Hesperian Health Guides
Коррекция контрактур тазобедренных суставов пораженных артритом
HealthWiki > Реабилитация детей с ограниченными возможностями здоровья > ГЛАВА 16: Ювенильный артрит > Коррекция контрактур тазобедренных суставов пораженных артритом
Look for ways that the child can relax with her head as straight as possible. If she also has contractures in her knees, she can lie like this.
 The child will relax and straighten her body more easily it she can play or read.
Place supports or cushions behind her back and head, but just enough so that she has to straighten herself some. As her hips and neck gradually straighten, keep lowering her back and head little by little.
Give just enough support under her knees and feet to keep her hips and knees stretched. As they gradually relax, lower her knees and raise her feet little by little, so that her hips and knees straighten.
In the morning, she may be stiff and bent, and will need help to straighten like this every day–or several times a day.
If possible, also have her lie on her belly. |
| Think of games or exercises in which the child will stretch his hips and knees. In this example, the boy rolls the log to lift the flag and hit the gourd. This helps strengthen the straightening muscles of his legs. |  |
| As the child’s back, hips, and knees straighten more and he gains strength, the hammock can be stretched more tightly and a heavier weight put on the top of the stick, where the flag is. | |
| log, barrel, or bucket |
| ADJUSTABLE SEAT | |
adjustable shoulder supports |
tie made of old inner tube
SIDE VIEW
nail or pin for adjusting seat
FRONT VIEW |
A homemade walker similar to this can help a child with hip contractures begin to walk. It also provides exercise for the straightening muscles of both the arms and legs.
As the child’s hips and knees straighten more and more, the crutches and seat can be raised. It is best if she walks backward (“Pretend you’re a crab!”). This way she will strengthen the straightening muscles in her legs. Walking forward would strengthen more the muscles that bend the legs, and this could increase contractures.