You can also find a seat, lean back against the chair, relax, put your hands on your chest and take a deep breath.
2. Facial movement: The special face of patients with Parkinson's disease is a kind of "mask face". This is because facial muscles are stiff, which leads to dull facial expression, so some facial movements are needed. Frowning action: frown as much as possible, then raise your eyebrows and repeat several times. Exercise hard to open your eyes and close your eyes and drum your cheeks: first drum your cheeks hard, and then try to inhale and drum your cheeks. Show your teeth and whistle, show your teeth as much as possible, and then whistle.
In front of the mirror, make your face smile, laugh, grin, pout, whistle, drum your cheeks and so on.
3. Head and neck movement: The neck of patients with Parkinson's disease tends to lean forward and is very stiff, which many people think is caused by cervical spondylosis. If you don't pay attention to the movement and rehabilitation of the neck, it is easy to aggravate the abnormal posture, which is manifested as an increasingly serious hunchback. Here is a set of neck rehabilitation methods. However, it should be noted that Parkinson's disease patients are mostly elderly people, often accompanied by different degrees of cervical spondylosis. So when doing the following exercises, you must step by step, gradually increase the range of movements, and move slowly and gently during the exercise. Head back, eyes staring at the ceiling for about 5 seconds, moving up and down: then head down and chin touching the chest as much as possible. Turn left and right: Turn your head and face to the right, look back for about 5 seconds, and then turn left in the same way. Turn your face slowly and repeatedly to your left and right shoulders, and try to touch your shoulders with your chin. Swing from side to side: slowly lean your head to your left and right shoulders and try to touch your shoulders with your ears.
Forward and backward movement: the mandible is extended for 5 seconds and retracted for 5 seconds.
4. Trunk movement: lateral bending movement: the feet are shoulder-width apart, the knees are slightly bent, the right upper limb is straight, the palm is inward, and the trunk is bent to the left and goes back and forth several times; Then repeat on the left. Turning action: the feet are slightly wider than the shoulders, the elbows are bent flat on the chest, and the movements are flexible. Then repeat in the opposite direction.
5. Abdominal muscle exercise: Lie flat on the floor or bed and bend your knees to your chest for a few seconds. Then do this action on both sides at the same time. Lie flat on the floor or bed, put your hands around your knees, and slowly extend your head to your knees. Back muscle exercise: prone, abdominal extension, legs and pelvis close to the floor or bed, lift with arms 10 second. Lie prone, with arms and legs off the ground at the same time 10 seconds, and then relax. Repeat many times. 5. Exercise of upper limbs and shoulders: The shoulders should be raised as far as possible in the direction of ears, and then droop as much as possible. Straighten your arms and hold your head high 10 second. Put your hands behind your back and pull back for 5 seconds. Repeat many times. Put your arms on your head, bend your elbows, grasp the opposite elbow with both hands, and bend your body to both sides in turn.
6. Hand movement: Parkinson's patients have many hand joints and are easily affected by muscle stiffness. Patients' hands are often in a strange flexion posture, and the metacarpophalangeal joints are flexed, making it difficult to unfold the palms. The small joints between other fingers are straight, so it is difficult for the palm to make a fist. In view of this situation, patients should always straighten their metacarpophalangeal joints and put their palms flat. They can hold the fingers of the other hand with one hand and press them in the direction of the back of the hand to prevent the metacarpophalangeal joints from deforming. You can also put your palm on the desktop, make your fingers touch the desktop as much as possible, and practice the action of separating and closing your fingers repeatedly. In order to prevent the deformity of finger joints, you can repeatedly practice the action of clenching your fist and extending your fingers.
7. Exercise of lower limbs: stand with your legs slightly apart, bend your knees slightly, bend over, and try to touch the ground with your hands. Hold the wall with your left hand, and pull your right foot back with your right hand for a few seconds, then repeat on the opposite lower limb. "Indian sitting posture": the feet are opposite to the palms, and the knees are on the floor to maintain repetition.
Sit with your feet in a "V" shape, with your head leaning against your right leg, between your feet and your left leg in turn, and keep each posture for 5- 10 seconds.
