Where to undergo rehabilitation with a child with cerebral palsy. Treatment of cerebral palsy in Russia

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

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

Rehabilitation of children with cerebral palsy includes a wide variety of procedures aimed at reducing muscle tone, stimulating mental development and collectivization of the child. The duration of the recovery period varies and depends on the severity of the disease (severe degrees require constant exercise). Doctors and rehabilitation specialists advise starting a recovery program at 1 year of age. Efficiency result therapeutic measures for cerebral palsy depends on the age of the child. Since kids neural connections in the brain recover much faster than in older children.

Basic methods rehabilitation of cerebral palsy:

massage;
physical therapy;
bobat and vojta therapy;
hydrotherapy;
the use of devices and exercise equipment that prevent the development of pathological postures and reduce muscle hypertonicity;
classes with a speech therapist to correct speech defects;
psychological support for parents and children;
drug therapy necessary to eliminate excessive muscle tone;
surgical operations – tendon plasty, corrective osteotomy;
performing neurosurgical operations;
physiotherapy;
hippotherapy, dolphin therapy;
art therapy (therapy using drawings);
sensory therapy.

During rehabilitation, the child is given one goal: to learn to roll over, stand, sit, and grasp or hold objects. During classes, the child’s adaptation to society improves, as well as intellectual abilities child.

Drug and surgical treatment

Rehabilitation for children with cerebral palsy necessarily includes drug therapy.

Purpose of use medications are:

decreased muscle tone (relieving pharyngeal spasm or paralysis, weakening pathological posture);
stimulation of blood circulation in the brain;
elimination of convulsive syndrome;
improved conductivity nerve impulses in brain tissue.

Patients with cerebral palsy often experience epileptic seizures. As anticonvulsant therapy apply medicines Lamotrigine or Toparamate. Mydocalm, Baclofen is actively used to reduce muscle hypertonicity, which facilitates recovery motor activity in the child in the future. For stimulation brain activity doctors prescribe the drug Actovegin, which is necessary to improve cerebral circulation. At severe pain The doctor prescribes analgesics and antispasmodics.

If a child with cerebral palsy has concomitant diseases, such as diabetes mellitus, hypothyroidism, therapy with Thyroxine and short-acting insulin is added to the treatment long acting. Obesity is treated with drugs that speed up metabolism, balanced nutrition And physical activity. In case of severe agitation, children are prescribed antidepressants.

Orthopedic and surgical correction

TO surgical care include operations to eliminate contractures in joints that arise from constant increased tone flexors (extensors) and atrophy of antagonist muscles. Surgeons perform surgery for joint replacement, tendon grafting, osteotomy. Brain surgeries are performed to restore the functioning of nerve bundles. These techniques help to partially alleviate and restore the patient’s motor activity.

Massage and physical therapy (physical therapy)

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

Therapeutic physical training is necessary to restore the functioning of atonic muscles. A physical therapy doctor works with the child and prescribes sets of exercises depending on the clinical manifestations Cerebral palsy. The child performs the exercises independently, as well as with the help of a doctor or mother. Classes are conducted on a mat, with a ball and dumbbells. The complex of exercises often includes bending, squats, lunges, crawling, stretching, and walking.

Exercise therapy doctors use the “tunnel” exercise, walking on an inclined or swaying board to train balance, jumping rope, elastic band, and the game “hopscotch.” Daily exercises 2 times a day for 1 hour for a year lead to positive results. It is not recommended to cancel classes.

Use of devices and simulators

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

Exercises on simulators are carried out only under the supervision of medical personnel or the mother. Parents are actively trained to use exercise equipment correctly so as not to harm their child. Using an Adele suit will improve your training results and make your movements easier. everyday life. “Rider” trainer, “spiral” suit, universal system Gross help you acquire new skills and sensations.

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

Other techniques

Medical rehabilitation of cerebral palsy includes many methods: physiotherapy, speech therapy classes, various board and outdoor games. Water procedures and swimming with dolphins are useful.

