Braun R, Mooney V, Nickel V L, Roper B
Calif Med. 1971 Nov;115(5):11-5.
Rehabilitation of hemiplegic patients begins with setting reasonable functional goals and a treatment plan to reach them. During the initial illness an effort is made to begin range of motion exercising and positioning to prevent contractures. Transfer from bed to chair is recommended as soon as the patient's general condition permits.Upper extremity function depends on sensory and motor function as well as visual and central cerebral impairment. Spastic symptomatic contracture of the shoulder must be prevented by adequate orthopedic management of any musculoskeletal problems such as arthritis or tendinitis and the initiation of an active exercise program. Surgical release of contractures is occasionally indicated in refractory cases. Elbow flexion and pronation flexion deformity of the forearm and hand have also required surgical release on occasion. The goal of lower extremity function is ambulation. A double upright short leg brace aids stability in gait. Long leg braces are not used but a cane may be necessary for balance assistance. Contractures must be prevented by an exercise program or surgically released.
偏瘫患者的康复始于设定合理的功能目标以及为实现这些目标制定治疗计划。在疾病初期，应努力开始进行关节活动度锻炼和正确摆放体位，以预防挛缩。一旦患者的一般状况允许，建议尽早进行从床到椅子的转移。上肢功能取决于感觉和运动功能以及视觉和大脑中枢的损伤情况。必须通过对诸如关节炎或肌腱炎等任何肌肉骨骼问题进行适当的骨科处理，并启动积极的锻炼计划，来预防肩部痉挛性症状性挛缩。在难治性病例中，偶尔需要进行挛缩的手术松解。前臂和手部的肘部屈曲和旋前屈曲畸形有时也需要进行手术松解。下肢功能的目标是行走。双侧直立短腿支具有助于步态稳定。不使用长腿支具，但可能需要一根拐杖来辅助平衡。必须通过锻炼计划预防挛缩，或进行手术松解。
