Massage and gymnastics after a stroke - Complexes of simple exercises. How to Massage a Bedridden Patient Massage Therapy in Nursing

Since a stroke often leads to loss of mental and physical capabilities, it is important to understand the specifics of the development of the disease and the further consequences. This happens especially often with the limbs, and patients experience paralysis, numbness, loss of sensation.

Such effects take a long time, require professional rehabilitation and sometimes can only partially return.

And all due to the fact that the areas of the right or left hemisphere are affected quite deeply, especially in old age.

Stroke means blockage and thrombosis of blood vessels, their rupture and hemorrhage in the brain area. Depending on the type of disease, the rate of progression and the age of the patient, the further consequences of a stroke also differ. So with a deep lesion of the left or right hemisphere, a person suffers from a disorder or loss of physical capabilities in full, in part. We are talking about paralysis, numbness, loss of sensation, paresis, convulsions and trembling in the limbs. If the foci of inflammation are located at a distance from the right hemisphere, then the symptoms do not appear so brightly, and recovery will take a little less time - about three months.

paralysis

Paralysis- this is a complete or partial loss of the physical capabilities of the body, a separate area or limbs due to damage to the peripheral nerves, the central nervous system. Paralysis develops when the right hemisphere is affected, sometimes accompanied by central pain syndrome, paresis or numbness of the legs. Often it is the limbs that suffer, although in old age patients are faced with complete paralysis of the body, which can only be partially overcome.

Paresis

If we talk about a decrease in muscle tone, loss of strength and atrophy of the joints, then we can be sure that the patient is faced with paresis. This condition is often observed in bedridden patients or those who suffer from paralysis of the legs or arms. It also develops with repeated thrombosis of the limbs, the location of the stroke in the right hemisphere of the brain. Paresis passes only after rehabilitation and prevention in the form of gymnastics, swimming or training on simulators. Sometimes accompanied by spasmolytic pain, numbness and loss of sensation.

Stroke massage: goals and contraindications

Since it helps to relax muscles, restore tone, eliminate the development of re-thrombosis, saturates the blood with oxygen and does not allow it to stagnate. Thus, the damaged hemisphere will recover faster.

If we talk about bedridden patients, then massage for them prevent tissue necrosis, bedsores and further deformation of the joints. In the initial stages of recovery, massage will allow relieve pain syndrome and restore the primary reflexes of the legs and arms.

But when carrying out the procedures, you need to remember a few precautions: you can put the patient on his back only if there are no heart and kidney diseases, only the same specialist performs massage in a hospital, home procedures are possible only in the later stages of rehabilitation after the permission of the doctor.

Massage Techniques

As mentioned earlier, foot massage after a stroke can only be done by professionals or under his supervision, and from the first days of recovery. In this case, several techniques and techniques are used, which include stroking, rubbing, vibration, shaking, warming up, shaking. All of them are aimed at returning reflexes, restoring blood circulation, so it is recommended to use all techniques in one session to achieve the maximum effect in a short period of time.

Stroking

It is with stroking that massage begins, as this allows you to warm up the skin, improve blood circulation throughout the body and prepare the muscles for work. Oils can be used, but the massage therapist's hands should be at room temperature. The pressure of the hands should be medium, while trying to rub, slightly press the hand into the body, leg or back. It is important that the skin turns pink, but does not turn red, so spend no more than three to five minutes stroking.

Trituration

The rubbing technique is not particularly different from stroking, but the difference is the intensity and pressure on the legs. Here you can use additional tools, massagers and creams. The skin may be slightly reddened, warm, or become hot. Rubbing is carried out for five minutes, especially intensively in the feet, fingers and lower leg.

Vibration

The essence of vibration is the transmission of oscillatory movements of a certain frequency to a separate part of the body. Starting from the place of massage, you can perform it with your fingers, the tip of one finger, the palm of your hand or your fist. In the process, it is important to ensure that the muscles that are not involved in the process do not tense up, that is, the action is only partial, but it was directed mainly to the nervous system. Weak vibration will increase muscle tone, and strong vibration will reduce joint tone and regulate the excitability of the nervous system.

shaking

Shaking is performed with two fingers - forefinger and thumb, which, as it were, capture the muscle. Next, the skin area needs to be pulled towards you, and then shaken off, but this is easy and quick to do. Manipulations with one area are carried out at least two or three times, and then the fingers need to be moved to the neighboring part. You can make movements diagonally or arbitrarily, sometimes the left hand can help, which creates burdens. It is easiest to perform shaking on the legs, but then the patient should stand upright, and the massage therapist should shake the muscles and skin with one hand.

slight concussion

Shaking is also performed with the palm of your hand or several fingers on a specific part of the body. To do this, you need to pat, create movement on the skin and muscle. It is better to repeat the procedure in one area twice, and then move on to the next part of the body. In this case, it is better for the patient to lie down or take a sitting position.

kneading

Kneading is the main type of massage, which is given almost half of the time of the entire session. But to achieve the maximum effect, it is necessary that the patient's muscles are completely relaxed. Kneading allows you to get to the deepest muscle layers, this is achieved by capturing muscle tissue and pressing it against the bones. Kneading is carried out with the thumb, tips or the entire palm, but make sure that the movements are quick and sliding. Perform the procedure slowly, painlessly, making about 50 movements per minute.

Preparing for a massage

Preparation for massage is necessary both for the patient and for the specialist himself. It all starts with washing hands and washing the body with warm water, after which it is necessary to dry the skin dry. Usually, the patient is undressed to underwear or completely, but the part of the body that is not exposed is covered with a towel or blanket. Keep track of the temperature in the room, as it should be at the level of 23 degrees. Before starting the procedures, the massage therapist needs to warm up the hands to room temperature, the same applies to the patient's legs. In the process, you can use oils, creams and warming masks. Massage is performed in a lying, standing or sitting position on a special couch or on the floor, so as not to create inconvenience or additional burden on the body.

Combination with exercise

Often light massage is combined with exercise., gymnastics, swimming or training on simulators. In this case, massage will prepare the muscles for stress, disperse the blood throughout the body and increase the overall tone of the joints. Then the procedure takes about 15 minutes and includes rubbing, shaking, vibration and kneading. Sometimes the procedure is carried out after exercises or gymnastics to relax the muscles.

Massage after the hospital

After the hospital massage is carried out at home or massage rooms for preventive purposes. The procedure should be repeated at least three to four times a week for 30-40 minutes. In this case, the massage can be complete, the whole body, and not just the legs or arms. It is especially necessary for those who suffered from paralysis, numbness and paresis, since manifestations can accompany the patient for a long time after treatment, leading to a second attack. After that, it is recommended to visit a massage therapist at least once or twice every two weeks.

Rehabilitation: restoring leg movement

Restoration of physical activity of the limbs after a stroke, they are often carried out on the territory of sanatoriums or rehabilitation centers. At the same time, the procedure can take up to eight months or a year and an individual course is developed. Medications, hydrotherapy and reflexology, motor skills exercises, diet, massages and rubbing, visits to a physiotherapist and exercise equipment, treatment of chronic diseases, mud wraps and acupuncture can be used. In some cases, one cannot do without art therapy, a bipolar effect on the nervous system or neurons. It takes about six months, sometimes a year, for rehabilitation. With a second attack or in old age, the legs may not be fully restored, and a second attack or thrombosis may develop as early as eight to twelve months. If you refuse to restore completely, then physical capabilities will be lost forever, and the second attack of a stroke may be the last.

He will cope with this, he is helped by a specialist. Massage is the first stage in the recovery of the patient. Assign it as soon as the patient's body allows.

Restorative massage after a stroke: can it be done?

Stroke massage plays a big role. Thanks to him, you can revive atrophied muscles, relax, normalize their tone. Massage will help improve lymph and blood circulation, which, in turn, will eliminate the formation of blood clots.

It is advisable to start the procedure while the patient is still in the hospital, but at home, therapeutic massage can be effective.

Therapeutic massage for a stroke is not only possible, but also necessary. The main thing is to follow all the prescriptions of the doctor

How to organize a massage at home

Rehabilitation after a stroke depends on the degree of damage to the body. Patients need to do therapeutic exercises, take walks in the fresh air.

When deciding to carry out procedures at home, the following factors should be considered:

• Invite a specialist for a therapeutic massage;
• To master the technique of conducting a treatment-and-prophylactic procedure under the supervision of a rehabilitation doctor.
• Having decided to personally massage, you need to take into account your strengths and capabilities. After all, now the health of a loved one is in your hands.

Proper positioning of the patient with a stroke

Recovery after a stroke largely depends on how the patient lies. The correct position will help to avoid many complications, such as pneumonia, bedsores.

From the first hours of illness, it is necessary to adhere to several principles of positioning:

• The patient must be placed on either side, the main thing is not on the back - this will help to avoid aspiration;
• To avoid the risk of bedsores, one should take into account how the support affects the change in muscle tone and the preservation of their activity;
• The head of the bed should be raised 30 degrees;
• The limbs of the patient lie naturally, do not rest against anything;
• Nothing should lie on the limbs.

Position on the "healthy" side: the pros and cons of positioning

• Blood circulation in the affected limbs is not disturbed, which means that there is no risk of bedsores;
• Drainage of the bronchus can be carried out without difficulty;
• The cervical asymmetric reflex is absent.

• Feeling of helplessness - the "sick" side crushed with its mass;
• Respiratory functions are worse than in the position on the paralyzed side.

Pros and cons of being on the "sick" side

• Respiratory functions are positive;
• The "healthy" side kept its activity;
• It is possible to stimulate the affected side.

Method of "verticalization"

Modern medicine, in the case of stroke patients, uses the method of "verticalization". It is prescribed from the second day of illness.

This rehabilitation method consists in smoothly transferring the patient to a vertical position. It can be carried out with the help of special beds or tables, on which the head part, the whole body rises.

Why early verticalization is necessary:

• The swallowing process improves;
• Communication becomes full, the patient gets the opportunity to take part in the surrounding life;
• The blood is saturated with oxygen, due to the improvement of respiratory function;
• It becomes possible to wash, toilet, eat on your own;
• The risk of pneumonia, bedsores is minimized.

For massage at home, the patient also needs the correct position. He should lie on his back, a roller is placed under his knees, and a flat pillow is placed under his head. If the patient has heart problems, then the procedure is carried out in the “lying on its side” position.

