How can parents train their children with cerebral palsy to crawl, sit, stand, etc.?

  When training a child with cerebral palsy to crawl, you should choose a field that is easy to turn around, make the child lie prone, place the toy away from the child with cerebral palsy and ask him to grab it with one hand, or help him if the ipsilateral lower limb cannot be flexed. Begin by shaking the toy to tease, then move it in the opposite direction and ask him to catch it.  When the child has finished turning over, gently press the body to limit its movement. If you can complete the belly crawling action, lengthen the distance, tease with sound-making toys or moving toys, and make the game of reaching and catching. When the child is able to crawl, move the toy forward and help him/her bend the knee, and ask the child to stomp on the palm of the helper’s hand to crawl forward. Hold the child’s heel tightly, toe outward to make the lower limb externally rotated, to induce its flexion. Then, use the palm of the hand to top the bottom of the foot and ask him to stomp strongly, and accordingly, alternate the two elbows to move forward.  In order to enable the child with cerebral palsy to complete the turning movement correctly, passive turning rehabilitation therapy must be carried out first. Passive turning rehabilitation therapy can enable the child to gradually learn the coordinated body movements during correct turning and suppress abnormal movement patterns, and also lay the foundation for sitting up rehabilitation therapy.  Method 1: The child lies on his back on the mattress, the trainer kneels on the side of the child’s feet, first stretching and separating the child’s lower limbs, then holding the child’s ankles with both hands, allowing the child’s legs to cross and drive the hips, rotating the pelvis, then the trunk, and finally the shoulders, completing the turning to the prone position. The same method is used for turning from prone to supine position.  Method 2: Start from the shoulders and let the child drive the trunk, pelvis and lower limbs with the rotation of the shoulders. The trainer kneels on the side of the child’s head, straightens the child’s upper limbs and raises them above the head, then holds the child’s elbows or one shoulder with both hands and makes the shoulder rotate to complete the turning movement.  When training children with cerebral palsy to stand, it should be noted that for children with spastic cerebral palsy or other types of cerebral palsy, passive standing not only reduces muscle tone and prevents osteoporosis, but also gives the child a correct weight-bearing sensation on both feet. At the same time, it can also avoid some phenomena such as foot inversion and valgus. Method: After the child’s feet are separated by using a slanting board, standing cabinet or stationery with fixed knee joints, the child’s toes are placed directly in front of him/her and fixed on the ground, and the child is allowed to stand in this position for about 15-20 minutes a day.  When the child with cerebral palsy is walking, the parents should stand in front of the child and hold his hands (pay attention to keep the child’s elbow joints straight) to assist him to slowly put his feet flat before walking. If the child has a certain ability to walk, we can also let him walk with both hands with the help of a stroller chair and other more stable objects. The height of the handrail should be such that the child’s body is slightly leaning forward with both elbows straight.  For children with hemiplegic cerebral palsy, if the affected side has high muscle tone, parents can hold his affected hand while walking. On the contrary, when the muscle tone on the affected side is low or close to normal, it is more beneficial for us to walk with the affected hand than with the healthy hand. Because, the affected side of the child in walking, can gradually learn a normal walking posture. For example, in the step, the body in the rotation, forward swing arm, etc..  If parents find that the child is standing in a knee hyperextension position, parents assist the child to walk in a similar way to the above, except that the height of the parent’s hands with the help of or other objects handrails should be slightly lower so that the child can maintain a smaller hip and knee flexion position when walking.