“We strengthen what is safe”: principles of rehabilitation of children with cerebral palsy / City news / Moscow Website

Rehabilitation of cerebral palsy is carried out for all sick children; such a program will help return the child to a full life. It is carried out under the supervision of a doctor, the doctor assesses the degree of brain damage and selects the most effective methods. It will not be possible to get rid of the disease completely, but if you do all the exercises and training, you can regain lost functions: motor activity, speech and correct the psychological status. The most effective results are observed if rehabilitation of cerebral palsy is carried out in specialized centers.

It is better to start recovery in the early years, because at a young age a child’s brain is formed and actively developing. With this approach, it is possible to effectively compensate for the main disorders that arose during intrauterine development.

Forms of the disease

Cerebral palsy does not progress, because organic brain damage occurs during pregnancy. But in the absence of rehabilitation, these complications become permanent, and a person has to live with them all his life. The main signs of cerebral palsy are movement disorders, weakening of muscle tone, the appearance of pathological reflexes, and speech impairment. All these disorders can be significantly compensated for if a rehabilitation program is started in time.

Before starting treatment, the doctor determines the form of the disease:

spastic diplegia - damage to the muscles of the back, legs and arms, rigidity of the lower extremities is more pronounced;
double hemiplegia – the muscles of the arms are most affected, and mental retardation is observed;
atonic-astatic type of pathology - deterioration of muscle tone throughout the body due to damage to the cerebellum and its pathways;
hemiparetic form - unilateral lesion with predominant weakening of the upper extremities.

How is the rehabilitation of cerebral palsy carried out? – the first two forms are more amenable to correction than others, but with constant treatment and training, even with the most severe course of paralysis, good results can be achieved.

Causes

Parents are interested in why their child may develop cerebral palsy. It is important to understand that pathology can appear during fetal development, during childbirth and after the birth of the baby. There are many factors that contribute to the occurrence of the disease. We can highlight the main ones so that people can roughly understand in what situations the disease is formed.

Main reasons:

Improper formation of the cerebral cortex. This happens under the influence of many negative factors. In particular, oxygen starvation contributes to the occurrence of cerebral palsy. Hypoxia mainly occurs due to problems during pregnancy, that is, due to late toxicosis, infectious diseases and impaired placental circulation. As a result, under the influence of negative factors, the child’s brain cannot develop to its full potential.

Birth injuries. They cause brain damage. Often they can be obtained in the case of prolonged or rapid labor, with reduced labor activity, due to a narrow pelvis and improper placement of the fetus. Even a long period without water can trigger the development of cerebral palsy in a child.
Infection of the fetus with a viral infection. Herpes and rubella have a particularly negative effect on the brain.
Acute maternal illnesses that occur during pregnancy. These include heart defects, obesity, diabetes and anemia.
Fetal intoxication. Poisoning, regardless of severity, has an extremely negative effect on the baby’s condition.
Errors of medical personnel during childbirth. To prevent this factor from occurring, it is important to choose a good clinic.
Rh conflict between the blood of mother and child. Because of it, the baby develops kernicterus, and cerebral palsy occurs as a complication.
Prematurity and extremely low weight in the child. If a woman experiences premature birth, then in about 50% of cases the baby may be diagnosed with cerebral palsy.

A woman should plan her pregnancy and prepare well for it in order to reduce the likelihood of illness. It is important to take preventive measures to protect your baby from cerebral palsy. If the disease has already been diagnosed, then rehabilitation of children with cerebral palsy will be required. There are many different methods that can be used to restore a minor who has encountered a disease.

Recovery stages

The first steps in the treatment of cerebral palsy are the most difficult - the child has lesions in the cerebral structures, which cause motor impairments. In the future, it will be easier to cope with pathology; as neural connections are restored and formed, it will be easier for the nervous system to adapt to new conditions.

There are several stages of recovery; such rehabilitation is carried out for cerebral palsy from an early age. It includes:

preparing the nervous system for upcoming loads and movements;
biomechanical effects to destroy neural connections and restore muscle tone;
consolidation of the results obtained, stabilization of coordination of movements and self-care.

