138 chapter 16
REST AND POSITION
Children with arthritis need a lot of rest. They tire easily, and should have a chance to
rest often. Help the child to be in positions that keep the arms, wrists, hips, and legs as
straight as possible.
NO YES
NO
no pillow or very flat
pillow, especially if
the neck is affected
YES
pillow
between
legs
In these positions, contractures
develop more easily.
Although it may hurt more, it is better for the
child to lie on her back or stomach, not on
her side with her legs bent.
When pain is worst, alternate rest with legs
straight and slightly bent.
In these positions, contractures
are less likely to develop.
Rest and sleep with the arms and legs
as straight as possible. Use pillows only
in a way that gently helps the joints
straighten more. Let the legs slowly
straighten under their own weight.
EXERCISES AND MOVEMENT
Our goal is to prevent contractures and dislocations, and to maintain the fullest
possible range of motion for the body. So exercises are needed to strengthen the
muscles that straighten the joints.
HOW PAIN CAUSES CONTRACTURES
When these muscles are tightened,
they straighten the knee,
Because it hurts to straighten the knee,
the child with arthritis does not use
these muscles much. So they become
very weak.
Since the muscles on top are
weaker than those below, the
uneven muscle strength keeps
bending the leg more and
more, even during sleep.
and these
muscles
bend it.
But these muscles stay tightened to
keep the knee bent and guard against
pain. So they stay stronger.
NOTE: This kind of uneven
muscle strength is called
muscle imbalance.
Disabled village Children