In order to avoid hypothermia, the patient is covered with a blanket, leaving the part of the body necessary for work open.

Therapeutic massage should be carried out in combination with drug therapy.

Goals of massage after a stroke

The main task of massage for stroke is:

• Restore joint mobility, restore both simple movements and grasping reflexes;
• Improve the passage of blood and lymph in the affected limbs;
• To resist the occurrence of contraction of tendons, contractions in muscle tissues;
• Prevent the development of synkenizia;
• Reduce pain;
• Remove increased muscle tone;
• Avoid the possibility of developing pneumonia.

Massage techniques

At first, after a stroke, it is allowed to do only local massage with the involvement of paretic and atrophied limbs. It is allowed to carry out the procedure in the lumbosacral zone, in the chest area on the side of the injury.

In the early stages, when bed rest is still maintained, stroking techniques are performed for tightened muscles. With reduced muscle tone, rubbing techniques are added to stroking.

In massage therapy, it is necessary to follow the correct sequence, namely:

• Massage begin from the front surface of the injured limb. This is due to the fact that with a unilateral lesion or hemiparesis, the lower body is less affected than the upper.
• Massaging the large muscle of the chest.
• Hand massage - from the forearm to the fingers.
• Work with the back of the leg begins with the thigh, then comes the lower leg and foot.
• On the back, massage is carried out along the passage of the lymph flow.

Massage therapy techniques, in addition to stroking, include light, continuous vibration in the form of shaking. In places where the muscles are not compressed - the surface of the hand, the back of the foot, along the front of the lower leg, stronger rubbing, deep stroking, kneading is carried out.

Due to the fact that each area of ​​the body of a stroke patient is massaged differently, they should be considered separately.

foot massage method

Consider the technique of massaging the lower extremities.

The specialist, before proceeding with the massage, puts the patient in the correct position:

• To work with the outer part of the thigh and lower leg, the patient is placed on a healthy side. The neck, knees are located on the roller, the head lies on the pillow.
• When massaging the back of the leg, the patient lies with his stomach on a pillow. This prevents back spasm from occurring. A roller must be placed under the feet.

Massage begins with kneading large muscles, moves to small ones and ends with fingers.

Hip

• To begin with, relaxation of the muscles from the knee to the groin is carried out.
• Next, strokes are performed in the form of spirals and circles from top to bottom.
• After the muscles relax, a gentle massage is added with the base of the palm.

Buttocks

Massage is done from the area of ​​the sacrum in the direction of the outer side of the hip joint.

Shin

• In this zone, it is allowed to apply a harder massage, but only if there is no muscle spasm.
• Longitudinal stroking is combined with stronger transverse stroking. The palm and all fingers are involved in the work.
• When massaging caviar, force is not used. Make smooth movements from the heel to the knee cavity.

Foot

• To work with the foot, it must be fixed. To do this, the heel rests on the palm of the massage therapist, the fingers are directed to the ceiling.
• The specialist performs warm-up movements of all the tubercles, cavities of the back of the foot.
• Particular attention is paid to the hollows between the fingers.

All foot massage techniques are performed 3-4 times.

Hand massage

Massage of this damaged area is performed in the supine position. Upon completion, the patient must be lifted and seated. The paralyzed arm is fixed with a bandage or on a special stand.

Massage of the pectoralis major muscle is done primarily because of the increased tone. The technique is gentle, the movements are superficial, circular. Light vibration is allowed.

Shoulders

• In the zone of the deltoid and trapezius muscles, deeper rubbing and kneading are allowed. Movements start from the spinal column to the shoulders.
• First of all, knead the triceps from the elbow to the shoulder joint.
• Next, proceed to the biceps. In this place, due to the passage of a large artery of the shoulder and high spasticity, massage should be done with caution.

forearms

• Massage is done from the wrist joint to the process of the elbow. From the outside to the back.
• The movements are smooth at first, then deep alternate.

Brush

• Fingers need to return tactile, tactile and motor functions. Therefore, massage of the hands is of great importance.
• Start with the inside of your fingers.
• Then they move to the inside of the hand, where the muscles are overstretched. More intensive kneading, stretching is allowed.
• Due to the high tone of the muscles of the palm, massage in this area is carried out using an easy technique.

Facial massage

With a stroke, paralysis of the facial muscles occurs. To restore facial expressions, normal facial expressions, special exercises should be done. Manual therapy is allowed.

It should be carried out only by a specialist who takes into account that the impact on certain points of the face may worsen the state of health.

With proper manual therapy:

• blood circulation is normalized;
• swallowing function is getting better;
• mimicry is restored.

Therapeutic exercises

• To give the frontal part of the face the former mobility, you should put your hand on this area and try to raise your eyebrows.
• Gymnastics for the eyelids involves closing and bulging the eyes for a few seconds. Between exercises, you should give the muscles a rest.
• The cheek muscles are relaxed by inflating and retracting.
• Mouth open to the maximum. At the same time, we move our lips, trying to stick them out, and then hook them on our teeth. It helps a lot to stretch the mouth in a smile.
• Exercise for the jaw consists in movements to the right, to the left, in imitation of chewing.

If it is difficult to perform the exercises on your own, then you should help with your hands, stretching the skin and muscles in the right direction.

Precautionary measures

It is impossible for a patient with a stroke to carry out a deep massage in the form of cutting with a palm edge, milking. This can cause muscle spasm.

Muscle relaxation should be checked by raising and lowering the limbs. If they fall freely, then the muscles are relaxed.

Rehabilitation after a stroke takes a long time. The main thing is to be patient, both for the patient and his relatives. Because of the astheno-depressive syndrome, the patient is more often without mood, everything is indifferent to him. At times like these, you need the support of family and friends.

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Classical massage for lying patients

Caring for bedridden patients is a very difficult task, since it consists not only in hygiene procedures and prevention of bedsores, but also in maintaining a satisfactory condition of the skin and muscles. The lack of movement for a bedridden patient means a gradual, and very rapid, deterioration of the soft tissues.

In the understanding of most people, a bedridden patient is a person completely immobilized as a result of a serious illness or injury, but there are plenty of situations in which the patient is temporarily bedridden. A serious leg fracture, extensive surgery, serious illness, etc. suggest a long and complete - but not lifelong - bed rest.

The most common situations in which a bed patient needs a special massage:

1. suffered a stroke with partial immobilization,

2. fractures of the spine and large bones, as well as multiple fractures of bones,

3. after severe operations or acute conditions (myocardial infarction), when strict (stationary) bed rest is indicated for a long time,

4. with many chronic diseases of internal organs (pneumonia, bronchitis, coronary heart disease, heart failure, etc.),

5. oncological and neurological patients.

In each case, the need and volume of the massage course is assessed by the attending physician. For patients who are in the hospital, massage is performed by a medical massage therapist under strict control of the patient's condition. Moreover, in each case, a certain set of massage movements recommended for a particular disease is used.

Factors of a positive effect of massage on a bedridden patient

Due to the active effect on soft tissues, nerve endings, and the vascular network, there is an effective improvement in blood circulation not only in the area of ​​massage, but throughout the body as a whole. Metabolism increases, organs and tissues receive a sufficient amount of oxygen and nutrients, toxins and metabolites are more actively excreted (since venous outflow is activated).

Through massage manipulations, it is possible to tone the muscles, the ability to contract which is reduced, and, conversely, reduce the increased muscle tone (this situation is often observed after a stroke).

During the course of massage, there is a significant improvement in the functioning of internal organs - the gastrointestinal tract, urinary system, lungs, heart, which allows the patient to improve well-being and prevent the consequences of prolonged bed rest, which inevitably develop in most bedridden patients. These are constipation, congestion in the lungs, swelling of the extremities, etc.

Massage has a pronounced lymphatic drainage effect, as a result of which tissue swelling is significantly reduced. This is especially important for people who are significantly overweight and have comorbidities such as hypertension.

For bedridden patients with serious illnesses that do not allow them to hope for a full recovery and independent movement, massage is especially important. With the help of special massage techniques and passive therapeutic exercises, a certain muscle tone and blood supply to tissues are maintained, which is the prevention of bedsores and congestion in the lungs.

It is also important that the massage process itself, as a rule, gives a person pleasant sensations and positive emotions. Massage is not only a method of physical impact on the body for medical purposes, it has an important psychological component, allows you to relax a little and distract from your illness. Often, for a bedridden patient, a massage session is not only a therapeutic manipulation, but also a pleasant pastime. Here, of course, much depends on the qualifications of the massage specialist and even on his personal qualities.

Note for relatives of bedridden patients

In the understanding of many people, massage is just an additional technique that allows the patient to recover from illness. In fact, it is an effective rehabilitation technique, the early use of which in some clinical situations can significantly reduce the severity of the consequences of the disease (stroke, heart attack, the consequences of major surgical interventions).

That is why it is very important that the massage is carried out only by a qualified medical specialist, according to a strictly defined technique. Simple stroking and kneading of soft tissues will be of little use if they are carried out by a person ignorant of medicine, especially since such an impromptu massage can be done in the wrong area of ​​the body where it is needed. If a relative caring for a bedridden patient wants to massage himself, he must definitely learn about the principles of massage for this disease and learn how to do it.

Rehabilitation after surgery with massage

Massage in the postoperative period has the following goals:

1. elimination of pain in the area of ​​the operation;

2. contributes to the normalization of the work of the cardiovascular and respiratory systems, the depth of breathing increases and its frequency decreases in comparison with postoperative patients who do not undergo a course of massage;

3. causes positive emotions and calms the nervous system;

4. increases the tone of the respiratory muscles, normalizes the act of breathing;

5. stimulates the regeneration process;

6. shortens recovery time and speeds up return to work.

Some experts advise to perform the first massage session immediately after the end of the surgical intervention on the operating table.

Massage after thoracic surgery

Contraindications: circulatory failure, pulmonary edema, surgery for lung cancer without complete removal of the tumor.

Starting position: the patient lies on his back and side, legs slightly bent.

Massage of the paravertebral zone in the region of the cervical, thoracic, lumbar vertebrae: superficial stroking with fingertips and palm, ironing, rake-like rubbing, stroking, pressure, continuous vibration with a small amplitude and at a slow pace. Rubbing the costal arches and iliac crests with the fingertips.

Belly massage: planar superficial spiral stroking around the navel, stroking the abdominal muscles in the direction from the groin to the armpits and vice versa, pinching, longitudinal and transverse kneading, shifting, continuous vibration.

