Children's rehabilitation center for children with cerebral palsy. Use of devices and simulators

Rehabilitation is a set of medical, psychological, pedagogical, professional and legal measures to restore the autonomy, ability to work and health of persons with limited physical and mental capabilities as a result of suffered (rehabilitation) or congenital (habilitation) diseases, as well as as a result of injuries.

Rehabilitation of children with cerebral palsy consists of 4 stages. (Appendix 2)

Therapy for cerebral palsy should be comprehensive and multidisciplinary. Treatment and rehabilitation started as early as possible in some cases allows one to avoid permanent disability patients with cerebral palsy and improve their quality of life. Basic complex therapy Cerebral palsy is a “team” approach using drug and non-drug methods.

Main directions and tasks of rehabilitation

1. Preparation

2. Development of a rehabilitation program and its implementation

3. Correction rehabilitation activities

4. Assessing the effectiveness of rehabilitation

5. Recovery correct system triggering afferentation and reflex activity.

6. Prevention of increased muscle tone, equalization of its asymmetry.

7. Preventing the formation of resistant pathological conditions and pathological motor stereotypes.

8. Prevention of contractures and deformities.

9. Development of amplitude and accuracy of movements.

10. Concentration of attention on the correct and consistent “inclusion” of muscles in the motor act.

11. Basic principles neurorehabilitation: early start, continuity, adequacy, complexity, phasing, continuity.

12. Rehabilitation

Basic principles and directions of rehabilitation measures (Shabalina N. B. et al., 1988):

b adaptation of patients to life in conditions of a severe defect;

ь timeliness, interconnectedness, continuity of rehabilitation measures (treatment, career guidance, socio-psychological assistance);

ь appeal to the patient’s personality, instilling in him strong-willed qualities and purposefulness;

b stages of social and medical care for patients with cerebral palsy, depending on age:

b specialized nursery-kindergarten, boarding school, vocational school, technical school;

ь outpatient, inpatient, sanatorium treatment(including a neurological, orthopedic hospital, prosthetics company, etc.);

b multidisciplinarity with the participation of specialists in various fields: rehabilitation specialist, psychologist, neurologist, pediatrician, speech therapist, etc.).

Types of rehabilitation

Physiotherapy

Taking into account the specifics of motor disorders in Cerebral palsy therapeutic Gymnastics has the following main tasks:

Development of straightening and balance, that is, the so-called postural mechanism, which ensures correct control of the head in space and in relation to the body.

Development of hand function and object-manipulative activity.

Development of hand-eye coordination.

Braking and overcoming incorrect postures and positions.

Prevention of the formation of a secondary motor stereotype.

Under the influence of therapeutic exercises, adequate motor sensations arise in the muscles of a child with cerebral palsy. In the process of therapeutic exercises, the postures and positions of the limbs are normalized, and the muscle tone, violent movements are reduced or overcome. The child begins to correctly sense postures and movements, which is a powerful incentive for the development and improvement of his motor functions and skills.

Children with cerebral palsy must do the following: physical exercise:

v stretching;

v muscle relaxation and decreased tone;

v increase in amplitude and range of muscle movements various parts bodies;

v strengthening the muscles involved in the movements of various parts of the body;

v exercises to develop muscle endurance;

v training of normal muscle patterns for proper walking;

v balance training by walking on inclined planes;

v exercises to increase muscle strength.

Spa treatment

Krasnodar region

Evpatorii

Zheleznovodsk

Pyatigorsk

Kislovodsk

Hippotherapy is a special type of physical therapy where treatment is carried out with the help of a horse, and is a recognized means of rehabilitative influence on patients with somatic and mental illnesses. Consists of 4 sections:

· Theoretical classes with patients.

· Training in communication with horses

· LVE including physical exercises

· Caring for horses, including cleaning, washing, feeding

Occupational therapy is aimed at developing or restoring previously lost elementary skills, including motor functions. This is a kind of therapeutic exercise that allows you to train coordination of movements and fine motor skills. She is able to adapt a person to Everyday life, achieve independence in actions, adapt to everyday life, namely, performing household chores, cooking, self-care behind you.

