Rehabilitation of children with cerebral palsy

Cerebral palsy develops as a result of damage to brain tissue (lesion of the trunk, cortex, capsule). Clinically, the disease is manifested by paralysis, atony or hypertonicity of individual muscle groups, as well as a violation of the swallowing reflex, mental development, and difficulties with social adaptation. Symptoms vary depending on the affected area. The most common causes of the disease are birth trauma, birth asphyxia, intrauterine infection. When diagnosing cerebral palsy, a child needs constant treatment and rehabilitation, which help to alleviate the severity of the pathology.

The main methods of the rehabilitation course of cerebral palsy

The rehabilitation course for patients with cerebral palsy is carried out on the basis of rehabilitation centers established by the state. Patients can be referred there by a local pediatrician, therapist or doctor of the somatic department.

Rehabilitation of children with cerebral palsy includes a wide variety of procedures aimed at reducing muscle tone, stimulating mental development and collectivization of the child. The duration of the recovery period is different and depends on the severity of the disease (a severe degree requires constant training). Doctors and rehabilitation specialists advise starting a recovery program from the age of 1. The result of the effectiveness of therapeutic measures for cerebral palsy depends on the age of the child. Since in babies, neural connections in the brain are restored much faster than in older children.

The main methods of rehabilitation of cerebral palsy:

• massage;
• physiotherapy;
• bobat and vojta therapy;
• hydrotherapy;
• the use of devices and simulators that prevent the development of a pathological posture, reducing muscle hypertonicity;
• classes with a speech therapist to correct speech defects;
• psychological support for parents and children;
• drug therapy necessary to eliminate excessive muscle tone;
• surgical operations - tendon plasty, corrective osteotomy;
• carrying out neurosurgical operations;
• physiotherapy;
• hippotherapy, dolphin therapy;
• art therapy (therapy with drawings);
• sensory therapy.

During rehabilitation, the child has one goal: to learn to roll over, stand, sit, grab or hold objects. In the course of classes, the child's adaptation to society improves, as well as the child's intellectual abilities.

Medical and surgical treatment

Rehabilitation in children with cerebral palsy necessarily includes drug therapy.

The purpose of using medications is:

• decrease in muscle tone (removal of spasm of the pharynx or its paralysis, weakening of the pathological posture);
• stimulation of blood circulation in the brain;
• elimination of convulsive syndrome;
• improvement of the conductivity of nerve impulses in the brain tissues.

Patients with cerebral palsy often experience epileptic seizures. As anticonvulsant therapy, the drugs Lamotrigine or Toparamat are used. Mydocalm, Baclofen is actively used to reduce muscle hypertonicity, which facilitates the restoration of motor activity in a child in the future. To stimulate brain activity, doctors prescribe the drug Actovegin, which is necessary to improve cerebral circulation. With severe pain, the doctor prescribes analgesics and antispasmodics.

If a child with cerebral palsy has concomitant diseases, such as diabetes mellitus, hypothyroidism, therapy with thyroxin and short-acting or long-acting insulin is added to the treatment. Obesity is treated with drugs that speed up the metabolism, a balanced diet and exercise. With strong excitement, children are prescribed antidepressants.

Orthopedic and surgical correction

Surgical care includes operations to eliminate contractures in the joints that occur with a constant increased tone of the flexors (extensors) and atrophy of the muscles of the antagonists. Surgeons perform surgery for joint replacement, tendon plasty, osteotomy. Brain surgeries are performed to restore the functioning of the nerve bundles. These techniques help to partially alleviate and restore the patient's motor activity.

Massage and physiotherapy exercises (LFK)

Massage and exercise therapy are considered the main areas of physical rehabilitation of cerebral palsy. Massage is carried out only by a specialist. This procedure is carried out daily and is designed to improve blood circulation in the limbs, relieve muscle spasms.

Therapeutic physical culture is necessary to restore the work of atonic muscles. A doctor for exercise therapy deals with the child, who prescribes sets of exercises depending on the clinical manifestations of cerebral palsy. The child performs the exercises on his own, as well as with the help of a doctor or mother. Classes are held on a rug, with a ball, dumbbells. The complex of classes often includes tilts, squats, lunges, crawling, stretching, walking.

Physical therapy doctors use the “tunnel” exercise, walking on an inclined or swaying board to train balance, jumping rope, rubber bands, and the “classics” game. Daily classes 2 times a day for 1 hour during the year lead to positive results. Cancellation is not recommended.

