Rehabilitation centers for children with cerebral palsy. Federal State Budgetary Institution "Scientific Center for Children's Health" of the Russian Academy of Medical Sciences
Although a child with cerebral palsy is different from other children, they also want to enjoy life, play, learn and have friends. Therefore, it is so important to promptly begin the process of rehabilitation of children with cerebral palsy, especially since this disease– this is not a verdict yet. And although it is impossible to return brain cells that died as a result of hypoxia, under suitable conditions, their functions can be taken over by other parts over time.
Physical rehabilitation of children with cerebral palsy
Children's cerebral paralysis represents chronic illness resulting from damage various departments brain, which entails dysfunction of motor and muscle activity. Together with various diseases nervous system, Cerebral palsy is the most common cause childhood disability.
This disease develops in utero, during childbirth or in early infancy as a result of damage to one or more parts of the brain. Moreover, cerebral palsy is not hereditary or infectious disease, does not progress and does not relapse. Children older than four weeks can no longer develop cerebral palsy, although it is also impossible to cure it completely. Rehabilitation of children with cerebral palsy comes down mainly to improving general condition child, providing suitable conditions for the realization of his potential.
Creating such conditions is painstaking, persistent, daily work of doctors, parents and the baby himself. The efforts of doctors without the help of the family will not work great result, since with such a pathology, drug treatment is not the most important thing. Moreover, rehabilitation of children with cerebral palsy should begin as early as possible, since it is in the first years of life that treatment can most effectively compensate for existing brain damage and minimize the manifestations of muscle spasticity. This allows in the future to reduce skeletal deformation and contractures, increase the ability to maintain balance, normal operation muscles and movement.
Currently, there are many rehabilitation centers around the world for children with cerebral palsy, where various specialists work with patients - neurologists, orthopedists, pediatricians, psychologists, speech therapists, chiropractors, and parents undergo training for the child’s rehabilitation at home. After all, even simple game in dolls allows you to improve coordination of movements, muscle function, and suppresses pathological reflexes.
Cerebral palsy can present with a range of symptoms, such as:
- Clumsiness, awkwardness of movements;
- Decreased concentration;
- Restlessness;
- Dislike of drawing or coloring;
- Inability to catch or kick a ball;
- Inability to jump on one or two legs or jump over obstacles;
- Difficulty walking.
Physical rehabilitation of children with cerebral palsy, first of all, consists of receiving medicines(antispasmodics, painkillers, antidepressants, tranquilizers), constant exercise physical therapy, surgical and orthopedic methods in combination with massage. Physiotherapeutic methods can achieve good results: electrical stimulation of nerves and muscles, thermal and mud treatment, electrophoresis. For severe contractures it is used surgery, during which muscles and bones are lengthened, and tendons are cut to relieve spasticity.
Social rehabilitation of children with cerebral palsy
Recovery period motor activity And social adaptation sick child consists of four stages:
- Acute period. Lasts 7-12 days, during which pronounced disorders are observed musculoskeletal system, convulsions;
- Early recovery period. Lasts until the baby is two months old;
- Late recovery. It ends in a child at about two years of age and is characterized by the presence of a pronounced tonic reflex, which does not allow it to develop in due time. installation reflexes and conscious movements;
- Last period. Characterized by the presence residual effects and can last for life.
Great value for successful treatment children with cerebral palsy have conditions under which recovery takes place. Rehabilitation centers for children with cerebral palsy allow qualified specialists, quality equipment to achieve more effective results. It is also very important to begin rehabilitation as early as possible, maintaining continuity of treatment.
As a child with cerebral palsy grows up and approaches school age should be given Special attention his motor development in order to facilitate his adaptation into society. Social rehabilitation of children with cerebral palsy is the development of abilities and preparation for life in a team. Therefore, it is imperative to ensure that children aged 4 to 7 years with preserved intelligence attend children’s preschool institutions with speech therapy groups, since motor defects are often accompanied by speech disorders.