Massage of the liver and stomach area: pressure, continuous vibration, shaking. Next, a slight concussion of the abdomen is carried out in the longitudinal and transverse directions.

Chest massage with fixation after surgical suture through a bandage (in the early postoperative period): light stroking and rubbing around the site of the surgical suture, planar stroking towards the axillary, supraclavicular and subclavian lymph nodes; stroking and rubbing the intercostal spaces, the area of ​​​​the sternum and shoulder joint, kneading the pectoralis major, trapezius and latissimus dorsi muscles, rubbing the area of ​​​​the shoulder blades and interscapular regions, rhythmic pressure with the palms along the ribs.

Indirect lung massage: rhythmic pressure, light patting, continuous vibration over the lung fields. Stroking and rubbing the muscles of the neck.

Heart area massage: continuous light vibration, rhythmic light pressure with the palm of your hand. Squeezing, concussion, stretching of the chest (during exhalation, press from the sides on the chest, and at the moment of inhalation, quickly remove your hands).

Upper and lower limb massage: wide stroking, rubbing the joints, kneading and shaking the limbs. Passive and active movements in the limbs.

The duration of the massage procedure is 20 minutes, the course consists of 8 procedures.

Massage after operations on the abdominal cavity and pelvic organs

Contraindications: circulatory failure, pulmonary edema, surgery for kidney cancer, kidney and liver failure, surgery with incomplete removal of a malignant tumor.

Massage of the perivertebral zone in the region of the cervical, thoracic and lumbar vertebrae: superficial stroking with fingertips and palm, ironing, light circular rubbing with fingertips and their back surface, shifting, continuous vibration with low amplitude at a slow pace.

Massage of the costal arches, iliac crests, sacrum area: trituration.

Massage of the pectoralis major, trapezius and latissimus dorsi muscles: flat, rake-like stroking, rubbing with fingertips, palm in semicircular directions, longitudinal kneading, shifting, pressing, shaking, gentle patting.

Intercostal space massage: rake-like stroking and rubbing in the direction from the sternum to the spinal column. Rubbing with the fingertips of the clavicles, sternum, shoulder blades and interscapular regions. Stroking the back and sides of the neck, spike-like stroking, rubbing and kneading the sternocleidomastoid muscles.

Diaphragm massage: rhythmic pressure with the palms along the ribs from the sternum to the spinal column, continuous vibration, Rhythmic pressure and continuous vibration over the lung fields.

Heart area massage: gentle rhythmic pressure in the region of the heart and the lower third of the sternum. Compression of the chest with palms along the axillary lines in the region of the ribs. Concussion, compression and stretching of the chest.

Abdominal massage is carried out through a bandage with fixation of the postoperative suture: gentle stroking with fingers around the seam, to the axillary and inguinal lymph nodes, stroking the oblique muscles of the abdomen, pressing, forceps kneading.

Massage of the colon area: stroking, stroking, continuous vibration, tapping and rhythmic pressure with fingertips. Concussion of the abdomen with small amplitude and at a slow pace.

Limb massage: stroking, rubbing joints, kneading, shaking.

Massage for children after heart surgery

When rehabilitating children after operations, it is necessary to limit the use of medicines as much as possible, since they can irreparably disrupt the work of a young organism.

With the help of therapeutic exercises and massage, the following tasks are solved:

1. facilitating the work of the heart, its pumping function, which is provided by massage techniques that contribute to the reduction of peripheral muscles and the activation of blood circulation;

2. prevention of pulmonary complications (pneumonia, atelectasis, pleural, pleuropericardial adhesions);

3. prevention of development in patients of postoperative phlebitis, limitation of movements in the limbs, especially in the shoulder joint, on the side of the operation;

4. prevention of complications from the gastrointestinal tract (atony of the intestines and bladder).

Massage techniques recommended for children after surgery: stroking (weak sliding of the hand over the skin); rubbing (circular stroking with slight pressure on the tissue); kneading (impact on deeper tissues, tendons and joints); patting (a slight movement of the fingers of both hands, which improves blood circulation and activates the activity of internal organs).

Each massage movement must be repeated once. Their direction during massage of the limbs is from the periphery to the center. The legs are massaged in the direction from the feet and shins to the inguinal folds, the hands - from the fingers and hand to the shoulder and axillary region.

With a moderate postoperative condition of patients, massage of the peripheral muscles of the limbs, chest, back, abdomen is used in combination with an early change in body position.

In the case of a severe condition of patients after surgery under artificial circulation, when the child is on controlled breathing, a feature of the technique is the inclusion of percussion massage techniques (patting and tapping the back), stimulation of the respiratory muscles in the supine position in order to improve sputum evacuation.

Additional articles with useful information

Massage

Basic requirements for the correct performance of massage

Currently, massage as an effective method of functional therapy is widely used in various areas of clinical discipline. It is used at all stages of medical rehabilitation of patients. In this regard, caregivers need to become familiar with the basic requirements of massage at home, as well as its simplest techniques. More complex techniques can be mastered in massage courses and specialized literature.

1. During the massage, the whole body, especially the massaged muscles and joints, should be as relaxed as possible. The most complete relaxation of muscles and joints occurs in a position when the joints of the limbs are bent at a certain angle (average physiological position).

When massaging the back, the person being massaged lies on the stomach, the arms are located along the body and slightly bent at the elbow joints, the face is turned towards the massage therapist, a roller is placed under the shins. All this allows you to further relax the muscles of the body.

When massaging the front surface of the body, a small pillow is placed under the head of the person being massaged, and a roller is placed under the knee joints.

2. The hands of the massage therapist should be warm, clean, without roughness. Long nails are not allowed.

3. The room for massage should be warm (not lower than +20 °C), previously ventilated.

4. Massage is carried out before taking or 1.5-2 hours after eating.

5. Massage should not cause pain.

6. Late massage (after hours) is unacceptable.

8. Massage movements are performed mainly along the lymph flow to the nearest lymph nodes. On the upper limbs - this is the direction from the hand to the elbow and axillary nodes; on the lower extremities - from the foot to the popliteal and inguinal nodes; on the chest - from the sternum in both directions to the axillary nodes; on the back - from the spine in both directions. When massaging the upper and middle parts of the body, the movements are directed to the axillary nodes, while massaging the lumbar and sacral regions - to the inguinal nodes; on the neck, head movements lead from top to bottom to the subclavian nodes.

9. The first massage sessions should be short and not intense. Time and intensity of massage increase gradually. The duration of the massage also depends on the massaged area (hand massage - 5 minutes, back - 20 minutes). The duration of the general massage increases otdomin.

In terms of intensity, the massage procedure should be built as follows: min-max-min. First, stroking is performed, then - light rubbing, kneading, vibration, shock techniques. The massage procedure always ends with smoothing.

10. Massage is carried out based on knowledge of the main muscle groups.

11. The intensity and duration of the massage depends on the age, gender, physique, as well as the condition of the patient.

12. Before the massage, the patient needs to take a shower or wipe himself with a damp towel.

13. After the massage procedure, the patient needs to rest for a minute.

Massage contraindications

Every caregiver should know the main contraindications to massage. They are divided into absolute (massage is completely contraindicated), temporary and local (i.e. massage is contraindicated in certain areas of the body).

Absolute contraindications to massage:

• malignant tumors (before their radical treatment);
• gangrene;
• thrombosis;
• active form of tuberculosis;
• acute venereal diseases;
• acute and chronic osteomyelitis;
• causal syndrome after injury of peripheral nerves;
• circulatory failure and heart failure of the 3rd degree;
• angiitis (disease of the arteries);
• diseases with severe mental changes;
• aneurysms of blood vessels, aorta;
• scurvy;
• HIV infection;
• blood diseases, tendency to bleeding;
• atherosclerosis of peripheral vessels, thromboangiitis in combination with atherosclerosis of cerebral vessels.

Temporary contraindications to massage:

• acute febrile conditions;
• acute inflammatory process;
• bleeding;
• purulent, infectious processes (furunculosis, etc.);
• lymphadenitis, lymphangitis;
• crises: hypertensive, hypotonic and cerebral;
• multiple allergic skin rashes, as well as hemorrhages and swelling;
• nausea, vomiting, abdominal pain;
• alcohol intoxication;
• acute pain requiring narcotic analgesics;
• acute cardiovascular, renal failure.

• massage of body parts affected by fungal, viral and other pathogens - warts, herpes, cracks, eczema, etc.;
• body massage in the area where a benign tumor is located, massage of other parts of the body is performed using a sparing technique (only stroking);
• body massage in areas adjacent to the site of excision of a malignant tumor;
• massage of the anterior surface of the chest with mastopathy;
• massage of the lumbar region, abdomen, thighs with ovarian cysts, fibroids, myomas, adenomas (in men);
• massage near protruding moles;
• massage in places of varicose veins;
• massage of the abdomen with hernia, pregnancy, menstruation, stones in the gallbladder and kidneys; massage of the lumbar region is performed according to a gentle technique;
• massage of the mammary glands, inguinal region, nipples;
• massage of the lymph nodes.

Basic massage techniques

Technique for performing the “stroking” technique

This technique is performed with the entire palmar surface of the hand, if the muscle is large (on the back, chest, arm, leg), and with the fingers of the hand, if the muscle is small (on the phalanges, toes).

When performing this technique, the massage therapist's brush should be as relaxed as possible and easily glide over the skin without moving it into deep folds. Stroking can be superficial (the palm lightly touches the skin) and deep. With this technique, we begin, finish the massage and alternate the rest of the techniques.

Despite the simplicity of its implementation, it has a huge positive effect on the entire body, having an analgesic and calming effect. The pace of strokes is slow and rhythmic. The trajectory of the movement of the hands can be different: rectangular, zigzag, spiral. This technique is performed with one or two hands.

If you perform deep stroking, it will have a tonic effect on the muscle and body. Stroking certain parts of the body, we also have a therapeutic effect on the organ with which this area is associated. For example, stroking the interscapular region, we have a beneficial effect on the heart. Thanks to this technique, the patient, in addition, adapts to the hands of the massage therapist.

With the help of stroking, we exfoliate the upper dead layer of the epidermis on the skin, remove the remnants of sweat and fat, which means we improve breathing, blood and lymph circulation in the surface layers of the skin.

