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 of age; ③ The inability to sit at 4 years of age or the inability to walk independently in kneeling position at 6 years of age is a reliable indicator of the inability to walk independently in the future; ④ The following 6 items? age ≥ 12 months for assessment of prognosis:a ATNR, b, cervical roll positive reflex, c, STNR, d, extensor extensor reflex,? e, tense vagus reflex, f, foot placement reflex Each of the above 6 items has a response of 1 point, 2 points or more have a poor prognosis, 0 points have a good prognosis, and 1 point has to be considered carefully.  ⑤ Before 3 years old, if the child has not formed a dominant hand or the upper limb still cannot move beyond the midline of the trunk, the prognosis of upper limb function is poor, and intelligence is balanced with the index of upper limb function; ⑥ The younger the age, the better the prognosis, generally not older than nine years old; ⑦ IQ>70 has a good prognosis, and if it is more than 80, the prognosis is better; ⑧ Low intelligence and visual impairment will also affect walking ability.  Factors related to the effect of rehabilitation ① Premature infants <30 weeks with hypoxic brain injury have poor rehabilitation effect and poor prognosis.  ②Long rehabilitation period for the sequelae of nuclear jaundice .  ③Poor outcome for children with hand-footed cerebral palsy over 3 years of age; ③Severe abnormal postural reflexes ATNR and long-term abnormal movement patterns; ④Poor rehabilitation outcome for children with malnutrition, poor physical condition, excessive sweating and fatigue; ⑤Poor outcome for children with cerebral palsy with recurrent respiratory infections; ⑥Poor prognosis for children with epilepsy, such as infantile spasms; ⑦Subsequent tendon contractures, knee retroflexion and joint deformation (8) Poor outcome in children with severe mental retardation or language development disorders; (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.