Postoperative rehabilitation in children with spastic cerebral palsy

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Children with cerebral palsy is a syndrome due to central motor dysfunction and abnormal posture is mainly caused by a brain injury, cerebra

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Children with cerebral palsy is a syndrome due to central motor dysfunction and abnormal posture is mainly caused by a brain injury, cerebral palsy and spastic or mixed with spasm is mainly accounted for more than 75% of the total number of children with cerebral palsy. In recent years, for the treatment of spastic cerebral palsy as our research focus, after long-term clinical validation, we conclude that should be "rehabilitation training - surgery (FSPR surgery) - rehabilitation of orthopedic treatment and rehabilitation training" means the comprehensive rehabilitation treatment of spastic cerebral palsy in order to obtain the ideal, the postoperative rehabilitation is the priority among priorities, not negligence.

We first look at the surgical treatment of spastic cerebral palsy and orthopedic treatment, which is to lay the foundation for future rehabilitation training one of the important links.

In general, after the early rehabilitation training, as long as the children with simple spasm, muscle tension in the above 3 levels, muscle strength in the fourth grade or more. ; no obvious or only mild fixed contracture deformity; preoperative spinal movement ability of limbs; intelligence to normal or near normal with postoperative rehabilitation; severe spasticity and rigidity, affect daily life, care and rehabilitation training conditions, we have advocated the implementation of surgery at the age of 2 half spasm to 6 year period, namely the FSPR operation (disconnection function of selective spinal nerve heel part). This operation is by selectively blocking the posterior spinal nerve root (dorsal root sensory, motor nerve is not) to reduce muscle tension, relieve spasm in patients with postoperative completely, reduce muscle tension and good effect, will not affect the limb motor function; the sensory function has little effect; prevention the occurrence and development of limb malformation; have significantly improved overall function and correction of deformity. In addition, if the children in spasm after surgery there are still obvious limb deformities (such as strephenopodia, scissors step, tiptoe etc.) it should also be combined with orthopedic treatment, in order to solve these problems.

After surgery, we can carry out a series of postoperative rehabilitation treatment for children with spastic cerebral palsy. As we know, is one of the important factors affecting severe spasm of motor function in children with cerebral palsy, many children will appear in the lower limb muscle tension adduction of hip internal rotation, abduction, ankle plantar flexion, and thus lost the ability to walk independently. Therefore, in the postoperative rehabilitation of children with spastic cerebral palsy, attention must be paid to exercise training, with emphasis on the re establishment of crawling, standing, squatting and walking functions. This kind of training can be divided into two aspects: passive movement and active movements of the former by the therapist as a training body, hip, knee and ankle joints in function, prevent the extension tendon avulsion wound healing, help children further, which has the ability of movement; the latter by children as training subjects, including active leg movement, and movement in the crawling training stand under the guidance of the therapist. The repetitive training of these tasks is an effective way to improve children's motor function. In order to establish the children's ability to walk, we should train the children's crawling training, squat training and walking training. In addition, but also all kinds of training equipment for children, including bike training and climbing training, daily 2 times. Some experts believe that good crawling ability not only shows that the children's joint activity is better, but also indirectly reflect the functional status of the lower limb as well as the coordination of movement, is the basis for children to re embrace the ability to walk independently. And this is our clinical practice has also been confirmed, specific repeated training bike training can not only provide complex gait, but also exercise the children with lower limb muscles, enhance the muscle strength of lower limbs, but also enhance the extremity of the crawling ability, improve the walking ability of children. In conclusion, long-term rehabilitation training for children with spastic cerebral palsy, throughout the child's daily life, they can see the effect.

 

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