When visiting kindergarten, a child with cerebral palsy receives the necessary communication with peers, his natural need in motion, number of speech contacts. In this way, the baby is instilled with invaluable communication experience. social interaction, his level of self-esteem increases.
Wherein physical rehabilitation should now be aimed at developing skills Everyday life, teaching the child to dress, eat, and use the toilet independently. All this will help make the patient’s life much easier and increase his confidence. But the most important thing to remember is that although cerebral palsy is serious illness, however, many people with this diagnosis manage to manage normal life. At proper rehabilitation children with cerebral palsy subsequently go to school, work, get married and have children.
It is important to understand that any brain damage that affects areas involved in planning and controlling movement will cause the person to move differently from other people. It is very difficult for him to learn new movements and adapt to constantly changing conditions external environment, it is difficult to control your posture. Rehabilitators help restore harmonious muscle function and learn those things that are not available to people due to their illness - maintain posture, walk, talk, etc.
Any specialist who is faced with the need to rehabilitate a child with cerebral palsy and other neurological disorders, knows that there are no and never will be two identical patients. There is no universal collection of recipes and set of exercises that will be ideal for everyone.
If a disabled person with cerebral palsy faces problems of lack of strength and physical endurance, lack of balance and coordination of movements, then we conduct part of the classes on the Galileo vibration platform. These exercises save time and greatly facilitate the labor-intensive rehabilitation process. Plus, they are fun, since most children really like the vibration.
Stretching activities are also carried out on the Galileo platform. The effect of such activities comes faster and lasts longer:
The vibration platform can be rented for a while, so that young patients can practice at home and be able to consolidate the results.
Not all rehabilitation techniques are like play. But the use of some of them, for example Vojta therapy, is especially justified at the age of up to 18 months. Vojta therapy helps to develop an excellent sensorimotor base, sufficient for building other types of therapy - speech therapy, defectology, occupational therapy, functional integration.
All rehabilitation programs are developed strictly individually, based on physiological state patient. With us you can undergo both individual procedures (classes using Vojta or on the Galileo platform) and comprehensive rehabilitation. In addition, our specialists can always come to your home to adjust your exercise program.
Since parents are full members of the rehabilitation team, we always actively share our knowledge with them. By teaching parents therapy methods, we help them gain knowledge that will allow them to continue the process rehabilitation of cerebral palsy home and consolidate the results achieved.
Our team of rehabilitation doctors
All professionals involved in the rehabilitation of patients with movement disorders must continually develop their skills in observation, assessment and analysis of movements. Most of our movements are automatic. But in order to teach a child to move, a specialist must have a clear understanding of the algorithm and sequence of each movement.
Indeed, in order to better understand other people's movements, you need to learn to analyze your own. Our profession is closely related to physical impact on the patient’s body, therefore we must know and subtly feel how much force can be applied, with what rhythm and intensity the exercises can be performed. We also teach this to parents. 
Experienced rehabilitation doctors, whom we have gathered in our Center, will help you understand what exactly is wrong with your child. After observing his movements, they will conduct a diagnosis right at the initial consultation, and then set goals and objectives that they will focus on in further work with the patient.
It is very important not only to help the baby learn to roll over, hold his head up, sit, crawl, walk and feed himself, but also to avoid secondary deformities such as joint contractures, dislocations hip joints, instability ankle joint etc. All these deformations significantly inhibit motor development.
Speech pathologist and speech pathologist clinical psychologist work closely with rehabilitation specialists. We teach children to express their thoughts and desires: if it is not possible to voice them in language, then this can be done with the help of signs and cards. The satisfaction of being understood provides a powerful incentive for further development.
Treatment of cerebral palsy in Russia
State centers
Scientific and Practical Center for Child Psychoneurology (NPC DP) of the Moscow Department of Health
Scientific and Practical Center for Child Psychoneurology (NPC DP) of the Moscow Department of Health is one of the leading medical, scientific, organizational and methodological institutions in Moscow and Russian Federation. Scientific and Practical Center for Pediatric Psychoneurology is government agency, works in the Moscow healthcare system and is subordinate to the Moscow Department of Health. The clinic was opened on July 1, 1983. During our work at the Scientific and Practical Center for Children's Care, we have accumulated a wealth of experience in the treatment and rehabilitation of children with congenital and acquired pathologies of the central and peripheral nervous system, pathologies of the spine and chest, deformities of the limbs, joint contractures.
