Rehabilitation program for children with cerebral palsy. Social rehabilitation of disabled children with cerebral palsy

Recognized 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 harmony) 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 consider the most well-known and effective rehabilitation methods 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 towards a loud sound or flash 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

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 forces the nervous structures to work actively, and this in turn helps to improve speech and motor function, and the 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. It also gives 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 motionless. 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 DPC 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.

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 for treating children cerebral palsy ";
New technology for the treatment of various types of psycho-speech delays, including ASD (autism spectrum disorders).
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 interhemispheric ones. 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 that has diplomatic relations with the Russian Federation. We also work as a center rehabilitation of 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.

Coursework treatment of cerebral palsy and ZPRR 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

Treatment of cerebral palsy in Russia

Government 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. The Scientific and Practical Center for Pediatric Psychoneurology is a state institution that operates in the Moscow healthcare system and is subordinate to the Moscow Department of Healthcare. 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 of 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 adult disabled people with severe forms of cerebral palsy who cannot move independently and do not provide services for 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 medical care to children and adolescents in Moscow, the Moscow region, Russia, and countries near and far abroad. 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.
The provision of paid medical services is 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 Health Care of the Russian Academy of Medical Sciences of January 15, 1999. Possible medical care 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.

Thanks to this combination - a clinic and a dispensary, a hospital and a sanatorium - it is possible to carry out step-by-step treatment and dynamic observation for the sick.
At 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 budgetary institution « Rehabilitation center for children and adolescents with disabilities” has been operating since 2003 on the basis of the Decree of the Head of the Administration of the Belgorod Region 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 carried out by the department of social protection of the 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-personal 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 disabilities undergo rehabilitation courses at the center. various types diseases.
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 limited health capabilities, 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 for 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 damage to the central nervous system (cerebral palsy, congenital anomalies development, consequences of neuroinfections, perinatal lesion nervous system, brain and spinal cord injuries, 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 etc.)
. diseases of the musculoskeletal system (motor 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. An individual program is being developed 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.

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 in patients with cerebral palsy and improve their quality of life. The main complex therapy for 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 measures

4. Assessing the effectiveness of rehabilitation

5. Restoration of the correct system of 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 of 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

Therapeutic gymnastics

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 provisions.

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, postures and positions of the limbs are normalized, muscle tone is reduced, and 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 perform the following physical exercises:

v stretching;

v muscle relaxation and decreased tone;

v increasing the amplitude and range of muscle movements of various parts of the body;

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 with exercise

· 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 peculiar therapeutic exercises, allowing you to train coordination 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 positions of the 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 and bladder muscles. Such stimuli contribute to the formation of motor rehabilitation, and therefore the normalization of body movements.

Hydrotherapy - It is based on 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 cerebral palsy, and improve coordination, sense of balance, and develop muscle strength.

Sadovaya therapy - essence therapy involves the child’s interaction with nature. So, 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 it happens active stimulation tactile, visual, 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 certain 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 disorders of the upper or lower extremities, respectively, have been identified.

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 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. Most common reasons diseases are birth trauma, asphyxia during childbirth, intrauterine infection. Upon diagnosis Cerebral palsy for a child 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. Duration 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 of 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 the classes, the child’s adaptation to society improves, as well as the child’s intellectual abilities.

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 the restoration of motor activity in the child in the future. For stimulation brain activity doctors prescribe medicinal product Actovegin, which is necessary for improvement 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

Surgical care includes 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 motor activity patient.

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 muscular system Doctors apply to child special complexes. They are attached to the ceiling and floor, have many stretching elements that slightly counteract the spasming muscles, and also carry out passive movements of atrophied muscles.

Training on exercise machines is carried out only under supervision medical personnel or mother. Parents are actively trained to use the equipment correctly so as not to harm the child. Using the Adele suit will improve your training results and make your movements easier in everyday life. The “rider” simulator, the “spiral” suit, and the universal Gross system help you acquire new skills and sensations.

Patients with cerebral palsy need wheelchairs, walkers, toilet chairs, hygienic bath seats, and 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 your child is agitated, wakes up at night, and 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, mass 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 introduce children with cerebral palsy to art therapy. Drawing calms the child, gives him the opportunity to express his thoughts and emotions, and prepares him for learning.

Sensory therapy, Bobath therapy, Vojta therapy

For patients with cerebral palsy, there are sensory rooms in rehabilitation centers. They are equipped various kinds 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 in patients with cerebral palsy. It is used in adults as well as pediatric practice. To achieve successful treatment it is necessary to persistently engage in therapeutic physical culture, attend physical treatments for several years. An integrated approach to rehabilitation therapy on 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.