Why does the limb on the hemiplegic side swell?

① Circulation obstruction: After hemiplegia, upper limb motor dysfunction and weakened muscle activity lead to decreased vascular muscle pump activity, poor blood circulation, and blocked lymph circulation, resulting in limited blood and lymphatic return in the hands and swelling.

②Improper posture: If the patient maintains an incorrect posture for a long time, it is easy to aggravate the circulation restriction on the affected side and cause edema of the hand. For example, the wrist joint continues to be flexed and compressed, the upper limb continues to be in a flexed position, and the upper limb droops for a long time when sitting. .

③ Soft tissue injury: In the early stage after hemiplegia, the patient's limbs are in the soft paralysis stage, and the muscle strength and muscle tension are reduced, and the muscles themselves and joints cannot be well protected. This is easily ignored in daily care and training, resulting in damage to joints or soft tissues. Excessive stretching causes an inflammatory reaction.

④ Infusion of the affected hand: Since the circulatory function of the affected hand is blocked, if an infusion is given to the affected hand at this time, the affected hand will not be able to circulate the fluid that has penetrated into the surrounding tissue back to the heart, resulting in edema of the hand.

⑤ Improper care: After hemiplegia, the patient's movement disorder in the affected limb may also be accompanied by sensory impairment, resulting in a decrease in the affected hand's sensation of pain, temperature, etc., increasing the risk of accidental injury to the hand, resulting in edema.



How to tell if your hands are swollen?

Observe the size of the hand: the hand is swollen compared to the healthy side, the back of the hand bulges, the fingers become thicker, etc.;

Touch skin hardness: Press the skin on the back of your hand to create a depression, which will rebound within a few seconds;

Observe the skin temperature: the temperature of the hand increases, and the hand on the healthy side is slightly hotter;

Observe skin color: redness, purpleness or blueness;

Check joint movement: pain occurs when moving the finger joints, accompanied by limited hand joint movement.



How to prevent the occurrence of edema?

1. Correct transfer and placement of good limbs

① Correct holding skills: During the transfer process, the affected limb on the affected side should be supported to avoid excessive pulling of the affected limb.


② Ipsilateral lying position
Head: Well supported, keeping the head slightly above the chest
Torso: Turn slightly backward
Upper limb on the affected side: Extend the shoulder forward, straighten the elbow joint, supinate the forearm, palm upward, and extend the fingers.
Unaffected upper limb: placed on the body or behind the body
The lower limbs are in a stepping position, with the healthy leg's hip and knee flexed on the pillow, and the affected leg's hip extended and knee slightly bent.



③Lying on the healthy side
Head: Well supported, keeping the head slightly above the chest
Trunk: at right angles to bed surface
Upper limb on the affected side: Lift the shoulder about 90°, straighten the elbow, extend the fingers, palm down, and place it on the pillow in front of the chest
Unaffected upper limb: Place in a comfortable position
Lower limb of the affected side: Bend the hip and knee and place it on the pillow
Lower limb on the unaffected side: lay flat on the bed, slightly extend the hip and bend the knee


④Supine position
Head: Good support, upper cervical spine flexion, but no thoracic spine flexion.
Upper limb on the affected side: place a pillow under the scapula to extend the scapula forward and keep the upper limb in a correctly elevated position. With the palm of your hand facing downward, keep extending your elbow, wrist, and fingers.
Pelvis: Place a pillow under the buttocks and thighs of the affected side to bring the pelvis forward and prevent external rotation of the affected leg.
Lower limb on the affected side: straight


⑤ Sitting position
When the patient sits up, place the affected limb on the table, wheelchair table or pillow, keep the shoulder stretched forward, the elbow, wrist and fingers extended, and the trunk upright

2. Early appropriate exercise
It includes passive movement and active movement. Passive movement mainly includes flexion, extension, adduction, abduction and other joint activities of the limbs on the hemiplegic side. Pay attention to the range of motion and duration of joint movement, which should be tolerated by the patient and not painful. Active activities include the Bobath handshake movement, interlocking the fingers of both hands, with the thumb of the hemiplegic side on top, and using the healthy side limb to assist the affected side limb in shoulder and hand movements.

3. Application of auxiliary braces

① Use wrist and hand functional braces to avoid hand flexion and pressure

② Early use of shoulder slings to fix the affected limb at or above heart level can prevent and promote the reduction of limb swelling, but be careful to wear it only when sitting or standing, and not for too long.

③Selective use of pressure gloves to prevent hand swelling



How to deal with swollen hands?

1. Alternating hot and cold water bath: Use warm water at 40-45℃ and cold water at 5-10℃. First soak in warm water for 2-3 minutes, then soak in cold water for 1-2 minutes, repeat 5-10 times, and finally take a hot water bath. period ends.

2. Centripetal wrapping and compression finger method: Use a thread with a diameter of 1-2mm to wrap around the finger from the distal end to the proximal end. The wrapping starts at the nail and makes a small loop, and then wraps it quickly and forcefully to the root of the finger until it can no longer be wrapped. After wrapping, the therapist immediately pulls away the wrapped cord from the small ring at the fingertip. Start with the thumb, wrap it around each finger, and finally wrap around the palm.

3. Centripetal pressure massage: Use your thumb to apply pressure from your fingers to your wrist. The pressure force should be as long as it is not uncomfortable for the patient. Continue to apply force and slow pressure on the swollen area for 15 minutes each time, usually twice a day.

4. Kinesio Taping: Control the direction of the skin through the pulling force of the density difference of the Kinesio Taping, further promoting the permeability and circulation of the fascial system, and at the same time improving lymph and blood circulation, reducing the risk of Edema of upper limbs

5. Physical factors:

① The use of ultrashort wave therapy is beneficial to the dissipation of edema and the removal of inflammatory and pain-causing substances 

② Medium-frequency electricity can improve local lymph and blood circulation, eliminate local edema, and inhibit sympathetic nerve function. Improve the nutritional status of limb neuromuscular

③ Treatment with a semiconductor laser therapy device can effectively enhance vascular permeability, improve local blood circulation, reduce edema, promote tissue repair, and relieve muscle spasm pain.