Paresis of the right foot is treated. Foot paresis: causes, symptoms, treatment of equine foot. Treatment of paresis with herbs
- a pathological condition associated with the weakness of some muscles. The main reason for this is a violation of the connections between muscle fibers and the nervous system. Moreover, paresis is not an independent disease, but a consequence of any pathology, for example, stroke, spinal cord injury or trauma.
Therefore, it should be understood that the treatment of paresis should never be carried out separately from the treatment of the disease that caused this condition. Along with exercise therapy, with paresis of the lower extremities, the doctor prescribes medication, massage and physiotherapy.
Basic exercises
The exercises performed will depend on which muscles are damaged. However, there are a number of universal exercises that can be performed by all patients with this diagnosis.
- Lying on your back. Raise your right leg and inhale, lower your right leg and exhale. Do the same movements with the other leg.
- Also on the back. Bend one leg at the knee and pull it in as much as possible in the chest. Stay in this position for a while, then stretch your leg. Repeat with the other leg.
- Lying on your back. Draw circles in the air, first with one foot, then with the other.
- Raising and lowering your legs using the block. It is important to monitor your breathing. When raising your legs, inhale, and when returning to the starting position, exhale.
- On the back. Turning the body to the right or left side with throwing the opposite leg to the side.
- Simulate swimming - make the movements with your feet like in water when swimming with a breaststroke.
- Lying on your back. Raise your leg and draw a circle with your toes in the air. After that, repeat with the other leg.
- Lying on your back, bend and unbend your toes. In this case, you must try to follow the sequence, that is, first bend the fifth finger, then the fourth, then the third, second and first. When extending the toes, it is advisable to spread them apart.
- Lying on your back. Pull your feet towards you. You can do it in turn, or you can do it with two legs at the same time.
- Turn the feet left and right. Can be performed both lying down and sitting.
- Bend and unbend the legs at the knee.
- Lying on your back. Stop right leg pull towards yourself, the foot of the left leg - away from you.
All exercises should be done very slowly, if you feel unwell, it is better to cancel all exercises. To perform passive movements, you need to use additional devices. Also, this may require the help of an instructor. The total duration of classes should not be more than 15 - 20 minutes, for weakened patients and lying patients - no more than 10 minutes. Each exercise must be repeated 3-4 times. At the same time, the patient should not experience fatigue, shortness of breath, or other signs that may adversely affect his health.
When to do
The peculiarity of exercise therapy is that you can perform exercises almost at any time of the day. This can be morning exercises, which have a significant positive effect on the body. Moreover, if the patient cannot get out of bed, he can perform them lying down.
This can be an independent lesson that is also conducted at home.
These can be classes in specialized centers of exercise therapy, under the supervision of an instructor. In this case, the breathing exercises, then the main, and the final part, which includes relaxation exercises.
It can be dosed walking on fresh air, or dosed ascents and descents along specially laid routes.
Contraindications
Exercise therapy may not always be prescribed for paresis of the extremities. This procedure, like many others related to human health, has its own contraindications, which must be remembered.
So, for example, the main contraindications should be considered the lack of contact with the patient due to certain mental disorders... Classes cannot be carried out in case of infectious diseases and intoxications. It should also be postponed for the duration of the exercise and when the patient complains of pain.
Other contraindications include:
- or risk of thrombosis.
- Embolism or risk of embolism.
- Bleeding or the threat of its appearance.
- Increased body temperature.
- Increased ESR.
- High blood pressure, especially when the numbers are 200 to 120 and above.
- All malignant neoplasms.
- Metastases.
This means that before starting to practice, it is imperative to consult with a specialist.
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Paresis of the left or right foot is a symptom of many diseases of the nervous system. The Yusupov hospital has created the necessary conditions for the treatment of patients with sagging feet:
- are used modern methods allowing to determine the cause of the paresis of the foot;
- an individual approach to the choice of a treatment regimen;
- application of modern medicines that have an effective effect and have a minimum spectrum side effects;
- innovative methods of physical rehabilitation.
The team of specialists of the rehabilitation clinic (exercise therapy instructors, physiotherapists, masseurs, reflexologists) works well, coordinates their actions. Professors, doctors the highest category at the meeting of the expert council, they discuss severe cases of the disease, collectively decide on the further tactics of managing patients with paresis of the foot. Psychologists, using the latest psychological techniques, restore the patient's mental balance, help to gain confidence in recovery and actively participate in the treatment process.
