well as a decrease in physical activity and reflexes. After helping the patient and returning home, he and his family will need to make a lot of effort to normalize life. The consequences of a stroke can be different - problems with the speech apparatus, memory impairment, etc. Many techniques have been created for each individual case.
How to restore an arm after a stroke
Recovery of motor functions after a stroke always requires a long period. This is due to the fact that the patient may initially lose sensation in the paralyzed limbs. In some cases, a person can deny that he has movement disorders. This is observed in patients with reduced mental activity.
You will need a lot of patience - you should not count on quick and easy hand recovery. You will definitely be able to achieve everything; it is important not to fall into despair and not stop doing the exercises. In this regard, the patient needs support in the form of communication and encouragement during the rehabilitation period.
It is possible to restore an arm after a stroke at home. It is necessary to first carry out diagnosis and therapy. You will need to do daily gymnastics, exercise equipment and visit the pool. In addition, rehabilitation of hand functions will require the use of electropulse and acupuncture therapy.
The result of restoring a hand after a stroke should be to eliminate the main difficulties:
- muscular spasticity;
- paralysis;
- contracture manifestations;
- muscle atrophy;
- disruptions in blood flow.
Exercises for fine motor skills of the hands, restoration of their sensitivity, improvement of muscle activity and strength are of great importance. Modeling exercises and lifting dumbbells, first of a small mass, help with this.
Fine motor skills can be developed when writing with a regular pen. To restore a hand after a stroke, doctors advise doing gymnastics, and race walking will also be beneficial.
Exercises are done daily in the morning and evening for 15 minutes. For the first month after an attack, it is forbidden to load the body due to the threat of a second attack.
Principles of post-stroke gymnastics
The nuances of hand rehabilitation are based on awakening the patient’s volitional activity and include:
- stimulation to action during the stage of passive gymnastics. It is performed by saying: “I will move your hand, and at this time you try to perform the movement yourself.” It is recommended to accompany training processes with instructions in the form of “Get ready! On the count of three..." This will encourage the patient to tune in and participate energetically in the exercises;
- sending impulses - visualizing the action in the hand. The principle is to visualize the movement of the limb. The patient performs visualized actions independently every day;
- training of short hand actions is performed after considering a large movement and combining several short ones into one full one.
Exercises for the hand in a post-stroke state will bring maximum benefit if you follow the following rules:
- You need to start with a healthy hand. This activates the areas of the brain responsible for using both hands. For example, the patient takes a position lying on his back, placing his arms along the body. The task is given to take turns placing your palms on your stomach. The palm of the healthy hand is placed on the stomach and returned to its original position. After this, the patient mentally places the palm of the affected hand on the stomach and returns it to its original position. The exercise is performed several times and left for home repetitions. Exercises with imaginary sending of impulses can be continued indefinitely. Even for a healthy person this is not easy, and in a post-stroke state it is even more difficult to concentrate and concentrate. You can check the accuracy of execution as follows: while focusing on the affected hand and its mental movement, the actions of the healthy hand will be soft and leisurely. This is based on the need to remember the sensation of movement in order to display it on the affected side.
- Impulse sending is highly effective when performing exercises with your eyes closed.
- Strengthening impulse sends is provided through weights. The patient visualizes holding a dumbbell in his hand. Then moving the hand requires more effort, and therefore the nervous system is more activated.
- Every day the exercises change - they become more complicated, or are replaced by others.
- The movement presented must be complete. The patient should be aware of the completeness of the movement with boundaries that determine the capabilities of the joint, or is limited to individual objects located nearby. This is a psychological nuance - a fully executed movement is taken by the patient as a victory, which adds to his confidence.
- It is important to remind the patient to concentrate on the affected arm.
- First of all, you need to warm up the large muscles, then start working on improving fine motor skills.
Regular exercises ensure gradual restoration of mobility. The main thing is not to stop.
Gymnastics after a stroke
Exercise for fingers after a stroke
Set of exercises:
- rubbing and kneading your fingers for 15 seconds in turn;
- in a sitting position, place your palms on your thighs, spreading your fingers wide. Perform alternate lifting of fingers to the top. After this, turn your hands with the backs of your palms towards your hips and repeat the exercise at least 10 times;
- in a sitting position, place your palms on your thighs closer to your kneecaps. The fingers are rotated one after the other. The palms turn over and the gymnastics is repeated. Exercises develop fine motor skills, which has a positive effect on brain function. Repeat 7 times;
- the fingers spread wide, after which they gather into a strong fist. Repeat 5 times;
- the hands are joined in the lock, the fingers are raised in turn, then in the reverse order. Repeat 10 times;
- clicking your fingers one by one. Repeat 5 times.
Doctors recommend warming up your fingers using special accessories, for example, pimply massage balls. They are thrown between the hands and help massage the fingers. Daily exercises with the ball should take at least 3 minutes.
How to cope with manifestations?
Spasticity is the first to affect a person who has lost motor activity. This is due to prolonged immobility of the hands - the muscles lose their elasticity and shorten slightly. Paralysis further enhances the tone.
The resulting spasticity hinders movement; to improve the condition, it is recommended to follow the rules:
- the position of the hands must be constantly changed;
- carry out special exercises throughout the day to stretch muscles;
- due to the fact that low ambient temperature causes increased spasticity, the patient’s living room should be quite warm;
- getting used to cold temperatures is necessary, but is done gradually;
- The massage is carried out exclusively with patting movements.
Restorative gymnastics should be both active and passive. The latter is performed with an assistant. For this reason, close people play the main role in the rehabilitation of the patient.
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