Medical rehabilitation program for children with cerebral palsy. Rehabilitation of children with cerebral palsy - types of recovery programs

Special children...

Their number increases every year. This is evidenced not only by dry statistical data, but also by specialists who are in contact with children on duty - pediatricians, neurologists, psychotherapists, teachers of correctional kindergartens.

If you are the parent of a special needs child , then you need to understand that any person by nature has certain potential capabilities. In some cases, they are suppressed by a congenital or acquired disease. But don't give up. All your child needs is to help him adapt to society. In this regard, it is very important to understand that special children need special integrated approach to solve their problems. To carry out proper rehabilitation work with them, a lot of effort will be required from parents, teachers and doctors. Moreover, these efforts should not be episodic, but continuous.

According to statistics, about 2/3 of all disabled people in Russia are children with disorders of the nervous system and mental health. However, it is important to understand that not all special children have disabled status. Quite a lot of people are suffering slight deviations in behavior, problems with perception and assimilation of information, cannot fully communicate with people around them and peers. If you do not find out the child’s problem in time and do not apply for appropriate help, it is quite possible that in the future he will simply not be able to adapt to life and will receive the status of a disabled person.

What diseases make children special?

Children with neurological and neuropsychiatric problems are most often called special children. This is a fairly broad category, including a whole range of very different diseases, including in terms of complexity and ability to overcome, diseases. Here are just a few of them.

Cerebral palsy (CP)) - serious disease Central nervous system, in which the centers responsible for the development of the musculoskeletal system are affected. The nature of the lesion does not imply degenerative processes. As a rule, the appearance of the disease is associated with deviations in intrauterine development, may be a consequence of birth trauma and is often detected in the first year of life little man. Children with cerebral palsy, in some cases, have related problems in the form of compensated hydrocephalus, autistic features and delays in psycho-speech development. At the same time, it is not at all necessary that all of the above problems appear simultaneously at once. Forms of the disease without accompanying changes are possible.

RDA (early childhood autism), Kanner's syndrome, Asperger's syndrome- diseases of this kind are expressed in disruption of the development of the psycho-emotional sphere. The following problems are typical for a child:

Extreme difficulty in interacting with other people (mild form of the disease).

Limited by autistic interests - in this case, the child reproduces stereotypical movements, his interests are narrowly limited and are not of a cognitive nature.

Active denial and rejection of the environment - the child exhibits extreme selectivity in relation to people, clothing, types of food. Violation of the usual way of life, deviation from the standard route can cause attacks of hysteria, sometimes turning into auto-aggression.

Total detachment from the world and the inability to interact with it (in the most severe forms illnesses). Such children do not smile, do not maintain eye contact, and do not have basic self-care skills.

As a rule, an autistic child has multiple neurological abnormalities, and the disease itself may be a consequence of the layering of various types of root causes. Often autistic traits come along with another serious illness such as hydrocephalus or cerebral palsy. IN Lately Information began to appear that some children developed autism after vaccination with preparations containing mercury salts (merthiolate or thimerosal) in their composition. Some autistic children have had elevated concentrations of mercury in their hair and red blood cells. For them, one of the methods to overcome the problem can be chelation therapy (chelation).

Hydrocephalus. It is also called hydrocele. The disease is associated with impaired cerebrospinal fluid dynamics. In this case, cerebrospinal fluid (CSF) is produced in excess, and its absorption occurs very slowly. In extremely severe cases, the child's head circumference becomes excessively enlarged. Children with hydrocephalus constantly experience increased intracranial pressure. Such phenomena as nausea and nosebleeds, as well as causeless hysterics are not uncommon. At the same time, a child at an early age can rub his head with his hands, hit his head on various objects and somehow demonstrate that it is his head that hurts. There are severe forms of hydrocephalus and milder compensated ones. If to get rid of the first one requires surgical intervention (bypass surgery), then in the second case it is enough to follow the doctor’s instructions. The disease is often accompanied by such a phenomenon as SRD or SRD (delayed speech or psycho-speech development). This is due to the fact that excess cerebrospinal fluid depresses certain areas of the brain.

A complete list of diseases associated with nervous and mental activity, much wider (Down syndrome, early organic brain damage, etc.). It is very important to diagnose the disease in time and contact a rehabilitation center. Leading neurologists warn about this - the sooner you start treating your child and working with his condition, the more strongly the brain’s restorative abilities will manifest themselves.