However, when performing even this simple technique, the dosage must be observed so as not to cause irritation in the patient. Even if you stroke a cat, at first she purrs with pleasure, and when she gets tired, she can scratch.

Technique for performing the "rubbing" technique

This technique consists in shifting, stretching the skin and underlying tissues. The masseur's hand does not slip, but shifts the skin, forming folds. The vigorous implementation of this technique contributes to the heating of all tissues. The skin at the same time slightly reddens, becomes more elastic and displaced. Rubbing helps to increase blood flow to the tissues and improve their nutrition. As a result, tissue mobility increases, scars and adhesions, pathological deposits soften. The trajectory of the movement of the hands may be different, but with edema - along the lymph flow to the nearest lymph nodes.

This technique should be performed with the base of the palm or fingertips, using one or two hands. You can also clench your hand into a fist and rub the skin with the back of your fingers or the ridges of your fist, making movements reminiscent of planing, hatching and sawing. Directions of movement can be straight (translational, zigzag), circular and spiral.

Rubbing with pads of 4 fingers. Reception is performed with the pads of 4 closed, slightly bent fingers, resting on the thumb and the base of the hand. The fingers can be slightly apart, making movements in a spiral, in a circle, or forward and backward.

Rubbing with the pad of the thumb. This technique is performed with the pad of the thumb while relying on 4 remaining fingers that are maximally laid aside. The movement of the thumb can be straight, spiral, circular.

Rubbing with the base and edges of the palm. When performing this technique, the brush is slightly extended, 4 fingers are slightly bent and raised above the skin. The movements of the brush are translational: back and forth, spiral or circular.

Rubbing can also be performed with the elbow edge of the brush - in circular and spiral movements.

Sawing is performed by the elbow edge of the brushes, located parallel to each other at a distance of 2 cm and moving in opposite directions. Soft fabrics should be rubbed between the palms.

Crossing is applied on rounded surfaces (neck, buttocks, lateral surfaces of the body). It is performed by the radial edges of the hands with the maximum abduction of the first finger. The brushes are parallel and move in opposite directions.

Rubbing with phalanges of 4 fingers. This technique is performed with the back side of the middle phalanges of 4 fingers, slightly clenched into a fist. With such a rather harsh effect on the muscle, it is, as it were, pressed against the bone. The thumb rests against the massaged area, helps to fix the brush and move it forward. Brush movements can be progressive: up and down, spiral or circular.

The technique of performing the "kneading" technique

This technique contributes to the passive gymnastics of blood vessels and muscles. When performing kneading, the massaged muscle is captured, lifted and pulled, squeezed and, as it were, squeezed out. And if the previous techniques had an effect on the skin (stroking), the subcutaneous fat layer and the surface layer of the muscles (rubbing), then kneading affects the state of the deep layers of the muscles. When kneading, the muscle tone increases, they become strong and elastic, the blood supply not only to the massaged area, but also to nearby ones, improves significantly. This technique also enhances the contractility of the muscles.

Kneading is carried out in different directions with one or two hands:

a) on small surfaces - the palmar surface of the nail phalanges of the I and II fingers (i.e., as if with the fingertips);

b) on large muscles - with all fingers.

Single kneading is performed with one hand. Tightly clasping the massaged muscle with the palm of your hand (on one side of the muscle is the thumb, and on the other - all the rest), it is lifted, squeezing between the fingers and making translational movements forward or towards the little finger. When tearing and squeezing the muscle, there should be no gap between the palmar surface of the hand and the skin of the muscle. The first movement is reminiscent of squeezing a sponge. In the second case, the muscle, as it were, breaks away from the bone bed, is compressed, rotates towards the little finger and thus moves forward in a spiral. The movement is performed along the muscle, so it is also called longitudinal.

Kneading with two hands (“double ring” or transverse) is performed as follows. The masseur tightly grasps the massaged muscle with both hands so that they are in the same plane at an angle of 45 ° to the surface of the patient's body. All fingers cover the massaged surface, but one hand pulls, squeezes the tissues away from itself, and the other pulls them towards itself. Then the direction of movement of the hands is reversed. Massage movements should be soft, without jerks and a bit like kneading dough.

This technique is performed slowly, smoothly, there should be no muscle twisting and pain. Kneading always alternates with stroking and is performed along the lymph flow.

Tong-like kneading is performed on one side with a large one, and on the other - with the rest of the fingers (they take the form of tongs); the muscle is captured, pulled up, and then kneaded between the fingers. On small muscles (fingers, toes) 2-3 fingers work. The execution technique is the same as for longitudinal and transverse kneading.

Felting is used on the limbs, mainly to reduce muscle tone in hypertonicity. Parallelly set palms tightly cover the limb and move in opposite directions.

Pressure is used to increase muscle tone in hypotension. The masseur firmly presses the palm to the skin and gradually increases the pressure with a delay of up to 3-5 seconds at the end point. Then also gradually reduces the force of pressure. Pressing can be carried out more vigorously. Reception is performed with fingertips, the back of the hand or a fist set flat.

The shift is performed with the thumbs on one side and all the others on the other. The underlying tissues are lifted, captured in a fold with the formation of a muscle roller, which is then rolled in any direction.

Pinching is done with the thumb and forefinger (or thumb and all) of one or both hands. At the same time, muscle tissue is captured and pulled upward. The movement is performed vigorously and helps to increase muscle tone in case of hypotension.

Vibration technique

Vibration is the transfer of oscillatory movements to the massaged area of ​​the body, produced evenly, but with different speeds and amplitudes. It is performed with the palmar surface, nail phalanges of one finger, thumb and index or index, middle and ring, thumb and other fingers. Oscillatory movements performed with a large amplitude and oscillation frequency of up to 120 movements per minute will increase muscle tone, and with a frequency of more than 120 and with a small amplitude - reduce muscle tone. In other words, weak vibration increases muscle tone, and strong vibration reduces it. Vibration has a strong and varied effect on deep tissues. The movements of the massage therapist's hands should be gentle, soft, painless.

Labile vibration is performed with a brush. It makes oscillatory movements, moving in any direction along the massaged area. If the vibration continues for at least 10 seconds, it is called continuous. If the exposure time is less than 10 seconds, and the hands are periodically taken away from the body, then this will be an intermittent vibration. Continuous vibration includes shaking, shaking and shaking (to reduce muscle tone), intermittent vibration - chopping, patting, quilting, puncturing (to increase muscle tone).

The direction of movements during oscillations is mainly from right to left and only on the stomach, while massaging certain organs - from top to bottom (pushing).

Stable vibration is performed in place with the pad of one or more slightly bent fingers (point vibration).

Shake. The masseur grabs the muscle by the abdomen (middle) with his fingers, pulls it back a little and shakes it with the brush with the required frequency. The technique is used in the massage of the limbs.

Shaking. This technique is also performed on the limbs and on large muscles (for example, on the latissimus dorsi muscle). The muscle is captured between the first and fifth fingers, the other three fingers are located above the skin. The brush performs oscillatory movements from side to side from one end of the muscle to the other (from the lower to the upper section).

Shaking. The masseur takes the patient's hand or foot with both hands and performs oscillatory movements of the entire arm or leg from top to bottom or from right to left.

Chopping. It is performed with the elbow edges of the brushes, set in parallel, at a distance of 2-3 cm from each other at an angle of 20-30 °. The brushes are relaxed. 4 fingers are slightly spread and bent. The movements of the brushes occur in opposite directions at a rate of beats per minute. Chopping is done along the muscle fibers.

Pat. When performed correctly, a dull sound should be heard. Patting is carried out with the palmar surface of the hand (thumb pressed) with slightly bent fingers. The brush takes the form of a box. Reception is performed with one or two hands alternately in opposite directions.

tapping. It is performed with a flat fist, and in small areas (on the hand, on the back of the foot) - with the fingertips.

Punctuation (for the elderly). It is performed with the pads of half-bent fingers moving alternately, like the movements of a typist.

Quilting. It is performed with the palmar surface of the brushes moving tangentially up and down.

Stroke Massage

From a medical point of view, a stroke is a severe and dangerous vascular lesion of the central nervous system. And if earlier a stroke was the lot of the elderly, then in recent years it has dramatically “younger”. In the first month after a stroke, rehabilitation measures begin. The sooner treatment is started, the more favorable the outcome of the disease! The success of recovery is largely determined by the mood of the patient himself, as well as his loved ones. Optimism, the desire to achieve the goal, diverse interests, an active attitude to life help to defeat the disease even more than drugs. It is clear that the treatment of stroke in a specialized stroke unit improves its clinical outcome. In such departments, specially developed programs of restorative procedures are used and specialists of various profiles work, including experienced massage therapists and exercise therapy instructors who specialize in this particular disease. But after the patient is discharged from the hospital, it is necessary to continue with him therapeutic exercises and massage for many months, and sometimes years.

Unfortunately, in our time, due to the difficult financial situation of most people, not every close relative can allow the patient to use the services of such specialists. In this regard, it became necessary to acquaint those caring for this category of patients with the basics of rehabilitation gymnastics and massage.

Before proceeding with these procedures, you should find out from the attending physician if the patient has any contraindications to them, and also clarify (ask to show) which muscles in your patient are relaxed and which are tense. It is also necessary to determine specific goals, i.e., the tasks of massage and therapeutic exercises:

• increase blood and lymph circulation in paralyzed limbs and throughout the body;
• improve the nutrition of all tissues;
• contribute to the restoration of the function of movement in the affected limbs;
• counteract the formation of contractures;
• reduce muscle tone in spastic muscles and reduce the severity of friendly movements;
• reduce or relieve pain;
• increase the emotional tone (mood) of the patient;
• prevent congestive pneumonia in the elderly;
• prevent the formation of bedsores.

In the first months after a stroke, only local massage is allowed, involving paralyzed or paretic limbs, the back with the lumbar region, and the chest (on the side of the lesion). General massage is allowed only in the late rehabilitation period, since prolonged exposure can cause overwork of the patient, which is unacceptable.

During the massage, each technique is repeated 3-4 times. During the first procedures in the early stages after a stroke, the area of ​​influence is small, only the shoulder and thigh are massaged, without turning the patient on the stomach. At the 4-5th procedure, depending on the patient's condition, a massage of the chest, forearm, hand, lower leg, foot is added. From the 6-8th procedure, the back and lumbar region are covered in the position of the patient lying on a healthy side. The prone position is used at a later date and only in the absence of contraindications due to heart disease.