The Bobath technique was developed by Bertha Bobath back in the 30s of the last century, an emigrant from Germany together with her husband, a neurologist. The approach is based on the stimulation of various body movements using special provisions body and limbs. As a result, weak muscles are strengthened, joint movement is improved, and imbalances in body proportions are reduced. Such restorative rehabilitation allows you to expand motor skills and improve balance.

Vojta therapy - the main idea is to influence certain parts of the body using graduated pressure. This helps the nervous system activate the muscles of the body as much as possible. Facial expressions and movement are also involved here. eyeballs, skeletal muscles, intestinal muscles and Bladder. Such stimuli contribute to the formation of motor rehabilitation, and therefore the normalization of body movements.

Hydrotherapy - It uses warm water, and the therapy itself is aimed at relaxing certain muscle groups. This course includes several sets of exercises to relax, stretch and strengthen muscles. The procedures themselves are performed in swimming pools. This type of rehabilitation, together with other methods, can increase the effectiveness of treatment for patients with childhood cerebral palsy, and improve coordination, balance, and develop muscle strength.

Sadovaya therapy - essence therapy involves the child’s interaction with nature. Thus, on the territory of all clinics in Germany there are beautiful parks. In addition to their aesthetic function, they also serve as relaxation for patients. As a result, they experience an improvement in their physical and mental condition. Such parks provide places for walking and solitude. All patients are given special shoes for walking. The entire territory of the park is designed in such a way that it has many natural exercise equipment - steps, slopes and various surfaces (grass, sand, wood, crushed stone). For the rehabilitation of children, there are play areas made from natural materials. These include caves, hills and other attractions.

Dolphin therapy is another type of rehabilitation treatment for children diagnosed with cerebral palsy. Interaction with the animal occurs under the careful guidance of several specialists - a trainer, psychologist, psychotherapist, physical therapy specialist, and speech pathologist.

Only specially trained dolphins are used for contact. The learning process is based on the principle of a game. In this case, there is active stimulation of tactile, visual, and emotional contact between the child and the dolphin, which leads to the development of speech and motor skills.

An important factor in the use of dolphin therapy is the increased interest and positive emotional attitude of children towards these animals, which reduces the internal psychological communication barrier and, as a result, stiffness of movements. In addition, tactile sensations are very important in the application of this therapy. By influencing biologically active points on the child’s body, the dolphin stimulates the necessary specific areas of the nervous system that are responsible for the corresponding reflexes. In some cases, the therapist invites the patient to touch the animal with his hands or feet if violations of the upper or lower limbs.

Another, no less important effect in this therapy is a kind of hydromassage of the skin and internal organs. This occurs due to the fact that the dolphin, using its tail fin, creates a certain movement of water around the child, which significantly reduces the load on the joints and actively trains the muscles.

Cerebral palsy is a disease that requires various procedures and programs.

Rehabilitation of children with cerebral palsy includes physical measures to restore muscle activity, social adaptation, medication use, psychological preparation.

Children diagnosed with cerebral palsy remain disabled for life.

This is explained by the fact that those areas of the brain that are responsible for correct speech and muscle tone. After birth, each child has its own individual recovery (rehabilitation) program.

First of all, a sick baby needs medical rehabilitation. Exists significant amount medical methods of treatment - this includes the use medications, And massotherapy, and specially selected physical exercises and physiotherapeutic measures.

Drug therapy

Medicines are used in the first six months of the baby’s life or when frequent seizures, as well as to prevent spontaneous actions and reduce muscle spasticity.

Drug therapy includes the following drugs: nootropil, piracetam, actovegin, cerebrolysate, cerebrolosin, solcoseryl, agapurin, trental, thymalin, cortexin, sermion and others.

The drugs are prescribed by a doctor in the required dosage.

To improve the functioning of the nervous system, folic and lipoic acids, bemityl, glycine and others complex amino acids, riboxin, ATP and others. Also, taking into account the characteristics of the body, autoimmune, hormonal and biogenic drugs are used.

Anticonvulsants are a group of medications that protect against seizure activity. As a rule, such drugs are used for quite a long time.

