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>> Orthosis in rehabilitation treatment for hemiplegia II
(A) The purpose of orthopedic brace for patients with hemiplegia
Hemiplegic patients has the constant change for functional state from the onset of injury.There are a lot of patients who change from flaccid paralysis gradually more to spastic paralysis.
The purpose of prescription for orthopedic brace is different from the beginning as some patients has relative complications like muscle contracture and deformities in the chronic phase.Mainly in the early stages the purpose is stable keeping body weight,recovering,supplementing and compensating the function ; and in the chronic phase the main purpose is suppression of contracture and correction and prevention of deformity.
1 main purpose of lower limb orthosis
(1) to obtain a stable stance. (2) easily out of bed early training. (3) get close to normal walking pattern. (4) the prevention of deformity. 2, upper limb orthotics main use of complementary and compensatory purposes (1) function. (2) Prevention and correction of deformity (3) of the auxiliary and control movement. (4) maintain limb fixation and limb position.
1.Lower limb orthosis
The common orthopedic braces for hemiplegia patients includes knee-ankle-foot orthosis, knee orthosis, ankle foot orthosis.
(1)knee-ankle-foot orthosis
Patients stroked with a moderate and severe hemiplegia in Class I and class II who have the dysfunction of advanced brain such as aphasia, spatial agnosia,in addition to serious dysfunction of body movement and feeling. That is difficult for patients with severe hemiplegia to recover from rehabilitation due to the severity and complexity of dysfunction.In recent years, the proposed concept of the "therapeutic" orthosis is for patients with severe hemiplegia in early rehabilitation. Use of knee-ankle-foot orthosis and exercise therapy are in close connection,that promote the function recovery of lower limb motor.Patients with severe hemiplegia use with knee-ankle-foot orthosis in early therapy training.
It may help patients stand out of bed early,promote positive support reaction, stimulate proprioception, reconstruct equilibrium reaction mechanism. Meanwhile the knee-ankle-foot orthosis can keep the knee in slight flexion of 15-25 degrees , which can promote weight-bearing for lower limb , and induce and stimulate quadriceps contractile activity. Standing training can prevent muscle contractures and joint deformities as well as contralateral lower limb muscle atrophy, improve heart and lung function and increase the confidence of patients after using knee-ankle-foot orthosis.
Therefore, the use of lower limb orthosis is the specific self-rehabilitation thought of being early out of bed ,walking and ADL.Especially it can promote lower extremity sports and walk function,recover and prevent the trophy effectively for patient with severe hemiplegia. Knee-ankle-foot orthosis can control knee and ankle joints, which can supplement and compensate the lateral weakened knee, knee flexion and knee hyperextension and so on,that ankle-foot orthosis can’t.
(B) Classification and applications of orthopedic brace for patients with hemiplegia
1.Lower limb orthosis
The common orthopedic braces for hemiplegia patients includes knee-ankle-foot orthosis, knee orthosis, ankle foot orthosis.
(1)knee-ankle-foot orthosis
Patients stroked with a moderate and severe hemiplegia in Class I and class II who have the dysfunction of advanced brain such as aphasia, spatial agnosia,in addition to serious dysfunction of body movement and feeling. That is difficult for patients with severe hemiplegia to recover from rehabilitation due to the severity and complexity of dysfunction.In recent years, the proposed concept of the "therapeutic" orthosis is for patients with severe hemiplegia in early rehabilitation. Use of knee-ankle-foot orthosis and exercise therapy are in close connection,that promote the function recovery of lower limb motor.Patients with severe hemiplegia use with knee-ankle-foot orthosis in early therapy training.
It may help patients stand out of bed early,promote positive support reaction, stimulate proprioception, reconstruct equilibrium reaction mechanism. Meanwhile the knee-ankle-foot orthosis can keep the knee in slight flexion of 15-25 degrees , which can promote weight-bearing for lower limb , and induce and stimulate quadriceps contractile activity. Standing training can prevent muscle contractures and joint deformities as well as contralateral lower limb muscle atrophy, improve heart and lung function and increase the confidence of patients after using knee-ankle-foot orthosis.
Therefore, the use of lower limb orthosis is the specific self-rehabilitation thought of being early out of bed ,walking and ADL.Especially it can promote lower extremity sports and walk function,recover and prevent the trophy effectively for patient with severe hemiplegia. Knee-ankle-foot orthosis can control knee and ankle joints, which can supplement and compensate the lateral weakened knee, knee flexion and knee hyperextension and so on,that ankle-foot orthosis can’t.
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