Thursday, April 21, 2011

Passive change from sitting to lying position

[Method] The patient sits as straight as possible. The hand on the healthy side grasps the hand on the affected side and is laid on the healthy side of the abdomen. The foot on the healthy side is placed in a position posterior to the foot on the affected side. The doctor or nurse stands before the patient and holds the patient's shoulders with both hands, slowly turning the body to the healthy side and bending the elbow on the healthy side to support it. At the same time, the foot on the healthy side leads the foot on the affected side to lift up. The doctor or nurse helps the patient to move the lower limbs to the bed with one hand, and prevents the patient's upper part of the body from leaning continuously backward with the other hand. This enables the patient to lie on the bed gradually and sequentially with his waist, back, shoulders and head. The patient then stays in a functional lying position.


[Effect] To exercise the muscles responsible for bending the shoulder and elbow joints and adducting and bending the hip joint on the healthy side, as well as the neck, back, waist and abdominal muscles; and to prevent atrophy due to disuse.


Active Change From A Lying Position To A Sitting Position


[Method] The patient lies face up. The hand on the healthy side grasps the hand on the affected side and is laid on the abdomen. The foot on the healthy side is put under the foot on the affected side in a crossover position. The former leads the lower limb on the affected side to the edge of the bed and turns toward the healthy side with the elbow on the healthy side supporting the upper part of the body. At the same time, the lower limbs continue to move out of the bed. When the lower limbs touch the ground, the patient stands up with both feet evenly on the ground. The doctor or nurse helps the patient keep a functional sitting position.


[Effect] To fully exercise the muscles responsible for extending the shoulder and elbow joints and stretching and abducting the hip joint on the healthy side as well as the neck, back, waist and abdominal muscles; to prevent atrophy from disuse; and to adjust and improve functions of the internal organs. The other effects are the same as those of the functional sitting.


Active Change From A Sitting Position To A Lying Position


[Method] The patient sits straight with the affected hand laid on the abdomen, the healthy hand on the bed and the healthy foot put behind the affected foot in a crossover position. Then, the patient slowly bends the healthy elbow to support the upper part of the body and enable it to lean slowly toward the healthy side. At the same time, the healthy foot leads the affected lower limb to the bed. Then, the patient continues to lean backward to enable the waist, back, shoulder and head to touch the bed sequentially. The doctor or nurse helps the patient keep a functional supine position.


[Effect] To exercise the muscles responsible for bending the shoulder and elbow joint and adducting and bending the hip joint on the healthy side as well as the neck, back, waist and abdominal muscles; to prevent atrophy from disuse; and to adjust and improve functions of the heart and brain vessels.


Functional Standing


[Method] The patient keeps both feet the same width as the shoulders; the feet are placed in a stable position on the ground. This is followed by stretching of the lower limbs, waist and back. The patient slightly raises the head and stares ahead without deviating the head and neck toward the healthy side; the lower limbs support the body in a balanced way. In doing functional  exercise, the upper limbs hang down in a natural manner. At ordinary times, the affected limb is suspended before the chest with a triangular towel. In the early period, the patient can stand up with the healthy hand grasping a supporter.


[Effect] To train the balancing function of the brain; to strengthen the myodynamia of the lower limbs, back and waist; to prevent atrophy from disuse, deformity of the lower limbs and foot droop and inversion; and to adjust and improve the functions of the internal organs, especially the heart and brain vessels.


Passive Change From A Sitting Position To A Standing Position


 [Method] The patient sits straight in a functional posture. The doctor or nurse stands on the patient's affected side with both hands supporting the patient's affected knee and waist, slowly lifting the waist to enable the upper part to lean forward, slowly lifting the buttocks off the chair and slowly stretching the lower limbs, neck, waist and back of the patient. The doctor or nurse should take care to fixate the affected knee to prevent anterior bending or over-stretching and collapse of the body. Then, the doctor or nurse helps the patient stay in a functional standing position.


[Effect] To exercise the muscles responsible for stretching the hip and knee joints and the neck, waist and back muscles; and to prevent spasms of the hip joint, knee joint and spine. The other effects are the same as those of the functional standing position.


