En este breve artículo quiero darte algunos consejos prácticos sobre cómo levantarte de una silla o una silla de ruedas.
Decidí sacar un pequeño extracto de la guía de video , porque ayer estaba en el grupo abierto de Facebook , y uno de los miembros nos estaba diciendo que su padre se levantó de la silla y se rompió el hueso del húmero izquierdo precisamente el en el lado hemipléjico.
Realmente es una pena porque trabajaron muy bien con los ejercicios neurocognitivos, y en el brazo de su padre la hipertonía había disminuido bastante y había mejorado su sensibilidad allí.
Por lo tanto, esto retrasará el proceso de recuperación, ya que después de un golpe la batalla es difícil, por lo tanto, es mejor evitar al máximo los riesgos de caídas.
¡ATENCIÓN!
Guía en video para la recuperación de la hemiplejia derecha , este es un extracto de este video, por lo tanto, en casos de hemiparesia izquierda, debe tener cuidado de adaptar las explicaciones para el otro lado, por ejemplo, la posición de la caña y el terapeuta mientras él Está ayudando al paciente.
VÍDEO
Mientras tanto, quiero que razona sobre cuáles son los problemas que podrían determinar una caída al levantarse de una silla.
- Sensibilidad alterada
- Falta de “fuerza”
- Atencion reducida
- Espasticidad
- Técnica incorrecta
Sensibilidad alterada
Después de un golpe el lado afectado es menos sensible.
Por lo tanto, podemos decir que no recopilamos correctamente la información de la atmósfera que nos rodea a través de nuestro cuerpo.
We do not perceive our body’s weight correctly.
This causes that the activity of raising the foot, becomes a true problematic activity, since we have to stay little time in a position whose base support is wide then it is suddenly turned into a reduced one. In fact, while we are sitting, we support the “butt”, and the back only with our feet and an eventual cane with our feet.
We do not perceive the pressure under one of the two feet correctly.
To feel the pressure under the feet also means to be able to perceive instant by instant the displacement of our body, this information is vital in order to keep the balance or equilibrium. Let us imagine not perceiving the position of our joints or articulations correctly.
To know where exactly the feet are without seeing them, means how to displace and organize the weight without this information the getting up action is at risk.
This specifically happens in the case of a left hemiplegia, where the patient does not have a proper image of his medium line of the body. Let us imagine how complex it could be to move in an upright position having this difficulty.
Shortage of strength.
It is clearly one of the most evident aspects after a stroke, to have a noticeable lack of muscle recruitment, which determines a change in the execution of the action, in fact, the greatest part of the load will take place in the “healthy” side thus determining a lack of equilibrium by itself.
Reduced attention.
As we have reasoned in the past, the affected side is very often considered difficult, especially in the left hemiplegia cases. Imagine just for a second, getting on your feet not considering your homogeneous, symmetric, and uniform side of the body.
Spasticity.
Imagine having the ankle rigid and not achieving getting the heel on the floor, while you are getting on your feet and that the foot turns itself only supported on its external side, this in itself establishes a great reason of equilibrium loss.
Wrong technique.
Imagine having all these contemporary difficulties (some more evident, others diffused and if it is you who is reading the article, you know what I am talking about) the technique that you will adapt will surely be far away from the proper one. That is why in the next paragraphs, I want to share with you some suggestions in order to reduce at the utmost, the risk of falling while getting up from a chair or a wheelchair.
Suggestions about the technique.
My suggestion is to divide the act into three different phases in order to make its learning it easier.
Phase 1.
Displace yourself forward with your butt.
I tell you this because I have noticed a common tendency which consists in getting up from the chair while the center of gravity is still very backwards. To make it clear the butt is very backwards, thus determining an increase of the effort when the center of gravity is far from the legs which will have to do the action.
Therefore, the first step to move forward with the butt is to move it towards the edge of the chair, (obviously not much!)
Phase 2.
Arrange the symmetry of the joints/articulations.
As I have said, the hypertonia is an element that goes in favor of the equilibrium and participates from the first phases of the movement, in fact, the foot very often is not properly placed and supported on the floor, it is done only by its lateral part and the thigh could go towards the outside.
To stand up with the plegic articulation in this position will only make matters more difficult. Thus once displaced forward with the butt, it is necessary to put the thigh straight and lean the plegic foot on the floor very well, this can be done with the help of the articulations that can move without problems.
This is the most difficult phase because it is the dynamic.
First we have to consider the type of support we need
If all the above mentioned difficulties are present, it is advisable to have the activity monitored by a relative, since help is going to be needed and a lean point is also needed for the use of the superior articulation.
In more complex cases, a fixed lean point placed in front of the hemiplegic patient is going to be needed, and the relative’s help will be placed in the plegic opposite side, (take into consideration that in a moment of difficulty, the superior plegic articulation could determine articular problems)
In cases where this activity has certain autonomy by the patient, a lean point placed laterally to where he sits could be suggested, like the windowsill of a window, a table, or a box with the proper height. In case where there is more autonomy then a cane (tripod, quadripod, or single) can be used.
That said, the third phase is made up by a first movement where the back should be close to the knees, bending the chest forward and after that “pushing” with the feet from the floor to get up, paying attention to the fact that the whole body should be aligned (extending the knees, and the chest and head in one line).
General suggestion.
It is obvious that what I have told you is a more or less generic situation, which influences the technique; the suggestion is to minimize the risk of a fall and work aimed to the base of the problem.
- Improve the sensibility.
- Improve the attention.
- Improve the use of the muscles.
- Reduce the hypertonia
This is actually the work atmosphere where the neurocognitive rehabilitation is focused.
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