Rehabilitation objectives

Features of development, first of all, are expressed in the deterioration cognitive activity and in some cases they completely weaken a person’s will (autism). In this regard educational process for children must fit into the system of their rehabilitation (habilitation). It is the rehabilitation of special children that is cornerstone on the way to their further socialization and more successful development. All rehabilitation centers, regardless of the specifics of the disease, essentially have one common goal - to provide the child with the opportunity to live a completely independent life in the future. They have to deal with the most difficult diagnoses, helping special children to prepare as much as possible for education.

Rehabilitation for severely ill children will be effective only if the problem is continuously addressed. Ideally, she should accompany the patient until the period of his adaptation to society and employment (if the level of development and type of disease allow this to be achieved).

Below are some rehabilitation centers in Moscow where parents with special needs children should go.

- federal state budgetary institution, sponsored by the Ministry of Health and Social Development, provides assistance to children from different regions Russian Federation with diseases of the central nervous system, musculoskeletal system and autism spectrum. The center operates a school for parents. Rehabilitation methods used in the center:

Carrying out corrective sensorimotor disintegration;

Use of Lokomat robotic technology;

Exercises using a Gross simulator;

Conductive therapy classes;

Logorhythmics;

Classes in medical suits “Atlant”, “Adele”, “Phaeton”;

Social and everyday adaptation;

And much more.

Payment for accommodation of residents is charged for children over 4 years old and their accompanying persons. At the same time, its sizes are: in a ward (regular) - 335 rubles per day; in a room with a shower (increased comfort) - 700 rubles per day, in a comfortable room without a shower - 600 rubles per day. The center provides paid services, If:

They are not included in the compulsory medical insurance program;

The representatives of the child do not have any direction towards the budget funds;

The service is provided on the initiative of the patient and his voluntary desire;

The patient does not have Russian citizenship.

At the same time, the cost of one bed-day for a child in a ward with meals, but without treatment is 750 rubles. The cost of an accompanying person staying with him is 335 rubles. A rehabilitation course for a child with cerebral palsy (21 days) will cost 56,865 rubles. The price of an initial consultation with specialists is within inpatient treatment- 800 rubles, repeated - 500 rubles (each specialist individually).

ICR "Children" is modern center rehabilitation of children with cerebral palsy in Moscow. We work with patients of different ages using advanced techniques, tested by Western and Israeli doctors. Every second child suffering from cerebral palsy (CP) needs our help, because without the necessary support, such people develop not only motor, but also mental disorders.

What do our patients get?

The Interdisciplinary Center implements a comprehensive program that includes hardware and drug treatment and subsequent psychological rehabilitation children with cerebral palsy. Its goal is evolution strengths affected by the disease and restoration of body functions lost due to cerebral palsy. To do this, we use advanced medical technologies, involving both the patient and his family members in the work.

We rely on our own methods of physical and social rehabilitation of disabled children with cerebral palsy, offering advanced methods of encouraging the patient to active work. The main task of the team of specialists is to develop and stimulate the desire to achieve physical, creative and mental activity.

Experienced doctors - rehabilitation specialists, psychologists, physiotherapists, neurologists, speech therapists, massage therapists and art therapists - are busy ensuring this aspiration. Children are supported by a multidisciplinary team that can develop and implement an individual rehabilitation plan.

Our specialists offer truly effective methods of psychological and motor rehabilitation of children with cerebral palsy in Moscow, therefore positive reviews You will see about the work of the IDC “Children” on any social networks or on thematic forums.

Main directions of the rehabilitation program

At the Children's Children's Center, individual, group and mixed approaches to the recovery of preschool children and adolescents with cerebral palsy who receive comprehensive care are practiced:

drug and movement therapy;
development of self-service skills;
stimulation of the cognitive sphere, speech and hearing skills;
joint overcoming of difficulties during socialization.

The medical institution uses innovative technical means and unique simulators for the rehabilitation of disabled children with cerebral palsy. Our medical center has hardware and software systems with feedback, simulators, modern massage tables and other equipment at its disposal.

Features of group work

After developing an individual plan, the child is offered group classes. This approach to therapy increases socialization and improves the results of interaction with a speech therapist, psychologist and movement therapist.