Causes and symptoms of foot paresis
A paresis of the foot is called a "flapping foot", "flapping foot" or "dangling foot". The cause of this condition is damage to the root of the fifth lumbar spinal nerve, which is responsible for the innervation of the extensor muscles of the foot. Patients with paresis of the foot feel better in boots or stiff high boots that do not allow the foot to sag. Walking in heels is problematic. Patients are often forced to use a stick. Inconvenience occurs when getting into the car and walking up the stairs.
Paresis of the foot with damage to the root of the first sacral spinal nerve can manifest itself in a slightly different way. Patients cannot stand on their toes. They walk, leaning on a sore leg, it is difficult for them to press the pedals of the car.
The cause of such conditions in most cases is a herniated disc of the lumbar spine, which causes compression and partial or even complete death of the roots. In the Yusupov hospital, the cause of the paresis of the foot is being investigated using magnetic resonance imaging. The study is carried out using modern tomographs from leading world manufacturers.
Benign positional paresis of the foot develops when sitting, crossing the legs. It disappears immediately after a change in posture or when walking. Diabetes, which is the cause of diabetic polyneuropathy, can lead to paresis of the foot without prior pain. A drooping foot develops when the patient has alcoholic neuropathy, a leg injury. The above reasons for paresis of the foot are easily established by doctors at the Yusupov Hospital using magnetic resonance imaging, which does not reveal a herniated intervertebral disc and compression of the roots of the spinal cord.
How to treat paresis of the foot
Patients often ask: "If a paresis of the foot is detected, what to do?" Paresis of the foot with a hernia of the spine cannot be cured using conservative methods. Only neurosurgical intervention, which is aimed at removing the hernia and releasing the affected root from compression, can help save the affected nerve or create the maximum possible conditions for restoring its function. Such an intervention under an operating microscope (microdiscectomy) is performed by leading neurosurgeons of partner clinics.
The rational time to complete the operation is limited. It should not exceed 7-10 days. Surgical interventions performed after a month or more do not give a clear clinical improvement. Can paresis of the foot be cured? Prescribing long-term conservative treatment to patients is an absolute mistake. This is the category of patients that should be dealt with by specialists in the field of neurosurgery. Neurologists, neuropathologists, vertebrologists, specialists in non-traditional methods of treatment at the Yusupov Hospital immediately involve neurosurgeons in the consultation. Recovery of foot function after surgery lasts 6-12 months.
Has anyone cured foot paresis without surgery? Paresis of the foot, which is not caused by compression of the roots of the spinal nerves, can be treated with conservative methods. Neurologists at the Yusupov Hospital prescribe an individual course of treatment for patients, taking into account the cause of the disease, age, gender and body characteristics. The course consists of at least five procedures.
How long is foot paresis treated? The restoration of the foot occurs within 4-6 weeks. The patient undergoes procedures 2-3 times a week. The course of treatment consists of the following procedures:
- resonant wave decimeter therapy;
- acupuncture;
- intra-articular injections of the fermatron chondroprotector;
- training on simulators;
- blockade of joints and spine with local anesthetics.
Physiotherapy for paresis of the foot consists in electrical stimulation of the affected muscles and nerves. Treatment of paresis of the foot in the Yusupov hospital returns the foot to the correct position and mobility, normalizes metabolism and blood circulation, strengthens the muscles and ligaments of the legs. After completing the course, the therapist gives the patient a manual with exercises for self-study at home.
Gymnastics with paresis of the foot
The first exercise is based on balance reflexes. The patient, standing on his feet, leans back as much as possible, or even falls. The instructor-methodologist of exercise therapy, standing behind, insures a person from falling to the floor. When performed correctly, the extensor digitorum tendon is developed.
The second exercise is pedaling. If necessary, the foot is fixed to the pedal itself. This facilitates passive flexion of the dorsum of both feet.
The patient performs the third exercise on his knees. He leans back as much as possible, but so that the buttocks do not touch the heels. With this exercise, the support reaction reflex is developed.
The patient sits on a high couch, while his feet do not touch the floor. The exercise therapy instructor puts skis on the patient's feet, and attaches a counterweight to them from behind. In this position, the patient alternately "steps" with his legs.
You can try to maintain balance by standing only on the sore leg and holding onto the handrail with your hands. The hand must be gradually torn off the handrail and on the leg affected by paresis, stand independently without support. For training, rehabilitation therapists advise using the stairs. Having risen one degree, the sore leg should be dangled down, but so that it does not touch the floor. You should stay in this position for some time.
One exercise involves walking in special shoes with the heel lower than the toe. To do this, a stop (wooden plate) is attached to the front of the boot, and the heel is hung. All physiotherapy exercises for paresis of the foot depend on the strength of the muscles. Before starting the course, the rehabilitation specialists of the Yusupov Hospital examine the patient and determine the muscle strength using a special scale.
