How is crossed gait treated?

  Children with spastic cerebral palsy have significantly higher muscle tone than normal children, and their lower extremities are often crossed, with tension in the Achilles tendon causing the soles of the feet to be uneven when they stand, and they can only land on their toes. The reason for this is the abnormally high muscle tone in the adductor muscles of the lower extremities, which leads to a crossed gait (scissor gait) in both lower extremities, thus affecting basic abilities such as turning over, crawling, standing and walking.  For crossed gait caused by hypertonia, rehabilitation training can be used in conjunction with FSPR: First, preoperative rehabilitation training: 1. Passive exercise: the child lies on a triangular mat, the therapist controls the knee joint on one side of the child with his N-fossa and the other lower limb with both hands, flexes the hip joint, knee joint and talocrural joint of the child, then abducts and externally rotates the lower limb, then extends The lower extremity is then extended while maintaining the dorsiflexion position of the talocrural joint, maintained for a certain period of time and then returned to the starting position. The action should be repeated to achieve the purpose of pulling the adductor muscle, should pay attention to the gradual progress, the angle from small to large; children riding in the toy horse to carry out the appropriate amount of exercise, will produce a continuous pulling effect of the adductor muscle.  2, active movement: the child supine or lateral position, the therapist take a toy in the hands of the child’s body is placed on the outside of the child, using language to guide the child to kick the toy, in order to achieve the child’s initiative to pull the adductor muscle. For children with walking ability, you can make them hold the wall horizontal walking, in the movement of active pulling the adductor muscle, this training can promote the child’s motor perception and motor cognitive ability. At the same time, sitting the child in a small chair and flexing the hip and knee joints can reduce the muscle tone of the adductor muscles.  Secondly, surgery is performed between the ages of 2.5 and 6 years in children who meet the surgical indications: here, the surgery refers specifically to FSPR (functional selective spinal nerve heel partial dissection), where intraoperative monitoring is performed by multi-conductor electrophysiological techniques to determine the proportion of the posterior spinal nerve roots to be removed, making the extent and proportion of sensory nerves to be removed more scientific and objective. The muscle tone of the patient is adjusted comprehensively so that the muscle tone of the spastic muscles is as close to normal as possible. It is worth mentioning that FSPR only selectively blocks part of the posterior nerve root fibers without affecting the anterior nerve roots that govern muscle movement and motor function. The exact site of surgery can depend on the patient’s specific condition: surgery in the lumbar spine can address lower extremity spasticity, and surgery in the cervical spine can address upper extremity spasticity. Of course, some children should also undergo orthopedic surgery after FSPR.  Finally, after surgery, continue to adhere to long-term targeted rehabilitation training: 1, the child to take the lateral position, so that the hip fully extended, therapist-assisted active lifting of the upper side of the lower limb, not bending the knee, if necessary, can be weight-bearing, such as artificial resistance or sandbag weight-bearing.  2, the child to take the supine position, knee flexion of both feet on the bed, the therapist fixed this position, the child is asked to actively lift the hip to do bridge-like movements.  3, single and double knee kneeling position training, the child to take the kneeling position, the therapist fixed his pelvis, to prevent hip flexion, after reaching a certain ability to carry out single knee standing training, one side of the lower limbs kneeling on the mat, the other side of the lower limbs flexed hip and knee plantar fixed on the mat, both sides of the lower limbs alternate training, in order to train the muscle strength around the pelvis and the alternate movement of both lower limbs.  4, the child to take the hands and knees position, the therapist to assist the child’s pelvis at the pelvis to the front of the child fully extended and then reset, so repeated several times, in order to train the child’s ability to extend the hip (rowing boat).  It is important to remind that the child’s active movement is the most important when conducting rehabilitation training, and the rehabilitator can give weight to the child according to the child’s condition to achieve the desired effect. As long as the treatment is carried out in strict accordance with the doctor’s instructions, the child with spastic cerebral palsy will have a good rehabilitation effect.