Meetings are held from 9:00 to 14:00 on Mondays, Wednesdays and Fridays and from 15:00 to 19:00 on Tuesdays, Thursdays and Saturdays, which allows you to choose a schedule convenient for children and their parents. The group does not exceed five people, and in difficult cases it can only include two children.

Family support

The parents of our patients receive help from psychologists. During group classes People accompanying children and schoolchildren with cerebral palsy are in comfortable waiting areas. They can influence the scheduling by choosing convenient time visit to the doctor. Our managers will help you choose a charitable organization that is ready to solve the financial difficulties of the patient’s parents.

How to make an appointment

The interdisciplinary center “Children” is ready to work with patients of any age. We are engaged in medical rehabilitation of children with cerebral palsy up to one year old, training of preschoolers and interaction with adolescents. To make an initial appointment with a speech pathologist, just indicate the phone number in the feedback form (it is located at the bottom of this page). Our consultants will contact you within 30 minutes and answer all questions.

Cerebral palsy (CP) in a child implies a certain style and rhythm of life aimed at restoring the motor activity of the affected limbs of the little 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 mother, a hereditary predisposition has been proven. 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 in health. The neurologist prescribes an individual plan for the treatment and rehabilitation of cerebral palsy. Traditionally, it includes balneotherapy, physical therapy, massage, and 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 opportunity to work in conditions of full provision of 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, indicators decrease blood pressure, heart rate, breathing stabilizes, 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. It is used for many neurological disorders, Down syndrome, and retardation in physical and mental development. Treatment of cerebral palsy in Russia with a similar 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 received 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, riding a horse, experiences oscillatory movements, controls his position in space, tries to hold correct posture. Strengthens musculoskeletal system, vestibular apparatus.

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 the vascular wall and 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 spine, upper and lower extremities involving large, medium and small joints. Passes pain syndrome, lymphatic outflow 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 classes physical therapy. 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 promotes rapid adaptation in society.

The massage is based on point impact 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 through regular external pressure the time frame is reduced several times.

Social rehabilitation

External changes to the upper and lower limbs, impaired coordination of movements and speech significantly affects 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 checks on families 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.

The drugs used, administered in sanatoriums, include anticonvulsants with strict dosage control, 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. Rehabilitation treatment was also carried out 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. About the main methods of rehabilitation of children, patients with cerebral palsy, we will tell you 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 a child, after consultation, is selected individual program classes, and parents are trained at seminars and work with the child at home.

Since 2003 in the balneological resort in Truskavets in international clinic rehabilitation treatment Professor Kozyavkin’s technique is used. 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 achieved in 94%, 62% of children learned to sit, 19% began to walk independently, correct control of head position was formed in 75%, 87% of children can open their hand (previously clenched into a fist).

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. Yes and final result rehabilitation depends on the degree of brain damage. It is currently believed that behavioral disorders associated with the defeat of the higher nervous activity, and not with muscle-motor function, so the child is not able to coordinate and perform a targeted movement.

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 is important for children to start rehabilitation activities at an early age, 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, manual therapy and massage, laser reflexology, and movement correction using electrical stimulation of muscles and movement centers in the brain are used.

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, gives good results water procedures. 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 the combined action of 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. A dolphin, touching a 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 motor impairments 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

Orthopedic devices, rehabilitation exercise equipment, gymnastic balls, ladders, and walkers are widely used. Modern mechanotherapy devices with software and biofeedback have been specially developed 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 V various poses and with special equipment);
classes using the Peto method (dividing each movement into separate acts and learning them).

The integrated use of techniques and procedures is especially effective.

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

Effective rehabilitation of children with cerebral palsy includes a set of measures. Attention is paid not only to the physical, but also to the mental development of the child, the acquisition of independence skills and social adaptation. For children with disabilities, free observation, vouchers for treatment in sanatoriums, and provision of medications and technical rehabilitation equipment are also possible.

Causes of the disease and risk factors

Causes development of cerebral palsy divided into intrauterine provoking factors and postpartum. The first type includes:

difficult pregnancy;
unhealthy lifestyle of the mother;
hereditary predisposition;
difficult childbirth, during which fetal asphyxia occurred;
acute or some chronic diseases of the mother;
children born prematurely and with low birth weight;
infectious processes occurring in hidden form in the mother's body;
toxic poisoning of the child’s brain due to incompatibility of mother and fetus in blood type and Rh factor or liver failure child.