The specialists of the rehabilitation clinic have an individual approach to the choice of the method of rehabilitation therapy for each patient. With paresis of the left or right foot, treatment is carried out using the same methods. In order to undergo an effective rehabilitation course for foot paresis, call the Yusupov hospital.
Bibliography
- ICD-10 (International Classification of Diseases)
- Yusupov hospital
- Badalyan L.O. Neuropathology. - M .: Education, 1982 .-- S.307-308.
- Bogolyubov, Medical Rehabilitation (Guide, in 3 volumes). // Moscow - Perm. - 1998.
- Popov S.N.Physical rehabilitation. 2005 .-- S. 608.
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* The information on the site is for informational purposes only. All materials and prices posted on the site are not a public offer determined by the provisions of Art. 437 of the Civil Code of the Russian Federation. For accurate information, contact the clinic staff or visit our clinic.
Foot paresis is a pathology in which there is a violation of the mobility of the joints caused by deformation of soft tissues. The first sign is limb deformity. Its appearance begins to resemble the hooves of a horse, the gait becomes flapping, the sole does not rise. Another name for the disease is equine foot.
Causes
One of the main causes of paresis is decreased tone and muscle weakness.
Also provoking factors can be:
- absence or insufficient physical activity for a long time;
- muscle damage or fractures of the lower leg, ankle joint;
- inflammation;
- polio;
- cerebral palsy, neurological diagnosis;
- oncology (with a dislocation in the lower limb);
- intervertebral hernia (the spine suffers);
- migraine;
- multiple sclerosis;
- encephalitis;
- diseases of the knee joints;
- diabetes mellitus (its complications);
- suffered a stroke;
- a case of spinal cord injury, pinching of its roots;
- genetic diseases;
- the use of alcoholic beverages.
Symptoms and Diagnosis
Paralysis of the foot is manifested in the following symptoms:
- the movement of the joints is difficult;
- pains, tingling sensations appear;
- the tone of the muscles of the legs decreases, numbness occurs;
- it becomes impossible to lift the limb up;
- gait changes, becomes spanking (or dragging);
- the foot is deformed (high level of arching - more than 90%).
To diagnose paralysis of the foot, the following are used:
- ultrasound procedure;
- magnetic resonance imaging;
- electromyography;
The neurologist will make a preliminary diagnosis already at the initial appointment, having examined the condition of the limb.
The paresis of the foot has pronounced symptoms, which are quite easily determined visually, and the treatment will depend on the source that caused it.
Risk factors
The risk group includes people who have:
- improper diet, diabetes mellitus;
- hereditary diseases associated with pathologies of the musculoskeletal system and the nervous system;
- oncology of the brain (spinal or brain);
- suffered a stroke or encephalitis;
- ischemia, arterial hypertension, high blood pressure;
- genetic pathologies;
- cerebral palsy;
- alcohol addiction.
Activities that can provoke an illness:
- a sedentary lifestyle, especially with crossed legs (infringement of the sciatic nerve roots may occur);
- squatting or kneeling for a long time (picking berries, laying tiles);
- wearing plaster.
Treatment methods
To determine how to treat paresis of the foot, it is first necessary to establish and get rid of the root cause that caused the disease. For this purpose, the following methods are used:
- surgical (removal of tumors, abscesses, stopping inflammatory processes; used for paralysis, when a person loses the ability to walk);
- medicinal (the use of drugs that affect the source of the disease);
- traditional (applying a flexible bandage, which should return the limb to its normal physiological position and fix it).
In case of illness, physiotherapy exercises, massage are prescribed. Any of them effectively strengthens muscles, improves nerve impulses, tissue trophism.
Orthoses are also used (technical means that fix the legs, raising them when walking).
Medicines
There is no single set of drugs that heal paresis.
They are applied selectively to target the source of the problem.
Doctors prescribe drugs:
- restoring blood pressure;
- normalizing metabolic processes and blood supply to the brain (such a medication as "Berlition");
- eliminating infections in the brain (antibiotics);
- "Neuromidin", "Nucleo CMF Forte", "Keltikan" (affect the central and peripheral nervous system).
Exercise therapy
Therapeutic gymnastics is the most important method, one of the mandatory in the treatment of paralysis of the foot, which has repeatedly proved its effectiveness.
Regular and correct implementation of special exercises can lead to a complete recovery of the patient.
The therapeutic set of exercises includes the following:
- standing on your feet, you need to lean back as much as possible and maintain balance (during execution, you can help with your hand, holding on to the support);
- in a kneeling position, bend towards the limbs, without touching the heels with the body;
- scrolling the pedals (using a training bike or lying on your back);
- sitting on a chair, imitate walking (raise the legs to which the load or skis are attached);
- jumping;
- walking (on heels and toes, alternately);
- flexion of the feet towards oneself and in the opposite direction.