In the early stages of bed rest for spastic muscles, only stroking techniques are used, and for muscles with reduced tone, stroking and rubbing.

To increase the effectiveness of massage and therapeutic exercises, it is advisable to pre-warm the paralyzed limbs. For this purpose, you can use a saline reusable heating pad applicator.

It must be emphasized once again that the increase in the intensity of exposure is strictly individual and depends on the patient's condition. After a stroke, in the absence of contraindications, massage is prescribed for an uncomplicated ischemic variant - on the 2nd - 4th day, and for hemorrhagic - on the 6th - 8th day. The duration of the massage is gradually increased from 10 to 20 minutes. During strict bed rest, massage should only be performed by a highly qualified massage therapist and under medical supervision. A caregiver of such a patient can be massaged only in the late recovery and rehabilitation period, when the patient's condition improves significantly and he is discharged from the hospital. But there are also unforeseen circumstances, and the caregiver's help may be needed in the early stages. It should be noted that massage is an additional method of treatment, while the main ones include positional treatment (special styling) and therapeutic exercises.

Position treatment

The principles of treatment are to give the paralyzed limbs the correct position during the time that the patient is in bed. It is currently believed that the development of hemiplegic contracture with the formation of the Wernicke-Mann posture (the hand is pressed to the body, the fingers are clenched into a fist, the leg is turned outward, straightened, the foot hangs and is turned inward) may be associated with a long stay of paralyzed limbs in one and the same volume. the same position in the early period of the disease. There are various options for laying paretic limbs.

Laying in the supine position. The paralyzed arm is placed on a pillow so that it is at the same level in the horizontal plane throughout. Then the arm is abducted to the side at an angle of 90 ° (for pain, they start from a smaller angle of abduction, gradually increasing it to 90 °), straighten and turn outward. The hand with fingers extended and spread apart is fixed with a splint, and the forearm is fixed with a bag of sand or salt weighing about 0.5 kg (any light material can be used as a splint - plywood, light metal, covered with gauze). A cotton roll covered with oilcloth is placed in the forearm cavity, and the fingers, hand and forearm are bandaged to the splint.

The paralyzed leg is bent at the knee joint by 15-20° and a roller is placed under it. The foot is flexed at a right angle and held in this functionally advantageous position by means of a wooden box ("leg case"). The sore leg should rest against one of its walls with the sole. For more reliable fixation, the case is tied to the back of the bed. The patient should be in this position for 1.5-2 hours. During the day, a similar procedure can be repeated 2-3 times.

Laying the patient in a position on a healthy side. With this laying, the paralyzed limbs are given a bent position. The arm is bent at the shoulder and elbow joints and placed on a pillow, the leg - at the hip, knee and ankle joints, placed on another pillow. If the muscle tone has not increased, the laying in the supine position and healthy side is changed every 1.5-2 hours. In cases of early and pronounced increase in tone, the treatment with the supine position lasts 1.5-2 hours, and on a healthy bokumin.

The sequence of the massage

The procedure begins with a massage of the front surface of the affected leg, since with hemiparesis the lower limbs are less affected than the upper ones. Then the pectoralis major muscle, arm, back of the leg, and back are massaged in succession. Foot massage is performed according to a certain scheme - first the thigh is massaged, then the shin, foot. On the upper limb - shoulder, forearm, hand, fingers. The direction of movement is along the lymphatic flow.

Massage techniques include various types of surface stroking, light rubbing and light continuous vibration (shaking, shaking) - for spastic muscles. The spastic state is distinguished by:

• muscles of the inner (front) surface of the shoulder, forearm and palmar surface of the hand;
• pectoral muscle on the side of the lesion;
• muscles that extend the knee (quadriceps) and turn the thigh outward;
• muscles of the back surface of the lower leg (calf, posterior tibial, long flexor and 1 fingers);
• muscles located on the sole.

During the massage of these muscle groups, light stroking and, somewhat later, rubbing techniques are used. For some muscles, light vibration is applicable.

In other areas - the back (outer) surface of the arm, the front surface of the lower leg, on the back of the foot - the muscles are not spastic. Therefore, here you can perform deep stroking, more intense rubbing, as well as light kneading.

Percussion techniques are contraindicated: patting, chopping, tapping, etc.

The position of the patient during the massage

The patient lies on his back, a roller is placed under his knees, a pillow is placed under his head. In cases of synkinesis (friendly movements), the non-massaged limb is fixed with sandbags. Massage of the outer surface of the leg can be carried out in the position of the patient on a healthy side. The back surface of the leg is massaged in the position of the patient on the stomach, a small pillow is placed under the stomach, a roller is placed under the ankle joints; under the head - a small pillow. In case of violations of the heart, the patient is massaged on his side. To keep warm, it is covered with a blanket and during the massage, only the massaged area is exposed.

With spastic paralysis, the patient does not have voluntary movements, muscle tone increases, all tendon reflexes increase, and involuntary friendly movements occur. So, when a healthy limb moves, exactly the same movement is reproduced by a paretic one and vice versa. Sometimes the affected lower limb mimics the movement of the upper limb, for example, bending the arm causes the leg to flex. It must also be remembered that unrest, physical stress, fatigue, cold impair the ability to move.

Therefore, before starting to perform massage techniques, it is necessary to achieve a maximum decrease in muscle tone, i.e. muscle relaxation. To do this, apply special relaxation exercises, first on a healthy hand, and then on the affected one. To test the ability to relax the muscles, the massage therapist lifts the healthy limb of the patient and releases it - the limb should fall freely. The masseur at the same time insures the hand from bruising.

Hand exercises

1. The caregiver supports the patient's elbow with one hand, and the hand with the other. Raises and lowers the hand with shaking movements. Rubs the area around the elbow.

2. The caregiver makes circular outward movements in the shoulder joint with simultaneous pressure on the head of the humerus. The range of motion should be small. Exercises are performed very slowly, gently and accurately. You can not cause overwork of the patient, so the number of exercises at first should be minimal (1-2 times). If, nevertheless, friendly movements arose during the exercise, then the other limb should be pressed against the body.

After the described exercises for the hands, they begin to perform techniques of stroking and shaking the pectoralis major muscle on the side of the paresis. Then the hand massage begins.

Leg exercises

1. The caregiver, supporting the foot, slowly raises the leg with shaking movements and gently swings it to the sides. Before the exercise, the patient takes a breath, and during the movements - exhale.

2. Then a slight concussion of the thigh muscles is performed.

3. The caregiver, with one hand supporting the leg under the knee joint, with the other, bends and unbends it, not bringing it to the limit of extension.

4. To relax the muscles of the foot, gently shake the calf muscle on the back of the leg. The leg should be bent at the knee joint.

5. The essence of muscle relaxation is explained to the patient, the signs indicating its onset are called (feelings of heaviness of the diseased limb). Next, the caregiver shows on himself what the state of the muscles is at rest, with tension and relaxation.

Massage technique

Foot massage

Hip massage. The front and inner surfaces of the thigh are massaged in the position of the patient lying on his back. First, light superficial strokes are performed on the inner, middle (front) and outer surfaces of the thigh. Movements go from the knee joint to the inguinal region. Then light, slow spiral and zigzag strokes are added. The criterion for correct execution is a slight relaxation of the spastic muscles. In the future, light rubbing with the pads of 4 fingers and the base of the palm is added to these techniques. All these techniques are combined with stroking. Each technique is performed 3-4 times.

Massage of the back of the thigh is carried out in the position of the patient on the stomach or on the side. On the back of the thigh are the gluteus maximus, biceps, semitendinosus, and semimembranosus. All these muscles are involved in hip extension, and, given their spastic state, sparing techniques should be used: stroking and light rubbing. Movements are performed from the popliteal fossa to the gluteal fold. The buttock is stroked from the back surface, the sacrum to the greater trochanter (it protrudes on the upper outer surface of the thigh and is well palpable on palpation).

Leg massage. On the anterior surface of the lower leg are the extensors of the foot - usually they are less spastic. Therefore, more intensive techniques are permissible here: first superficial and then deep stroking, more vigorous rubbing techniques, as well as transverse and longitudinal kneading. Massage is carried out with all fingers and palm. Movements go from the ankle up to the knee joint.

The gastrocnemius and soleus muscles extend to the posterior surface of the lower leg, which flex the lower leg at the knee joint and foot. They are very spastic, and therefore they must be massaged in a gentle manner. Movements go from the calcaneal tuber to the popliteal fossa.

Foot massage. On the back of the foot there are muscles - extensors of the fingers with unexpressed spasticity. Therefore, techniques of stroking, rubbing and kneading are used here. The caregiver fixes the foot with one hand (puts the heel of the patient in his palm so that the toes are pointing upwards), and II-IV fingers with the other massages its back surface from the fingertips to the lower leg. Then I finger strokes and rubs the interosseous spaces. If you spread your toes, then the interosseous spaces will stand out well in the form of depressions on the back of the foot.

On the plantar side of the foot there are muscles with increased tone, and they are massaged using a gentle technique. The direction of movement is from the toes to the heel.

Massage of the pectoralis major muscle on the affected side

With hemiparesis, this muscle has a very high tone, so the massage here should be very gentle. Apply superficial stroking, very light rubbing with the pads of 4 fingers and light vibration in the form of shaking or light shaking. Shaking can be done with fingers I-II, or by placing the entire brush on the chest and moving it along the massaged area in the direction from the sternum to the armpit.

Hand massage

Hand massage is carried out in the position of the patient lying on his back, and at the end of bed rest - in a sitting position (the patient's hand is on a nearby table, and the caregiver sits opposite him).

Shoulder massage. Massage begins with the trapezius and deltoid muscles. Their tone is not increased, so they use the techniques of deep stroking, intense rubbing and light kneading. The direction of movement is from the VI-VII cervical vertebrae (if you bend your head, the VII vertebra will protrude more than the rest) to the end of the deltoid muscle. The deltoid muscle should be well rubbed and kneaded.

Next, massage the triceps muscle, which is the extensor of the forearm. The tone of this muscle is not so high, therefore, with hemiplegia, it is advisable to start the massage with this particular muscle. Apply techniques of superficial and deep stroking, vigorous rubbing and light kneading. Movements go from the elbow joint along the outer back surface of the shoulder to the shoulder joint.