Use of devices and simulators

To facilitate movements and redistribute the load on the child's muscular system, doctors use special complexes. They are attached to the ceiling and floor, have many stretching elements that slightly counteract spasmodic muscles, and also carry out passive movements of atrophied muscles.

Classes on simulators are carried out only under the supervision of medical personnel or mothers. Parents are actively trained in the correct use of simulators so as not to harm the child. Using the Adele suit will improve the results of training, facilitate the movements in everyday life. The “rider” simulator, the “spiral” suit, the Gross universal system help to acquire new skills and sensations.

Patients with cerebral palsy need wheelchairs, walkers, toilet chairs, hygienic bath seats, and exercise bikes. You can buy verticalizers. These are devices for keeping the child in a standing position. They are equipped with a special table for eating and wheels that make it easier for the child to move around the room. Physical education, massage, specialized devices are also used in the rehabilitation of adults with cerebral palsy.

Other techniques

Medical rehabilitation of cerebral palsy includes many methods: physiotherapy, speech therapy classes, various board games, as well as outdoor games. Useful water treatments, swimming with dolphins.

Physiotherapy

Physiotherapy includes hydrotherapy, electrotherapy, magnetotherapy, mud therapy, electrical stimulation, ultrasound, electrophoresis. From water procedures, swimming in the pool, sea, coniferous baths, dolphin therapy are distinguished. Swimming has a positive effect on all muscle groups, promotes the growth of the skeleton, and calms the child. It is often combined with gymnastics. A color dynamic quantum camera combines swimming pool sessions with a laser shower.

Electrotherapy is prescribed to stimulate the brain by improving blood flow. Galvanic baths combine the effects of electric current, water, medicinal substances. Ultrasound therapy is performed to improve blood circulation. If the child is excited, wakes up at night, and also has frequent epileptic seizures, he is shown electrosleep.

Dolphin therapy, hippotherapy

Rehabilitation of cerebral palsy includes treatment with dolphin therapy. The course of classes lasts 2 weeks. The child receives new sensations, a lot of positive emotions. When moving with its fins, the dolphin sends streams of water to the baby, which have the effect of vibration massage. Touching a dolphin stimulates sensory sensitivity, which helps the functioning of the functional centers of the brain.

Hippotherapy - riding a horse. This technique strengthens the back muscles, promotes balance training, and prevents depression in children. It is suitable for babies over 2 years old, teenagers as well as adults.

Classes with teachers, speech therapists and psychologists

The task of teachers and psychologists during the rehabilitation of cerebral palsy is to teach the child to communicate with other people using speech, emotions, gestures, play, work. The staff must create an environment for the child in which he will not feel inferior. Teachers and parents teach the baby to serve themselves independently, prepare the child for the learning process. Speech therapists build a clear, correct speech, correct the pronunciation of words, form the strength of the voice and speech flow.

Educational games and drawing

During rehabilitation, doctors advise to do more fine motor skills. It develops the intellectual abilities of the child. For these purposes, mosaic, puzzles, constructors, picking up sticks, playing musical instruments are suitable. It is very useful to introduce children with cerebral palsy to art therapy. Drawing calms the child, gives him the opportunity to express his thoughts and emotions, and prepares him for learning.

Sensory therapy, Bobath therapy, Vojta therapy

For patients with cerebral palsy, there are sensory rooms in rehabilitation centers. They are equipped with various kinds of irritants (multi-colored garlands and lamps, massage chairs, couches, balls with a pimply surface, dry baths filled with colored balls). The child is in the room with his mother for 30-40 minutes.

Bobath therapy is carried out through supportive and stimulating techniques for movement. Vojta therapy is the launch of certain muscle groups at the reflex level. It is used in children under 1 year old. Timely use of this method can stop or prevent the onset of the disease.

Conclusion

Rehabilitation is an important stage of recovery in patients with cerebral palsy. It is used in adult as well as pediatric practice. To achieve successful treatment, it is necessary to persevere in physical therapy, attend physiotherapy for several years. An integrated approach to rehabilitation therapy at an early stage of the disease can lead to an improvement in the patient's condition, and in children under 1 year old to the prevention of the onset of cerebral palsy.

Rehabilitation of cerebral palsy - video