Focus on upper limb rehabilitation for children with cerebral palsy

  Under the long-term influence of cerebral palsy, the upper limb function of the child will be severely damaged and will slowly show contracture and deformation, and lose the ability to take care of himself/herself normally. The focus of the rehabilitation training for upper limb dysfunction is to teach the child the body movements and hand and foot activities, so that he or she can master the normal motor movements, and should follow the principle of moving from simple to complex and from easy to difficult. This early functional training can effectively prevent upper limb muscle atrophy, contracture and joint ankylosis and skeletal deformity.  Of course, in the specific training process, we must also note that the upper extremity gross motor function fine motor function respectively to make training. We know that many fine movements of the hand need to be done in the sitting position. Therefore, before training children with cerebral palsy in fine hand functions, we need to train them to obtain good sitting balance and maintain good sitting posture; or provide them with appropriate chairs and tables to help them obtain good sitting posture during training, and then carry out fine hand function training. During the training of children with cerebral palsy, the rehabilitator can help them practice visual fixation, visual tracking, and hand-eye coordination by using fun toys and their own faces, and by maintaining visual contact with the child frequently.  Through these purposeful, casual and effective functional training of the upper limbs and hands, the child’s ability to take care of himself/herself, improve his/her sensory and cognitive abilities, and develop his/her learning and social interaction skills are maximized. In the upper limb gross motor training, we should pay attention to strengthen the training of arm and scapular belt separation, encourage the child to do more forward reaching movements; and do more arm straightening, abduction and backward reaching movements in the prone position. At the same time, attention should also be paid to inducing elbow joint straightening. During the training, the child should hold a magnet at one end of the column to suck a metal object placed on the table, and the movement should involve elbow joint straightening. For young children, parents or the rehabilitation teacher can sit the child on their lap and let the child reach out to pat the therapist’s palm, taking care not to lose postural control. In addition, it is important to reinforce sitting balance training, induce hand-to-mouth movements and movement of the child’s hands on the midline.  Of course, surgical treatment is also necessary to effectively address the hypertonicity and muscle spasticity with FSPR, followed by orthopedic treatment to better help the deformed limb return to normal as soon as possible. In addition to surgical and orthopedic treatment, it is still necessary to adhere to long-term standardized functional rehabilitation training and occupational therapy in order to consolidate the training effect. Finally, it is important to emphasize that these trainings must be carried out before and after the cerebral palsy surgery, and must be adhered to for a long period of time, without any interruption, so as not to affect the overall rehabilitation effect.