State Autonomous Institution "MNPC for the rehabilitation of people with disabilities due to cerebral palsy"
The center was established by order of the Moscow City Government No. 1979-RP dated September 21, 2010. The purpose of the Center is to create innovative technology, which significantly affects the quality of life of Moscow families with disabled people with severe limitations (in movement, communication, training, orientation, etc.).
Center for Medical and social rehabilitation disabled people with severe forms of cerebral palsy State government health care institution of the city of Moscow "Center for medical and social rehabilitation with a permanent residence department for adolescents and adults with disabilities with severe forms of cerebral palsy who do not move independently and do not serve themselves of the Moscow Health Department" (GKUZ TsMSR cerebral palsy DZM) .
Federal State Budgetary Institution "Scientific Center for Children's Health" of the Russian Academy of Medical Sciences
The center provides outpatient and inpatient care medical care children and teenagers of Moscow, Moscow region, Russia, near and far abroad countries. Children from the neonatal period to 18 years can receive specialized medical care at the Scientific Center for Children's Health of the Russian Academy of Medical Sciences.Providing paid medical services carried out in accordance with Decree of the Government of the Russian Federation No. 27 of January 13, 1996, Regulations on the commercial sale of medical services in the Scientific Center for Children's Health of the Russian Academy of Medical Sciences of January 15, 1999. Possible medical service both upon application for registration of a voluntary medical insurance monopoly, and under contracts with attachment through leading Insurance companies Moscow and regions.
Morozov Children's Hospital
At the Morozov Children's Hospital city Hospital has four city advisory clinics:- advisory clinic;
- children's ophthalmological advisory clinic (eye);
- Consultative and diagnostic cardiology department;
- consultative and diagnostic department for children with central nervous system lesions,
- disorders of the musculoskeletal system.
On the base Morozov Hospital students are trained in 20 departments of two medical universities(RUDN University and Russian State Medical University). The third medical school of the Moscow City Health Department operates on the territory of the hospital.
Institute of Correctional Pedagogy of the Russian Academy of Education
The institute conducts research and experimental work, analysis of experimental data, programs and methods for teaching children with intellectual disabilities are being developed, and scientific and methodological materials are being produced. The institute's staff includes specialists in the field of physiology and neurophysiologists, general practitioners, ophthalmologists, psychiatrists, neurologists, child psychologists, teachers of the deaf, typhlopedagogues, speech therapists, and oligophrenopedagogues.The CDC provides consultation to children starting from infancy and up to 18 years of age, with no special referral required. The CDC provides consultations to children and adolescents living in any region of the Russian Federation, CIS countries, near and far abroad.
St. Petersburg Scientific and Practical Center for Medical and Social Expertise, Prosthetics and Rehabilitation of Disabled People named after G. A. Albrecht
The center includes a multidisciplinary clinic with 500 beds, which has several orthopedic departments. The children's rehabilitation and recovery center for disabled children provides comprehensive rehabilitation of children aged 14-18 years, mainly with limitations in the ability to move, self-care, labor activity, training.OSU Rehabilitation Center for Children and Adolescents with Disabilities
Regional state state-financed organization « Rehabilitation center for children and teenagers with disabilities» has been operating since 2003 on the basis of the Decree of the Head of the Belgorod Region Administration dated March 27, 2001 No. 200 “On the organization of the regional Center for medical and social rehabilitation of children and adolescents with disabilities.”Property owner (founder): Belgorod region.
The functions and powers of the founder of the Center from the Belgorod region are managed by social protection population of the Belgorod region.