Acupuncture
Acupuncture (acupuncture) is used to get rid of many ailments. In case of paralysis and paresis, 4-6 courses are carried out for 10 days. The break between them is three days. The procedures are carried out daily, starting on a healthy limb, the next day on a sick limb.
The essence of the method consists in puncturing certain points on the human body with needles, each of which is responsible for influencing one or another organ.
This method is also used for hemorrhages, closed brain injuries, epilepsy, chorea, to eliminate the consequences of poliomyelitis.
Massage
A good effect is given by its joint implementation with gymnastics. With paresis, it develops nerve impulses in the tissues, normalizes muscle tone, and helps to saturate them with nutrients.
Massage has certain contraindications. These are:
- oncology;
- violation of the integrity of the skin (open wounds);
- acute period of infections.
Traditional medicine
Traditional medicines to combat paresis include the use of clay and herbal medicine.
V medicinal purposes use purified powdery clay, which is diluted with warm water in certain proportions (20 grams of powder per 150 ml of liquid). The solution is taken in the morning on an empty stomach for two weeks, two teaspoons.
So they rid the body of toxins and harmful substances, restore the performance of cells.
To eliminate the consequences of pathology, rubbing is used (2 tablespoons of clay per glass of water, you can add garlic). Rub your feet with the composition several times a day (20 minutes each).
From plants, decoctions of marjoram, chamomile, peony, rosehip, laurel, thyme, pine are taken as medicinal tinctures.
Vegetables (freshly squeezed), birch or dandelion, plantain, nettle and celery juice give a good healing effect. They have a good effect on digestion, the work of the urinary system, metabolic processes, and purify the blood.
They use such a remedy: take goat's milk (one glass), add pine nuts(shredded, 200 grams). The mixture is brought to a boil, one teaspoon of honey and two tablespoons of wheat grains are introduced into it. Consumed throughout the day.
Disease prognosis
The outcome of the disease depends on the cause that caused it.
Paralysis due to injury to nerve fibers is successfully cured. If neurology caused it, then the disease cannot be completely cured, serious consequences remain.
Prevention of pathology
Prevention of foot paresis includes the following measures:
- active lifestyle (hiking in the fresh air, physical education);
- walking barefoot;
- adherence to sleep and nutrition (good sleep should be at least 8 hours, consume more fresh vegetables and fruits);
- avoid hypothermia;
- carry out timely prevention and treatment of infections;
- monitor blood pressure, do not trigger arterial hypertension;
- wear comfortable shoes.
Foot paresis is a disease in which recovery is fraught with serious physiological disorders.
For its treatment, it is necessary to correctly establish the root cause. With the right therapy, it can be cured, but it can have serious consequences for the rest of your life.
This information is intended for healthcare and pharmaceutical professionals. Patients should not use this information as medical advice or guidance.
Therapeutic gymnastics for paresis of the foot
K. B. Petrov *, D. M. Ivanchin **
* GOU DPO "Novokuznetsk Institute for Advanced Training of Doctors" of Roszdrav, Department of Restorative Medicine
** Federal Scientific and Practical Center for Medical and Social Expertise and Rehabilitation of the Disabled. Novokuznetsk. Russia
SUMMARY. The original techniques of therapeutic gymnastics for paresis of the foot, based on the action of inertial forces, gravity and mechanical coordination of the osteo-ligamentous apparatus, as well as on stepping automatisms, balance reflexes and support reactions, are described. Their differentiated use is recommended depending on the depth of muscle dysfunction according to the Lovett scale.
Key words: rehabilitation, remedial gymnastics, kinesitherapy, foot function.
MEDICAL GYMNASTICS AT PARALYSES of the FOOT
K. B. Petrov *, D. M. Ivanchin **
* Novokuznetsk institute after degree training of the doctors, Faculty of Medical gymnastics, Physiotherapy and Resortologie.
** The federal scientific - practical center of medical and social examination and rehabilitation of invalids.
SUMMARY. Original receptions of medical gymnastics are described at paralyses of the foot, based on action of forces of inertia, gravitation and mechanical coordination of the bone - copular device, and also on automatisms of walking, reflexes of balance and reaction of a support. Their various application is recommended depending on depth of infringement of muscular function on Lowet`s scale.
Key words: rehabilitation, medical gymnastics, kinezitherapy, function of a foot.