Benzodiazepines – This group of drugs is used for very severe convulsions or epileptic seizures. The most common among drugs is diazepam - it acts directly on chemical processes occurring in the brain.

To eliminate spasticity ( painful contraction muscles) the following drugs are used: diazepam (relaxes both the brain and body), baclofen (blocks brain signals about muscle contraction), dantrolene (has a direct effect on the contraction of muscle tissue).

Drug treatment also includes injections of botulinum toxin A, better known as Botox.

The drug causes moderate paralysis of muscle tissue and relieves tension. The effect of the injections can last from 3 to 6 months.

Drug therapy does not have a long-term effect and is an addition to other treatment methods.

Physiotherapy

Therapeutic exercise (physical therapy) is necessary procedure at rehabilitation of cerebral palsy. With the help of physical education, a child will be able to improve the coordination of his movements, reduce muscle tone disorders, and acquire the necessary skills necessary for a normal life.

Therapeutic physical education will develop in the child the necessary work skills, teach correct body movements, and master self-care skills.

For each individual child, a specific program of activities is drawn up in accordance with his degree of illness, age, and developmental characteristics. Important has regularity, continuity and a gradual increase in loads.

For the first two years of life of a child with CP, it is very important to develop his vestibular apparatus.

To do this, the following exercises are required:

walking with head turning;
walking with arms swinging back and forth;
walking with eyes closed/open;
raising the head from a lying position;
body tilts left and right, back and forth;
“crawling” on a hard surface;
development of the neck, limbs and joints.

"mill";
body tilts left and right;
longitudinal and transverse lunges with legs;
squats;
stretching the legs in various ways;
pull-ups and push-ups;
"boat";
lifting the legs from a lying position.

About the main reasons development of cerebral palsy V childhood read . Primary disorder of the brain structure birth injuries and other pathologies.

Massage

Massage is also included in the mandatory rehabilitation program for children with cerebral palsy.

The technique of performing a massage can be different: shaking, light stroking, rubbing, kneading movements, pinching, rolling various objects, and vibration.

The choice of technique also depends on age and accurate diagnosis little patient. Massage stimulates some changes in the body:

metabolism improves;
normalizes muscle tone, improves motor skills;
muscles are strengthened and muscle mass increases;
articulation improves;
increases reflex influence to internal organs.

Physiotherapy

Physiotherapy includes many different procedures: hydrotherapy, electrotherapy, magnetic therapy, mud therapy, electrical stimulation, hippotherapy, ultrasound, electrophoresis and others.

Electrotherapy can be prescribed from the first day of life and lasts from a few seconds to several minutes.

This procedure improves blood circulation and brain impulses.

Ultrasound is used as a thermal procedure used to dilate the baby's blood vessels.

Electrical sleep is used for sleep disorders, epilepsy attacks and contraindications to other methods of physiotherapy.

One of the most popular physiotherapy procedures is water activities: these include salt baths, swimming in the pool, sea and pine baths, dolphin therapy. As a rule, water procedures are combined with gymnastics and an underwater shower-massage.

Psychological, pedagogical and speech therapy correction

Comprehensive treatment of cerebral palsy also includes sessions with educational psychologists and speech therapists.

Basic principles of psychological and pedagogical work:

development of communication skills with others: speech, emotions, gaming and work skills;
organization environment the child, so that because of his illness he is not too different from his peers;
stimulation of intellectual activity;
formation of ideas about space and time;
development of the five basic senses;
preparation for training and cognitive activity: reading, mastery of writing, mathematical and physical concepts;
formation of correct coordination and motor skills;
developing self-care and hygiene skills.

Speech therapy makes a great contribution to correctional work with a child. The main principles of speech therapy work are:

development of correct and understandable speech to others;
improved articulation;
eliminating violations of the pronunciation of any words;
formation of speech breathing and voice;
development of voice strength and speech flow.

Social and environmental rehabilitation of children with cerebral palsy

Social-environmental adaptation is aimed at teaching the child communication skills and behavior in a particular social environment: At school, kindergarten, on the street and so on.