Then they move on to massage the biceps muscle, which is the flexor of the forearm and shoulder. She is very spastic, so only light stroking and rubbing is used here. Movements are performed from the cubital fossa along the inner front surface of the shoulder to the armpit. The brachial artery, veins and nerves pass along the inner surface of the shoulder (on the inner groove). Therefore, when performing a massage, one must be especially careful and in no case exert any pressure on this surface.

Forearm massage. The muscles of the back (outer) surface of the forearm - the extensors of the hand and forearm - are overstretched, so it is advisable to start massaging the forearm with them. Perform techniques of deep and superficial stroking, rubbing, kneading. Movements go from the wrist joint along the back of the forearm to the olecranon.

The muscles of the anterior (inner) surface of the forearm - the flexors of the hand and forearm - are spastic in hemiparesis, so they are easily stroked and rubbed in the direction from the wrist joint to the cubital fossa.

Massage of the hand and fingers. The muscles of the back of the hand are overstretched. Therefore, the massage starts from the back of the fingers, then they move to the back of the hand. Here energetic techniques are performed: deep stroking, rubbing, kneading.

The tone of the muscles of the palmar surface of the hand is very high, so the massage is performed according to a sparing technique - only superficial stroking.

Back massage

The patient lies on his stomach or on a healthy side, a pillow is placed under his head. When massaging the back, all techniques are used, but they must be soft and gentle so that muscle tone does not increase and tissue nutrition improves. The direction of movement was described in the previous sections.

Therapeutic gymnastics and massage for the elderly

Numerous examples of the beneficial effects of therapeutic exercises and light massage on the body of the elderly put beyond doubt the expediency of their use. Twenty years ago, the motto of the elderly was the words: "We grow up to a hundred years without old age." Every day on the racetracks of our stadiums one could see numerous groups of people who are over 60, 70, and even over 80 years old. Today there is a completely different picture. Only small groups of people who have suffered strokes, heart attacks and other diseases or injuries can be found in medical and physical education dispensaries and specialized centers. This suggests that in our troubled times there is no attention or funds left for the elderly, and they sometimes feel they are useless and are in dire need of the care and help of loved ones.

We can provide such assistance by doing short gymnastics with them, performing simple massage manipulations on limited areas of the body. The technique of massage and therapeutic exercises, as in diseases, is different in each case.

Physiotherapy

When drawing up a plan for therapeutic exercises, it is necessary to take into account:

• age;
• accompanying illnesses;
• human condition: blood pressure, pulse, muscle tone, general well-being;
• contraindications (see earlier).

Therapeutic exercises with the elderly should be carried out every other day or once a week. The load should be minimal, the time of classes should be from 10 to 30 minutes, the exercises should be performed in lightweight starting positions: sitting, lying down. To make sure that you are doing everything right, you can keep a journal in which you need to note the following indicators:

• mood;
• fatigue;
• feeling of cheerfulness;
• performance;
• headache;
• dyspnea;
• pain and discomfort in the region of the heart or other places;
• appetite;
• pulse;
• arterial pressure;
• activity of the gastrointestinal tract.

We should try to make such observations unobtrusively, not particularly focusing the attention of older people, since among them there is such a category that likes to delve into their feelings and aggravate their condition.

Gradually, you need to ensure that your wards are on their own every day, remember. doing exercises, doing daily housework. Then they will have an incentive in life and many "sores" will pass by themselves.

Massage

Massage for the elderly is done mainly in a sitting position. Perform light strokes of the collar zone, i.e. from the scalp down the neck to the shoulders. You can iron and rub your hands easily, starting from the fingers up to the shoulder joints. Light shaking is acceptable. Kneading and percussion techniques are excluded. You can massage your toes, feet and legs slightly to the knees, and then the thighs - from the bottom up. Massage of the arms and legs is best performed in the supine position, half-sitting.

Approximate complex of therapeutic exercises

1. Arms extended in front of the chest. At the expense of "one - two" spread your arms to the sides and take a breath. At the expense of "three - four" return to the starting position (sp).

3. Put your hands on your knees, raise your shoulders at the “one” count, lower them at the “two” count. (You can raise your shoulders at the same time, or you can alternately).

4. Perform turns of the torso in one direction or the other.

5. On the count of “one”, spread your arms to the sides and take a breath, on the count of “two”, wrap your arms around yourself and exhale.

6. On the count of “one”, bend the torso forward and stretch your chest to your knees, on the count of “two”, take the I.p.

7. On the count of "one", straighten one leg, on the count of "two" - the second, on the count of "three" return one leg to the SP, on the count of "four" - the other. This exercise can be combined with arm movements. In addition to physical activity, exercises will develop attention and coordination of movements. Hands can be straightened with the same name as the legs, or opposite ones. At the expense of "one" straighten the right leg and left arm, at the expense of "two" - the left leg and right arm, at the expense of "three" bend the right leg and put it on the knee, at the expense of "four" return the left leg and right hand to and .P.

8. In i.p. while sitting, lower your arms along the body. At the expense of "one - two", slowly tilt the body to the right, the left hand slides up the body up to the armpit, and the right hand reaches for the floor. At the expense of "three - four" return to I.p. Then repeat everything on the other side.

9. At the expense of "one", pull one knee to the chest and clasp it with your hands. At the expense of "two" take I.p. At the expense of "three - four" pull up the other knee and return to the sp.

10. At the expense of "one - two" raise your hands through the sides up and inhale, at the expense of "three - four" lower your hands through the sides down and exhale.

Each exercise is worth doing. You can also connect exercises with massagers. Periodically roll the rolling pin with your hands, feet, and also rub your fingers and hands, you can lightly rub your ears.

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Many patients after a stroke manage to return to working capacity and lead a normal life. The main condition is activity, perseverance, self-confidence. And most importantly - movement, movement, movement. Even a bedridden patient after a stroke can and should do restorative exercises at home. And if he cannot, due to complete immobility, then those who care for him should do passive gymnastics to the patient.
Here are a few examples from the newspaper "Bulletin of Healthy Lifestyle", how paralyzed bedridden patients after a stroke were able to fully recover from disabled people to full-fledged people. As well as advice on the rehabilitation and care of paralyzed patients.

More stories with a happy ending in the article "Complete recovery after a stroke at home"

Caring for paralyzed patients after a stroke at home - Doctor's advice.

In the first days after a stroke, a paralyzed patient is doomed to complete immobility. It is especially difficult to care for paralyzed patients at home. To prevent pulmonary edema, a bedridden patient should be turned in bed every 2 hours. When the condition improves, sit him in bed for a few minutes. If the patient is conscious, it is necessary to force him to do breathing exercises; at home, inflatable toys are most often allowed to be inflated.
So that a paralyzed bedridden patient does not form bedsores after a stroke, it is necessary to wipe the skin daily with camphor alcohol or a mixture of vodka and shampoo. If the patient still has skin damage, it is necessary to wipe them with a solution of potassium permanganate and lubricate with rosehip oil.
With a paralyzed patient after a stroke at home, even if he is completely immobilized, it is necessary to carry out passive gymnastics, this prevents blood stasis and thrombophlebitis. The patient's arms and legs must be bent, unbent, lifted and massaged.
It is necessary to constantly talk with the patient, even if it seems to you that he does not understand the words addressed to him. This will allow you to quickly restore logical thinking and speech. Good care of a paralyzed patient will help to avoid a secondary stroke. (HLS 2001, No. 3, p. 8-, from a conversation with Dr. MN Kadykov A. S.)

Mental gymnastics after a stroke.
"Mental gymnastics" helps patients recover, even paralyzed patients after a stroke can do it in a hospital and at home. It is possible to restore the central nervous regulation that controls the motor activity of the affected areas of the body by creating a mental image of a particular exercise.
Imagine that you clench your fingers into a fist, raise your feet up, lower them down. The clearer the “picture”, the faster connections are formed with other parts of the brain, which will take over the functions of nervous regulation of the parts of the body affected by paralysis.
Each mental exercise leaves its mark in the brain, when repeated, a chain of such traces is created and a new center of nerve connections is formed that controls movement.
Depending on the severity of brain damage, the will of the patient, patience and perseverance, the process of building new connections can take a month or a year. And you also need unconditional faith in the power of mental training. Whether this faith is true or false, it will work miracles. Set goals and go for them. (HLS 2002, No. 13, p. 19. Boris Goryachev, doctor)

How to start rehabilitation exercises after a stroke - Stages of rehabilitation
1st stage
From the first hours of the acute period of a stroke, positional treatment is applied to avoid contractures of the paralyzed limbs. Also, relatives or medical staff do passive gymnastics to a paralyzed patient.
2nd stage
By the end of the first week after a stroke, active restorative gymnastics is prescribed, a set of exercises of which is developed by exercise therapy instructors in a hospital. It is first performed in isometric mode, without movement in the joints. Sick limbs are lifted by an assistant, and the goal of the patient is to hold the raised arm or leg. The hand cannot be raised by the wrist. If the sick hand is raised by the sick healthy hand, he should lift it by the elbow, turn the hand with the palm up, if the assistant raises the hand, then with one hand it is taken above the elbow from below, and with the other hand by the wrist from above.
3rd stage
The patient is taught to sit. They begin with 3-5 minutes of reclining, putting pillows under the back and head, after 2-3 days the patient is transferred to a semi-vertical position.
Then they sit on the bed with their legs down, substituting a bench under them.
4th stage
Strengthening the muscles of the legs. Exercises are carried out using an expander or a frog pump for inflating rubber mattresses. In a supine position, they do the exercise "imitation of walking" - the legs bend and unbend at the knees, the feet slide along the sheet.
5th stage
Walking. The patient from a sitting position tries to get up, holding on to a stable support - the back of the bed, a nearby chair or armchair. When the patient learns to stand confidently, he should begin to shift from foot to foot. Having mastered this exercise, you can move on to walking in place, holding on to the headboard. Then they try to walk in place without support.
Gymnastics after a stroke for the hands.
Simultaneously with exercises for the legs, it is necessary to develop the muscles of the hands. To do this, they assemble and disassemble pyramids, children's designers, cubes, and sculpt from plasticine. It is useful to shift objects with a sore hand, leafing through books, tightening nuts, fastening zippers, tying ribbons.
To relax the muscles, it is useful to lie on your back and dangle your paralyzed arm and swing it.
Gymnastics after a stroke for the development of the shoulder joint:
1. hands in the lock, raise them up, tilt them left and right
2. take a stick with both hands, lift it up, lower it behind your head.
At the same time, the diseased hand is passive, it is pulled by a healthy hand.

