Every minute there are 4 children with cerebral palsy in China, there are 12 families suffering from cerebral palsy! And the incidence of cerebral palsy in China has been increasing year by year, and there are currently more than 5 million children with cerebral palsy in China. In this group, many children cannot take care of themselves, which brings a heavy burden to the family and society. Unstandardized treatment is also one of the reasons for aggravating the disability of cerebral palsy. The treatment of cerebral palsy must abide by the principles of individualization, multi-professional participation and staged treatment. What is the pathogenesis of cerebral palsy? Cerebral palsy is mainly due to defects in the formation of the embryo, or from pregnancy to delivery. Some factor within the first year of life damages the immature brain tissue, resulting in organic lesions of motor disorders, that is, the brain is damaged due to some kind of aggression before the completion of growth and development. Permanent abnormal postural and motor abnormalities caused by injury. Such postural and motor abnormalities are constantly changing with the growth and development of the affected child. The nervous system originates from the neural plate composed of ectodermal cells on the surface of the spine of the embryo, which appears at 2-3 weeks of gestation. The neural plate folds into a long, hollow neural tube, which widens at its tip to form a ventricle and three distinct bulges, which eventually develop into the three main parts of the brain – the forebrain, midbrain, and hindbrain. The neural embryo formed during the period from the earliest signs of neural plates to the closure of the neural tube undergoes a developmental process consisting of induction-proliferation-migration-differentiation-neural function. The developmental process of human embryonic nerves is divided into five periods. Stage 1: corresponds to the 7th-10th week of the embryo, during which the cortical plate begins to form. Stage II: corresponds to the 10th week of the embryo, during which the thickness of the cortical plate increases and the density of cells increases. Stage III: corresponds to the 12th-13th week of the embryo, during which the cortical plate is divided into two distinct inner and outer layers. Stage IV: Equivalent to embryonic week 13-15, in which the cortical plate further thickens and the cell volume increases. Stage V: corresponds to the 16th week of the embryo until birth, when the cortical structural pattern is complete by the 7th month. The complete brain development process includes, in addition to the above stages, the development of nerve cells. The human brain consists of 140-150 billion cells and has an extremely complex structure. Human brain development, the number of neurons per minute hundreds of thousands of speed growth, from only a trace of immature, the end of the differentiation of the cells to the output of a complex structure and function of the brain, is very strict, fine, such as the planting of crops, as the need to have good seeds, fertile land and rainy climate, in order to get a good harvest. In human beings, it is necessary to have good and complete genes and chromosomes, a healthy gestation environment, and abundant and comprehensive nutrition in order to develop a perfect brain. What causes pediatric cerebral palsy? Pediatric cerebral palsy is one of the common pediatric diseases, which seriously affects the physical and mental development of children. If not treated in time, it is very likely to cause lifelong disability of the affected children, which will cause great pain to the children, and will also bring a heavy burden to the family and society. So what exactly causes pediatric cerebral palsy? Over the years, many perinatal risk factors have been recognized to be associated with the development of cerebral palsy: preterm birth and low birth weight, cerebral hypoxia-ischemia, birth injury, congenital brain developmental abnormality, kernicterus, and congenital infections. The etiology of cerebral palsy has been discussed in greater depth both at home and abroad, and it is agreed that developmental abnormalities in the early stages of the embryo are likely to be the major cause of preterm birth and low birth weight, and the susceptibility to perinatal hypoxia-ischemia and other events. These early developmental abnormalities are mainly caused by maternal environmental influences before and after conception, genetic factors, and diseases that cause placental-amniotic inflammation in early pregnancy. There has been literature that summarizes the current causes of cerebral palsy as follows: parental smoking, alcoholism, drug abuse, maternal mental illness, diabetes during pregnancy, vaginal bleeding gestational hypertension syndrome, placenta praevia, preeclampsia, or taking contraceptives to treat infertility, birth control, and other contraceptives; high frequency of births, high frequency of pregnancy, with a history of stillbirths and stillbirths, preterm labor, history of miscarriage, dual or multiple births, fetal developmental delays, intrauterine infections, intrauterine distress, placental abruption, placental dysfunction, and other causes of cerebral palsy. Placental abruption, placental dysfunction heavy pregnancy reaction, umbilical cord around the neck, emergency delivery inappropriate assisted