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. Basic complex therapy Cerebral palsy is a “team” approach using drug and non-drug methods.
Main directions and tasks of rehabilitation
1. Preparation
2. Development of a rehabilitation program and its implementation
3. Correction rehabilitation activities
4. Evaluation of 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
Physiotherapy
Taking into account the specifics of motor disorders in cerebral palsy physiotherapy has the following main tasks:
Development of straightening and balance, that is, the so-called postural mechanism, which ensures correct control of the head in space and in relation to the body.
Development of hand function and object-manipulative activity.
Development of hand-eye coordination.
Braking and overcoming incorrect postures and positions.
Prevention of the formation of a secondary motor stereotype.
Under the influence of therapeutic exercises, adequate motor sensations arise in the muscles of a child with cerebral palsy. In the process of therapeutic exercises, 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 special kind therapeutic physical education, where treatment is carried out with the help of a horse, is a recognized means of rehabilitative influence on patients with somatic, mental illness. Consists of 4 sections:
· Theoretical classes with patients.
· Training in communication with horses
· LVE including with physical 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 kind of therapeutic gymnastics that allows you to train coordination of movements and fine motor skills. She is able to adapt a person to Everyday life, achieve independence in actions, adapt to everyday life, namely, performing household chores, cooking, and self-care.
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, there is a strengthening weak muscles, improving joint movement, reducing imbalances in body proportions. This restorative rehabilitation allows you to expand your motor skills and improve your balance.
Vojta therapy - the main idea is to influence certain parts of the body using graduated pressure. This helps the nervous system activate the muscles of the body as much as possible. Facial expressions and movement are also involved here. eyeballs, skeletal muscles, intestinal muscles and Bladder. Such stimuli contribute to the formation of motor rehabilitation, and therefore the normalization of body movements.
Hydrotherapy - It is based on warm water, and the therapy itself is aimed at relaxation certain groups muscles. 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, also made from natural materials. These include caves, hills and other attractions.
Dolphin therapy is another type 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 in this case There is active stimulation of 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 specific areas nervous system, 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.
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 and adapt to constantly changing conditions external environment, it is difficult to control your 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 and set of exercises that will be ideal for everyone.
If a disabled 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 the physiological state of the 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 physical impact on the patient’s body, therefore 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 begin the process of rehabilitation of children with cerebral palsy in a timely manner, especially since this disease– this is not a verdict yet. 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 illness resulting from damage various departments brain, which entails dysfunction of motor and muscle activity. Together 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 general condition 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 give much result, since with such a pathology drug treatment– 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 for the child’s rehabilitation at home. After all, even simple game in dolls allows you to improve coordination of movements, muscle function, and suppresses pathological reflexes.
Cerebral palsy can present 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 receiving medicines(antispasmodics, painkillers, antidepressants, tranquilizers), constant exercise physical therapy, surgical and orthopedic methods in combination with massage. Good results Physiotherapeutic methods can achieve this: electrical stimulation of nerves and muscles, heat and mud treatment, electrophoresis. For severe contractures it is used surgery, during which muscles and bones are lengthened, and tendons are cut to relieve spasticity.
Social rehabilitation of children with cerebral palsy
Recovery period motor activity and social adaptation of a sick child consists of four stages:
- Acute period. Lasts 7-12 days, during which bright colors are observed severe disorders musculoskeletal system, convulsions;
- Early recovery period. Lasts until the baby is two months old;
- Late recovery. It ends in a child at approximately two years of age and is characterized by the presence of a pronounced tonic reflex, which does not allow development of due date installation reflexes and conscious movements;
- Last period. Characterized by the presence residual effects and can last for life.
Great value for successful treatment children with cerebral palsy have conditions under which recovery takes place. Rehabilitation centers for children with cerebral palsy allow with the help 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 for movement and the number of speech contacts increase. In this way, the baby is given invaluable experience of communication and social interaction, and 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 manage normal life. With proper rehabilitation of children with cerebral palsy, they subsequently go to school, work, get married and have children.
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 a parent special 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 suffer from slight deviations in behavior, problems with perception and assimilation of information, and 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 abnormalities 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 ( light form illnesses).
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 the result of a layering of various 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 been identified increased concentration mercury in 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. Wherein cerebrospinal fluid(cerebrospinal fluid) is produced in excess, and its absorption occurs very slowly. Extremely severe cases The baby'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, the child in early age may rub his head with his hands, bang 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 lesion brain, 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 the cornerstone on the path 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 state-financed organization, sponsored by the Ministry of Health and Social Development, provides assistance to children from different regions of the 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:
IN compulsory medical insurance program they are missing;
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).
MCR "Children" is a modern rehabilitation center for 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 childhood needs our help. cerebral palsy(cerebral palsy), 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 be active. 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 techniques psychological and motor rehabilitation of children with cerebral palsy in Moscow, therefore positive reviews you will see about the work of the ICR “Children” in any in 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-care 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 development individual plan The child is offered group lessons. 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 a convenient time to visit 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.