Rehabilitation methods of sequelae of apoplexy

Apoplexy is divided into 2 types of “apoplexy involving meridians and collaterals” and “apoplexy involving viscera” in TCM. The main clinical manifestation is hemiplegia, namely paralysis of unilateral limbs. Therefore, the disease is also called “ban shen bu sui (hemiplegia)” in TCM.

Rehabilitation methods

1. Functional training

When the patients gradually restore their functions of limbs and the body, they may be supported to practice some simple free activities in bed such as getting up, raising arms, lifting legs and lifting feet. The patients should leave the bed as early as possible to practice standing and slow walking. At the begging, the patients should be supported by the medical and nursing staff to practice these activities. Then gradually increase the amount of exercise from the moment the patients use the walking stick to the moment the patients stop using it. Or the patients may do some knitting by hand to have functional training. The patients with stiff tongue and non-fluent speech may say simple words during the training. Then practice saying longer sentences gradually.

2. Acumox

Acupuncture:

Select CV6, CV4, ST36, BL23, KI3, SP10 as the main acupoints;

LI15, LI10, LI11, TE5, LI4, GB30, GB31, GB34, BL58, LI16, GB39 as the adjunct acupoints.

Select 3 to 4 main acupoints and adjunct acupoints respectively. Adopt the reinforcing method when needling CV6, CV4, BL23, ST 36, and GV4. Apply the reducing manipulation while puncturing KI3 and SP10 as well as the acupoints of limbs. Add ST40 and SP9 in the case of phlegm and dampness due to splenic asthenia.

Acupoint injection:

Inject 4ml of magnesium sulfate injection or injection of compound Danggui, 1ml each acupoint. As for the upper limbs, select PC6, LI11, and LI10; as for the lower limbs, select SP6, ST37, GB34, BL57. Select 2 acupoints from the upper and lower limbs respectively each time. First, puncture the acupoints with the syringe needle while injecting the medicine to enhance the stimulation until there appears the sensation of soreness and distension. Then inject the drug. Inject the drug once every other day, and five times in succession constitute one course of treatment. Assume the second course of the treatment after three-day rest. Stop the treatment when the muscular strength of the affected limbs reaches degree four during the treatment.

3. Massage

Shift the manipulations from gentle ones to heavy ones, and increase the strength gradually as the patients adapt to the methods until no muscular spasmodic contraction is caused. Generally, use the rubbing method first, and then gradually shift to kneading method, proceeding from the distal end to the proximal end of the limbs for five minutes. The massage points of the upper limbs include ST12, LI15, SI19, LI11, LU5, HT3, PC7, TE4, LI5, SI5, LI10, LI4; the massage points of lower limbs include ST30, GB30, GB29, GB31, ST36, GB34, SP10, BL40, BL57, KI3, BL60, ST41. Passive activities may be adopted at the same time in combination with massage. The doctors may guide the patients to have various passive activities for the affected limbs with the help of the healthy limbs.

When the muscle has slight autonomic activities, use forceful manipulations with kneading and pinching the muscle as the main manipulations. Reduce acupoint massage, but still massage more on the acupoints of the yang-ming meridians such as LI10, ST36. The patients should mainly have sports events and medical training after the adjunct massage when the limbs restore autonomic activities, but resistance still exists in the muscle. It is advisable to knead and pinch the muscle, strike and pat the whole limbs to promote the excitability of tissues. At the end of the activities, it is suitable to massage with the kneading, rolling and palm-pushing manipulations from the distal end to the proximal end. The manipulations may promote muscular relaxation and venous return.

(To be continued)

Written by Wangxudong

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