Techniques deal with hemiplegia in stroke
Hemiplegia is the term which is mainly used to describe paralysis of one side of the body. The term can be broken down into “hemi” means “half,” and “plegia,” means paralysis. The most common cause of hemiplegia is stroke. . After stroke, the next most common cause of hemiplegia in adults is trauma. In hemiplegia one side of the body can become paralyzed or weak after a stroke. One sided paralysis or weakness occurs when a stroke affects the corticospinal tract of one side of the brain. The right side of the brain controls the motor function of the left side of the body. The left side of the brain controls the motor function of the right side of the body. Thus when one side of the brain is damaged, it causes only one side of the body to be affected. There are certain techniques which helps an hemiplegic patient to become mobile and help to perform their functional activities. These include
a) range of motion
Range of Motion – Moving the paralyzed or weak limb or extremity can help to prevent stiffness and muscle contractures. Range of motion can be passive, active-assistive, or active depending if the extremity or limb can voluntarily produce any movement or if it has to be moved by an external factor such as a caregiver.
Orthotics (Braces) – sometimes braces may be prescribed such as wrist and hand orthoses (WHO), elbow brace, or ankle foot orthoses (AFO) which help to maintain proper joint alignment and provide support to weak muscles, and prevent contractures.
Slings – There are various arm slings that help to support the arm when subluxation occurs. Subluxation commonly caused when the head of the humerus (upper arm bone) has dropped out of the shoulder socket due to weakened ligaments and musculature.
Positioning – It is important to position the weak arm or leg appropriately. When sitting, one can support the affected arm on a pillow, lapboard. The leg during sitting should be positioned comfortably without too much rotation at the hip. Try to position the knee where it is facing forward and not out to the side or turned inward. The foot should be flat on the floor or footrest with no rolling of the ankle.
When lying on back, place a pillow by side (parallel to your body) and place the weak arm out straight on the pillow. If there is edema in the hand, we can use an extra pillow to elevate the hand to decrease swelling. When lying on non-affected side, support the weak arm and leg on pillows in front of the body. If lying on the weak side, just make sure the affected shoulder is slightly forward and we are not lying directly on the shoulder joint.
Strengthening – Strengthening and active range of motion exercises can be done with stroke patients who generaaly have weakness . Patients with more severe paralysis may have some small individual movements that can be strengthened as well.