Rehabilitation center for children and adolescents with disabilities, OGBU SO
Our Center is a modern state rehabilitation institution equipped with rehabilitation, diagnostic equipment for medical and social rehabilitation and equipment for psychological and pedagogical correction, development of communication skills, socialization of children with disabilities.The main components in the work of the Center with special children are an individual and differentiated approach to each child, complexity, continuity, systematicity and continuity in rehabilitation work.
Regional rehabilitation center for children and adolescents with disabilities “RODNIK”
Created in 1997 for the purpose of social adaptation and rehabilitation of children and adolescents with disabilities from 3 to 18 years old. It is a specialized institution with year-round operation. During the year, the Center organizes 14 races, of which 4 are in summer period. The duration of the rehabilitation shift is 21 days. The center is unique, has an excellent material and technical base, and is equipped with modern equipment.
Every year, more than 1,000 children with various types of diseases undergo rehabilitation courses at the center.
The youngest children and children in need special care, come to the center with their parents. An individual rehabilitation route is drawn up for each child - schedule medical procedures, correctional, educational classes, leisure.
GUSO Kusa Regional Rehabilitation Center for Children and Adolescents with Disabilities
The inpatient unit of the Center accepts disabled children with pathologies of the musculoskeletal system aged from 4 to 17 years inclusive, who have partially or completely lost the ability to self-care and who need constant outside care and do not have established medical contraindications for admission to this institution.
The complex rehabilitation department accepts disabled children, children with disabilities, children under dispensary observation in healthcare institutions, as well as family members and other persons accompanying them.
The main pathology of children undergoing rehabilitation is a disease of the musculoskeletal system:
- cerebral palsy;
- arthrogryposis;
- Perthes disease;
- congenital malformation of the limbs;
- consequences of traumatic brain injuries and conditions after removal of spina bifida;
- myopathy.
Republican Center for Rehabilitation of Children with Cerebral Palsy and Mental Disorders
The Republican Center for the Rehabilitation of Children with Cerebral Palsy and Mental Disorders has been operating since 1992. Services are provided to children aged 1-2 months. up to 18 years of age in a day care department. Day hospital designed for 75 beds.
Children are admitted to the department on referrals from local neurologists, psychiatrists, orthopedists with various neuropsychiatric disorders:
. organic lesion central nervous system (cerebral palsy, congenital anomalies development, consequences of neuroinfections, perinatal lesion nervous system, brain injury and spinal cord, mental retardation, diseases of the peripheral nervous system, etc.)
. functional disorders(neuroses, encephalopathy of various origins, diseases of the autonomic nervous system, minimal brain dysfunctions and etc.)
. diseases of the musculoskeletal system ( movement disorders with cerebral palsy, scoliosis, flat feet, etc.)
Federal State Institution "Children's psychoneurological sanatorium "Teremok"
The sanatorium accepts for treatment children from 2 to 17 years old, with or without an accompanying person, with psychoneurological diseases and disorders of the musculoskeletal system. Under development individual program rehabilitation treatment and rehabilitation.
The sanatorium is located in Kaliningrad region, resort town of Zelenogradsk, on the shore Baltic Sea(300 m.).
Federal State Institution Clinical Sanatorium "Progress"
In a picturesque corner of the Khostinsky district of Sochi, at an altitude of 150 m above sea level, the Progress multidisciplinary clinical sanatorium is located. The territory of the Progress sanatorium in Khosta is 15 hectares, the perimeter length is 2 km 800 m. In total natural factors The Progress sanatorium in Sochi is considered unique: the clean air of the foothills and subtropical vegetation create a special healing microclimate that promotes good mood, rest and treatment in Sochi.
Medical Center Clinic Melnikova E.A. – specialized medical institution neuropsychophysiological direction, whose activities are aimed at organizing complex treatment children and adults with diagnoses such as cerebral palsy (CP), mental retardation speech development various etiologies(ZPRR), autism, as well as treatment of the consequences of strokes and traumatic brain injuries. Our clinic is also a rehabilitation center for children with cerebral palsy.
