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Rehabilitation of Cerebral Palsy & Motor Delay
Rehabilitation of Cerebral Palsy & Motor Delay
Rehabilitation of Cerebral Palsy & Motor Delay
REHABILITATION:
The process of making the child w/ disability maximally able again through
the application of rehab principles & techniques.
•
REHABILITATION OF C.P
Principles of proper rehabilitation :
1. Proper evaluation ( individual treatment )
- to plan a therapy program.to assess progress.
- to add observation to the diagnostic picture.
2. Early treatment( increasing functional deficits w/
age as secondary effects of spasticity &other
primary problems
3. Team work ( global dysfunction )
EVALUATION OF CP CHILD
(A) Clinical evaluation
1. Functional : Postural control Mobility
GAIT
• Hemiplegia Toe walk
• Diplegia Bilateral equinovaras,
Knee flexed & in valgus
Scissoring
• Cerebellar Ataxic
MOTOR EXAMINATION
DEFORMITIES
d) Mirrors
e) Stairs with bannisters: very in height.
f) Rumps, uneven ground, various floor services for gait training.
NEURODEVELOPMENTAL
TRAINING
7.Walking aids
Walkers
Crutches
Braces & Calipers:
Knee gaiters (polyethylene knee moulds) to keep
knee straight abduction parts to keep legs apart.
Elbow gaiters which keep elbow straight for
correct arm push & grasp of walkers.
MOTOR FACILITATION APPROACH
PHYSICAL AGENTS
Aim: a. Analgesia b. Ms. Relaxation c. Collagen extensibility
Modalities: 1) Ice 20mins.
2) Heat: Superficial : Dry: I.R. Moist: hot packs
Deep : S.W. U.S
ELECTRIC CURRENTS Aim: Ms. strengthening (galvanic & faradic) .
Analgesia ( TENS, IF)
EXERCISES For spasticity : Passive ROM Stretch (short ms.)
Strengthening (weak ms., antagonist),
resistive > 3/5
For hypotonia : Strengthening ( weak ms) Balance
For athetosis : Training to control simple joint motion
TREATMENT OF SPASTICITY
Nerve/ Motor Point Block
NEUROSURGERY
Dorsal Rhizotomy
- Ideal patient: young child (3-8 yrs.) w/ spastic diplegia
ambulatory w/ spastic gait.
- Method: - Surgical cutting of posterior (sensory) root to
decrease sensory input to spinal cord reducing
muscle tone (but decreases sensation)
- Must be followed by PT & OT
- Cutting anterior root produces atrophy &? ulcer
REHAB OF SWALLOWING
PROBLEMS
• Team: speech language specialist, OT, Dietary specialist.
• Items:
• Changes in posture & head position during feeding.
• Oral motor exercise for the tongue & lips to increase
strength,
ROM, velocity, percision.
• Use of thickened fluid & soft food in small boluse
• Use of alternative feeding routes e.g. nasogastric tube,
gastrotomy or jejunostomy tubes with severe aspiration or
caloric need.
REHAB OF SPEECH PROBLEMS