As a rule, a social adaptation program includes the following points:

teaching the child skills to behave in society (society);
occupational therapy;
socio-cultural adaptation;
social and domestic rehabilitation;
individual therapy – tailored according to age, diagnosis and already acquired skills.

As a rule, children with cerebral palsy are much more emotional and excitable than their peers, so classes with professional psychologists and sociologists.

As part of the social-environmental adaptation, the child learns to distinguish bad from good, to have a positive attitude towards his family, towards friends and peers, towards school and the learning process, towards the world around him. Children learn by example how to behave appropriately in a changing and sometimes frightening world.

Thanks to constant and continuous studies with various kinds specialists and undergoing various procedures, the child will learn to coexist in his environment, learn, develop and enjoy life.

Video on the topic

Subscribe to our Telegram channel @zdorovievnorme

Recognized by traditional medicine, have high efficiency, If treatment started early in the 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 a good result in the 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 physical exercises are performed with the small patient - they are placed 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

The author of 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 of 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, due to his physical capabilities, cannot sit, he is placed on the back of the horse. 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 therapeutic factor of 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 should not 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.

Cerebral palsy (CP) in a child implies a certain style and rhythm of life aimed at recovery motor activity affected limbs of a small patient. It is almost impossible to do this on your own, since adequate treatment includes a whole range of measures that must be carried out by a qualified doctor. The developed rehabilitation of children with cerebral palsy in specialized centers develops muscle abilities and allows them to calmly adapt to society.

The disease develops as a result of damage to the central nervous system, in particular the departments responsible for the functioning of the musculoskeletal system. The causes may be birth injuries due to improperly performed care, discrepancy between the size of the fetus and the pelvic outlet of the woman in labor, intrauterine infections, affecting nervous tissue, in diseases endocrine system mothers, proven hereditary predisposition. Detection of pathology is possible using ultrasound screening, blood tests, or after birth in the first year of life, when the child should begin to take his first steps.

The earlier the disease is detected, the more likely significant improvement health status. The neurologist prescribes an individual plan for the treatment and rehabilitation of cerebral palsy. Traditionally it includes balneotherapy, physiotherapy, massage, physiotherapy using specialized modern equipment. Sometimes dolphin and hippotherapy are added.

Balneotherapy

It involves relieving symptoms by placing the patient in natural baths. mineral water or artificially prepared solutions of mineral salts with the addition of sulfur or carbon dioxide, oxygen, their increased concentration enters the blood through skin and lungs, the functioning of the nervous system, heart, blood vessels is stabilized, tissue trophism and metabolism are improved. As a result, the pain subsides, the muscles relax, and movements become more active.

Typically, a rehabilitation center offers therapy with artificial waters, since not all treatment and preventive institutions have the ability to work in conditions of full provision natural sources. There are two main groups of baths: pearl and radon.

Radon baths are based on the healing effect of the decay of a radioactive substance - radon. Immunity improves, blood pressure and heart rate decrease, breathing stabilizes, and cell regeneration accelerates.

Pearl baths influence due to air bubbles, the difference between the temperature of water and air. Recommended for atonic and ataxic forms cerebral palsy.

Dolphin therapy and hippotherapy

Dolphin therapy first appeared in the United States of America and then spread throughout the world. Used for many neurological disorders, Down syndrome, retardation in physical and mental development. Treatment of cerebral palsy in Russia, this method is less relevant, but such a central region as the Moscow region has similar resources.

The therapy is based on ultrasonic vibrations produced by animals, beneficial influence water, moderate limb activity and positive emotions obtained from contact with dolphins. The child’s well-being is monitored by a pediatrician, neurologist, psychotherapist, and other doctors.

Contraindications to this procedure include epileptic seizures, sharp or chronic diseases in the acute stage of infectious or non-infectious origin, benign, malignant neoplasms, phobias.

Hippotherapy differs in its mechanism of action on the damaged organism. A child, while riding, experiences oscillatory movements, controls his position in space, and tries to maintain the correct posture. The musculoskeletal system and vestibular apparatus are strengthened.

Physiotherapy

The rehabilitation center must have modern equipment that medical personnel can use.