The clinic uses the latest world, domestic and proprietary methods and methods for identifying and treating diseases of the human nervous system, including the brain and spinal cord, auditory and visual analyzers, peripheral nerves and musculoskeletal system. Qualified neurologists, using advanced Russian and international technologies, on specialized high-tech equipment, conduct thorough diagnostics and treatment, combined into a single complex, called: " New technology treatment of cerebral palsy";
New treatment technology various types psycho-speech delays, including ASD (autism spectrum disorder)."
New technology for treating the consequences of TBI (traumatic brain injury) and strokes;
Medical technology pathogenetic treatment of cerebral palsy and delayed psycho-speech development – autoneuritotherapy - including diagnostics, basic pathogenetic treatment And auxiliary treatment- developed and patented by the Chief Physician of the Clinic, Ph.D. medical sciences, neurologist highest category Melnikova Elena Anatolyevna. She has used this method for more than ten years and has proven itself very well in the treatment of such patients in “ Medical center"Cortex", whose chief physician she was all this time.
In July 2014, a restructuring took place at the CORTEX MC: one of the departments, the neurological department in Moscow, was separated into an independent Clinic.
Managers scientific activity Melnikova Elena Anatolyevna are:
Basic treatment for PVD is based both on the activation of the speech centers themselves (Broca's area, Wernicke's area, angular gyrus etc.), and on the restoration of lost connections not only between centers, but also between hemispheres. In addition, scattered axonodendritic connections of speech centers with other areas of the brain involved in speech function are restored. As a result, Speech appears. For more details, see the section of the site: "Treatment of ZPRR"
Autoneuritetherapy is carried out in combination with drug treatment (introduction of nootropics bypassing the blood-brain barrier, lymphotropic therapy), antigravity therapy, therapeutic massage, dry immersion baths and Exercise therapy , music therapy. The effectiveness of treatment is increased by the use of special unique neuro-orthopedic rehabilitation pneumatic suits RPK "Atlant", plantar load simulators"Corvit", which received the name "Legs" from patients at the Clinic, as well as the use Gross simulator And anti-gravity baths. Classes are held with speech therapist-defectologist.
Clinic Melnikova E.A. accepts for treatment patients diagnosed with cerebral palsy, delayed psycho-motor and speech development, consequences of TBI and strokes for citizens of the Russian Federation and any country with diplomatic relations from the Russian Federation. We also work as a rehabilitation center for cerebral palsy.
Patients aged from 9 months to 40 years are accepted for treatment (older – on an individual basis). Knowledge of the Russian language or payment of a translator (additionally) is required. Medical documents(extract from the medical history and conclusions based on examination results) must be translated into Russian.
Treatment of patients with cerebral palsy and cerebral palsy carried out in the mode day hospital. Baby strollers are provided for patients to travel around the Clinic.
Course treatment of cerebral palsy and cerebral palsy carried out by courses of treatment 20 days. The treatment process is carried out from Monday to Saturday inclusive, Sunday is a day off.
Arrivals for treatment are made on certain days in accordance with
Recognized traditional medicine, have high efficiency, If treatment started in early period development of the disease(approximately up to two years of age). After several rehabilitation courses, patients begin to independently perform previously inaccessible movements, restore speech function and show other successes. This once again confirms the need for timely.
The rehabilitation program is developed individually for each child. Rehabilitologists in various ways help patients recover coordinated work muscles (flexors and extensors must contract in concert) and learn everything that they could not learn due to the disease: hold their head, sit down, stand up, walk, talk, etc.
To achieve good result V treatment of cerebral palsy, patients and their parents have to try various rehabilitation techniques. And this is not surprising. Each of the rehabilitation systems has its own characteristics of influence on the child’s body, so what does not suit some children suits and helps other children. Parents should remember this and not be upset if they fail.
Let's look at the most famous and effective techniques rehabilitation used for cerebral palsy.
Kozyavkin method
The method is based on a multimodal approach, including the following areas:
The main goal of the Kozyavkin method is to achieve new functional state the patient's body. This state opens up opportunities for the development of the necessary motor skills and rapid motor-mental development of the child.
