Rehabilitation prognosis for children with cerebral palsy

  In the past, cerebral palsy was thought to be incurable, but in recent years, scholars from various countries have shown that if early diagnosis and early treatment are provided, all but the most severe cases can be cured or normalized. 207 cases of cerebral palsy under 8 months of age treated by Vojta himself were cured in 199 cases. The cure rate was 96.1%. Early treatment is effective because the brain tissue is not yet mature in infancy, and is still in the stage of rapid growth and development, while the brain injury is also in the early stage, and the abnormal posture and movement are not yet fixed, so there is great plasticity, high compensatory ability and strong recovery ability in this period. Therefore, the plasticity of this period is high, the compensatory ability is high, and the recovery ability is strong. The best treatment effect can be obtained at this time.  Rehabilitation prognosis assessment of children with cerebral palsy: 1. Most children with hemiplegia can walk at 18-21 months; 2. 87% of those with parachute reflex before 24 months can walk, and the walking ability reaches a plateau at 7 years old; 3. 4. The inability to sit at 4 years old or to kneel independently at 6 years old is a reliable indicator of the inability to walk independently in the future; 4. 6 of the following items are evaluated for prognosis at age ≥ 12 months: a ATNR, b c, cervical rollover reflex, c, STNR, d, extensor extension reflex, e, tense vagus reflex, f, foot placement reflex.  Each of the above 6 items has a response of 1 point, more than 2 points have a poor prognosis, 0 points have a good prognosis, and 1 point has a prognosis to be considered carefully. 5, before the age of 3 years if the child has not formed a dominant hand or upper limb still can not exceed the trunk midline activities, upper limb function prognosis is poor, intelligence and upper limb function index balance; 6, the younger the age, the better the prognosis, generally not more than nine years old; 7, IQ> 70 prognosis is good, if more than 80 prognosis is better; 8, low intelligence, visual impairment will also affect walking ability.  Factors related to the effect of rehabilitation: 1, <30 weeks preterm infants with hypoxic brain injury have poor rehabilitation outcome and poor prognosis.  2, long rehabilitation period for the sequelae of nuclear jaundice .  3. Poor prognosis for children with tardive dyskinesia aged 3 years or older; 4. Poor prognosis for children with severe abnormal postural reflexes, ATNR, and long-standing abnormal movement patterns; 5. Poor prognosis for children with malnutrition, poor physical fitness, excessive sweating, and easy fatigue; 6. Poor prognosis for children with epilepsy, such as infantile spasms; 7. Poor prognosis for children with secondary tendon contractures, knee retroflexion, and joint deformation; 8. 8. Poor outcome in children with severe mental retardation or language development disorder; 9. Poor outcome in children with visual impairment (such as optic atrophy); 10. Poor outcome in children with cerebral palsy who are severely stressed or agitated.