Most widely used electric currents, modulated fixed frequency of electron movement (amplipulse therapy), their effect is combined with the administration of drugs (electrophoresis). The current increases muscle tone during muscle atrophy (electric stimulation) or, conversely, calms (electrosleep).

Magnetotherapy predominantly has a bioresonant effect and calms nervous system, improves blood circulation.

Laser therapy strengthens vascular wall, increases the restorative abilities of the blood. It is carried out in three ways: acupuncture, intravenously and cutaneously.

Additionally relaxes the striated and smooth muscles thermal wrap, application of paraffin and mud. The impact occurs on the cervical, thoracic and lumbar region spine, upper and lower extremities involving large, medium and small joints. Passes pain syndrome, lymphatic drainage increases, metabolic processes aimed at synthesis necessary substances and energy education.

Therapeutic exercise and massage

The longest item in terms of time is the one that includes continuous physical therapy exercises. Gymnastics are performed either individually or with a small group of patients. The movements consist of smooth turns of the head, tilts of the body in different directions, and the arms and legs are included in the process. A rehabilitation therapist teaches how to crawl, sit, hold a certain position, and correctly transfer body weight from one limb to another. Older children learn to walk, correct gait defects, and maintain coordination of movements. Of particular interest to young patients are aerobics, dancing, hobbies that develop fine motor skills, drawing, and playful activities. Articular gymnastics corrects and restores speech, which contributes to quick adaptation in society.

Massage is based on a targeted effect on certain parts of the body, rubbing, kneading muscles that are in hypertonicity. Experts use essential oils, sudden changes in temperature up to very low indicators. Rehabilitation of children with cerebral palsy with the help of regular external pressure is reduced in time by several times.

Social rehabilitation

External changes in the upper and lower extremities, impaired coordination of movements and speech significantly affect the perception of a person by the people around him. Society is wary of the patient or laughs at him, especially in kindergarten or school. The patient's self-esteem drops, signs of mental disorders and perception of the surrounding world appear, and emotional timidity develops.

The rehabilitation center for children with cerebral palsy provides a staff of specialists, including psychologists, speech therapists, who regularly work with patients, capable of treating not only the body, but also the mental state. Therapy takes place in a conversational form using techniques and tests to identify psychological problems, individual therapy is being developed to eliminate behavioral discomfort.

In addition, in ordinary comprehensive schools social education should be carried out; teachers are obliged to explain behavior to children, educate right attitude to the sick, disabled and other people with certain special needs. Social workers are required to conduct family checks and analyze the parents’ attitude towards the child.

Sanatoriums

Sanatoriums imply not only rehabilitation, but also drug treatment of pathology. Such treatment and preventive institutions are organized in cities and regions with a pleasant climate, mountainous terrain, near the sea or in conditions full contact with nature in order to stabilize the emotional sphere.

Medicines used and administered in sanatoriums include anticonvulsants with strict control of the dosage of the drug, analgesics and antispasmodics for constantly recurring seizures, antioxidants, neuroprotectors and vitamin complexes in combination with the use of essential microelements.

Rehabilitation depends on the type of disease, but in 60% of cases the person begins to walk independently and calmly finds his own place in society.

Absolutely every child with cerebral palsy (cerebral palsy) needs long-term rehabilitation. Over the course of a number of years, special centers, clinics, boarding schools and rehabilitation rooms for such children were created, many of which were patronized by charitable organizations and foreign investors. Conducted rehabilitation treatment and abroad (in China, Germany, Greece and other countries).

Thus, since 1993, a children's rehabilitation center has been operating in Moscow, created with the assistance of the Department of Church Charity of the Moscow Patriarch and the English Christian charitable society Barnardos, which was sponsored by Princess Diana for many years.

Since 1999, an orthopedic workshop has been created and continues to operate in Moscow in collaboration with the Catholic German charitable society “Liebenau” and the “Holding of Rehabilitologists of Heidelberg”. Rehabilitation there is carried out using German technologies. We will talk about the main methods of rehabilitation of children with cerebral palsy in this article.

