Functional exercise is a method to prevent and treat some diseases through training physique in self-exercise. The functional exercise in orthopedics and traumatology is an effective means to put into effect the therapeutic principles of consideration of both locality and the whole, and combination of motion and quiescence so as to promote functional recovery.
Action of functional exercise
Improving general and local circulation of qi and blood, and functional coordination of viscera so as to make qi-blood supply abundant in the diseased part, promoting absorption and removal of various pathological products early, and nourishing skin, muscles, tendons and bones for guaranteeing recovery of tissues.
Preventing disuse myoatrophy, osteoporosis, ankylosis and cicatricial adhesion.
Under an effective fixation, stabilizing the reduced fracture ends through actions of muscular dilation, antagonism and crush.
Benefiting quick recovery of functions of limbs.
Methods of functional exercise
Functional exercise of neck
Either sitting or standing positions may be taken. In standing position, stand with feet shoulder-width apart and arms akimbo while doing deep respiration, as well as do the following movements.
Requirement and principles of functional exercise
Functional exercise should take active exercise as the principal and passive exercise as the secondary, and bring along the diseased limb through healthy one. The acts taken should be cooperative, symmetrical, parallel and multiple; and be done with patience and care, proceeding in an orderly way and step by step, and gradually enhanced. Any crude passive movement should be avoided. The act of exercise should be chosen according to time, extent, nature, region and type of injury, as well as stability of fracture ends after reduction. Harmful acts (such as early rotation movement in fracture of forearm, and early abduction movement in abduction fracture) should be strictly forbidden for avoiding pain, swelling, displacement and fracture again. Therefore, the significance of functional exercise should be clearly explained to patient, helping the patient build up confidence to struggle against disease, bringing the initiative of the patient into full play, and making the patient adhere to correct exercise methods.
Left and right flexion
Flex the head leftward while inhaling, then return to neutral position while exhaling; flex the head rightward while inhaling, then return the neutral position while exhaling. Repeat it 7 to 8 times with alternation of left and right.
Anteflexion and retroextension
Anteflex the neck as much as possible to let the chin near the upper border of presternum while inhaling, retroextend the neck maximally while exhaling. Repeat the movements 7 to 8 times.
Left and right turn
Turn the head to the left while inhaling, and turn the head from the left to the right while exhaling. Repeat it 7 to 8 times with alternation of left and right.
Functional exercise of waist and back
Anteflexion and retroextension
Stand with feet shoulder-width apart, keep two legs straightened, with arms akimbo. Anteflex and retroextend the waist for 4 to 5 times, relax the lumbar muscles as much as possible when doing exercises.
Left and right circle rotation
Make the head do circle movement for 3 to 4 small circles, and finally a large cycle, alternately clockwise and counterclockwise.
Left and right flexion
Stand with feet shoulder-width apart, with two arms banging down, flex the waist to the left with left band dropping downward along the lateral aspect of left leg as much as possible, return to neutral position. Repeat the same movements, reversing sides. Do the movements repeatedly for 7 to 8 times.
Left and right circle rotation
Stand with feet shoulder-width apart, and arms akimbo, rotate the waist clockwise and counterclockwise respectively for one time, then from slow to rapid, from small to large do the rotation for 4 to 5 rounds.
In supine position, bend the elbows, hips and knees; taking the five points of head, feet and elbows as supporting points, presses the two palms against the waist forcefully to make it arched. Do the movement several times. When the lumbar muscle gets stronger after a period of exercise, bend two arms and put them on the front of chest, taking the three points of head and feet as supporting points, do the waist circling exercise. Gradually, take the four points of palms and feet as supporting points to do the arch-bridge-like exercise.
In prone position, stretch the arms respectively along with two sides of the body, raise head and shoulders with two arms backward and upward, or raise the two stretched legs backward and upward, further do the two movements simultaneously just like a flying swallow. Repeat the exercise many times.
Functional exercise of shoulder and elbow
Ante-extension and retroflexion In semi-squatting position, clench two hands into fists at the waist, make an effort to straighten one arm forward and upward, then return forcefully to starting position. Repeat the movement, reversing sides. Do the same movement many times with alternation of left and right sides.
Bending waist and drawing circle
Stand with feet apart, bond the waist forward, let the diseased arm straightened out and dropped downwards. Do circle movements clockwise and counterclockwise, from small to large and from slow to rapid.
Inward and outward rotation
In semi-squatting position, let hands clenched into fists, elbows flexed with forearms supinated. Do intorsion and extorsion of shoulder joint by using the forearm to draw semicircles to and fro. Do the movements alternately with two arms. Repeat many times.
Upper limb rotation
Stand with feet shoulder-width apart, one hand akimbo and the other hand clenched into a fist. Do circle-drawing movement of the whole arm clockwise and counterclockwise, from small to large and from slow to rapid. Do the movements alternately with two arms. Repeat many times.
Finger climbing wall
Stand with feet apart and front or lateral side of the body against a wall, fingers of the diseased side slowly climb the wall till the arm raises to the maximal height, then along the wall return to the starting point. Repeat many times.
Hand waving on bow step
Set two legs apart posteroanteriorly to form a how step, hold the diseased forearm with the healthy hand. Shift center of gravity of the body backward first, bond elbows with forearms on the front of chest. Then shift the center of gravity forward, at the same time, thrust out the diseased forearm, at the same level, clockwise or counterclockwise in an arc. Repeat the movement above, reversing "backward" and "forward". Do the same movement many times.
Flexion and extension of elbow
In sitting position, put the diseased elbow on a cushion on a table, set the hand into a fist, make an exertion to slowly flex and extend elbow. Repeat the movement many times. ,
Hand pulling pulley
Install a pulley, the patient sits or stands under the pulley with hands holding the two ends of rope, uses his healthy arm to bring along his diseased arm to slowly pull the rope up and down.
Functional exercise of forearm, wrist and hand
Put arm near the side of chest with elbow bent at the angle of 90° and hand clenched into a fist. Do movements of pronation and supination of forearm.
Grasping about in the air and clenching fist
Make an effort to open five fingers, then make an effort again to clench them into a fist.
Dorsal extension and palmar flexion
Forcefully clench fists, do dorsal extension and palmar flexion movements.
Fingers trundling balls
Hold two balls in the band, move fingers to make balls roll or change position.
Functional exercise of lower limb
Kicking with heel
In supine position, raise the straightened leg slowly, then bend the hip and knee, and extend ankle dorsally as much as possible, finally thrust and kick foot forward and upward. Repeat in the same way.
Stand with heels together, knees slightly bent to form semi-squatting gesture. Put hands respectively on the knees, rotate the knee joints clockwise and counterclockwise from straightening to flexing and then from flexing to straightening. Repeat alternately.
Extension and flexion of ankle
Taking either lying or sitting position, extend the foot dorsally to the maximum, then flex it metatarsally to the maximum. Repeat many times.
Taking either lying or sitting position, rotate the ankle clockwise and counterclockwise. Repeat alternately many times.
Rubbing and rolling
In sitting position, the diseased foot steps on a log to make it roll forward and backward, making the knee and ankle joints do flexing and extending movements.
Sit on a vehicle specially made for functional exercise, pedal with the tip of foot, making muscles and joints of leg exercise.
Moving body to drive leg
During the period of fixation of a leg, move the arm and body to drive the diseased leg to exercise.