But the main thing in rehabilitation after a stroke is walking. Choose flat routes without climbs with benches for rest. Gradually increase the distance. The pace of walking is slow - 40-50 steps per minute. Rest every 5-10 minutes.
Do not spare the paralyzed side, because the idle muscles cannot be restored, so they must actively work.
(Conversation with the chief physician of the Center for Recovery and Rehabilitation of the First Moscow State Medical University Yu. K. Mokhrov from the newspaper "Bulletin of Healthy Lifestyle" 2011, No. 22, pp. 6-7)

Gymnastics after a stroke at home - Recovery reviews.

Simple gymnastics for bedridden patients
A 58-year-old man suffered a stroke. He knew that the only way for a bedridden patient after a stroke to become a full-fledged person is through daily exercise. There is no time to waste, you need to start exercising immediately, while still lying in bed, in order to overcome the consequences of a brain stroke.
You can start with the simplest exercises (1) and move on to more complex ones (10):
1. Raising a paralyzed hand, first you can help with a healthy hand, and even earlier, those who care for paralyzed patients after a stroke at home should raise the diseased hand.
2. Squeeze a clothespin with the affected hand, it will not work the first time, but it will work out on the tenth or hundredth attempt.
3. Lying down, squeeze the mattress with a sick hand and make circular movements on it.
4. After you get stronger and start to sit down, learn to write with your left hand.
5. Dip in water and wring out a rag. Over time, wipe the tiles in the kitchen and bathroom.
6. Squeeze a rubber ball with your hand to make it more pleasant to do - pierce it. Perform 100 repetitions.
7. Sculpt balls from plasticine.
8. To develop the legs, use a rubber ball, round sticks - you need to roll them with your foot on the floor, gradually increasing the pressure.
9. Rest against the wall with your hands (if the sick hand does not rise, help her with a healthy one), shift from one foot to the other.
10. Lean forward, touching the floor with your fingers.
The most important thing is to defeat apathy, laziness, the belief that you are no longer good for anything and will not be able to return to normal life.
A man has been doing these exercises for three years, as a result, he learned to serve himself, walks freely around the apartment, and on the street with a stick, he learned to write with his right hand, on which, after a stroke, he could not even move his fingers. (Healthy lifestyle 2003 No. 17, p. 10)

Exercise after a stroke
After a stroke, the son took the woman to his home, she began to do gymnastics in the hospital - the doctors showed her a set of exercises. Soon the exercises seemed too easy. She asked her son to find more large buttons, there were 17 pieces. They were dumped into a pile, and the woman carried them with one paralyzed hand to another pile at a distance of 30-50 cm. Then she did the same exercise with matches, then she learned to put the spilled matches into a box.
A table was placed near the patient's bed so that she could learn to get up and walk leaning on it. Over time, she was able to walk around the apartment, holding on to the wall.
The paralyzed arm after a stroke was very swollen, the woman bandaged aspen pegs to it, and the swelling went away. Also, a paralyzed hand can be tied to the neck so that it is less below, so it almost does not swell.
The patient had a strict routine - 3 times a day exercises, exercises with buttons, exercises with matches, long walking around the apartment. Soon she learned how to peel potatoes and cook soup for the arrival of children. To develop strength in a paralyzed arm, she carried in a bag first half a loaf of bread, then a whole loaf.
Now, 4 years after the stroke, her main exercise is “Kalmyk yoga”, she does 30 squats daily. Previously, an ambulance was called 2-3 times a month, now the pressure has returned to normal, and we have managed to give up the pills.
A wish for those who have experienced a stroke: work slowly and hard, work and work within your capabilities. Movement is life, while we move, we live. The main thing is not to lose heart, always set a goal and achieve it. (HLS 2006, No. 23, p. 18,)

Walking and gymnastics helped to recover from a stroke
A man in 19955 was in the hospital with a diagnosis of stroke. The left side was paralyzed. The memory was gone for 8 days. 41 days after the stroke was in the hospital. I couldn't sit, I couldn't hold a spoon, I couldn't eat, because my mouth hardly opened, I only drank, my head hurt a lot.
When the hands began to act a little, he began to rise on the bed with the help of a rope with knots tied to the headboard. Sat for two minutes. After some time, he began to lower his legs from the bed, he immediately felt relieved, because the blood began to flow into his legs. I did this exercise several times a day. He began to roll the roller with his feet, plus a foot massage. Feel a little better, appetite appeared.
When he was discharged home, he began to learn to walk, first around the house, holding on to the wall and with a cane. A month later, he asked to go outside. There he decided to go alone to the next entrance, somehow he succeeded, sat there on a bench and on the way back. After that, his legs hurt all day, but the next day he walked 2 times more, and every day he increased the distance. A week later, I was already walking around the three-entrance house.
Then the patient asked to be taken to the village where he had a house built. There he every day 100 m to the farm and 100 m back. His legs became more obedient, but still he often fell. Soon he began to train his left paralyzed arm - he carried a bucket with 2 liters of water. At first with a rest, then he carried it to the end, without letting go of it, it was very hard - the fingers unbent and the bucket tried to slip out.
Gradually increased the distance - did 5 walkers daily - 1 km, then 2 km. Arms and legs got stronger, he began to work in the garden and at home, 12 years have passed since the stroke, the patient is now 70 years old, he emerged victorious from the fight with the disease.
(HLS 2007, No. 8, p. 8,)

Gymnastics after a stroke - a set of exercises for arms and legs.
A 65-year-old woman suffered a stroke, her right side was paralyzed. At first she fell into depression, wanted to die so as not to be a burden on the family, but her daughters convinced her to fight for life. And she began to fight.
At the hospital, doctors taught the patient to walk, moving a chair in front of her, at home she continued these classes, and as a result she was able to move independently.
Every day he does exercises for paralyzed arms and legs: exercises for the hand and finger motor skills, moving the abacus knuckles, rolling with sticks (smooth and spiked), rolling a tennis ball and rubber balls. He also collects pyramids with his right hand, puts 100 pencils from the table into a box, collects dominoes, squeezes the carpal expander, sorts through the beads with his fingers, shakes the “frog” with his right foot (a foot pump for inflating the chambers) 120 times, pulls the expander with his right hand - 200 times, sits down and stands on a highchair, holding on to the handrail - 50 times, reads aloud to restore speech.
There is a desire to reduce the number of exercises, but every time a woman pulls herself up and tries to increase them every month. Everyone is happy to celebrate small victories: the hand has already begun to clench into a fist, now it’s already possible to eat with a spoon in the right hand, etc ... (HLS 2002, No. 10, p. 3)

Gymnastics after a stroke - a set of exercises for the hands and fingers.
1. Drum your fingers on the table.
2. Make a “twine” with your fingers.
3. Widely spread, and then squeeze your fingers.
4. Put the brush on the table or on the bed. Raise each finger in turn, then raise the whole palm.
5. Holding a paralyzed hand with a healthy hand, raise a sore hand.
6. Putting your elbow on the table, hold your hand vertically, reach your palm with your fingers.
7. With your thumb, press on each other finger of the same hand.
8. Putting your palms together, rest each finger in turn on the opposite one.
9. Elbows on the table, palms together. Raise and lower your elbows, sliding them on the table.
10. Roll the rolling pin on the table with your palm.
11. Roll up the foam with your fingers.
12. Take the stick in both outstretched hands and twist it, intercepting, clockwise and counterclockwise.
13. Throw a stick from one hand to another.
14. Roll the ball with your fingers away from you and towards you.
15. As if twisting a light bulb, twist the ball clockwise and back.
16. Squeeze the ball between the palms and put pressure on it.
17. Toss the ball from hand to hand.

A set of exercises for the hands and the development of the shoulder joint.
1. Stretch your arms forward and put the diseased healthy arm, bending at the elbows. A "frame" is formed. We make turns, moving the "frame" to the left and right.
2. Lower and raise the hands in the lock, helping the paralyzed healthy hand.
3. With hands clasped in a lock, make circular movements.
4. Without disengaging your hands, rotate your shoulders back and forth.
5. Raise the hands clasped into the lock up, spread apart and lower.

Stroke - exercises for the legs.
1. Sit on the floor, unbend and bend your knees, sliding your feet along the floor.
2. Sitting on the floor, legs extended forward. Take your legs in turn to the side, sliding your feet along the floor.
3. Raise a straight leg and put it on the other.
4. Pull one knee to the chest, then the other.
5. Lying on your stomach, toes rest on the floor, tear your knees off the floor.
6. Crawl in a plastunsky way.
7. Sitting on a chair, roll your feet from heel to toe and back.
8. Sitting on a chair, spread and flatten your heels. Then lower your legs to your heels and bring them together - spread your socks.
9. Put the affected leg on the healthy one and rotate the ankle joint.

Breathing exercises after a stroke at home.

This breathing exercise helps with a variety of diseases, in particular, cerebral vascular sclerosis and stroke. Just a month of classes at home, and you will forget what sclerosis is, and stroke patients will gain hope for recovery. A 74-year-old woman, after reading an article about this gymnastics, practiced for almost 2 years. As a result, high blood pressure, which was not lowered by any medication, returned to normal, and her health improved significantly.

First you need to choose a position: either reclining in a chair or lying on your back. Relax and drop all thoughts. Close the left nostril with the left hand and inhale calmly, very slowly through the right nostril. Take a deep breath so that the chest rises. Then close the right nostril, freeing the left. Do not breathe as long as possible, endure with the last of your strength. This is the point of the exercise. Then begin to exhale through the left nostril. Repeat the exercise 5-7 times. Then we do the opposite: inhale through the left, exhale through the right nostril, also 5-7 times. This is 1 cycle. Such cycles should be done 3-5 times.
After about a week in the solar plexus area during the exercise, you will feel a slight tingling and warmth. After 2 months, your abdominals will become elastic like a drum. All this suggests that the exercises are going correctly and are beneficial (HLS 2011, No. 9, p. 19)

Exercise "Kalmyk yoga".
Many senile diseases are associated with impaired cerebral circulation. Patients fight these diseases with the help of breathing exercises according to the methods of Strelnikova, Budeiko, Frolov. These systems have one thing in common: the content of carbon dioxide in the blood increases, and this increases the blood flow to the brain and heart, dilates blood vessels. The exercise “Kalmyk yoga” works on the same principle.
There are cases when the exercise "Kalmyk yoga" completely removed the diagnosis of "diabetes", many people significantly lower their blood pressure (from 190/100 to 140/90). But you need to practice every day for 2-3 years. This is a long time, but this exercise will not only save you from recurrent stroke and heart attack, but also completely rejuvenate and strengthen the body.
“Kalmyk yoga” is squats with breath holding and the torso tilted parallel to the floor. When performing the exercise, the bases of the thumbs close the nostrils. You should do 10-15 sets of 20-60 squats.
The man suffered a heart attack, his wife showed him an article about Kalmyk yoga. He began to exercise every day, gradually gave up all medications, the pressure returned to normal, his health became perfect. (Healthy lifestyle 2003 No. 3, p. 23)

Massage after a stroke at home.