Postpartum triggers include:

baby weight up to 1 kg at birth;
the birth of twins or triplets;
head injuries at an early age.

In every third case, however, it is not possible to identify the specific cause of the pathology. And as a rule, rehabilitation of children with cerebral palsy does not depend on the causes of the disease. can be reconsidered only in the case of premature and low birth weight babies - such patients often require more careful care and medical supervision.

Main phases of the disease

Rehabilitation of children with cerebral palsy depends on the phase of the disease, the severity of the disease and the age of the patient. There are three phases of the course of the disease:

Early (up to 5 months). Cerebral palsy is manifested by developmental delay and preservation of unconditioned reflexes.
Primary (up to 3 years). The child often chokes on food, does not try to speak, asymmetry, hypertonicity or excessive muscle relaxation are noticeable.
Late (over three years). It manifests itself as shortening of one limb compared to the other, disturbances in swallowing, hearing, vision, speech, convulsions, disturbances in urination and defecation, and mental retardation.

Early signs of cerebral palsy

TO early signs Cerebral palsy includes the following deviations:

delay physical development: head control, rolling over, sitting without support, crawling or walking;
preservation of “childish” reflexes upon reaching 3-6 months of age;
one hand dominance by 18 months;
any symptoms that indicate hypertonicity or excessive relaxation (weakness) of the muscles.

Clinical manifestations of the disease can be either pronounced or almost invisible - it all depends on the degree of damage to the central nervous system and brain. You should seek medical help if:

the child’s movements are unnatural;
the child has seizures;
muscles look excessively relaxed or tense;
the baby does not blink in response to loud noise in one month;
at 4 months the child does not turn his head towards a loud sound;
at 7 months does not sit without support;
at 12 months does not speak individual words;
the baby does not walk or walks unnaturally;
The child has strabismus.

Comprehensive rehabilitation of children with cerebral palsy gives the best results if it begins at an early age. In severe forms of the disease, untimely recovery physical activity or late development of social skills, the child may remain completely unadapted to life.

Is it possible to cure the disease?

Cerebral palsy is a disease that is almost impossible to cure completely. However, comprehensive and timely rehabilitation allows children with this diagnosis to undergo education on an equal basis with healthy children and lead a full life. Significant progress can be considered if the child retains a few symptoms of the disease.

Modern methods of treating cerebral palsy

The main task for children with paralysis is gradual development skills and abilities, physical and social adaptation. The techniques, which are developed individually for each child, gradually correct motor defects, improve motor activity, develop the patient emotionally, personally and socially, and develop independence skills in everyday life. As a result of systematic rehabilitation, the child can integrate into society and adapt to later life on one's own.

The rehabilitation program for children with cerebral palsy includes the following approaches:

treatment with water procedures: swimming, balneo- or hydrotherapy;
PET therapy, or treatment with animals: hippotherapy, psychophysical rehabilitation in the process of communicating with dolphins and swimming;
application orthopedic devices, exercise equipment, gymnastic balls, ladders;
increasing bioelectrical activity of muscles;
massotherapy allowing to reduce the degree of lethargy and muscle spasms;
drug treatment: Botox, botulinum toxin, Xeomin, Dysport are used;
Vojta therapy, which allows you to restore natural behavior patterns;
physiotherapeutic treatment: myoton, ultrasound, magnetic therapy, darsonvalization;
Montessori therapy, which allows you to develop the ability to concentrate and develop independence;
sessions with a psychologist;
speech therapy classes that correct speech disorders (the Logorhythmics program);
special pedagogy;
shiatsu therapy - massage of biologically active points;
classes using the Bobath method - special gymnastics using certain equipment;
laser impact on reflexogenic zones, tip of the nose, joints, reflex segmental zones, area of paretic muscles;
art therapy aimed at preparing the child for learning;
Peto's technique - dividing movements into separate acts and learning them;
surgical orthopedic interventions;
Spa treatment;
alternative methods of treatment: osteopathy, manual therapy, catgut therapy, vacuum therapy, electroreflexotherapy.

Of course, not all methods of rehabilitation of children with cerebral palsy are listed above. There are many ready-made programs developed and currently being developed by rehabilitation centers, alternative approaches and techniques.

