Trunk flexion(abdominal) exercises for a Hypertensive pt

[Morton]

I'd like to know if Trunk flexion exercises can be given to a 56 yr old female, Hypertensive patient with Lt. Hemiplegia. As part of the Rehabilitation Program, i've ben working on her trunk with a hint of doubt though on whether I can give her Trunk flexion exercises. The reason of my doubt is Valsalva maneuvere. Won't the large +ve intrapleural pressure reduce cardiac output.

I feel this could be detrimental to the pt. But however i do wish to train her trunk flexors, since she has a tendency to fall backwards(weak trunk flexors) when ever i bring her to erect stance.

Is there any other way of handling this situation?>D

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[Physiobase]

Why not sit her on a gymball and work in circular motions and forwards and backwards working on pelvic tilt which would therefore work on the abs. You can sit on a stable surface behind her for safety. 8o

[cyberphysio]

check whether she is stable or unstable HT. if stable there is no problem. start with static abdomial exe,then progress.make few contraction and then breathing exe. u will get confidence.
why u try abdominal with breath holding? try without holding breath.
i hope this works

[jaishingdia]

maybe you could try central and/or peripheral key points and facilitate the movement byincreasing tone?

[Rajul vasa]

Dear Mortondave
Do not worry about cardiac output for a hemiplegic with high BP during trunk flexion, voluntary movement or static abs will not influence autonomic nervous system.

The reason why her trunk goes into hyper extension is not necessarily due to weak trunk flexor but is a pure defensive CNS response affecting biomechanics to alter muscular response.

rajul vasa
working on total solution for stroke with vasa concept.
www.brainstrokes.com

[tnmuralidharan]

hi,
you got to work on the trunk of a hemiplegic which is very important!! the is a book wirtten by patricia davies by the name right in the middle which emphasises the importance of triining the trunk!! according to the book, extension pattern is the primitive pattern an i is very important to train the combo of flexn and extn in a patient after cva!! and these are techniques where you dont want to strengthen the abs, you want the abs on the paralyzed side to work!! so go ahead see if you can read the book and find out techniques of facilitating the abs!!

[Morton]

Thanks for all the views. Well I've got my hands on the book "Right in the Middle" by Patricia Davis.
Very informative.