Hesperian Health Guides
Prevention of Contractures and Deformities in Persons with Paralysis
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HealthWiki > Disabled Village Children > Chapter 26: Leprosy: Hansen’s Disease > Prevention of Contractures and Deformities in Persons with Paralysis
Prevention of contractures from paralysis due to leprosy is similar to prevention of hand and foot contractures due to polio and other forms of paralysis. However, loss of feeling makes prevention more difficult.
Exercises to maintain full range of motion are covered in Chapter 42 (see especially "Guidelines for Doing Stretching and Range-of-Motion Exercises").
- Exercises to prevent fixed clawing of the hands can be done by gently straightening the fingers like this:

and like this:
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Open your fingers as much as you can without help. Then use your other hand to open them the rest of the way. Close fingers and repeat. |
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- A good exercise to prevent ‘tiptoe’ contractures with ‘foot drop’ is to stretch the heel cords by leaning forward against a wall or by squatting with heels on the ground.
Footwear for persons without feeling in their feet
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The best footwear has:

Possible ways to get footwear
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An insole that is thick may work if the foot is already short. |
soft insole |
- Make (or have a local shoemaker make) special footwear.
For the inner sole, you can use a soft, sponge sandal or ‘thong’. Or buy ‘microcell’ rubber, which is soft but firm. | ![]() |
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For the under-sole you can use a piece of old car tire. |
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a bar here or a foot support here may help take pressure off the ball of the foot and prevent new sores. |
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- For persons with a ‘drop’ foot, a brace or ‘lift’ can help prevent sores and injuries.
You can get a brace or support at a rehabilitation workshop, or make a specially-fitted, well-padded plastic brace (see Chapter 58). | ![]() |
Or make a simple device to hold the foot up. | ![]() |