The second stage is the most difficult; many difficulties arise during this period. A complete restructuring of the nervous system is coming - the child will actually have to learn to walk again, talk normally and deal with stress.

Auxiliary training equipment

Additional simulators for early development that it is advisable to have at home include:

A rug with an uneven surface, covered with small bumps. It is necessary to teach the child to walk on it with bare feet. It is better to focus on your heels. This is where the largest number of nerve endings are concentrated. Another undoubted advantage of the procedure is the normalization of blood circulation. To create more interest in this activity for the child, it is recommended to paint the rug, apply interesting appliqués and patterns. This decision will contribute to intellectual development.
Expander. Nowadays there are already quite a few similar simulators for the development of grasping reflexes. But before, beautiful rag bags with cereals (buckwheat, rice) were used. This remedy also eliminates finger spasticity.
Walkers or jumpers. You need to carefully consider the choice of this simulator. It is advisable to select special ones for children suffering from cerebral palsy. They have a unique orthopedic insert and have the function of attaching to a vertical surface. However, doctors have very different opinions about the need to use walkers. It is recommended that parents study all the reviews and, after consulting with a specialist, make a decision.

Recovery methods

Rehabilitation methods for children with cerebral palsy are varied, they include ongoing treatment, physical therapy and training. Medicines are used as basic therapy, exercises and procedures help develop new skills and consolidate the results. To obtain a pronounced effect, the impact must be complex and targeted, therefore, to prescribe a program, you should contact specialized centers. A doctor in such an institution will be able to observe the patient and, if necessary, adjust rehabilitation.

Speech development, training and psychological rehabilitation for cerebral palsy

A proper rehabilitation system for a child with cerebral palsy must necessarily include classes with a speech therapist, psychologist, and speech pathologist. These specialists help to promptly identify and treat various disorders of speech, behavior, and psychological adaptation. Almost all children with cerebral palsy have such deviations.

First of all, sick children should organize an environment in which they will not feel disadvantaged compared to their healthy peers. It is important to simplify their movement in space as much as possible, remove thresholds and steps in the apartment, and widen doorways if the child moves in a stroller. Unfortunately, on the streets of our cities and in public institutions there are still few facilities for the disabled. Therefore, such people often become even more limited in their capabilities.

Psychological rehabilitation of children with cerebral palsy also includes the development of communication skills, correct emotional reactions to certain events, the ability to play and complete tasks. Specialists help the child form an understanding of space and time, develop sensory organs and coordination of movements, which in turn will help them take care of themselves. From the first months, the intellectual development of children should be stimulated in accordance with their age.

Children of preschool and school age must study with a teacher who will help teach them writing, reading, and counting. Drawing, modeling, and handicraft lessons are very useful for developing fine motor skills. The program is always developed individually, depending on the capabilities of a particular child and his age.

Approximately 80% of children with cerebral palsy have speech impairments. They begin to utter their first words late, at two or three years old, and by the age of five they communicate in short sentences and phrases. Speech develops more intensively at six to seven years of age. Regular sessions with a speech therapist can speed up this process. It is important to start them no later than three years. Here are the main goals that a speech therapist sets for himself in classes with a child:

improve articulation and intelligibility of pronunciation of sounds;
improve the tone of the ligament muscles in the vocal apparatus;
teach your child to control his own voice and breathing;
synchronize speech, correct articulation of sounds and breathing;
correct the pronunciation of some sounds and letters.

Classes with a speech therapist should be included in other stages of rehabilitation. A child’s speech is influenced by many factors, including muscle tone, the presence of hyperkinesis, and the ability to control his own limbs. Therefore, without proper physical and medical rehabilitation, it is impossible to teach children with cerebral palsy to speak correctly. Speech therapy classes consist of the following steps or stages:

Children are introduced to real objects, images, and are taught to look for named things on the game table or in a picture.
In the form of a game, they are introduced to the properties of objects: size, color, shape.
Expanding the characteristics of objects (hard and soft, smooth and rough, warm and cold), children are asked to independently describe certain objects.
Formation of generalizations, the ability to group objects based on their properties.