delivery, forceps delivery, breech delivery long duration of labor, preterm or expired baby low birth weight baby, postnatal asphyxia aspiration pneumonia, hypoxic ischemic encephalopathy, nuclear jaundice or jaundice delayed intracranial hemorrhage, head trauma, convulsions infections, poisonings, and malnutrition, and so on. There are also high number of births, high number of pregnancies, history of stillbirth, preterm labor, history of miscarriage, twin or multiple births, fetal growth retardation, intrauterine infection, intrauterine distress, placental abruption, placental dysfunction, severe gestational reaction, umbilical cord wrapping around the neck, emergency labor, inappropriate assisted delivery, forceps delivery, breech delivery, prolonged labor, preterm or expired delivery of a low birth-weight baby, postnatal asphyxia, aspiration pneumonia, hypoxic-ischemic encephalopathy, kernicterus or delayed kernicterus, intracranial hemorrhage. delayed jaundice, intracranial hemorrhage, head trauma, convulsions, infections, poisoning and malnutrition are also causes of pediatric cerebral palsy! Which expectant mothers are likely to give birth to a child with cerebral palsy? What are the factors that can cause a mother-to-be to give birth to a child with cerebral palsy? Cerebral palsy, also known as pediatric cerebral palsy, is a common syndrome of central nervous system disorders in children, with lesions in the brain and limbs, often accompanied by mental retardation, epilepsy, behavioral abnormalities, psychiatric disorders, and visual, auditory, and speech disorders. Multiple pregnancies In recent years, in the treatment of infertility, the application of ovulation promoters has led to a significant increase in the rate of multiple pregnancies, and the relationship between multiple pregnancies and cerebral palsy has also attracted increasing attention from the medical community. The incidence of preterm labor and low birth weight is significantly higher in multiple fetuses than in singletons. Experts believe that the reasons may include: multiple pregnancies are prone to relative placental insufficiency; inter-fetal transfusion syndrome may cause fetal anemia, low birth weight, heart failure, etc.; multiple pregnancies are also prone to the combination of excessive amniotic fluid and preterm rupture of membranes. Trauma in pregnancy Some studies show that trauma in pregnancy occurs mostly in late pregnancy, and trauma in pregnancy of the mother is closely related to the development of cerebral palsy. In addition, trauma during pregnancy can also cause reduction of placental blood flow, placental thrombosis and premature rupture of membranes, and even very small trauma can cause fetal death or premature delivery. Cardiopulmonary diseases in pregnant women Cardiovascular and respiratory dysfunction can lead to cerebral ischemia in preterm infants, such as arterial ductus arteriosus, hypotension, pneumothorax, bronchopulmonary dysplasia, and respiratory distress syndrome. Radiation Exposure of pregnant women to radiation and other radiation can lead to cerebral palsy, microcephaly and mental retardation. Cerebral Palsy 3 elements and 2 conditions Pediatric cerebral palsy (CP) is a syndrome of non-progressive brain damage caused by a variety of factors during the developmental period from prenatal to less than 1 month after birth. It is mainly characterized by central movement disorders and postural abnormalities, accompanied by varying degrees of mental retardation, epilepsy, and visual, auditory, and speech-behavioral disorders. Organic lesions of movement disorders are caused by defects in embryogenesis, or by some factor that damages immature brain tissue from pregnancy to delivery and even 1 month after birth. It also refers to permanent postural and motor abnormalities caused by some kind of aggression or damage to the brain before the completion of growth and development. Such postural and motor abnormalities change as the child grows and develops, and are usually detected when the child reaches the age of one year, when they gradually become apparent. The concept of pediatric cerebral palsy is centered on 3 elements i.e. developmental period, non-progressive and permanent. There are also 2 conditions i.e. motor developmental delay and abnormal postural reflexes and abnormal motor patterns. American Academy of Cerebral Palsy Pediatric Cerebral Palsy Classification The American Academy of Cerebral Palsy classifies cerebral palsy into four grades. Grade 1, with little or no movement restriction; Grade 2, with moderate degree of restriction; Grade 3, with severe degree of restriction; and Grade 4, where useful movements and actions are almost completely impossible to accomplish. From the therapeutic point of view, children with cerebral palsy can be further classified into: children with cerebral palsy who do not need treatment; children with cerebral palsy who only need to utilize supportive devices and a small amount of necessary treatment; children with cerebral palsy who need to utilize the necessary appliances and supportive devices, as well as systematic treatment; and children with cerebral palsy who need to be admitted to a medical institution for a long time for treatment. Clinically, cerebral palsy can be categorized into mild, moderate and severe according to the functional status. Understand the cerebral