There are nine methods of training for children with spastic cerebral palsy as follows.
1. Inhibit the inward internal rotation of the upper limbs, thumb inward, fist clenching, elbow flexion, shoulder joint retraction, and maintain good posture and position with the Bobath hand technique. The training methods are as follows.
①Thumb key point control training.
②Passive finger flexion and extension training.
③ upper limb with key point control, double upper limb abduction external rotation, supination.
④Holding ball position.
⑤Training on Bobath ball or roller, supine on it to promote whole body extension posture. Supine side and hold legs to inhibit head dorsiflexion, prone on it to promote head lift and hand support.
⑥Towel wringing training to correct internal rotation and back extension.
(7) Promotion of midline activity.
2.Inhibit the inward cross of the lower limbs, bending knees and hips, pointed feet, and inward and outward turning of the feet, the training methods are as follows.
(①Double lower limbs interactive movement training, to reduce muscle tone, lifting leg straddle are helpful.
② Training of abduction and external rotation of both lower extremities, and correction of adductor cross.
③ Relaxation and massage of bilateral adductor muscles.
④Riding across on a roller, peanut ball or with the help of hip abduction training chair.
⑤ Correction of internal and external rotation of the foot using manipulation and internal and external rotation correction board.
(6) Training of carpus muscle retraction (see section on knee mobility training).
(7) Iliopsoas retraction training.
(8) Retraction training of Achilles tendon and maintenance training of foot dorsiflexion to correct acromegaly.
⑨ Hip extension training to correct hip flexion.
⑩Hitching exercises to promote pelvic extension and strengthen the muscles of the low back.
3, joint mobility improvement training and stability, coordination training.
① Passive joint mobility training for major joints.
②For severe ankle clonus or muscle tension, it can be combined with spastic muscle therapy instrument.
③ Hand-mouth-eye and hand-foot-mouth coordination training.
④Double upper limb support training (to promote both hand support and finger extension and head lift, as well as hip extension): passive support on training bed; training on wedge-shaped mat; training on roller.
⑤ Standing promotion plate training to promote standing and enhance lower limb stability.
⑥Bike riding and treadmill can be used to strengthen the lower limb training if the age is over 3 years old. The quadriceps trainer can enhance the muscle strength of the lower limbs and also promote the perfection of the lower limb separation movement.
(7) Use recreational gymnastics to improve the joint activities of lateral lifting, up lifting and abduction of the upper limbs.
(8) Finger training can be used to pinch small food, play with blocks, fold paper, hold a pencil and trace a diagram, wooden nail plate training, etc.
4.Enhance the body axis rotation ability and body stem mobility training.
①Body axis gyration mode (lying, sitting, standing).
②Lie on your back on the roller and use the rotation of the roller to make the child’s lower limbs, hip joints, trunk and neck and back appear in an extended position.
③ Turning training: reflex turning; hand-controlled turning; leg-controlled turning; head-controlled turning.
5.Sitting position and sitting balance training: sitting balance depends on the position of the head, trunk muscle weight-bearing ability, and the coordination ability between the head, trunk and limbs.
①First of all, the sitting position maintenance training.
②After being able to sit alone, carry out front, left, right and rear balance, weight transfer, recovery sensory training, can be trained with the help of Bobath ball, balance board to enhance the training difficulty.
6, crawling training.
① Four crawl position is maintained.
② Four-point, three-point, two-point support weight-bearing balance training.
③ training crawl.
7, kneeling training.
① holding objects double kneeling training.
② not holding objects double kneeling.
③ single-leg kneeling training.
8, standing and standing balance training.
Sitting position to standing; kneeling position to standing; single-leg stand; squatting and standing training; standing balance training.
9, walking training.
Walking requires a certain degree of balance, the ability to shift the center of gravity and active hip flexion and knee flexion and foot dorsiflexion function. After the completion of the solo station, you can use walkers, walking ladders, parallel bars to practice walking, if there is a double lower limb cross can use the abductor walking board for training.