Standardized and sufficient systematic rehabilitation training is an indispensable link to treat gluteal muscle contracture (external splayed leg and frog leg) and prevent new adhesion contracture, and it is also an indispensable link to enhance patients' confidence in rehabilitation. When all movements are as free as normal people, you can stop targeted exercise.
First, prevent or improve the rehabilitation of contracture.
Objective: To maintain prolonged length, improve skin contracture and increase ligament elasticity.
1. There are two kinds of movements: active movement and passive movement. Passive hip flexion and knee flexion is suitable for patients under 6 years old who can't understand the purpose and method of exercise and can't actively cooperate, and patients who need exercise-assisted drainage in the early postoperative period (within 1 week after suture and/or within/2 hours after minimally invasive surgery) but can't exercise well in pain. Specific methods: After the knees are fixed together, the operator lifts the patient's feet to contact with the operator's chest, holds the patient's calves and ankles with both hands, and slowly exerts force with both hands and chest, and instructs the patient to take a deep breath to fully flex the hips and knees, with 3-4 in each group, 6-8 in the conservative treatment group and 3-4 in the postoperative group. If the pain of passive exercise is alleviated, take active forging. Knees are fixed together, and hands hold solid support for squat training. The time required is the same as passive.
2. The active and passive operation requirements of hip flexion and knee flexion (sitting with legs crossed) of both lower limbs are the same as those of knee joint exercise, but the starting time is 1-2 days later than that of knee joint exercise, and knee joint exercise should be done first and then every time to reduce pain and increase adaptability.
3. Cross your legs in the whole process (also known as devil's action): hold your hands tightly (or pull hard), then stand with your legs crossed, one leg down, each leg 5 times, and your legs alternate as a group.
4. Knee-hugging and shoulder-touching method: After sitting firmly, hold the knee joint of the right calf with both hands and approach the left shoulder as close as possible until touching; Then hold the knee joint of the left calf with both hands and approach to the right shoulder, and train alternately repeatedly, and the knee joint always turns inward in the process of holding the knee.
Second, prevent hematocele from remaining.
Because the greater trochanter area before and after the incision is used as a working cavity for non-minimally invasive surgery, patients are required to take supine position every 2 hours, especially after early exercise, and each group should exchange positions at an interval of about 15 minutes. In minimally invasive surgery, because the working cavity is in front of the incision, there is no need to lie prone, just exercise on time, increase the pressure of the working cavity and squeeze out the blood.
Third, adductor muscle rehabilitation.
Objective: To increase the strength of adductor and abductor muscles.
The patient bends slightly, grasps the fixture with both hands, and needs to practice swinging the lower limbs forcibly from left to right after standing in the later stage, especially when adduction swings, the higher the swing, the better. Remember that the trunk must remain neutral and stable during the swing, and the swinging lower limbs should be in the pronation position. After swinging on one side for 10 times, swing on the other lower limb as well. The starting time of exercise should be 1 week after operation, and those who don't meet each other should be in 3-4 groups every day for two days after operation.
Fourthly, the rehabilitation of gait and posture.
Objective: To change the original gait of "external splay" and "frog-shaped leg"
Look up at the markers two meters ahead, move forward step by step (that is, model step), swing the upper limbs step by step, and exercise at least three times a day from the first day after operation, at least 200 meters each time. At the same time, it is required to use this step as long as you get out of bed and walk. For patients with scoliosis and hip joint tilt, lateral flexion exercise and suspension traction of both upper limbs must be done every day before operation. From the third day after operation, three groups of lateral flexion 10-20 times a day, suspension for 5- 10 minutes, and deep breathing exercise when suspension.
Verb (abbreviation of verb) pronation and rehabilitation of flexor muscles
Objective: To increase the strength of adductor and abductor muscles.
Stand upright with your elbows bent, your forearms and hands stretched forward horizontally, and your lower limbs rotated inward to lift your thighs. When lifting the thigh, the knee should bend naturally and try to make the palms on the same side touch each other. Those with suture started from the 7th day after operation to 10 day, and those without suture started from the 3rd day after operation. Three groups were practiced every day until the muscles were slightly sour.
Sixth, the rehabilitation of gluteus maximus.
Objective: To enrich buttocks and change flat buttocks and concave buttocks.
Grasp the fixture with both hands, one side of the trained lower limb deviates from the fixture, and then swing the lower limb back and forth, raising it as high as possible when stretching backwards every time; The patients with suture started to exercise on the 7th 7- 10/0 day after operation, and those without suture started to exercise on the 3rd day after operation, with no less than 3 groups per day. Each group exercises until the muscles are slightly sore, and the interval is at least 2 hours, so as to recover.
VII. Rehabilitation of Back Muscles
Objective: To strengthen back muscles and correct humpback and buttocks.
Lying on the bed (prone position), all the heads and limbs slowly leave the bed upwards. The higher the limbs leave the bed, the better. Only the stomach (abdomen) touches the bed and then slowly returns to the bed. Every time you stretch backwards, raise it as high as possible; Exercise starts from 1 day after operation, and there are no less than 3 groups every day. Each group exercises until the muscles are slightly sore, and the interval is at least 2 hours, so that they can recover. At least 3 months, if you persist for life, you can better protect the stability of the spine and prevent low back pain.
Eight, the rehabilitation of pelvic tilt
Objective: To correct false unequal length of lower limbs.
Action 1: Lifting method: put the body center of gravity on the short leg that stands straight, straighten the long leg vertically, and keep the foot off the ground for 2 minutes; Repeat 20 times each time.
Action 2: Back-pumping method: keep your knees together, keep level and slowly squat down to the end, then stand up slowly with your knees together.
Action 3: tuck your knees and touch your shoulders: hold them with both hands after sitting firmly.