palsy classification and clarify the treatment of cerebral palsy. Mild: walking independently, no limitation of fine motor skills, IQ score more than 70, speech more than 2 words, independent in daily life. Moderate: Crawling or supported walking, limited fine motor function, IQ score 50-70, single word speech, need help in daily living. Severe: unable to perform gross motor activities, no function in fine motor activities, IQ score of 50, speech is severely impaired, unable to pronounce single words, requires complete care in daily life. Cerebral palsy is categorized into mild, moderate and severe according to the degree of motor impairment. (a) Mild The symptoms are mild and the child does not need to rely on others for care and can perform all daily activities independently. (b) Moderate The symptoms are more severe and after treatment, the patient still needs to use braces and assistive devices to perform daily activities. (c) Severe Cerebral palsy is characterized by severe motor dysfunction, speech and mental retardation, and difficulty in treatment, making it difficult for the patient to live independently and requiring lifelong care in the future. Cerebral Palsy Grading Grading Gross Motor Fine Motor IQ Language ADL Mild Independent Walking Functional Unrestricted 70 2 words Independent Medium Crawling or supported walking Functional Restricted 50~70 Single word Needs help Heavy Non-functional Non-functional 50 Severe Impairment Complete Care Functional Grading of Cerebral Palsy According to the International Symposium on Cerebral Palsy in 2004, the systematic cerebral palsy categorization should include: 1) Motor impairment (type, degree of functional impairment); 2) Concomitant impairments (sensory, cognitive) ① motor impairment (type, degree of functional impairment); ② concomitant impairments (sensory, cognitive, communication, behavioral, epilepsy, etc.); ③ anatomy (site of paralysis) and neuroimaging; and ④ aetiology (time of onset, high-risk causative factors, etc.). The traditional classification of cerebral palsy mainly focuses on the type of motor disorder and the site of paralysis, but in recent years, functional classification has become an important part of cerebral palsy classification, in which the Gross Motor Function Classification System (GMFCS) has been widely adopted both at home and abroad, and the Hand Function Classification System (HFCS) is gradually being promoted. The GMFCS has been widely adopted at home and abroad, and the Hand Function Classification System for cerebral palsy is also being gradually promoted. GMFCS is a grading system designed by Palisano et al. in 1997 on the basis of long-term clinical experience and according to the law of motor function change with age in children with cerebral palsy, which can reflect the development of gross motor function of children with cerebral palsy in a more objective way. The system divides children with cerebral palsy into 4 age groups, and each age group is divided into 5 levels according to the performance of children’s motor function, with level I being the highest and level V being the lowest (Table 1).GMFCS is a grading method born under the concept of ICF, which focuses on the function, skill, and spontaneous movement, and determines the different levels of the children by evaluating their ability in daily environment (home, school, and community). Overseas scholars have conducted a large number of reliability and validity studies on the GMFCS. The original designers reported that the GMFCS has good inter-rater reliability (kappa coefficient of 0193), and other scholars have also obtained good inter-rater reliability (kappa coefficient of 0184).Morris et al. also reported inter-rater reliability between parents and professionals (ICC of 0194), indicating that the GMFCS has good inter-rater reliability. GMFCS has good inter-rater reliability. A number of scholars have studied the validity of the GMFCS using parallel validity methods, and the validity scales used include the Gross Motor Function Measure (GMFM), the International Classifica2tion of Impairment, Disability, and Handicap (ICIDH), and the International Classification of Impairment, Disability, and Handicap (ICIDH). Rosenbuam et al. analyzed the results of 2632 GMFM266 assessments of 657 children with cerebral palsy aged 1-13 years, and successfully depicted a good parallel validity between the GMFCS and the above mentioned scales. Rosenbuam et al. analyzed the results of 2632 GMFM266 assessments in 657 children aged 1-13 years with cerebral palsy, and successfully depicted the gross motor development curves of the 5 levels of the GMFCS, which provided a good basis for predicting the gross motor development of children with cerebral palsy, and effectively proved the predictive validity of the GMFCS. The GMFCS is widely used in the world, and its clinical importance is even higher than that of the typing method based on the type of paralysis and the site of paralysis. Hanna et al. analyzed the results of 1940 GM2FMs of 650 children with cerebral palsy according to their age and the GMFCS classifications by stratified random sampling, and determined the percentile of GMFM 266 scores in different ages and the GMFCS classifications, as well as the reference curves, which can help the clinic to better predict the gross motor development. In 2008, Palisano et al. reported the