What principles should be followed in pediatric cerebral palsy physical therapy?

  The motor deficits in children with cerebral palsy are varied and change more differently with age and the demands of growth. Therefore, it is necessary for physiotherapy to adopt appropriate and practical corresponding means.  For children with cerebral palsy, the most important thing is to suppress the abnormal posture and movement and promote the training of the normal neural and muscular system. Especially in infancy, which is the best period of brain plasticity, the best effect is to conduct the training to promote the normal motor development of the neuromuscular system.  The importance of early detection and early treatment: For infantile cerebral palsy, some scholars believe that there is no defect in the development of the central nervous system itself. If thorough and systematic physiotherapy is implemented at an early stage, the brain’s own maturation ability can be promoted and the so-called plasticity can be expected to compensate for the functional substitution of the organic brain damage. When contracture, deformation, secondary disorders of the musculo-skeletal system are formed, it is very difficult to treat.  3. Treatment of ability disorders: Normal children around the age of 3 can take care of themselves in terms of feeding, defecation, dressing and undressing, are almost self-sufficient and move freely, and will join the group. Children with cerebral palsy in this age group, on the other hand, mostly show poorer motor skills in daily life and often need assistance in handling things around them, i.e. the problem of impaired ability becomes more obvious. Therefore, they cannot participate in ordinary child care institutions, and social disadvantages such as restrictions come with them.  In the later stages of early childhood, in order to adapt the child to group activities, the physiotherapist (nurse) should first pay attention to the development of the child’s self-reliance in daily life movements, especially the acquisition of sitting and mobility means as the most important task. It is not only required for the child to be able to sit and move, but also to suppress the abnormality to the maximum extent, so that the movement points to normal posture and movement, and to instruct the child to learn to apply auxiliary supports and rehabilitation devices to subsidize the motor function defects of the child with cerebral palsy.  4. Management of the musculoskeletal system: No matter how normal the musculoskeletal system of cerebral palsy is, the musculoskeletal system is prone to deformation and contracture with the passage of time due to the stereotypical, general and compulsory symptoms. The physical therapist (nurse) must be active in prevention and thorough correction. If necessary, report to the doctor for full discussion, surgical treatment, application of braces and other measures.  For children with cerebral palsy, the range of motion (Rom) training, which is particularly important for spasticity, hypertonia, and passive extension of contracted muscles, may be operated at the risk of inducing difficult extension reflexes and tendon rupture. To avoid inducing the extensor reflex, it is important to give continuous extension. In the Rom training of the limbs, the limb bones play a lever-like role when extending the contracture muscles of the limbs, and accidents can occur when too much force is exerted.  5, the management of daily life scene: If the child only in the limited time, place for physiotherapy functional training, but daily life in the family, school and other places do not training and requirements, then their abnormal posture, motor training effect will have half, there is a possibility of deterioration. Therefore, physiotherapists (nurses) should pay equal attention to the basic posture of the child’s movement and postural management of daily life situations. Only in this way can the effect of training be continuously consolidated and further generalized. There are many examples of motor development improvement in infants and children with motor delays with appropriate postural management. Some people say that functional training for children with cerebral palsy is based on the premise of postural management in daily life, but this is not true.