Physical rehabilitation of children with cerebral palsy

Physical recovery of a sick child should begin as early as possible. Leading experts in the world have recognized that the rehabilitation of a disabled child (CP) brings the best results up to three years of age, but in Russia many centers refuse to accept children under one or three years of age, and doctors are in no hurry to establish a diagnosis and register disability. But still physical rehabilitation - the most important stage adaptation of a special child to future life, and you should start working with a young patient immediately after the diagnosis of cerebral palsy is established.

Rehabilitation of children with cerebral palsy is necessary to prevent weakening and atrophy of muscles, to avoid the development of complications, and is also used to promote the child’s motor development. Therapeutic massage, physical education and exercises on special simulators are used. In general, any physical activity is useful, and the supervision of a specialist will help to form motor stereotypes, properly develop physical fitness and prevent addiction to pathological positions.

Rehabilitation Bobath therapy

The most common form of rehabilitation is Bobath therapy in combination with other equally effective techniques. The essence of the therapy is to give the limb a position opposite to that which it, due to hypertonicity, tends to assume. Classes should be conducted in a calm environment, three times a day or a week, each movement is repeated 3 to 5 times. The movements themselves are carried out slowly, because the main goal of treatment is muscle relaxation. Exercise sets are developed individually. Treatment using the Bobath therapy method can also be carried out at home - a parent or guardian is trained to perform the techniques with the help of a specialist in a rehabilitation center.

Means of technical rehabilitation

When physically restoring the motor activity of a child with cerebral palsy, means of technical rehabilitation of children are also used. Severe cerebral palsy requires mobility aids (walkers, wheelchairs), development (exercise bikes, special tables and chairs) and hygiene (bath seats, toilet seats) of the child. Also, rehabilitation means for children with cerebral palsy involve the use of orthopedic devices and exercise equipment. For example, the Adele suit is used, which redistributes the load and develops motor skills, the “Veloton”, which stimulates the muscles, the “Spiral” suit, which allows the formation of new stereotypes of movements, and so on.

Social rehabilitation of disabled children with cerebral palsy

Closer to school age More attention is paid to the child’s social adaptation. Efforts are aimed at developing independence skills, mental development, preparing the child for collective learning and communication. In addition, the patient is taught to dress independently, take care of himself, perform hygiene, move around, and so on. All this will reduce the burden on those caring for a disabled child, and the youngest patient will be able to adapt to life.

Psychologists, speech therapists and teachers work with special children. The role of parents or guardians who will work with the child at home is extremely important. Social rehabilitation of children (CP) pursues the following goals:

extension vocabulary and outlook;
development of memory, attention and thinking;
developing personal hygiene skills;
developing self-service skills;
development of speech, formation of culture.

Children with this diagnosis can study in experimental classes, which are often formed in private schools, but if there are significant restrictions, it is better to think about boarding or homeschooling. In a boarding school, a child can communicate with peers, gain special skills and participate in career guidance activities. Homeschooling requires more Active participation parents and daily medical monitoring.

In many cases further work activity a person diagnosed with cerebral palsy. Such people can master the professions of mental work (teachers, but not junior classes, economists, architects, junior medical staff), work at home as programmers, freelancers and even (if hand movements are preserved) as seamstresses. Employment is impossible only in severe cases.

Disability due to cerebral palsy

It has several forms and degrees of severity. Disability for cerebral palsy is registered if the disease is accompanied by restrictions in relation to normal life, training, self-care, speech contact. Registration of disability is possible only after medical examination. Mother and child will have to see a neurologist, surgeon, psychiatrist, pediatrician, orthopedist, ophthalmologist and ENT specialist. The “adventures” do not end there. Followed by:

draw up a final conclusion from the head of the medical institution;
go through the document verification procedure in an adult clinic;
submit the package of documents to the collection point for medical and social examination.

Depending on the period of establishment of disability, carry out medical and social examination(and therefore, to go through all the doctors again) must be repeated after a certain period of time. You also need to obtain a new opinion if the completed individual rehabilitation program undergoes changes - for example, if a child, as prescribed by a specialist, requires a new means of rehabilitation.

Benefits for disabled children with cerebral palsy

Registration of disability for some families is a vital issue, because it makes it possible to receive cash payments for rehabilitation and benefits.