content validity of the GMFCS Extended Revised Version (revised the content of the 6-12 age group and extended it to the 12-18 age group), and experts unanimously agreed on the clarity and accuracy of the content of each level of the GMFCS Extended Revised Version through three rounds of Delphi evaluation. Shi et al. were the first to report the reliability and validity of the Chinese version of the GMFCS in China, thus laying a good foundation for the use of the GMFCS in China. Although many cerebral palsy rehabilitation organizations in China have begun to use the GMFCS to determine the degree of functional impairment of cerebral palsy patients, the extent of promotion in China is not as good as that in foreign countries, and the GMFCS should be included in the routine diagnosis and treatment of cerebral palsy as soon as possible. The GMFCS has been used to determine the developmental trajectory of gross motor function in children with cerebral palsy, but due to the limited sample size of the study, the results need to be further confirmed. The large absolute number of cerebral palsy patients in China is very favorable for in-depth study. Defining the developmental trajectory of gross motor function in cerebral palsy patients is of great significance for the early prediction of developmental outcomes and the development of appropriate rehabilitation methods. Hand function grading system in cerebral palsy A large proportion of children with cerebral palsy have hand dysfunction, and impaired hand function will affect the development of other functions, such as sensation (especially touch), fine motor ability, gross motor ability, cognitive ability and daily life ability to a different extent, so it is important to strengthen the management of hand dysfunction in cerebral palsy children. In 2006, Swedish scholar Eliasson et al. published a hand function grading system for children with cerebral palsy (MACS), which is a grading system for children with cerebral palsy’s ability to manipulate objects in daily life, aiming to reflect the most typical daily performance of children with cerebral palsy at home, school and community, and to assess the ability of children with cerebral palsy’s hands to engage in daily life activities through the grading system. The MACS is based on the GMFCS, which also has 5 levels, with Level I being the highest and Level V the lowest, and is applicable to children aged 4-18 years (Table 1).The MACS was evaluated by professionals and parents of 168 children aged 4-18 years with cerebral palsy in Sweden and Australia, and it was determined that the MACS had a good inter-rater reliability among the professionals (ICC = 0197), and a good inter-rater reliability with the parents (ICC = 0196). The MACS has gained international attention and has been translated into 17 languages. Morris et al. investigated the reliability of the MACS in children with cerebral palsy in the United Kingdom and found that it maintained similar reliability to that of the developers, while suggesting that the environment may influence the evaluation of the MACS. Shi et al. reported the reliability and validity of the Chinese version of the MACS, and the results showed that the Chinese version of the MACS also has good reliability and validity, and is suitable for grading the hand function of children with cerebral palsy in China, and also pointed out that the environment should be taken into account when evaluating the MACS, and that parents should be guided to participate in the evaluation of the MACS. Early diagnosis of pediatric cerebral palsy: Why is it so important to understand what early diagnosis of cerebral palsy is? It refers to the diagnosis of cerebral palsy in infants between 0-6 months or 0-9 months of age, and the diagnosis of cerebral palsy in infants between 0-3 months of age is also called ultra-early diagnosis, which is often referred to as central coordination disorder (ZKS). coordination disorder (ZKS). Specifically, early diagnosis of cerebral palsy is actually the early diagnosis of brain-injured children, or to be more precise, the early diagnosis of brain-injured children with risk factors for cerebral palsy in order to achieve early treatment. The emphasis on early diagnosis and early treatment is based on the following two reasons: 1. Babies’ brains continue to develop after birth. Not only is the weight of the brain increasing (generally approaching the brain weight of an adult by the age of 7), but the nerve cells also continue to differentiate and develop (generally completing differentiation by the age of 3 and approaching adulthood by the age of 8). Although the damage to brain cells is irreversible, there are many normal brain cells around them, and if the function of these brain cells is fully utilized, then the function of the damaged brain cells may be compensated. Therefore, seizing the critical period to promote the development of normal brain cells is a key to the treatment of cerebral palsy. Clinical practice shows that the rehabilitation treatment for children with cerebral palsy starts within 1 year of age and has a great effect, followed by 3 years of age, and after 8 years of age, the effect is unpredictable. Early stage, especially in infancy, children’s movement disorders and postural abnormalities are not yet stereotyped and can be easily corrected. If the abnormal posture and