Classes with a speech therapist help not only to learn how to speak correctly and articulate sounds, but also to think, and have a positive effect on the child’s intellectual development.

Hydrotherapy

This method is used in the process of pediatric rehabilitation to improve motor abilities and sensory activity. The rehabilitation room has a swimming pool with different depths, it is equipped with parallel bars and other auxiliary elements for therapeutic exercises. All classes are held individually: the therapist works with the child and at the same time teaches one of the parents. This helps improve the child-parent relationship, increase confidence levels and develop new motor abilities.

Classes are held for the purpose of:

walking training;
reducing spasticity;
strengthening and development of muscles and joints.

A virtual reality

This is an artificial world in which a child can identify himself and perform various actions, in other words, this is a real world that obeys the same laws of physics, only in virtual reality.

Artificial intelligence monitors changes that occur in the virtual world and provides the patient with new data and tasks for action. This therapy opens up great possibilities. The system is able to individually adapt to each patient, helping the doctor in the process of patient rehabilitation.

There are more than enough advantages of such virtual therapy, which actually helps patients, including:

artificial intelligence perfectly adapts to the capabilities and characteristics of each patient, providing exercises that he can do;
the ability to change the difficulty level of exercises;
helps to measure the patient’s performance in exercises and use this data to develop further exercises for rehabilitation;
patients are very happy and friendly about activities in the virtual world, which undoubtedly affects the general condition of the patient;
in fact, entertainment contributes to patient care.

Sensory Integration

This therapy takes place in a special room – a snoezelen. The room is a multi-sensory environment designed to either stimulate or suppress the patient's core senses through music, various scents, colors, images and other sensory objects.

The environment is controlled, the patient is left to his own devices and has the right to manage his own time and enjoy the environment around him. In such a room, all 5 human senses can be active. The environment can be adjusted and adapted to a specific patient, which has a very effective effect on rehabilitation as a whole.

Sensory integration has the following goals:

relaxation, pleasure and rest without the interference of the patient’s intellect and expectations from surrounding people, there are no failures in the environment;
treatment of psychosomatic disorders;
reduction of aggression, stress and depressive mood;
activation of all human senses (vision, touch, hearing, taste, smell);
increased concentration;
the ability for people with disabilities to respond to stimuli in the created environment or, conversely, to limit the patient from certain ones;
helps the patient understand and recognize his body in a specific space, improve the coordination of the body in movement in relation to the created environment and space;
reduction of self-stimulation.

The ultimate goal of being in such an environment is complete sensory integration and the development of the ability of the central nervous system to respond to sensory information, process it and transmit it to the brain through the senses for the body's further response to surrounding objects and environment. This therapy is suitable for both children and adults.

In what cases does the health of children and adolescents require rehabilitation?

Rehabilitation measures are necessary for those children who have limited capabilities. They allow them to reach their full potential and return to normal living conditions in a short period of time.

The recovery program consists of specific services that are used from birth through adolescence. These are not just specialized interventions, but methods that aim to ensure children's participation.

The recovery program should be based on the following principles:

Rehabilitation should take place in specialized institutions that deal with all types of rehabilitation treatment and have highly qualified workers. Institutions must have established connections with other highly specialized rehabilitation clinics.
Therapy should begin at an early stage of the disease, only in this case can a good result be expected. Initially, a rehabilitation program is drawn up, which complements complex treatment.
The rehabilitation process must be carried out continuously until a good result is achieved.
Rehabilitation therapy must be comprehensive. Medical workers, teachers, psychologists, sociologists, and other participants must be united by a common goal.
A program is selected for each individual patient, taking into account the individual characteristics of the child, as well as the nature of changes in the body.
In a short period of time, there is a return to normal living and studying conditions. In case of irreversible changes, rapid adaptation to new living conditions, excluding psychological trauma.

Rehabilitation of children and adolescents takes place in three stages:

A clinical recovery phase that is carried out comprehensively. Consists of restoring the operation of the affected systems. This stage ends when the underlying disease is cured and lost functions are restored. The child’s body is preparing for the next stage of recovery.
The sanatorium stage is the restoration of affected functions, normalization of the work of other organs and systems.
The adaptation stage allows you to achieve complete restoration of health, a return to normal living conditions, physical education and sports.