Peripheral paralysis of the leg muscles is the core of the clinical symptoms of a number of neurological diseases. In this case, the dorsiflexion function of the foot (neuropathy of the peroneal nerve, paralyzing sciatica syndrome, etc.) suffers more often and more or their combined lesion with plantar flexors (spinal paraplegia, polyneuropathy, etc.) is observed.
Even with the intactness of the overlying links of the musculoskeletal system, this almost certainly leads to severe disorders of the musculoskeletal function of the lower limb; bilateral paresis of the feet makes it impossible to walk without additional support in all cases.
Approaching the systematization of already known and the development of new methods of therapeutic gymnastics for paresis of the foot, it is useful to differentiate them depending on the depth of muscle dysfunction, guided by the Lovett scale (Table 1).
Table 1. Lovett scale
| Scale degree (in points) |
Assessment of motor abilities on a scale | Strength of the affected muscle in% of its condition is normal |
| 0 points (complete paralysis) | No signs of movement when trying to voluntary muscle tension. The patient tries to perform any movement, but it is not even accompanied by palpable muscle or tendon tension. |
0 |
| 1 point (traces of function) | Feeling of tension when trying to voluntary movement. Muscle contraction is palpated, but no movement is performed. |
10 |
| 2 points (mediocre function) | The movement of the full volume is possible with complete unloading of the limb. The patient performs any movement, but cannot overcome the force of gravity. |
25 |
| 3 points (satisfactory function) |
Movement of full or partial volume is possible when weighed down only by gravity. The paretic muscle can overcome only the mass of the moved segment of the limb, while performing a full or partial range of motion. |
50 |
| 4 points (good feature) |
Full-volume movements are possible under the influence of both gravity and a small external burden. The muscle can overpower a little resistance, but is unable to develop maximum effort. |
75 |
| 5 points (normal function) |
The movement is carried out in full under the action of gravity and maximum external resistance | 100 |
If the residual function of the muscles providing the restored movement corresponds to 0 - 1 point on the Lovett scale, the use of kinesitherapeutic techniques associated with the action of inertial forces, gravity and mechanical coordination of the osteo-ligamentous apparatus is shown. With a strength of 1 - 3 points, exercises with unloading, based on stepping automatisms, balance reflexes or support reactions, are effective. As soon as the patient achieves the ability to counteract external resistance, motor training with weights is prescribed in inferior, isometric, and then overcoming modes.
Exercises to restore dorsiflexion of the foot.
The exercise is based on balance reflexes. The position of the patient is standing. If only one leg is interested, stand on one leg, holding the handrail with the opposite hand.
The patient deviates, or even falls, back. The instructor standing behind insures him from a complete fall.
With the correct execution of the exercise on the dorsum of the foot, there is a distinct contouring of the tendons of the extensor digitorum longus (Fig. 1).
Picture 1
The patient pedals the exercise bike, which promotes passive dorsiflexion of both feet (if necessary, the foot is fixed to the pedal with a strap). In this case, the degree of weighting of the pedals does not matter (Fig. 2).
Figure 2
While kneeling, the patient tilts the trunk backward, trying to maintain balance, so that the buttocks do not touch the heels (Fig. 3).
Figure 3
Stabilization is achieved by tightening the quadriceps muscles of the thigh. At the same time, the dorsal flexors of the foot are synergistically tense (support reaction reflex).
The patient sits on a high couch, so that the lower limbs hang freely and do not touch the support. Legs are shod in sneakers with skis attached to them. A load is attached to the ski about 15 - 20 cm behind the heel.
Figure 4
The patient performs alternating plantar flexion of the feet in the rhythm of walking. In this case, the counterweight, fixed at the back of the skis, like a pendulum, promotes passive dorsiflexion of the feet (Fig. 4).
Figure 5
Sitting on a chair, the trained leg is straightened at the knee joint, the heel rests on the floor.
The patient bends his torso forward and with force rests the heel on the floor, using it as a lever, he bends the shin at the knee joint.
This promotes synergistic tension of the dorsal flexors of the foot (Fig. 5).
The patient sits on a chair, the forefoot is mounted on a spring pedal on the floor or on a thick (6-8 cm) piece of foam rubber.
Figure 6
The patient makes active pressure with the forefoot in the direction of plantar flexion (in this case, the heel should in no case come off the plane of the floor.
The exercise promotes synergistic tension of the tibialis anterior muscle and the extensor digitorum longus (Fig. 6).
Sitting on a chair opposite the seated instructor, the trained limb is extended at the knee joint and lies on the knee of the doctor. With one hand, the doctor fixes the heel, with the other to stimulate the flexion reflex, he performs maximum dorsiflexion of the foot.