abnormal movement exist for a long time, it will lead to secondary myoclonus and wasting muscle atrophy, which in turn will cause bone deformation, joint dislocation and other deformities, and the deformation and dislocation of bones and joints will aggravate the abnormal posture and movement, thus forming a vicious circle. The older the age, the more difficult the rehabilitation treatment will be. Therefore, the treatment effect of cerebral palsy is the earlier the better. Spastic Cerebral Palsy and Childhood Torsion Spasms are very different. It is easy to confuse the two disorders for those who are not familiar with them, and this needs to be clearly diagnosed by a specialized doctor. For torsion spasticity patients can do bilateral carotid artery ependymal stripping surgery to improve the blood supply and nutrition to the brain to improve the patient’s torsion, hyperactivity, increased muscle tone and other phenomena, however, the risk of this surgery is high and the weight of more than 18 kg of children can be used in deep brain electrical stimulation (pacemaker) treatment to achieve the goal of complete control of the symptoms; at the same time, it is also necessary to combine with the cooperation of the family for a good rehabilitation, the results through the clinical surgeon’s guidance. The results are excellent through the guidance of the clinical surgeon. The most appropriate treatment for spastic cerebral palsy patients is FSPR surgery, which is a comprehensive adjustment of the patient’s muscle tone, so that the muscle tone of spastic muscles is as close to normal as possible. Muscle spasms in cerebral palsy patients are not limited to a single muscle, but are often manifested as spasms of multiple muscles or muscle groups. FSPR surgery can also achieve the effect of comprehensively adjusting the muscle tone, and it can solve the pain of muscle spasms of the patients in a long term, stable, and complete manner, which provides the prerequisites for the recovery of their motor functions to the maximum extent possible. In addition, FSPR also has the incomparable advantage of other surgeries, which is to selectively block part of the nerve back root fibers without affecting the nerve front root and motor function of the innervated muscle movement. The specific site of surgery can be determined by the patient’s condition: surgery in the lumbar spine for lower limb spasticity, or in the cervical spine for upper limb spasticity. After surgery, with the corresponding rehabilitation therapy, a more satisfactory result can be achieved. Rehabilitation training before cerebral palsy surgery is also very important, if simply rely on surgery to solve the spasticity is completely insufficient, because once the surgery is implemented the child’s muscle strength will be reduced, if the child itself has not been trained the muscle strength was not high, after the surgery all of a sudden soften, even more unable to walk, so that children with cerebral palsy in the implementation of the FSPR surgery before the implementation of a long period of rehabilitation training, at least the child can hold a wall to walk, before the implementation of surgery, as commonly known as the cerebral palsy surgery. Therefore, children with cerebral palsy must undergo long-term rehabilitation training before FSPR surgery can be performed, at least the child can walk with the help of the wall. And the rehabilitation training Khan is still a long-term process that needs to be adhered to. But torsion spasm and cerebral palsy etiology, many times because of the birth of nuclear jaundice factors, if the newborn was found at birth nuclear jaundice to immediately stop breastfeeding, if necessary, blood exchange therapy. What are the symptoms of ataxia type pediatric cerebral palsy? Ataxia type cerebral palsy is mostly caused by cerebellar injury, due to perinatal abnormality, cerebellar hemorrhage caused by immature children or congenital cerebellar hypoplasia or cone and extracerebellar system injury. Main clinical manifestations: 1. Motor development is obviously delayed compared with that of children of the same age, manifesting clumsy and uncoordinated movement, head and trunk regulation disorder, not being able to sit at about 1 year of age, and even if they can sit, they are not stable. Only when the two lower limbs are flexed, abducted and the support surface is expanded can they sit stably. Standing time is late, the eldest end 2-3 years old or later, the child can not stand steadily, easy to fall, finger fine motor disorder, inflexible movements. 2. There is intentional tremor and nystagmus, and it is very difficult to catch up with the eyes and grasp things purposefully. 3.Children often open their mouths, drooling, slow and unclear speech, and speech disorders. 