Hemiplegia

HemiplegiaDone By: Mariam Droubi

1Hemiplegia:

Is defined as paralysis of muscles on side of the body, contra lateral to the side of the brain in which the CVA occurred.

Hemiplegia rehabilitation:Hemiplegia rehabilitation starts at the beginning with passive mobilization and then after a period of time active mobilization is occurred.

To have less spasticity the therapist perform mobilization slowly .

Passive mobilization:The patient must not feel a pain while passive mobilization occurred.

It most be performed not more than 3 times a day.

Slowly.Active mobilization:The therapist must encourage the patient and help him to do the movement.

The patient must be conscious to be aware for the affected limbs.

Bed mobility activities:Bridging in bed stabilization of the lower limbs can be done on the ankle or around the knees.

Rolling in bed to the sound side. The affected arm can be placed across the chest and the affected knee flexed. The patient is asked to bring his head and affected shoulder towards the opposite side while pushing himself with the affected foot.

Sit to stand:Before attempting to stand, we must observe the patients balance and muscle strengthen in hole body.Feet must be well positioned on the floor behind the knee and the head and shoulder well forward over the knee.The affected shoulder should be stabilized by a band or a sling to prevent shoulder capsulitis. The gait:While walking the hemiplegic patient have difficulties in controlling his body having a good balance.

The therapist must be sure of having good muscles.

The hemipligic gait is known as fauchage gait.

The patient stands with unilateral weakness on the affected side, arm flexed, adducted and internally rotated. Leg on same side is in extension with plantar flexion of the foot and toes. When walking, the patient will hold his or her arm to one side and drags his or her affected leg in a semicircle (circumduction) due to weakness of distal muscles (foot drop) and extensor hypertonia in lower limb. This is most commonly seen in stroke. With mild hemiparesis, loss of normal arm swing and slight circumduction may be the only abnormalities.Reeducation of upper and lower limbs:The upper limb should be supported with a sling to prevent any subluxation.

The therapist support the upper limb (forearm supinated,elbow extended,wrist extended,fingers spreaded,thumb abducted) he must avoid shoulder distraction to avoid shoulder dislocation.

In the lower limb the therapist make stimulation for the pelvis then the patient moves his lower limbs to have a movement and walk.

In the lower limb the therapist make stimulation for the pelvis then the patient moves his lower limbs to have a movement and walk.