Neurorehabilitation » Rehabilitation after stroke » Restoration of coordination and gait
Restoration of coordination and gait
One of the complex tasks in stroke rehabilitation is restoration of a stable body position and gait. In severe cases the first measures of mobilization aim to improve the balance in the sitting position and the ability to stand while holding to some object. Patients with unilateral paralysis can stand up thanks to even distribution of the force load on the body muscles. Patients with severe injuries use a walking training machine. Belts provide security. Legs are fixed on two platforms, which correspond with their movement when the patient is walking. Special mechanisms help to conduct vertical and lateral movements with the body. Later on, other physiotherapeutic methods are used for restoration of walking. If the corpus of the patient is not stabilized, second doctor is needed to fixate the pelvis of the patient while first controls the knee of the paralyzed leg at the same time.
Walking problems often arise when a patient straightens the leg in the knee and hip joints or when the leg is hanging. As a result, patients can develop a Wernicke-Mann walk characterised by raising of the hip and flapping of the foot when walking. To avoid development of this defect, special measures should be taken during the recovery period. When a patient is raising a leg, a roller is put under it. A special prosthesis can also be used to improve the (gait ), and make it more confident. Doctor use the valenser tire, in spastic paralysis cases. The tire provides relaxation to the upper ankle joint region. This positively affects the extension/flexion of the limb. Alternatively, lightweight carbon tires can be used as well. If the damage to the leg is not very severe, doctors may use a bandage as a substitute to the tire.
Additionally, functional electrotherapy (electrophoresis of Peronaeus-Orthese, FEPO) is also effective. The principle of its functioning is similar to the method described above. Patients train their perception of movement. By observing the patients, the specialists can determine whether a patient should walk with a cane, crutches or walkers.
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