In Moscow, the rehabilitation medicine and rehabilitation clinic BiATi also deals with rehabilitation. The clinic has a hospital (for hospitalization of a child with an accompanying person) and has developed the “Mobile Rehabilitation” method, when, after consultation, an individual program of activities is selected for the child, and parents are trained at seminars and work with the child at home.

Since 2003 in the balneological resort in Truskavets in international clinic Professor Kozyavkin’s technique is used for rehabilitation treatment. This rehabilitation system has been recognized as one of the 4 most effective for cerebral palsy throughout the world.

The results of rehabilitation therapy for 12,000 patients with cerebral palsy using this system were processed: normal muscle tone was achieved in 94%, 62% of children learned to sit, 19% began to walk independently, correct control of head position was formed in 75%, they could open their hand (previously clenched in fist) 87% of children.

The purpose of rehabilitation, which is different from drug treatment, is the physical and social adaptation of the child, expanding his individual capabilities. The rehabilitation program is developed individually for each patient. In rehabilitation centers, specialists work with each child: rehabilitation specialists, occupational therapists, speech therapists, neurologists, orthopedists, psychologists, physical therapy and massage therapists.

When to start rehabilitation classes for a child with cerebral palsy?

The earlier the rehabilitation course of treatment is started, the more effective it is. It is advisable to start this course when the baby is one year old. In addition to the work of specialists, the active and constant participation of parents is required. Some rehabilitation centers have created conditions for parents and children to stay together for a long time.

The duration of rehabilitation depends on the severity of the disease and the individual capabilities of the child. Sometimes the duration of the rehabilitation course is 6 months, and for other children it is a year, one and a half or two daily hard studies. In some cases, parents complete a training course and study the proposed program with their child at home.

Experience working with children with cerebral palsy indicates that the program is built on the gradual achievement of the next set goal, even if it is insignificant. This is the so-called “fractional goal” method. For one child, this may be the opportunity to change the position of the body while lying on the mat (roll over independently), for another - to sit independently, for a third - to hold a spoon or cup.

The results are reflected in a specially created calendar, with which you can track the time it took to achieve your goal. As a result, every day will be a new step in development and will set motivation for further activities, strengthen hope and faith in their effectiveness.

It is impossible to achieve everything at once. And the final result of rehabilitation depends on the degree of brain damage. It is currently believed that behavioral disorders are associated with damage to higher nervous activity, and not to muscle-motor function, so the child is not able to coordinate and perform targeted movements.

Rehabilitators are engaged in the systematic development of the child’s motor abilities. Formation physical body influences and creates conditions for the development of intelligence and psyche. Therefore it matters early age children to begin rehabilitation activities, when intelligence can still be developed.

Individual program classes are held several times a day. On average, the duration of one session is 1-2 hours. Both the duration of the lesson and the number of lessons are selected specifically for a given child.

From the age of one year, classes take the form of a game. Special games promote motor-sensory correction and the development of intelligence: hearing, vision, and hand sensitivity develop. The duration of classes at this age is from 10 minutes. up to an hour. From the very beginning, rehabilitation is aimed at the child’s everyday and social adaptation.

The basis of rehabilitation methods is the training process, repetition of certain exercises to form a new stereotype of movements, and loading physical therapy. Additionally used manual therapy and massage, laser reflexology, movement correction using electrical stimulation of muscles and movement centers in the brain.

A number of general approaches in the rehabilitation process:

swimming is recommended for all children: it strengthens muscles well; coordination during movement and maintaining balance are less important, so all children can practice;
phasing of loads: gradual increase in training time;
improving the function of interaction between the hemispheres brain is achieved by special exercises: moving on all fours, exercising on wall bars with overlapping arms, alternating raising of versatile arms and legs when walking, etc.;
balance and coordination training: exercises on a “swaying board” while standing on two legs, then on one; slow walking on an inclined board; trying to catch the ball; jumping using a skipping rope, playing hopscotch; walking on hands while holding legs; drawing figure eights with your hands in the air;
spatial orientation is improved by playing balls different sizes, use of the tunnel simulator;
Fine motor skills are developed by playing with mosaics and puzzles, collecting sticks, and playing musical instruments.