Children need rehabilitation in the following cases:

respiratory diseases;
nervous system disorders;
diseases of the urinary system;
rheumatism;
pathology of the nasopharynx of a chronic nature.

Bobath method

This method of neurodevelopmental treatment was named after its creators, Bertha and Karel Bobath. The approach to treating patients with cerebral palsy is based on knowledge and development of the nervous system and its pathologies:

sensory-motor;
emotional and social development of young children;
perceptual;

The program is completely individualized and applied exclusively by the hands of a therapist. The focus is on natural sensory nutritional feedback and musculoskeletal control training.

The principles of treatment are:

learning to sense movement;
motor pattern training;
facilitating the natural movement pattern and inhibiting pathology;
setting goals, taking into account the stage at which motor ability is, the age and abilities of the child, always occurs in close connection with the family;
assistance in the development of normal motor skills of the child;

The success of achieving goals affects the development of the child’s fine motor skills and speech. Close cooperation with the family is a must.

Additional rehabilitation methods

Free rehabilitation of children with cerebral palsy through government programs should include all of the above methods. But there are a number of treatments that are widely practiced in private centers, along with standard treatments.

Balneotherapy or hydrotherapy

The technique is often used in sanatoriums. Its essence is taking baths with the addition of various minerals. They penetrate the skin and have a positive effect on the entire body. Warm water itself relaxes and calms the child. Children with cerebral palsy are most often prescribed the following types of therapeutic baths:

chloride;
hydrogen sulfide;
iodine-bromine;
nitrogen;
pearl;
oxygen

Often, underwater massage and shower massage are used in complex treatment. Mud therapy gives good results. Applications are applied to the neck-collar area, in the area of the hands and feet. In cases of stunted growth, mud applications are made in the lumbar region to stimulate the adrenal glands.

Swimming with dolphins

Swimming in a pool with dolphins (dolphin therapy) has become popular in recent decades. This technique combines a number of positive effects:

swimming relaxes and at the same time strengthens muscles, relieves spasms, and hardens;
contact with dolphins improves nerve conduction and tactile sensitivity;
children receive positive emotions, which has a good effect on the further course of treatment.

Prices for dolphin therapy are high; not every city has dolphinariums or specialists who provide such treatment. There is no authoritative scientific evidence of the effectiveness of the technique, which is why many doctors do not take it seriously. But parents of children who have undergone dolphin therapy speak very positively about it

Hippotherapy as a method of rehabilitation

There is another type of therapy based on the child’s contact with animals. This time horses act as “therapists”. When riding a horse, a lot of muscles of the human body are used, so it is recommended to combat hyperkinesis, muscle spasms, and contractures. In addition, horses arouse great interest in children, positive emotions, and stimulate communication and discovery of the world.

Author's methods

There are several recognized proprietary rehabilitation methods that are used in many centers along with classical treatment methods. Here are some of them:

Voight method, or Voight therapy. Its basis is the impact on certain areas of the body with pressure of varying strength. This stimulates the nervous system, which ultimately leads to increased movement.

Bobath method. It consists of developing a natural motor stereotype in the child. In this case, special, individually selected body styling is used. Children are taught to sense movements and move independently in ways that are as close to natural as possible.

Bloom's method. The basis of the technique is a deep biomechanical effect on skeletal muscles.

In fact, there are many more original treatment methods. You should consult your doctor about the possibility of using one or another additional method of rehabilitation.

PADOVAN method

This method is also called neurofunctional reorganization of the brain. It is based on the human neurological system, on neuralgia of the development of speech, walking, thought processes, on neuroplasticity of the brain and development through the formation of new synapses.

During a PADOVAN session, several methods are combined: occupational therapy, physiotherapy and logotherapy. Exercises are used for the upper and lower extremities to promote speech learning, coordination of body movements, swallowing and breathing.

The method is effective in treating children:

with developmental delays;
with dyslexia;
with learning problems (reading, numeracy and writing;
with attention disorders;
with the presence of hyperactivity.

