FSPR surgery cuts Ia fibers, the root cause of limb spasticity, and effectively and stably reduces muscle tone, which is the basis of orthopedic and rehabilitation treatment. And orthopedic surgery is to correct the limb deformity and adjust the limb muscle strength and muscle tone. Based on FSPR, orthopedic surgery and the pathophysiological characteristics of cerebral palsy patients, Prof. Sun Chengyan has created a “five-phase post-operative standardized rehabilitation program for cerebral palsy”, which includes recovery, progression, strengthening, reinforcement and home rehabilitation periods. The program is designed to enable patients with cerebral palsy to take care of themselves and survive on their own.
Recovery period (1-3 months after surgery)
The key goals of rehabilitation are
1. Spiritual recovery: to treat the inferiority complex, emotional depression, and the “fear, fear, fear” caused by surgery and anesthesia.
2. Physical recovery: to solve the problems of weak resistance and poor tolerance of the child and the impact of general anesthesia and surgery on the body.
3.Adjust muscle morphology, improve blood circulation and muscle tension reflex.
4.Improve muscle strength, muscle tone, excitability, fatigue resistance, etc., so as to lay a good foundation for the rehabilitation of the ascending period.
5.Prevent joint edema and ligament adhesions.
6.Goal: muscle strength recovery to 2+～3 levels; muscle tone decrease amplitude 0.5～1 level.
Key rehabilitation treatment items.
Main rehabilitation devices.
1.Suspension; 2.Plate; 3.Standing frame;
4.Quadriceps trainer; 5.Hip abduction and adduction orthosis; 6.Lower limb joint exerciser.
Main physical therapy items.
1.Wax therapy, ultrasound, ultrashort wave, extracorporeal antibo, medium frequency, biofeedback, etc;
2.Acupuncture, Tui Na, Chinese medicine foot soak;
3.PT.
Special attention.
1, 1 to 2 months after surgery, can not go down to the ground, only in bed or equipment training.
2.In the 3rd month, you can do plate standing training.
3.Normal muscle strength is grade 5 and muscle tone is grade 1.
4.The training intensity should not be too high to avoid mechanical injury to tendons, muscles, incisions and joints.
5.Nutrition must be strengthened and scientific meal preparation.
6.Physicians need to select and adjust physical therapy items and rehabilitation equipment according to the rehabilitation evaluation.
Progressive period (4th-6th month after surgery)
Rehabilitation focus goals.
1.Consolidate the rehabilitation effect of the recovery period.
2.Regulate motor muscle tone: ensure continuous and smooth muscle movement (no trembling, twitching and spasm), so that the stability and flexibility of the body can be well improved.
3.Rapidly improve muscle strength: improve the coordination and balance of the body, and lay the foundation for walking.
4.Goal: muscle strength recovery to 3 to 4 levels; muscle tone decline amplitude 0.5 levels; to achieve standing and squatting – walking with assistance – independent walking
Key rehabilitation treatment items.
Main physical therapy projects.
1.On the basis of the recovery period, add: cerebellar stimulator and magnetic vibration instrument;
2.Acupuncture and Tuina: continue to strengthen, individual patients can be twice a day;
3.PT: continue to strengthen, individual patients can be twice a day.
Main rehabilitation equipment.
1.Slanting board; 2.Foot pedal;
3.Bicycle; 4.Four-combination trainer;
5.Other: The physician selects and adjusts the rehabilitation apparatus according to the rehabilitation evaluation.
Special attention.
The physician increases the intensity, frequency and time of training moderately according to the physical recovery of the child.
Strengthening period (7th-9th month after surgery)
Rehabilitation focus goals.
1.Training muscle power (explosive power): impedance training (including isometric training, isometric training and isotonic training)
2, correction of walking gait and posture
3, the goal: muscle strength recovery to 4 ~ 4 + level; muscle tension decline of 0.5 ~ 1 level or close to 1 level (normal); restore the normal gait and walking posture, so that it is equal length and equal speed when walking.
Key rehabilitation treatment items.
Major rehabilitation equipment: all rehabilitation equipment
Major physiotherapy items.
1.All physiotherapy equipment ;
2.Acupuncture and Tuina: continue to strengthen, most of them can be done twice a day;
3.PT: continue to strengthen, most patients can be twice daily.
Special attention.
Medium and high intensity training during this period: up and down stairs; starting and running, 3-5 times a day or more.
Intensification period (10th-12th months after surgery)
Rehabilitation focus goals.
1.Training muscle endurance: it is to train the muscle to work continuously for a long time, so that the affected person can stretch and exert force durably without being easily fatigued.
2.Make the muscle strength and tension relatively constant, tolerance, and fatigue resistance reach or approach the normal level.
3.Strengthen the stability, coordination and flexibility of the trunk.
4.The rehabilitation doctor guides the child and the family under active and passive rehabilitation training, and prepares for the family rehabilitation period.
5.Goal: muscle strength recovery to 4+~5 level (normal); muscle tone close to or close to normal (level 1); return to school, return to society.
Key rehabilitation treatment items.
Major rehabilitation equipment: the same as in the strengthening period.
Main physical therapy items: the same as in the strengthening period.
Special attention.
Perform moderate intensity and longer training. Walk 3-5 km daily; jog 2-3 km daily.
Home rehabilitation period (after one year)
Rehabilitation focus goals.
1. Rehabilitation is a long-term, long-lasting process, not a one-off.
2.Family rehabilitation: it is one of the most important aspects of cerebral palsy treatment.
3. Principles of home rehabilitation: standardized, long time and uninterrupted.
4.Family rehabilitation method: follow the guidance of the rehabilitation physician.
5.Objective: To consolidate the effect of surgery and rehabilitation treatment in hospital; to enhance the patient’s self-confidence, to make him/her take care of himself/herself, to integrate into society and to become a useful person in society.
Key rehabilitation treatment items.
1.Main rehabilitation equipment and physical therapy instruments can be purchased according to the rehabilitation physician’s recommendation and family conditions.
2. Rehabilitation programs and methods are carried out according to the guidance of the rehabilitation physician.