Postoperative nursing and training of disabled limbs
From the perspective of rehabilitation, amputation is not only a destructive operation, but also the beginning of functional reconstruction. By cutting off harmful or useless limbs, and reassembling artificial limbs, artificial limbs can replace some functions of the amputated limbs, so as to achieve the purpose of self-care life and return to society. After amputation, in order to eliminate the swelling of the residual limb, set the model as soon as possible, treat the disease of the residual limb, increase the range of motion of the residual joint, strengthen the muscles, and meet the good conditions of the residual limb needed for the assembly of the prosthesis, it is not always necessary to timely care and train the residual limb. This is also an essential link in the rehabilitation treatment of amputees. The following introduces several main methods of disabled limb nursing and training. Elastic bandage is a traditional treatment. It is a key step to prevent or reduce the swelling and excessive fat tissue of the stump and promote the maturity of the stump. The following aspects should be paid attention to when bandaging: (1) locm wide elastic bandages with a length of 2-4m should be used for the leg stumps and 12.5-5cm wide elastic bandages for the thigh stumps. (2) In the winding process, it is wrapped 2-3 times along the long axis of the stump, and then it is wound up as spiral as possible. For the stump of the leg amputation, it should be wound to the pelvis; for the middle, short and long stump of the leg amputation, it should be wound to the thigh. (3) It can't be removed even at night, but it should be changed 4-5 times a day. (4) The elastic bandage should be tightened to the end of the stump, and should not be neglected. Pictures related to this topic physical therapy according to different complications of the disabled limb choose different physical therapy methods. Generally speaking, physical therapy can effectively improve the health status of the body, prevent and reduce the contracture of the residual limb, enhance the muscle strength of the residual limb, improve the range of joint activity, and improve the coordination of movement through the residual limb and whole body training. This not only creates a good condition for the prosthesis assembly, but also lays a foundation for the prosthesis to recover its self-care and working ability. To maintain the normal posture (1) after amputation of one side of the lower limb, the pelvis tilt and scoliosis are often caused due to the imbalance of the limb. Once the deformation is fixed, the gait and walking ability will be greatly reduced after the prosthesis is is installed. In order to solve this problem, the methods of correction training in front of mirror and early assembly of temporary prosthesis are often used. Figure 2. The bad limb position that must be avoided (2) the original muscle balance of the thigh is broken after the amputation, and there are bad positions of flexion, abduction and external rotation after the amputation. Attention should be paid to correct and avoid all kinds of bad positions. (3) There is a tendency of knee flexion after leg amputation. In order to reduce the pain, patients often unconsciously take the bad posture that promotes this trend. In this way, it is easy to make the residual limb joint produce the flexion contracture which is very disadvantageous to the assembly of prosthesis. Therefore, from the next day after amputation, it is necessary to keep prone several times a day and absolutely avoid all kinds of bad postures. In order to train the amputees, we should strengthen the flexor and extensor muscles of the knee joint, especially the extensor muscles, so as to gradually strengthen them after wearing the prosthesis. The following figure is some basic methods for amputees to train the amputees. Because of the long-term bed rest and the elderly patients, the reduction of trunk muscle strength is very significant. It is very important to enhance the trunk muscle strength in order to obtain the walking endurance of the prosthesis and maintain a good gait. It should be based on the training of abdominal and back muscles, supplemented by the trunk's rotation, lateral movement and pelvis lifting. The training of healthy side leg is very important for improving the walking balance. (1) Healthy leg standing training: after lower limb amputation, the pelvis of the residual side mostly inclines downward, resulting in scoliosis, and the prosthesis side is always longer when the prosthesis is is initially installed. For this reason, it is necessary to do standing training in front of the mirror, mainly focusing on correcting the posture and aiming at keeping standing for 10 minutes without support. (2) Continuous one legged jump: for patients with one side of lower limb amputation, one legged jump is often encountered in daily life. However, after long-term bed rest after amputation, many patients are difficult to perform one legged jump. Moreover, it is also important to enhance the muscle strength of the healthy leg and obtain the balance and stability of the healthy leg. In training, in order to avoid monotony and dullness, if volleyball, table tennis and other ball games are used, the effect will be better. (3) Knee flexion and extension in standing position: This is a very useful training for the stability of up and down steps and the change of posture. The goal is to flex and extend the knee joint at least 10-15 times in a row. It is difficult to do without support at the beginning, but after three weeks of training, it can generally reach the level of 30-70 times. You can also take the thigh half bow, each time for a few seconds, as an auxiliary training.