Acupressure after a stroke.
A man at work had a stroke. The right side of the body was taken away, swallowing functions disappeared. Hospital, injections, tube feeding... 10 days have passed, and there was no improvement. Then the wife got down to business, who decided to use folk remedies. Daily gave 8 teaspoons of blue iodine on jelly during feeding. As a result, 4 days after that, he began to swallow on his own. From Gavaa Luvsana's book "Essays on Oriental Reflexology Methods," she wrote out points on the meridians that should be massaged in case of a stroke. First, the right foot warmed up, which was icy, then the right side began to function. As a result, the man again went to work (HLS 2000, No. 24, p. 7)

Massage after a stroke helped to recover.
A woman who has been giving massages at home to people for 25 years already wrote to the newspaper. Her main patients are bedridden patients paralyzed after a stroke. When she came to another patient for the first time, she decided that no massage would help here. The woman was very heavy - she did not speak, did not move, did not think, did not understand where she was and what had happened to her.
For the first six months after the stroke, the patient was massaged daily. And then courses 2 times a year.
3 years have passed after the stroke, her speech and memory have returned to her, now she is learning poems and reciting them by heart, knitting socks, planting flowers, doing everything around the house herself, doing gymnastics.
The masseuse did not have such patients yet, usually lazy patients who did little to heal themselves came across. In order to defeat the consequences of a stroke, one must simply not be lazy.
Employees of the editorial office of the newspaper "Herald Healthy Lifestyle" called this patient to find out the secret of the cure. It turned out that there is no secret, but there is an amazing fortitude and perseverance. “I don’t give myself a moment of rest, I do something all day long. Sometimes I get so tired that I have no strength, I want to lie down, but I can’t, I have to move, move and move. The only indulgence is to lie down after dinner for 15 minutes, ”the patient said by phone. (HLS 2009, No. 9, p. 9)

Massage and gymnastics for stroke prevention
In Russia, 400,000 strokes occur annually. The reasons are stress, deterioration of blood circulation in the vessels of the brain.
To manage yourself and cope with stressful situations, it will help relaxation exercises. It is necessary to sit comfortably, close your eyes and be alone with yourself for 10-15 minutes. Do this exercise 2-3 times a day.
To increase cerebral circulation and avoid stroke, it is useful to do head massage.
1. With fingers clenched into a fist, you need to stroke your head from the forehead to the back of the head and neck, and then in the opposite direction (2-3 times)
2. Beat the whole head with fingertips for 1-2 minutes
3. With fingertips, beat whiskey and cheeks for 1-2 minutes
4. Rub your ears with your palms.
5. Rub the left shoulder with the right hand
6. Rubbing the right shoulder with the left hand

To improve cerebral circulation at home, it is useful to do vibro-gymnastics. Stand on tiptoe and drop sharply, hitting the heels on the floor. 20 concussion-lifts with the vertical position of the head, 20 - with the head tilted to the right, 20 - with the tilt to the left and 20 - with the head tilted forward. (HLS 2002, No. 24, p. 12)

Healing rubbing after a stroke.

Rubbing for those who have had a stroke.
This tool helps to restore body mobility to bedridden patients after a stroke. To prepare the rub, you need to take the following dry crushed ingredients: half a glass of black radish peel, 1/2 cup horseradish leaves, 2-3 hot pepper pods, 1/4 cup walnut partitions, 1/4 cup pine nut peel. Put all this in a jar and pour 500 ml of alcohol or triple cologne. Infuse the mixture for 7-9 days. Rub the entire body of a paralyzed patient dry from head to toe. (HLS 2000, No. 14, p. 12)

You can limit yourself in tincture to only black radish peel and hot capsicum (HLS 2010, No. 14, p. 19)

Movement is the key to life, even in the case when a person is not able (partially or completely) to move independently.

That is why it is so important to change the position of the body of a bed patient several times a day, if possible, go for a walk using special means of transportation, such as a wheelchair, and also apply the so-called passive gymnastics.

What is passive gymnastics?

Passive gymnastics are exercises that are performed with the help of extraneous force without the participation of the patient's muscular system.

A logical question may arise: why, in fact, do we need movements in which the human muscles still do not work?

The answer is simple: such manipulations provide vital processes in the patient's body, namely:

They have a beneficial effect on the functioning of the cardiovascular system, including by accelerating blood circulation;

Provide the necessary ventilation of the lungs and thereby prevent the occurrence of congestive pneumonia;

Activates the central nervous system due to irritating mechanical effects on peripheral nerve endings;

Improve bowel function and prevent constipation;

Actively help in the fight against bedsores.

Who can do passive gymnastics?

Passive gymnastics is related to massage. Of course, the manipulations performed by a professional will be as competent as possible from a medical point of view and therefore most useful for the patient.

However, it is not always possible to regularly resort to the services of medical personnel, and meanwhile, the patient needs passive gymnastics every day, and even more than once.

That is why it is important for relatives of the patient to master the basics of passive gymnastics in order to be able, first under the supervision of a doctor, and then independently help a bedridden patient.

Basic principles of passive gymnastics

Passive gymnastics, like massage, should be as delicate as possible. Follow a number of simple rules so as not to harm a sick person:

If the patient is able to speak or otherwise express his emotions and feelings, make sure that he does not experience discomfort, and even more so pain.

All passive gymnastics exercises should be carried out according to the “bottom-up” principle, that is, massaging the arms or legs, we start from the fingertips and gradually rise up.

Avoid sudden movements, as well as movements of large amplitude.

During passive gymnastics, as with massage, you can use creams and ointments, including warming ones, if there are no contraindications from the attending physician.

Do not do passive gymnastics immediately after eating. Wait at least 1-1.5 hours.

We draw your attention to the fact that all the above rules and exercises are advisory in nature! A set of exercises for passive gymnastics, as well as drug treatment, can only be prescribed by the attending physician.

Working on different parts of the body

As mentioned above, passive gymnastics is designed for all parts of the body, except for those that need immobilization (for example, injured limbs). So, let's get to the exercises.

Arms

Let's start with the gymnastics.

We knead each finger from the base up, then gently bend and unbend the fingers;

Let's work on the brush. To do this, we will enclose the hand of a sick person in a “lock” and make several circular movements in one direction and the other;

Let's move on to the elbow: carefully bend and unbend the arm at the elbow, and then make several rotational movements of small amplitude in both directions. Performing the exercise, we fix the elbow with one hand, and the hand with the other;

Forearm and shoulder. Raise the arm up several times and take it to the side at a slight angle, holding the elbow and hand.

Legs

Passive gymnastics of the legs is carried out by analogy with the hands: we work out the fingers, feet, knees and hip joints in turn. Separately, you can massage the foot, calf muscles and thigh.

Then, without taking your feet off the bed, bend the patient's leg at the knee by 90 ° or a little more, and then return it to the prone position in the same way. The scissors and bicycle exercises will also be useful.

Head

Carefully clasping the head of the patient with your hands, turn it to the right and left, and then tilt your head to one shoulder and to the other;

Press your head to your chest, and then take it back;

Gently massage the trapezius muscle;

Run your fingers over your face and closed eyelids.

Muscles of the abdomen and chest

These parts of the body need to be worked out especially carefully. The main manipulations in this area will be:

planar, embracing (in the chest) and forceps (in the abdomen) stroking;

circular rubbing with palms and fingertips;

transverse and longitudinal stretching.

Begin and end the massage of the chest of the abdomen with stroking. This massage improves blood circulation and digestion, prevents the formation of constipation and congestion in the lungs.

Be close to those who need your support and help so much!

When caring for bedridden patients, regular massage deserves special attention, in the absence of contraindications from doctors. Bedridden people face the problem of deterioration in the quality of tissues, skin and muscles. These changes can cause pain. and affect the normal functioning of internal organs. Also, with a constant horizontal position, bedsores may begin to develop.

Indications for the use of massage: a stroke or surgery, exacerbations in a state of health that require constant bed rest, oncological diseases, some types of chronic diseases - heart failure, disorders in the stomach and other internal organs. Such patients are accepted in the Moscow region.

Service prices

The effect of massage

Regular massages for a bedridden patient not only improve the condition of the tissues in the massaged area, but also have a beneficial effect on the entire human body.

After the massage, you can notice the following positive effects:

• Increased muscle tone;
• The work of the gastrointestinal tract, urinary system, heart, etc. improves.
• Edema significantly decreases or completely disappears;
• Blood circulation improves and internal organs receive more oxygen;
• The healing process is greatly reduced.

Massage is very necessary in cases where the patient has a hope to return to a normal lifestyle and get back on his feet. The use of complex therapy in this case will help to significantly shorten the recovery process and achieve the desired result faster.

Massage techniques

For each bedridden patient, depending on the cause of his illness, the necessary set of massage procedures is individually selected.

For example: patient who has had a stroke, at first it is necessary to massage only in the area of ​​​​paralyzed limbs. Such actions improve lymph flow. The use of general massage is possible only at the stage of late recovery. Also, together with massages, a passive type of therapeutic gymnastics is used.

For patients after surgery, most often they use light stroking and rubbing, without resorting to intense exposure. At the initial stages of recovery, massage is performed near the seam; over time, it is possible to connect massage in other areas in order to normalize the functions of all body systems.

For the prevention of bedsores in bedridden patients, it is necessary to massage in the region of the spine and shoulder blades. Such sessions are indicated for almost all bedridden patients.

Care for bedridden patients in the boarding house "Edem" in Moscow