Medicines

Medicines are used mainly at a younger age, when problems with muscle tone are observed. Next, the drugs are prescribed as maintenance therapy to eliminate complications. Psychological disorders are also treated.

The doctor may prescribe the following medications:

to stimulate muscle tone: Mydocalm, Baclofen, Dysport;
medications to improve cerebral circulation: Piracetam, Lucetam, Biotredin;
vitamins and mineral supplements to strengthen the body.

The doctor adjusts the dosage according to the child’s condition and the effectiveness of the therapy. Taking medications without a doctor's prescription is not recommended.

Exercise therapy

Therapeutic exercises help restore lost functions, normalize tone and prevent muscle wasting. It is recommended to perform exercises from an early age - this will help you quickly cope with weak tone and restore self-care.

The following program is recommended:

physical exercises with a trainer - to develop a specific muscle group;
kinesitherapy - “treatment with movement” and constant physical activity;
mechanotherapy – performing approaches on specialized simulators in rehabilitation centers.

The main feature of the rehabilitation of children with cerebral palsy is that the effect appears only with systematic training. That is why you need to fully follow all the doctor’s recommendations and engage in physical therapy.

Medical methods of rehabilitation of children with cerebral palsy

The first stage of treatment for children with cerebral palsy is physical or medical rehabilitation. It is aimed at maximizing the restoration of motor function, relieving muscle spasms, and suppressing foci of pathological excitation in the nervous system. Physical rehabilitation includes the following techniques:

drug therapy;
physical therapy (physical therapy);
massage;
physiotherapy.

Complex treatment should be carried out without interruption. A neurologist prescribes procedures and monitors their effectiveness in close collaboration with a rehabilitation doctor. Parents must work with their children at home, using the techniques they learn in the rehabilitation center. Effective treatment and rehabilitation of disabled children with cerebral palsy is impossible without the active participation of relatives.

The effectiveness of measures largely depends on the severity of the motor dysfunction. It is customary to distinguish four degrees:

Minor violations. After rehabilitation, the patient can walk independently, without any special obstacles.
Average degree of violation. After therapeutic courses, children walk with support or with assistive devices.
Severe degree of motor impairment. You can achieve independent movement of a child in a stroller equipped with an electric drive.
Very severe. Motor rehabilitation is minimal; children cannot move without assistance; they sit with support.

Drug therapy

Drug treatment plays only a supporting role in the rehabilitation of children with cerebral palsy and is aimed at achieving the following goals:

relieving inflammation and combating autoimmune processes that could cause cerebral palsy during fetal development;
preventing the formation of adhesions and scars after hemorrhages, injuries, inflammations;
combating the consequences of asphyxia (oxygen starvation of brain tissue);
improvement of metabolic processes in brain tissue and other parts of the nervous system;
elimination of seizures and intracranial hypertension;
elimination or reduction of muscle spasms, violent movements, normalization of muscle tone;
launching compensatory mechanisms in the nervous system;
stimulation of the development of speech and psyche of the child.

Drug therapy must be carried out in the first six months of a child’s life. Then it is prescribed, depending on the indications, to complement other methods of rehabilitation of children with cerebral palsy. For example, with cramps, muscle hypertonicity. Children are prescribed the following groups of drugs:

drugs that reduce muscle tone. Their effect is short-lived, it is recommended to use them 30-60 minutes before the start of exercise therapy or massage;
drugs to improve neuromuscular conduction;
tranquilizers and antipsychotics are prescribed for muscle hypertonicity and hyperkinesis. Atropine derivatives are used less frequently. It is important to note that atropine and proserine derivatives are antagonists and cannot be used simultaneously;
drugs that stimulate the central nervous system are prescribed for cerebellar forms of cerebral palsy, when the child’s muscle tone is reduced;
metabolic drugs that improve metabolism in the central nervous system;
means for improving microcirculation;
drugs that stimulate tissue regeneration and prevent scar formation;
diuretics (diacarb, hypothiazide, lasix) to reduce intracranial pressure, relieve edema;
Anticonvulsants should be taken continuously for three to five years, and they should be withdrawn gradually.