4. The child has low muscle tone but normal tendon reflexes. Balance dysfunction, the center of gravity is in the heel when standing, in order to maintain the balance, the child often toe up, increase the distance between the feet in order to expand the support area, bend forward to make up for the center of gravity backward shift. When walking, due to the lack of simultaneous muscle contraction, the ability to maintain posture is impaired, which is manifested as a drunkard’s gait with the trunk swaying back and forth and tilting to the side. How to let children with cerebral palsy recognize their own hands Children with cerebral palsy are limited by spasticity or uncoordinated movement, which makes them unable to reach and recognize their own body and surroundings well through their hands, therefore, letting children with cerebral palsy recognize their own hands is the first step in hand training. When a mother holds her newborn baby, she will involuntarily touch his little hand and put her fingers inside his palm, the baby will hold his mother’s fingers tightly with his hand, and the mother will think that this is the baby’s reaction before he cannot look at himself and smile. After that, the mother can use the infant’s grasping reflex to let him hold some hand-held toys, or use both hands to pull him to sit up and so on. Soon, the infant’s hands can slowly extend to touch the mother’s face, scratch their own clothes, eat fingers, toes, toys, etc., gradually from touching the mother to recognize their own bodies and expand to the surrounding environment. These early non-random movements – touching, stretching fingers and holding hands in infancy – are the basis for functional hand activities and fine motor movements in the future. Rehabilitation Principles of Pediatric Cerebral Palsy and Rehabilitation Principles of Rehabilitation Treatment: According to the plasticity of the brain (refers to the adaptive ability of the brain, which can modify itself structurally and functionally to adapt to changed objective phenomena, so as to make it possible to recover from brain injury), it continuously strengthens the transmission function of contact, promotes the release of transmitters, increases the contact potentials, activates or establishes new contact contacts, and restores the normal mobile movement function. Principles of rehabilitation treatment: 1. Early detection and early treatment. The earlier the better, not only can promote the normal development of the nervous system, improve abnormal posture and movement, inhibit abnormal reflexes, but also prevent tendon contractures and bone and joint deformities. 2.Comprehensive treatment. According to the law of neurodevelopment and the principle of kinesiology, the Vojta method and Bobath method are mainly used, together with the fine motor and language training of the hands, together with appropriate physical therapy, combined with the massage of Chinese medicine and the auxiliary treatment of about things. Some of the older patients need to be combined with necessary surgery on the basis of rehabilitation. 3.Combination of rehabilitation, education and games. Pediatrics is an important stage of growth and development and the acceptance of enlightenment education, combined with each other will help the physical and mental potential to obtain the maximum possible development. 4. Parents’ participation in rehabilitation therapy. Cerebral palsy rehabilitation is a long term process, it is not possible to solve all the problems only by the therapist’s 1-2 hours of training every day, in order to ensure that the patients get effective and efficient treatment. 5. Adhere to long-term treatment. Cerebral palsy rehabilitation is a long-term, complex process, must be persistent, do not interrupt. Rehabilitation training should be carried out by a professional rehabilitator to diagnose the dysfunction of the patient, and then carry out targeted treatment through professional training equipment, mainly focusing on the functional exercise of the limbs. The earlier you start, the better. Even for patients undergoing surgical treatment, preoperative and postoperative rehabilitation training is necessary. Golden time for cerebral palsy treatment: Rehabilitation treatment within 6~9 months after birth Pediatric cerebral palsy is not an incurable disease. The key principle of treatment is early detection and early treatment, and rehabilitation measures should be taken within 6~9 months after birth, which not only promotes the normal development of central nervous system, improves the abnormal postures and movements, and inhibits the abnormal reflexes, but also prevents comorbidities, such as contracture of tendons and deformity of joints, and thus reduces the rate of disability. Therefore, it is crucial for children with cerebral palsy to receive early treatment. It is understood that cerebral palsy is a syndrome in which children suffer from non-progressive trauma to the brain before or after birth, resulting in motor or postural disorders as the main clinical manifestation. Currently, there are more than 5 million children with cerebral palsy in China, with an incidence rate of about three out of 1,000 in our country, and the most common one is spastic cerebral palsy, which is usually manifested as tremor of the hands and feet, joints are inflexible, and walking is unstable with a robotic gait. Cerebral palsy usually has no obvious manifestations, but if parents pay attention to observation, some signs can be detected at an early stage. Normal newborns have the ability to interact with others after birth, they can follow adults to talk or smile, they can cry to arouse adults’ attention, and their sense of touch is very sensitive, whereas children with cerebral palsy have poor responsiveness and reduced movement, even their sucking ability is very poor, and choking often occurs, and they also have abnormal muscle tone and postures, such as difficulty in adduction of the