Figure 7
Figure 8
From this position, the patient performs active flexion of the leg in the knee and hip joint, which promotes dorsiflexion of the foot fixed to the heel due to the synergy of triple shortening (Fig. 7).
The patient sits with his legs crossed "in a European way," so that the trained leg is on top.
From this position, the patient flexes the knee joint while simultaneously trying to dorsiflex the foot (Fig. 8).
The patient tries to maintain balance, standing on the sore leg, trying only in extreme cases to adhere to the handrail.
Figure 9
Balancing on one leg promotes the activation of all muscles of the lower leg due to the balance reflexes (Fig. 9).
Strength 2 - 3 points on the Lovett scale.
The patient walks on skis, with weights fixed on them at a distance of about 15 - 20 cm. This promotes dorsiflexion of the foot through gravity.
Figure 10
It is necessary to pay attention that the patient lifts his legs and “walked” on skis, and not “rode” on them (Fig. 10).
With the help of a soft rubber band, the foot is fixed with a "figure eight" in a position that is neutral between dorsal and plantar flexion.
Figure 11
When walking, this makes it easier to overcome the force of gravity during dorsiflexion of the foot (Fig. 11).
A bag of sand or shot is wrapped in a scarf (you can use sports weights). The load is tied to the lower third of the lower leg, with a cut above the ankles. So that it sits over the heel.
When walking, this counterweight assists in dorsiflexion of the foot (fig. 12).
The patient stands on a "healthy" foot on a flight of stairs or dais, holding on to the handrail.
The trained leg is pulled down, simulating descent to the underlying step (the heel should be lower than the forefoot), but without stepping on it (Fig. 13).
The patient trains in a precise hit (or strike) with the heel on any target located at some distance from the floor (Fig. 14).
Figure 12
The patient walks in shoes with the heels torn off, so that the forefoot is higher than the hindfoot.
Figure 13
Figure 14
Figure 15
You can use specially modified shoes for this, the sole of which is wedge-shaped, thicker in the front and thinner in the heel. Raising the forefoot increases the load on the dorsal flexors (Fig. 15).
The patient trains the tibialis anterior and extensor digitorum longus, trying to walk on the heels.
The patient does squats with shoes. For this purpose, it is better to use old sneakers, or soft shoes with high lacing, which are nailed to the floor or a massive wooden board, so that the heel does not come off the support.
At the moment of flexion, the dorsal flexors of the foot are strongly strained.
To train the lifting of the predominantly outer edge of the foot, the patient sits on a chair, the sore leg is straightened at the knee joint and abducted in the hip, so that the foot rests on its inner edge. The other leg, bent at the knee and hip joints, stands with the entire plane of the sole on the floor.
The patient rotates the trunk in the opposite direction, as if turning away from the trained leg, while dorsiflexion is carried out mainly on the outer edge of the foot.
Figure 16
This exercise is designed to train the extensor digitorum longus (Fig. 16).
Lying on your back, arms are intertwined behind the head, elbows are directed forward or to the sides, legs are slightly bent at the knees and ankle joints, the foot in relation to the lower leg has an angle of 90 °.
The methodologist holds the patient by the feet or the feet are fixed with a belt.
Figure 17
The patient moves from a lying position to a sitting position, which promotes a powerful activation of the entire flexion synergy, including the dorsal flexors of the feet (Fig. 17).
Strength 4 - 5 points on the Lovett scale.
The patient jogs in heavy boots or sneakers with a weighted lead plate in the forefoot.
Figure 18
The patient places a bar under the forefoot, the height of which should not exceed 7 - 8 cm (the thicker the bar, the greater the load on the muscles of the anterior surface of the lower leg) and performs squats, which can be performed with a load with a load on the shoulders, for example, with a barbell (Fig. . eighteen).
Exercises to restore plantar flexion of the foot.
Strength 0 - 1 point on the Lovett scale.
Figure 19
Standing in a closed knee support, which is a flap 50-70 cm long and 40-50 cm wide, upholstered with a 2-5 mm layer of foam rubber and covered with leatherette. Three vertical bars with a cross section of 5 cm, this shield is divided into two sectors (for each leg). The knee support is attached to a fixed support 25-30 cm from the floor on parallel bars in the form of a "wicket" (Fig. 19). Triangular supports are placed under the feet, so that the forefoot is higher and the heel is lower.
The patient shifts the center of gravity forward, which promotes hyperextension of the knee joints and activates mainly the upper calf muscles (jump reflex).
The patient sits on a chair with his legs crossed "in a European way." The trained leg is on top.
Figure 20
Slightly unbending the leg at the knee joint, the patient tries to simultaneously do plantar flexion of the foot (Fig. 20).