Thus, families with disabled children with cerebral palsy are entitled to the following benefits:

free rehabilitation in federal and regional centers and sanatoriums;
a discount of at least 50% on payment for municipal or public housing, as well as housing and communal services;
the right to priority receipt of land plots for individual construction, gardening and housekeeping;
provision of medicines (as prescribed by a doctor), medical nutrition products;
free travel to and from the place of sanatorium-resort treatment, as well as on public transport (benefits are given to a disabled child and one accompanying person);
compensation for the services of a psychologist, teacher and speech therapist, determined by the individual rehabilitation program (in the amount of no more than 11.2 thousand rubles per year);
exemption from fees in kindergartens;
compensation payments to unemployed persons caring for a disabled child (a parent, adoptive parent or guardian can receive 5.5 thousand rubles, another person - 1.2 thousand rubles);
pension for a disabled child and additional payments (in total 14.6 thousand rubles as of 2017);
the period of caring for a child with a disability is counted as part of the mother’s work experience;
the mother of a disabled child with cerebral palsy has a number of benefits labor legislation: cannot be involved in overtime work, business trips, has the right to work part-time, retire early, and so on;
a single mother raising a disabled child cannot be fired, except in cases of complete liquidation of the enterprise.

Rehabilitation centers in Russia

In special centers, rehabilitation of children with cerebral palsy is carried out comprehensively and under the supervision of relevant specialists. As a rule, systematic classes, an individual program and professional medical support for both children and parents make it possible to achieve significant results in a relatively short period of time. Of course, to consolidate the results, you need to continue studying according to the proposed program at home.

Russian Scientific and Practical Center for Physical Rehabilitation and Sports (Grossko Center)

There are several rehabilitation centers in Russia. The Grossko Center in Moscow operates on comprehensive program: upon admission, a diagnosis is carried out, then specialist instructors in physical rehabilitation work with the special child. Physical rehabilitation Children with cerebral palsy at the Grossko Center include physical therapy classes, swimming, exercises with special simulators that allow them to develop coordination of movements and consolidate motor stereotypes, exercises on a treadmill, and roller skating. Based on the results of pedagogical testing, programs are adjusted so that the rehabilitation meets the needs and condition of a particular small patient.

The cost of rehabilitation of a child (cerebral palsy) at the Grossko Center is, of course, not small. For example, you will have to pay 1,700 rubles for the initial appointment, and the cost of 10 physical therapy sessions (45-50 minutes each) is 30 thousand rubles. One session with a speech therapist (lasting 30 minutes), as well as a massage session (30-40 minutes according to the doctor’s indications) will cost 1000 rubles. However, there really are results from the classes, and the Grossko Center itself is a prominent institution.

Russian Research Institute of Traumatology and Orthopedics named after. R. R. Vredena

The Rehabilitation Center for Children with Cerebral Palsy named after R.R. Vreden (RNIITO - Russian Research Institute of Traumatology and Orthopedics) in St. Petersburg provides its clients full complex services: from diagnosis to surgery, including, of course, treatment and recovery. Highly professional specialists of the center with many years of experience are at their disposal. practical experience more than twenty fully equipped departments.

Moscow Scientific and Practical Center for Rehabilitation of Persons with Disabilities Due to Cerebral Palsy

The Moscow Scientific and Practical Center for the rehabilitation of people with disabilities due to cerebral palsy is considered one of the most accessible and well-known. The center’s doctors work on the basis of several dozen rehabilitation programs, use all modern domestic developments and find individual approach to every patient. The center accepts children from three years old. In addition to directly physical recovery, speech pathologists, speech therapists, professional massage therapists and conductologists - teachers who work with children and adults who have disorders of the central nervous system - work with young patients.

Institute of Conductive Pedagogy and Regenerative Movement Therapy in Budapest, Hungary

Rehabilitation of a disabled child (cerebral palsy) at the Institute named after. A. Petyo in Budapest, the capital of Hungary, is a center where hundreds of families strive to get to. The institution is famous for its excellent specialists, the use of the most modern developments in the treatment of young patients, as well as visible results achieved by children with cerebral palsy who have completed a rehabilitation course.

There are many other rehabilitation centers and sanatoriums that accept children with cerebral palsy for rehabilitation. Only in Moscow, for example, there are the “Movement” Rehabilitation Center for Children with Cerebral Palsy, the “Ogonyok” Rehabilitation Center, the “Overcoming” Rehabilitation Center and others. Some institutions also offer free rehabilitation for children with cerebral palsy. Families with disabled children are also supported in charitable organizations and social centers.