thighs, flexion of the knees which are not easy to be straightened, crossing of the legs in the form of scissors, flexion of the elbows and wrists, and clenched fists and inwardly retracted thumbs. and the thumb is inwardly retracted. Some children have backward intellectual development and cannot reach the ability of children of the corresponding age. Gait training for pediatric cerebral palsy? Can pediatric cerebral palsy be completely cured? Can pediatric cerebral palsy be cured? Many parents have such questions. Experts point out that the earlier the diagnosis and treatment, the better the result, and the normalization rate of starting treatment at less than 6 months old can reach 96.1%. If your child has already appeared the symptoms of cerebral palsy, you must treat your child in time. The diagnosis and treatment of cerebral palsy disease have high requirements for the technical equipment of the hospital and the level of experience of the experts, so the cerebral palsy must go to the regular and professional cerebral hospital for treatment. For pediatric cerebral palsy gait training today to do a simple explanation, cerebral palsy children walking need to have a certain degree of balance, center of gravity transfer ability and active hip flexion and knee flexion and foot dorsiflexion function. After standing alone, walking aids, walking steps and parallel bars can be used to practice walking, and if there is double lower limb crossing, abduction walking boards can be used for training. Advantages of surgical treatment of cerebral palsy 1. Completion of multi-limb and multi-site surgery at one time, with small incision, less bleeding, no blood transfusion, less pain, and no side effects and after-effects. 2.Deformity correction is complete and thorough, overall function recovery is fast, the effect is obvious in one week, and generally hospitalization is about half a month after surgery. 3.Among the advantages of surgical treatment of cerebral palsy, deformities in non-surgical areas can also be corrected when surgery is utilized to treat cerebral palsy. 4.Because surgery is used at the key place, it plays the role of root cure; after surgery, it is good for recovery with medication to restore brain function. 5.Surgery is successful once, avoiding multiple treatments and greatly reducing the economic burden of patients. Cerebral palsy speech disorder training = articulation + comprehension + expression Cerebral palsy is also known as cerebral palsy, and speech disorder is a common cerebral palsy symptom. Today, we will talk about language disorders in children with cerebral palsy. The language training for children with cerebral palsy pays attention to the motor function training of the organs of articulation and articulation training to a large extent. In fact, a more scientific method is to train the whole body of the child with cerebral palsy before the training of the organs of articulation because the movement of the organs of articulation is influenced by the whole body condition. Only when the state of the whole body tends to be normal, children with cerebral palsy can pronounce normally, and the jaw, mouth and tongue can move normally. Cerebral palsy speech disorder training: 1, articulation function training: tongue function training to stretch the tongue, add the upper and lower lips tongue tip movement tongue and accessory muscle movement tongue body movement training blowing lip movement. 2.Comprehension training: verbal comprehension training, auditory (calling names), visual (looking at pictures, objects, etc.), non-verbal comprehension training, understanding gestures, recognizing frequently heard sounds and clapping hands with the rhythm of music. 3.Expressive ability training: verbal expressive ability training imitation pronunciation articulation training naming objects on pictures imitation movement practice speaking retelling stories non-verbal expressive ability training expressing the need to express the use of objects. Why spastic cerebral palsy can cause high muscle tone Cerebral palsy increased muscle tone: there are two kinds of spasticity and tonicity. Spastic hypertonia is associated with damage to the pyramidal tract, and spinal reflexes are facilitated. Passive movement of the patient’s joints is accompanied by an impedance sensation in the presence of increased muscle tone, which is related to the speed of the movement. Rapid stretching of a muscle in a shortened state immediately causes contraction and spasm, and the resistance suddenly disappears when the muscle is stretched to a certain amplitude, which is known as a folding knife-like increase in muscle tone. Spastic cerebral palsy hypertonia has nothing to do with “spasticity”, which refers to an involuntary muscle contraction. Tonic dystonia can be seen as a special dystonic change in some extrapyramidal lesions, and its dystonia is selective, with the upper limbs being dominated by the adductors, flexors, and pronators, and the lower limbs being dominated by the extensor dystonia. The resistance to passive movement of the patient’s limbs is generally less than in spasticity, but there is no relationship to the length of the muscle, i.e., the contraction pattern, and there is no difference between the extensor and flexor muscles. Surgery + rehabilitation for children with high prevalence spastic cerebral palsy = optimal treatment.