8. Gait exercise: Most patients with Parkinson's disease have gait disorders, and those who are light drag their feet and can't lift their feet when walking. At the same time, their upper limbs do not swing their arms and have no coordinated movements. In severe cases, it is difficult to rush forward, turn around and cross the threshold with small steps. During gait exercise, patients are required to look straight ahead and stand upright. When starting, raise your toes as high as possible, and then touch the ground. The stride should be as slow as possible and as large as possible, and the upper limbs should swing back and forth as much as possible when walking. The key is to lift your feet and take a big step. It is best to have other people present during exercise, and you can remind and correct abnormal posture at any time.
When patients start marching, they often have "freezing phenomenon" and can't walk away, just like sticking to the ground. In this case, don't worry, you can adopt the following methods: First, stand upright with your feet on the ground. Before you start walking, you must remember to follow the ground with your feet, bend your toes backwards, and then touch the ground with your toes. Put an obstacle with a height of 10- 15 cm in front of your feet at each step, and do walking exercises with your feet crossing the obstacle. But this method is more troublesome, and it is impossible to put a bunch of obstacles at home, so it is a good method to use an "L" crutch.
9. Exercise of balanced exercise: Patients with Parkinson's disease are characterized by postural reflex disorder, rushing forward quickly when walking, and easily falling down when encountering obstacles or when the patient stops suddenly. Balanced exercise can improve the attention to symptoms. Keep your feet 25-30cm apart, move your center of gravity left and right, back and forth, and keep your balance. The trunk and pelvis rotate left and right, and the upper limbs swing greatly, which has a good effect on balancing posture and relieving muscle tension.
10. Training of language barriers: Patients often become more and more unwilling to talk because of language barriers. The more they don't talk, the more degraded their language function will be. Long-term nonverbal communication with family members, coupled with the lack of expression of patients with Parkinson's disease, often leads to emotional communication barriers and barriers between patients and relatives. Therefore, patients must often carry out language function training.
1 1. tongue exercise: keeping your tongue flexible is an important condition for speaking, so you should keep practicing the following actions-repeatedly stretching and shrinking your tongue; The tongue moves left and right between the two mouths as soon as possible; Move the tip of the tongue around the mouth and lips as quickly as possible; Say "la-la-la", "ka-ka-ka" and "ka-la-ka" accurately as soon as possible, and repeat them several times.
12, lip and jaw exercises: slowly and repeatedly open your mouth and shut up; Close your upper and lower lips for a few seconds, then relax; Raise your upper and lower lips repeatedly, such as kissing, and then relax; Repeat the action of opening your mouth and shutting up as soon as possible, and repeat it several times; Say "do-do-do ..." as soon as possible, and then repeat after the break.
13, reading practice: read a newspaper or beautiful prose, slowly and loudly. It is best to recite poetry, Tang poetry, Song poetry or modern poetry, and you can choose according to your own preferences. Poetry has cadence and catchiness, which can not only cure language barriers, but also cultivate sentiment. Good poetry can also stimulate your fighting spirit, which is a good way.
14, Singing Practice: Singing is a good way. You can choose your favorite songs to practice. A patient told me that after I got sick, my speech became awkward, but my singing was not affected. After practicing singing, my speaking ability has also improved obviously. More importantly, singing can exercise vital capacity, which is conducive to improving the feeling of lack of speech and preventing pneumonia.
Nursing care of patients with Parkinson's disease should generally pay attention to the following issues:
1, pay attention to diet and nutrition: this disease is mainly seen in the elderly, and the gastrointestinal function is mostly decreased, and it may also be complicated with gastrointestinal peristalsis, spasm, constipation and other symptoms. In addition, the muscle tension of the disease is obviously increased, the limbs are trembling and the energy consumption is relatively increased. There are also some patients with different degrees of dementia, loss of appetite, hunger and so on. Therefore, we should pay attention to conditioning in patients' nutrition. First of all, we can give enough total calories according to the age and activity of weapons, pay attention to the adequate supply of sugar and protein in the diet, give priority to vegetable oil, and eat less animal fat. Eating seafood in moderation can provide high-quality protein and unsaturated fatty acids, which is beneficial to prevent atherosclerosis; Eating fresh vegetables and fruits many times can provide a variety of vitamins, promote intestinal peristalsis and prevent constipation. Patients sweat a lot, so pay attention to hydration.