Physiotherapy

Physiotherapy includes hydrotherapy, electrotherapy, magnetotherapy, mud therapy, electrical stimulation, ultrasound, electrophoresis. From water procedures They include swimming in the pool, sea and pine baths, and dolphin therapy. Swimming has a positive effect on all muscle groups, promotes skeletal growth, and calms the child. It is often combined with gymnastics. The color-dynamic quantum chamber combines swimming pool activities with a laser shower.

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

Dolphin therapy, hippotherapy

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

Hippotherapy – horseback riding. This technique strengthens the back muscles, helps train balance, and prevents depression in children. It is suitable for children over 2 years old, teenagers, and adults.

Classes with teachers, speech therapists and psychologists

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

Educational games and drawing

During rehabilitation, doctors advise practicing more fine motor skills. It develops the child's intellectual abilities. For these purposes, mosaics, puzzles, construction sets, collecting sticks, playing musical instruments. It is very useful to involve children with cerebral palsy in art therapy. Drawing calms the child, gives him the opportunity to express his thoughts and emotions, and prepares him for learning.

Sensory therapy, Bobath therapy, Vojta therapy

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

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

Conclusion

Rehabilitation is important stage recovery if patients have childhood cerebral palsy. It is used in adult as well as pediatric practice. To achieve successful treatment, it is necessary to persistently engage in therapeutic physical training and attend physical procedures for several years. An integrated approach to rehabilitation therapy for early stage disease can lead to an improvement in the patient’s condition, and in children under 1 year of age, to the prevention of the onset of cerebral palsy.

Rehabilitation of cerebral palsy - video

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, adapt to constantly changing environmental conditions, and it is difficult to control his 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 or set of exercises that will be ideal for everyone.

If a 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 a wealth of knowledge that will allow them to continue the process of rehabilitation of cerebral palsy at home and consolidate the results achieved.

Our team of rehabilitation doctors

All specialists who are involved in the rehabilitation of patients with motor disorders, must continually develop their skills in observing, assessing and analyzing 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 the physical impact on the patient’s body, so 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.

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 is not a death sentence. 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

Cerebral palsy is chronic disease, resulting from damage to various parts of the brain, which entails dysfunction of motor and muscle activity. Along 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 the general condition of the 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 muscle function and movement.

Currently, around the world there are many rehabilitation centers for children with cerebral palsy, where various specialists work with patients - neurologists, orthopedists, pediatricians, psychologists, speech therapists, chiropractors, and parents undergo training in child rehabilitation at home. After all, even a simple game of dolls allows you to improve coordination of movements, muscle function, and suppresses pathological reflexes.

Cerebral palsy can manifest itself 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 taking medications (antispasmodics, painkillers, antidepressants, tranquilizers), constant exercise therapy, surgical and orthopedic methods in combination with massage. Good results Physiotherapeutic methods allow you to achieve: electrical stimulation of nerves and muscles, thermal and mud treatment, electrophoresis. For severe contractures it is used surgical treatment, during which muscles and bones are lengthened, and tendons are cut to relieve spasticity.

Social rehabilitation of children with cerebral palsy

The period of restoration of 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.

The conditions under which recovery takes place are of great importance for the successful treatment of a child with cerebral palsy. 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.

At the same time physical rehabilitation should now be aimed at developing everyday life skills, 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 lead normal lives. At proper rehabilitation children with cerebral palsy subsequently go to school, work, get married and have children.

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, use of medications, and 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 are affected. After birth, each child has his own individual program on recovery (rehabilitation).

First of all, a sick baby needs medical rehabilitation. There is a significant amount medical methods treatment is also the use medications, And therapeutic massage, and specially selected physical exercise, 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 seizures or epileptic seizures. The most common among drugs is diazepam - it acts directly on chemical processes occurring in the brain.

To eliminate spasticity (painful muscle contraction), 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).

Also to drug treatment include 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.

Therapeutic exercise

Therapeutic exercise (physical therapy) is necessary procedure during rehabilitation of cerebral palsy. With the help of physical education, the child will be able to improve the coordination of his movements, reduce muscle tone disorders, and acquire the necessary skills necessary for 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 a child’s life 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;
the reflex effect on internal organs increases.

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

IN complex treatment Cerebral palsy also includes classes 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.

Great contribution to correctional work Speech therapy contributes with the 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 a 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.

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