Bobath therapy
This technique, like the previous one, is named after the authors - the Bobath spouses. The main essence of Bobath therapy is to stimulate the affected areas of the brain using sensory, tactile and other stimuli. These irritants force healthy newborn the child masters new movements - he turns his head to the side loud sound or flashes of light, reaches for something interesting, etc. In the same way, you can push a sick child to perform certain movements.
According to the Bobath therapy method, the patient must sequentially go through all the stages of the child’s physiological motor development - first learn to hold his head up, then roll over, sit down, etc.
Classes using the Bobath system are supervised by a kinesiotherapist, who helps the child develop correct motor patterns. It looks like this: the child is shown a bright toy, he begins to reach out and move towards it, and the doctor at this time corrects his movements. In addition, special procedures are carried out with the little patient physical exercise– place it in a position in which muscle spasticity and pathological reflexes are reduced. Such exercises are carried out on a special ball or in the hands of a rehabilitator.
Voight technique
Author this method, Vaclav Vojt, proposed using crawling and turning reflexes for motor rehabilitation of sick children. For each child, according to the Voight method, an individual set of exercises is developed with subsequent adjustments.
The peculiarity of Vojta therapy is that the main role in it belongs to the parents, since they are the ones who have to deal with the child, every day and 3-4 times a day. To do this, before starting rehabilitation, parents are taught all the necessary skills, so there are no problems with training.
Treatment using the Voight method can begin from the neonatal period. However, mothers and fathers must seriously prepare for this psychologically, since the child will not always react calmly to what is being done to him. And this is connected not so much with pain as with fear and natural protest.
Dolphin therapy
This is probably the most pleasant rehabilitation method for sick children. It is based on communication between a child and a dolphin. Such communication has a beneficial effect on the psyche, gives positive emotions, relaxation and even some kind of peace.
What can a sick child take from dolphin therapy? First of all, it is a change in attitude towards oneself and the world around us, a decrease in isolation. Secondly, communication with a dolphin is a powerful sensory stimulus that makes nerve structures work actively, and this in turn helps improve speech and motor function, intellectual development mentally retarded children.
Classes are conducted with dolphins with the participation of a rehabilitation doctor, parents and a trainer who is responsible for the animal. There is no need to be afraid of any aggression or unexpected reactions from dolphins. Animals are prepared specifically for medicinal purposes.
Hippotherapy
Hippotherapy – treatment with horses. Sick children are not only introduced to animals, but also taught horse riding, no matter how strange it may sound. If the baby, by virtue of his physical capabilities unable to sit, he is placed on the horse's back. This also has a very positive effect.
How does hippotherapy work? While riding a horse, the child reflexively tries to take the most stable and comfortable position for himself. He squeezes his legs tightly and tries to keep his back straight. In this case, almost all muscles of the body are included in the process, including those that are usually immobile. That is, hippotherapy in its essence is very similar to physical therapy, but there is one difference - the child trains his muscles not consciously, but reflexively.
Another healing factor hippotherapy is massage and thermal effects on the legs and pelvic area. As the horse moves, it uses its back muscles to knead the child’s muscles and give him its warmth.
Dynamic proprioceptive correction method
DPK – dynamic proprioceptive correction. The method consists of motor correction, which is carried out using a special device "Graviton". “Graviton” is a system of elastic rods that is assembled individually for each patient depending on clinical situation. In such a device-suit, the patient must engage in physical therapy. A set of exercises for exercise therapy is developed taking into account the existing movement disorders.
Course of treatment according to WPC method usually lasts 20 days. Apply this technique Possible for children over 3 years of age.
Montessori method
According to the Montessori method, every child should develop in natural conditions and he doesn’t need to be disturbed. Teachers in this system do not act as mentors, but only as assistants. For classes, special materials are used, from which children learn independently.
The choice of a specific area of study depends on the age of the child, or more precisely, the sensitive period of development. For example, speech develops from 0 to 6 years, sensory perception develops up to 5.5 years, and social skills develop from 3 to 6 years. A specific part of the brain is responsible for each of these functions, and it must be stimulated on time.