The patient sits on a chair, the exercised leg rests on the heel, the knee joint is slightly bent.
Figure 21
Extending the leg at the knee through the lever formed by the heel, the patient achieves passive plantar flexion of the foot (Fig. 21).
To stimulate plantar flexion, the practitioner strengthens the flexion of the fingers with his hand.
If there is an isolated paresis of the plantar flexors of the foot without disturbing the strength and range of motion in the remaining joints of the lower limb, skiing without a load is indicated.
The sneakers are attached to the skis in such a way that only their toe is fixed, and the heel can rise freely.
Strength 1 - 2 points on the Lovett scale.
The patient kneels and tilts the torso forward, trying to maintain balance.
The methodologist supports the patient by the lower third of the legs.
Figure 22
Stabilization of the body is achieved mainly due to the ischiocrural muscles, but the gastrocnemius muscles are also tense synergistically (Fig. 22).
The patient applies pressure to a spring-loaded pedal or thick foam rubber with the forefoot.
Figure 23
In this case, the heel does not touch the support, so that its level is above the level of the toe (fig. 23).
The patient walks in high-heeled shoes (over 6 cm), which contributes to the load on the gastrocnemius muscle.
Strength 3 - 4 points on the Lovett scale.
The patient pedals the exercise bike. The weight of the pedals gradually increases (Fig. 2).
The patient stands facing the wall, resting against it with both palms and chest. One leg is straightened and closed at the knee joint, the trained leg is bent at the knee and the entire plane of the foot rests against the horizontal support.
Figure 24
From this position, the patient extends the leg at the knee, trying to passively close it, which contributes to the tension of the gastrocnemius muscle (Fig. 24).
Strength 4 - 5 points on the Lovett scale.
Figure 25
Holding onto the support, the patient rises and falls on the toes. The forefoot can be elevated to increase movement excursions. Shoes should be on thick, soft soles (fig. 25).
Starting position, standing, on the shoulders of a barbell or dumbbells with arms extended along the body. Feet are shod in shoes with thick soft soles, under the heels there is a block up to 10 cm high.
The patient squats with a load. If the socks are turned outward, then the internal head of the gastrocnemius muscle is predominantly loaded, and if inwardly, then the external one, with the neutral position of the feet, the entire mass of the gastrocnemius muscles is loaded.
Figure 26
The block is placed under the forefoot. The patient squats with a load, as in the previous exercise, but at the same time he lifts the heels off the floor and even stands up on his toes (Fig. 26).
Bibliography
In a person's life, there are often times when he gets tired and does not monitor his health. Every day, every person feels a huge load on the musculoskeletal system, and, in particular, on the legs. A sedentary lifestyle, or, conversely, a frantic rhythm in which you have to spend the whole day on your feet - all this affects the health of your legs.
But there are times when a simple rest will not help. Sometimes, foot problems are caused by disorders of the nervous system. Such a violation is paresis of the limbs.
What is leg paresis? It is a neurological symptom that is caused by damage to the peripheral (motor) nerves. This disorder manifests itself, first of all, in the weakening of the strength and tone of the muscles of the lower extremities (feet and legs in general).
Limb paresis is mainly of two types: organic and functional. In the first case, paresis occurs due to organic damage, in which nerve impulses simply do not reach the muscle fibers. In the second case, the disorder arises in the cerebral cortex and manifests itself in a violation of inhibition, balance of movements, etc.
Also, paresis is characterized by a violation of muscle strength, in this case, the neurological status is assessed on a five-point scale, where 0 is the complete absence of muscle strength, and 5 is the complete absence of any disorders.
There is also a classification of paresis by limb involvement:
- monoparesis: impotence of one specific organ (intestine, left or right leg);
- hemiparesis (damage to organs on only one side of the body);
- paraparesis: impotence of one organ system ( gastrointestinal tract, lower limbs, etc.);
- tetraparesis: damage to all organ systems.
Symptoms of paresis are found not only during observation and during the collection of the patient's anamnesis, but also in a number of diagnostic studies: examination, general analysis of blood and urine, neuropsychological examination.
- Change in gait: due to the weakness of the muscles of the pelvic girdle, gait disturbances occur, first of all, a sort of "waddling" step from foot to foot becomes noticeable;
- Weakness in the muscles of the legs, which manifests itself quite widely: from difficulty walking to difficulty getting up from a sitting position;
- Decreased tone of the extensor muscles of the leg (foot): manifests itself when walking - the patient can observe that when lifting the leg - the foot hangs powerlessly;
- Depending on the type, paresis can manifest itself either by hypotonia (decreased tone) or hypertonicity (increased tone) of the muscles;
- The appearance of deep reflexes or pathological (Babinsky, Zhukovsky);
- Violations of the circulatory system, because legs and feet suffer from a lack of movement, then their blood supply deteriorates, the walls of blood vessels atrophy. In the future, this may threaten with violations from the entire cardiovascular system;
- Often, paresis of the lower limbs is combined with paresis of the upper limbs or even internal organs(intestines, stomach, blood vessels, etc.).