Passive Change From A Standing Position To A Sitting Position


[Method] The patient stands in a stable position in a functional posture. The doctor or nurse stands on the affected side of the patient and holds the affected knee and waist with both hands. The patient slowly bends the head and the waist, leaning the upper part of the body forward, slowly bending the hip and knee, shifting the body in a posterior direction and slowly sitting down. The doctor or nurse helps the patient to remain in a functional sitting position.


[Effect] To exercise  the muscles responsible for bending the hip and knee joints and the waist muscles and to improve the functions of the joints on the lower limbs. The other effects are the same as those of the functional sitting position.


Active Change From A Sitting Position To A Standing Position


[Method] The patient sits straight in a functional posture. The affected upper limb is suspended before the chest, keeping it from deviating medially and laterally. The patient bends the head and waist, leaning the upper part of the body forward and lifting the buttocks off the chair, stretching as hard as possible the hip and knee, raising the head, and slowly straightening the waist into a standing position. The doctor or nurse helps the patient to remain in a functional standing position.


[Effect] To fully exercise the muscles responsible for extending the hip and knee joints as well as the neck, waist, back and abdominal muscles; and to prevent stiffness and spasms of the joints of the lower limbs.


Active Change From A Standing Position To A Sitting Position


[Method] The patient stands in a functional posture, slowly bending the head and waist, leaning the upper part of the body forward, slowly bending the hip and knees and shifting the body in a posterior direction slowly into a sitting position. The doctor or nurse helps the patient to remain in a functional sitting position.


[Effect] To fully exercise th


e muscles responsible for bending the hip and knee joints, as well as the waist muscles; and to improve the functions of the joints of the lower limbs. The other effects are the same as those of the functional sitting position.


Functional Walking


[Method] The patient suspends the affected upper limb with a triangular towel before the chest; the center of the body is shifted to the healthy side, raising the head, stretching the waist, bending the affected hip and knee, lifting the foot, dorsally bending the ankle joint as much as possible, taking a small step forward, stretching the hip and knee with the sole in a stable position put on the ground, swinging the healthy arm forward and shifting the center of the body to the affected side. With the same method, the healthy lower limb takes a big step forward. The center of the body is shifted to the healthy side and the affected lower limb is swung forward parallel to the healthy lower limb. The affected lower limb takes another small step forward with the repetition of the methods above to walk straight forward while maintaining balance.


[Effect] To fully exercise the muscles responsible for bending the hip, knee and ankle joints, and improve the physiological functions of the brain, especially the balance and directional functions.


Passive Change From A Standing Position To A Walking Position


[Method] The patient stands in a functional posture with the affected upper limb suspended before the chest and the center of the body shifted to the healthy side. The doctor or nurse stands by the patient's affected side with both hands holding the knee and waist on the affected side to help the patient slowly bend the affected hip and knee, lift the foot and dorsally bend the ankle joint as much as possible. The patient then slowly takes a step forward, extends the hip and knee with the sole in a stable position on the ground. At the same time, the healthy arm is swung forward and the center of the body is shifted toward the affected side. Then, the healthy lower limb takes two small steps forward to keep parallel to the affected lower limb. The doctor or nurse should take measures to fixate the affected knee to prevent it from anterior bending or over-stretching and leaning to the affected side. The patient then walks in a stable manner forward, with the repetition of "affected side, healthy side, healthy side; affected side, healthy side, healthy side..."


[Effect] To exercise the muscles responsible for bending and extending the hip, knee and ankle joints, and to improve the balancing function of the brain.


Active Change From A Standing Position To A Walking Position


[Method] The patient stands in a functional posture with the affected upper limb suspended before the chest. At the beginning, the patient holds a fixated transverse pole with the healthy hand and walks forward with the affected limb in the fashion mentioned above (see the section on functional walking). Gradually the patient walks alone without support of the pole. The doctor or nurse should walk by the affected side to take care of the patient.


[Effect] To fully exercise the muscles responsible for bending and extending the hip, knee and ankle joints; and to adjust and improve physiological functions, especially the balance and directional functions of the brain.


The TCM approach is fundamentally different from that of Western medicine. In TCM, the understanding of the human body is based on the holistic understanding of the universe as described in Daoism, and the treatment of illness is based primarily on the diagnosis and differentiation of syndromes.

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