2. Get a lot of guidance and help: At the initial stage of the disease, the patient's motor function is barrier-free and he can persist in certain labor. He should be instructed to participate in various forms of activities as much as possible, and his self-care ability has obviously declined. At this time, we should pay attention to the safety problems in patients' activities and help them walk with crutches. If the patient has difficulty squatting and standing in the toilet, he can sit on a high stool to defecate. If the patient is clumsy and often makes many mistakes, be careful of burns and other accidents when eating. For those who have difficulty in holding bowls and chopsticks, prepare metal tableware for them. If you can't eat, you should feed soup and rice. People who have difficulty in dressing, buttoning, tying belts and shoelaces need help.
3. Strengthen physical exercise: In the early stage of this disease, we should adhere to certain physical activities, take the initiative to do physical exercise, and do the maximum range of flexion, extension, rotation and other activities in all joints of limbs to prevent limb contracture and joint stiffness. Passive physical activity and massage of muscles and joints are carried out for patients with advanced stage. Promote blood circulation of limbs.
4. Prevention of complications: Elderly patients with this disease often have low immune function and poor adaptability to the environment. Pay attention to the temperature, humidity, ventilation and lighting of the room. Change clothes according to season, climate, weather, etc. And decide the way and intensity of outdoor activities. All the above measures can effectively prevent colds. Late bedridden patients should turn over on time, do skin care well, and prevent urine and urine immersion and bedsore. It is of great significance to passively move limbs and strengthen muscle and joint massage to prevent and delay bone and joint complications. Combined with oral care, turn over and knock on the back to prevent aspiration pneumonia and falling pneumonia. Pay attention to whether there is skin crush when turning over to prevent skin abrasion.
5. Closely observe the changes of the disease, observe the efficacy and side effects: Pay attention to the "on-off phenomenon" and "end-of-dose phenomenon" in the application of levodopa, and provide clinical basis for drug replacement and dose adjustment.
Psychological nursing is an important branch of medical psychology, and it is a science that applies the theory and technology of medical psychology to nursing work.
1. Psychological factors play an important role in the onset and rehabilitation of human body, and Parkinson's disease is no exception. Usually, it can be found that the patient's limb tremor is aggravated under the condition of emotional tension, excitement or embarrassment, but it is relieved when the mood is calm, and mental factors can make the condition worse. The course of the disease is very long, which gradually aggravates, causing certain pressure on the patient's spirit. Good psychological nursing is of great significance for overcoming patients' negative emotions such as pessimism, disappointment and anxiety, establishing a correct view of life and death, fighting diseases and maintaining psychological balance.
2. There are different psychological imbalances at different stages of the disease. At the beginning of the disease, the patient can maintain a considerable ability to work, take care of himself, have no obvious tremor, and have no pain in the disease. Patients can take it in stride and have little psychological change. With the development of the disease, limb tremor is aggravated, movement is slow and clumsy, and expression is indifferent and stiff, which is a "mask face". Single tone and intermittent conversation make patients feel inferior, unwilling to go to public places, avoid interpersonal communication and feel lonely. Patients will feel anxious and worried. Some patients know the end of the disease, and they also have fear or despair. In the later stage of the disease, patients can't take care of themselves, which may lead to pessimism or world-weariness. Dementia often exists in advanced patients, which can dilute psychological activities.
3. Psychological nursing emphasizes caring for people. To do psychological nursing well, it is necessary to understand and master the patient's psychological state and carry out psychological nursing according to the patient's psychological needs. Psychological nursing is the fusion of scientific knowledge and emotion. Through the beautiful language of medical staff, patients' families and friends, patients' hearts can be opened, and through specific care, consideration and help measures, a good relationship between doctors, nurses and patients can be established and maintained psychologically, so as to promote patients to have positive psychological activities that are conducive to stabilizing their emotions and establishing confidence in disease resistance. To do this, nurses should strengthen psychological conditioning, pay attention to language art, be thorough and meticulous in clinical nursing, carefully observe the changes of illness and psychological activities, master the formation of patients' psychological characteristics and the laws of psychological activities, and carry out targeted psychological nursing. According to the specific situation of patients, paying attention to individualization and psychological nursing by nursing staff can achieve better psychological nursing effect.