Recently, there have been reports of the successful use of Botox to relax muscles in children with cerebral palsy. But this treatment method is still new, before using it you should definitely consult with your doctor and find out the opinion of other specialists

Exercise therapy for children with cerebral palsy

Therapeutic exercise is an old and proven method of rehabilitation of patients with cerebral palsy. It is prescribed to achieve the following results:

develop the child’s ability to independently slow down his movements;
reduce muscle tone;
improve coordination of movements;
increase joint mobility;
teach the child household skills, self-care, and proper body movements.

Exercise therapy can bring positive results if carried out regularly, systematically and continuously. When developing a set of exercises, the approach to each patient must be individual, otherwise motor rehabilitation will progress too slowly. The severity of the disease, stage, age of the children, and tolerability of the procedures are taken into account. During classes, the child should not get very tired; the loads are increased gradually. Exercise therapy should bring joy and pleasure to children with cerebral palsy.

Massotherapy

Therapeutic massage helps children get rid of a number of symptoms and is included in the mandatory treatment program. Its main goals:

reduce muscle tone;
stimulate the growth of muscles and skeleton in a child;
improve lymph flow and blood circulation in tissues;
speed up metabolism;
prevent the development of contractures and scars;
reduce the number of synkinesis (involuntary movements of the limbs).

Types and methods of massage are selected strictly individually. The type of disease, condition and age of the small patient are taken into account. Massage is performed after taking medications and completing physiotherapeutic procedures. The child's pose should promote maximum muscle relaxation. At the end of the session, the results obtained are consolidated with special exercises from the exercise therapy complex.

The following types of therapeutic massage are used to treat children with cerebral palsy:

Classical. Includes stroking, rubbing, kneading (felting, rolling), vibration.
Phelps massage. The main technique is shaking the limbs to relieve muscle spasms and combat contractures.
Massage to improve breathing. Classic techniques are used in certain combinations, and point effects.
Massage to stimulate bone growth. Affects the growth zones of tubular and flat bones.
Segmental massage. Its essence lies in the effect on areas of the skin that are innervated by certain segments of the spinal cord, as well as improving trophism and blood circulation in the central nervous system. Physical rehabilitation after a course of such massage is significantly accelerated.
Manakov massage. Aimed at combating contractures and adhesions. The main massage technique is vibration.
Acupressure. There are two types: inhibitory and exciting. The first is performed for spasm and increased muscle tone, the second for muscle hypotension.

Physiotherapeutic treatment

Physiotherapy is used in combination with exercise therapy, massage, and drug treatment. The course consists of 10-20 procedures, which are selected individually, depending on the child’s age and type of disorder. Very often, physiotherapy is included in the course of sanatorium-resort rehabilitation. The following types of treatment are used:

Electrotherapy. Involves the effects of different types of current on nerve endings and muscles. Galvanic, pulsed, sinusoidal, pulsed currents, and electrical stimulation are used.
Electrosonotherapy. Indicated for increased excitability of the child, sleep disorders, hyperkinesis.
Magnetotherapy. Helps relieve increased muscle tone, improves blood circulation in the muscles.
Ultrasound therapy. Used to relieve contractures in older children.
Laser therapy. Using a laser on the vascular wall, you can improve blood circulation in the muscles and joints.
Ultraviolet irradiation of the paravertebral zone. Involves exposure of areas around the spine to ultraviolet rays. It is often used to prepare a child for electrical muscle stimulation.

Physiotherapy should not cause pain or discomfort to patients. The specialist who carries out the procedures must have good contact with older children and carefully observe the behavior of the children. In most modern clinics, parents or guardians of sick children are always present at sessions

Neurostimulation

This method uses weak currents to stimulate neurons in the brain and spinal cord. This makes it possible to reduce the activity of inhibition in cerebral structures and resume motor activity. Using this method, it is possible to cope with chronic pain and paresthesias, which often arise as complications of cerebral palsy.

The decision to perform neurostimulation is made by the doctor based on the child’s condition. Such therapy is considered successful if it helps eliminate half of all complications.

