I. Overview
1.Definition
Cerebral palsy refers to a clinical syndrome in which brain development is impaired due to injury or disease during prenatal, delivery or one month after delivery, with resting central motor control disorders and postural abnormalities as the main manifestations, accompanied by various degrees of intellectual, epileptic, language, visual, auditory, perceptual cognitive, behavioral, emotional and psychological disorders.
2, etiology common causes include.
(1) prenatal infections, radiation, chemical attacks and genetic factors that lead to abnormal brain development during the embryonic period.
Premature birth, obstructed labor, asphyxia and hypoxia, birth injury, nuclear jaundice, etc.
③Postnatal neonatal encephalitis, CO2 poisoning, cranial trauma, hyperthermia, etc.
3.Pathological cerebral cortex
Degeneration, softening, fibrosis, atrophy of nerve cells; loss of cerebral white matter, cystic degeneration, narrowing of cerebral gyrus, widening of cerebral sulcus, enlargement of ventricles, hydrocephalus; reduction in the number of nerve cells, delayed myelination of nerves, proliferation of glial cells, etc.
4. Clinical typing.
(1) Spastic type with the main lesion in the pyramidal fasciculus. Features: muscle spasm, flexor spasm in the upper limbs, knee flexion, foot drop, foot inversion or valgus, thigh inversion or crossover in the lower limbs.
(2) The involuntary movement type has the main lesion in the extravertebral tract. Involuntary movement of the limbs, walking is a large swing of the trunk and upper limbs to maintain balance, and facial muscles, articulation and articulatory organs are involved.
(3) The ataxic type has the main lesion in the cerebellum and usually presents with low muscle tone, uncoordinated movements, and poor walking and standing balance.
(4) Hypotonia type has low muscle tone, weak limb movement, lack of protective head rotation response, and is prone to the risk of airway obstruction and asphyxia. 2-3 years old may turn into tardive dyskinesia or spasticity.
(5) Tonic type of extravertebral injury, with stiffness of the limbs, reduced activity, and increased muscle tone in a lead pipe or cogwheel pattern.
(6) mixed type.
Second, the main functional disorders and rehabilitation goals
1.Rehab treatment principles
(1) Early detection, early diagnosis, early treatment, and attention to new problems in the developmental process.
(2) Obtain active cooperation from the family and the affected child, combining training with education, with games, with drugs and surgery, and with traditional Chinese treatment.
(3) Motor control disorders.
(4) Set up training programs according to the laws of motor development.
(5) Develop individualized training programs to correct the wrong movement patterns according to the different conditions of patients.
2.Rehab treatment program rehabilitation
Treatment emphasizes comprehensive treatment, including clinical treatment, physical therapy, occupational therapy, speech therapy, orthotics and assistive devices, environmental modification, psychotherapy, behavior therapy, occupational therapy, etc.
3.Objectives of physical therapy
Avoid spasticity, improve muscle strength, improve physical cognitive ability, avoid the development of non-random movement, promote the development of random movement, promote motor conversion, promote self-motor ability, and promote social interaction ability.