Exercise Guidelines for Complications of Hyperglycemia: Rehabilitation Exercises for Frozen Shoulder and Hemiplegia

Exercise Recommendations and Restrictions for Patients with Hyperglycemia:

Exercise should be tailored to the characteristics of complications: The most frequently mentioned term in medicine is "treating the symptoms." Similarly, diabetic patients should exercise according to the characteristics of their complications. Frozen shoulder is one of the common musculoskeletal complications of diabetes. Patients can consistently perform internal rotation, external rotation, abduction, and circumduction of the upper arm in the morning and evening for extended periods. It is crucial not to rush the process; only in this way will the desired effect be achieved. In addition, diabetic patients with frozen shoulder can also perform the following exercises:

(1) Pulling the arm to touch the ear: Use the healthy limb to pull the patient's limb above the head, trying to touch the ear root. Repeat several times.

(2) Side-lying wall climbing: Have the patient stand sideways close to a wall and perform shoulder abduction and lifting movements 2-3 times daily for 5-10 minutes each time, gradually increasing the degree of upper arm abduction each day.

(3) Up-and-down traction: The patient holds the ends of a pulley rope with both hands and uses the healthy limb to pull the affected limb up and down to help the shoulder joint move. In addition, gymnastics and dance, which involve more upper limb movement, can be chosen, such as the crane flying movements in the Five Animal Frolics. The more limited one's mobility, the more important it is to persist in exercising to avoid giving up halfway. The saying "He who travels a hundred li is only halfway there at ninety" perfectly illustrates this point.

Relatively speaking, diabetic patients with hemiplegic complications should maintain an optimistic attitude and must not become pessimistic and depressed because of limited mobility. Prolonged rest can worsen insulin resistance, which is detrimental to recovery. Therefore, hemiplegic patients should also exercise appropriately. Exercise should be tailored to the individual. First, functional exercises of the healthy limbs can be performed, such as raising, flexing, extending, and rotating the limbs in bed, to promote blood circulation and consume excess glucose. Second, passive movements of the affected limbs can be performed, such as movements of the head, neck, upper and lower limbs, wrists, and ankles. This prevents disuse muscle atrophy and strengthens blood circulation in the affected limb, thus promoting early recovery. Family members should encourage and assist the patient to get out of bed and move around as limb function recovers, progressing from assisted movement to walking with a cane, and eventually walking without a cane, until the patient can move outdoors. During activities, the following reminders should be given:

(1) Rehabilitation exercises for hemiplegic patients require the help of doctors, family, and even society.

(2) It is important to provide psychological support to the patient, ensuring they are not left idle in bed. Their initiative should be fully utilized, and they should actively cooperate both psychologically and physically.

(3) Passive movements should not be too strenuous to avoid straining or damaging joints.

(4) The amount of activity should not be excessive, especially for those who have been bedridden for a long time and are generally in poorer physical condition; extra caution is needed.