Balneotherapy

Balneotherapy, or treatment with water procedures, gives good results. Water relieves muscle tension (which helps increase volume active movements), muscle twitching decreases. Various types of baths are used (radon, pine, pearl, sea, turpentine, oxygen, etc.), hydromassage, underwater massage with jet aeration and ozonation.

Galvanic 4-chamber baths "Werishofen" allow you to use combined action water, current and medicine(bischofite, pine extract, turpentine, etc.).

A color-dynamic quantum chamber combines a swimming pool and a laser shower. In the pool it is possible to stretch the spine, work out joints, and use various types of showers for massage.

Dolphin therapy

In Evpatoria and many others major cities Dolphin therapy is popular: psychophysical rehabilitation occurs in the process of swimming and communicating with specially trained dolphins. The course of dolphin therapy should be at least 2 weeks. Treatment is carried out all year round.

The child and the animal interact in the form of a game. At the same time, the child not only receives a lot of new positive impressions, but also develops his abilities. The dolphin, touching the child's body, stimulates biologically active points. The child touches the animal with his hands or feet under the supervision of a trainer, if he has any movement disorders in them.

Gradually, the elements of the classes become more complex. In addition, the dolphin, constantly working with its fins, creates the movement of water flows and thus provides hydromassage to the child. Water relieves stress on joints and trains muscles.

The beneficial emotional impact is also important: the dolphin reduces psychological stress, feelings of anxiety and anger go away, and the child develops confidence and initiative.

Hippotherapy

Hippotherapy (treatment with horses) is unique in its effectiveness, and has no analogues in the world. During close contact with the horse, about 100 vibrational impulses are transmitted to the rider. This promotes the development of motor skills and the formation of precise movements, activation of muscle reflexes.

The child receives a double effect: a motor “trainer” of arms and legs for controlling the horse and a “heated massager” (the body temperature of a horse is about 2 degrees higher than that of people). The ability to maintain balance and control the synchronization of movements develops. Horses have a very strong biofield; they feed children with positive energy.

Hardware development

Found widespread use orthopedic devices, rehabilitation exercise equipment, gymnastic balls, ladders, walkers. Specially developed modern mechanotherapy devices with software and biological feedback for the treatment of children with paralysis.

The active-passive simulator “Veloton” and “Gross simulator” help develop motor skills, joint mobility, and stimulate muscles. Universal system Gross allows you to conduct simultaneous training on other exercise equipment (on a wall bars, treadmill, roller skates or bicycle). The simulator can also be used in the pool, allowing you to expand the range of aquatic exercises. At the same time, the device protects the child from injuries and falls.

The “massager-rider” imitates the process of riding a horse and transmits similar motor impulses to the child.

The “Spiral” suit allows you to form a new stereotype of movements. The child is fixed in the pelvis, hips and armpits, and suspended in a special net. The instructor rocks it. The brain receives the correct signal from the muscles, and new movement skills are learned.

The orthopedic pneumatic overalls proposed by Russian specialists not only fix the joints, but also cause muscle tension, thanks to which the limbs move correctly. Other technologies and auxiliary devices are also being improved.

Spa treatment

In the complex of rehabilitation treatment for children with cerebral palsy, treatment can be used in sanatoriums in Odessa, Evpatoria, Truskavets, Saki, where such effective techniques are used as:

physiotherapeutic treatment (magnetic therapy, myoton, ultrasound, darsonvalization);
mud therapy;
shiatsu therapy (massage of active bio-points);
laser therapy;
massage (allows you to reduce the degree muscle spasms or lethargy);
Montessori therapy (a special technique for developing the ability to concentrate attention and developing independence);
classes with a speech therapist;
classes using the Bobath method ( special exercises in various poses and with special equipment);
classes using the Peto method (dividing each movement into separate acts and learning them).

Particularly effective complex use techniques and procedures.

Rehabilitation of children with cerebral palsy requires a long time and active participation parents.

Summary for parents

The goal of the rehabilitation course of treatment is to improve the child’s quality of life and help him in social and everyday adaptation.