The main cause of this disorder is damage to any part of the nerve pathway., whether it be motor neurons or a site in the cerebral cortex.
Psychogenic causes of paresis are often identified, i.e. having a psychological trauma underneath, which affected the work of the nervous system. In this case, the treatment should not take place with the help of medications or physiotherapy, but with a psychotherapist and neurologist.
Most frequent reasons paresis of the lower extremities are:
- The presence of neoplasms in the brain or spinal cord;
- Inflammatory processes in the spinal cord and brain: encephalitis, myelitis;
- Spinal or cerebral hemorrhage;
- Epilepsy;
- Various diseases of motor neurons: atrophic sclerosis, multiple sclerosis, muscle atrophy of the lower extremities;
- Severe infectious diseases that affect the nervous system, such as botulism;
- An abscess is a purulent process in the spinal cord or brain caused by infection, inflammation, etc.;
- Spinal cord and brain injuries: bruises, contusions, fracture of the cranial vault, fracture of the spine, etc.;
- Diseases associated with impaired conduction in nerve fibers due to a decrease in the myelin layer: Alzheimer's disease, Pick's disease, etc.;
- Disruption of metabolic processes in the body, and in particular in muscle fibers, for example, in the case of myopathy;
- Vascular disorders of the brain or spinal cord;
- Mechanical trauma and damage to the spinal cord (spine) and brain.
First of all, the risk group includes newborns and infants, because at this age, most often external circumstances can harm the health of the child. For example, birth trauma: hypoxia, caesarean section, forceps, etc.
Also at risk are people who have had traumatic brain injuries, operations on the brain and spinal cord, infectious diseases, disorders of the nervous system and diseases of the neuropsychiatric circle.
How is foot paresis treated? Depending on the cause of the limb paresis, treatment and recovery can be different. For example, if the main cause of paresis is a neoplasm in the spinal cord, then first, the tumor should be promptly or chemically removed. After that, in most cases, the symptoms disappear by themselves.
In case of hemorrhage, firstly, the disturbance of blood circulation at the site of injury is eliminated, then medications are prescribed, which helps to improve blood flow, strengthen the walls of blood vessels, and normalize pressure.
Treatment of paresis of the foot begins after the root cause of the disease has been eliminated. Therapy in case of paresis is always complex, it includes drug treatment, gymnastics, massage (including mechanical), HAL-therapy (gymnastic exercises carried out with the help of robotic complexes, by repeated repetition of movements).
Massage is one of the main methods of treating paresis; it is called "passive gymnastics". The fact is that massage movements are not only aimed at warming up or relaxing the muscles, but they also include resistances that help in growth and strengthening. muscle mass... The massage itself will help not only to strengthen the muscle structure of the leg, but also to improve blood circulation in the affected organ, and in the case of hypertonicity - to relax the muscles, eliminate spasms, and help with pain syndrome.
Gymnastics is also the main component in the treatment of paresis, an important condition is daily practice and continuity of treatment. Gymnastics will help to avoid stagnation of blood, atrophy of muscle fibers, and also to hedge against the aggravation of paresis in the future, which can turn into paralysis.
Taking into account individual characteristics, the severity of the disease and the conditions of therapy, recovery can take from one month to several years. It is important not to give up physiotherapy (massage, gymnastics, swimming) and do it constantly, because it is the increase in load and continuity that will provide the desired result.
In addition, in any case, drug therapy will be necessary. Basically, they prescribe antispasmodics, vasoconstrictor, pain relievers, etc. Also, medication treatment will be directed to the cause of paresis, it may include chemotherapy, anti-inflammatory drugs, antibacterial and antiviral, etc.
It is important to understand that any of the above symptoms can have various reasons, including psychological ones (which do not require surgery or prolonged physical therapy). In addition to therapy, it is necessary to provide the patient with home care and attention - this will accelerate recovery.
Prevention of this disease consists in preventing the main causes of paresis: tumors, cardiovascular problems, head injuries, infectious diseases and so on. In addition, it is necessary to strengthen the nervous system of the body, muscular and circulatory systems, increase immunity and stress resistance, because the cause can be not only an organic factor, but also a psychological one. It is much more difficult to cure a disease than to engage in prevention, which will prevent the violation and bring no side effects.