Year: 2018 | Month: May | Volume: 8 | Issue: 5 | Pages: 360-369
Evolution in Hemiplegic Management: A Review
Vandana Yadav1, Charu Gera2, Ravinder Yadav3
1Assistant Professor, Dept. of Physiotherapy, GJUST, Hisar-125001. Haryana. India.
2MPT Student, Dept. of Physiotherapy, GJUST, Hisar-125001. Haryana. India.
3H.O.D., Dept. of Physiotherapy, Arora Orthopedic Hospital, Hisar-125001. Haryana. India.
Corresponding Author: Vandana Yadav
Hemiplegia/ hemiparesis is the paralysis of either right or left side of the body with loss of functions. The main cause of hemiplegia is cerebrovascular attack (CVA) or stroke. Stroke is the third main cause of the death & disability in India. There are two major categories of brain damage in stroke i.e. ischemia & haemorrhage. The aim of rehabilitation in subjects with hemiplegia is to promote recovery of lost function, independence, and early reintegration into social and domestic life. Many stroke patients have a number of serious disorders such as hemiplegia, motor disturbance, sensory disability, and cognitive impairment. Stroke rehabilitation is the process by which those with disabling strokes undergo treatment to help them return to normal life as much as possible by regaining and relearning the skills of everyday living. Physiotherapy treatment includes conventional therapies & neurophysiological approaches. Conventional therapies(Therapeutic Exercises, Traditional Functional Retraining) comprises of: Range Of Motion (ROM) Exercises i.e. passive followed by active assisted, active then active resisted exercises, Muscle Strengthening Exercises to reduce flaccidity, Stretching techniques to reduce spasticity, Mobilization techniques, Fitness training & Compensatory Techniques. Neurophysiological Approaches: 1. Muscle Re-education Approach. 2. Neurodevelopmental Approaches: – Sensorimotor Approach (Rood, 1940S), Movement Therapy Approach (Brunnstrom, 1950S), NDT Approach (Bobath, 1960-70S), PNF Approach (Knot and Voss, 1960-70S). 3. Motor Relearning Program for Stroke (1980S). 4. Contemporary Task Oriented Approach (1990S). We conclude that above all the techniques, Bobath, NDT, PNF, Roods approach, speech therapy, robotic devices, balance training and kinesiotapping are effective in the improvement of patient’s condition.
Key words: Hemiplegia, stroke, assessment, positioning, physiotherapy management.