Physiotherapy

Physiotherapeutic treatment is used as a complement to primary therapy; such procedures strengthen the body. They increase tissue regeneration, activate blood flow in muscles, bones and joints, improving cellular nutrition.

Modern methods of treating cerebral palsy include sessions of the following procedures:

electrical stimulation;
magnetic therapy;
warming up;
light therapy

Treatment is carried out in courses of 10-15 sessions. You need to visit the office strictly on schedule and not skip physical therapy. A referral can be obtained from a pediatrician or a specialized rehabilitation center.

Visit to a psychologist

Working with a psychologist is an important support for a child, which will help with social adaptation. The doctor conducts conversations and finds out what worries the patient in the first place. Game techniques, trainings and questionnaires are used. The program is selected individually according to leading methods for children with cerebral palsy.

During rehabilitation, the emphasis is on physical activity, but without overcoming psychological problems and barriers, it will be difficult for the child to return to social life. Only an integrated approach will consolidate the results obtained.

Types of rehabilitation measures

The system of comprehensive rehabilitation therapy includes the following types of rehabilitation:

medical;
physical;
psychological;
professional;
household

Medical rehabilitation includes a set of procedures that consist of medical therapy, surgery, psychotherapy, reflexology, spa treatment, and physical therapy. This type begins when an injury occurs. Continues until the patient recovers completely or enters the chronic stage, accompanied by maintenance therapy.

Depending on the form of the disease, there are: cardiac, neurological and orthopedic rehabilitation. The main task of restorative actions is to eliminate the defect, stabilize remission, and reduce pathological disorders.

Non-drug therapy methods include nutritional therapy, occupational therapy, manual and aerosol therapy.

Strict bed rest and loss of usual contacts often lead to the development of depression.

Physical rehabilitation includes the restoration of motor activity at home.

Carrying out morning exercises, sports elements, measured walking. This type of recovery is used from the first days of injury.

Psychological rehabilitation is carried out under the supervision of psychologists. Their main task is to adapt children to new living conditions. Psychological rehabilitation allows the child to feel more confident, without a feeling of inferiority.

The patient, as well as his family members, must develop a rational attitude towards the illness. The child must be motivated to participate in the treatment process.

In the first days of the disease, a calm and businesslike attitude of all contact persons is necessary. The atmosphere in the family should be friendly, without haste, fuss, or anxiety.

Auto-training gives good results. Children learn to induce a state of calm in themselves and implement self-hypnosis schemes in practice.

Social rehabilitation is designed to restore physical and psychological status. It guarantees the right of sick children to free medical treatment, certain medications, and visits to sanatoriums.

Forecasts

Rehabilitation of cerebral palsy depends on the form of the disease and the degree of brain damage. Usually, when therapy is carried out from an early age, the prognosis is relatively favorable - most disorders can be compensated for by primary school age. With a mild form of pathology, the manifestations of cerebral palsy will be almost invisible.

If you delay therapy and do not follow the doctor’s recommendations, the prognosis will be unfavorable. This is a child’s mental retardation and serious dysfunction of the musculoskeletal system. In case of cerebral palsy, parents and children are required to take a responsible approach and implement a rehabilitation program.

The role of massage in therapeutic medicine

Massage serves as an auxiliary, but very important element for cerebral palsy deviations. It normalizes blood circulation, improves metabolism, has a beneficial effect on muscle tissue, and relieves spasms.

There are three main types of massage for cerebral palsy:

classical;
segmental;
point;

Massage for a child with cerebral palsy should begin as soon as the diagnosis is made.

The extent of the disease can be determined at about 2 months.

Classic massage is aimed at relieving spasms and relaxing tense muscles, as well as toning weakened ones. This helps to change the child's distorted postures. Movements during the procedure should be smooth and slow. The skin should not move with the hand.

Stimulation methods:

continuous stroking warms and relaxes muscles;
felting – used to target large muscle groups;
skating – ideal for influencing the hip and shoulder joints;
intermittent stroking – suitable for maintaining tone in muscle tissue;
rubbing with the palm of your hand – helps stimulate large muscles (buttocks, back, thigh);
tingling.