What are the goals and principles of pediatric cerebral palsy rehabilitation therapy?

  The purpose of cerebral palsy rehabilitation treatment is to provide comprehensive and diversified rehabilitation treatment and training for children with cerebral palsy by using various useful means, so as to promote the maximum improvement of their motor ability, intelligence, language ability, social adaptation ability and other aspects and give full play to their residual functions; to maximize their daily life, mental strain, social interaction, recreation, as well as their future ability to receive education and engage in a To improve the quality of life by maximizing their ability to perform daily living, psychological adaptation, social interaction, recreation, education and a suitable occupation in the future.  Principle 1: Early detection and early rehabilitation treatment for the best results (1) Reasons for better results in early rehabilitation: Since the brain in infancy and early childhood is at its most vigorous stage of development, the brain has strong plasticity, strong compensatory capacity, and good results after receiving treatment, early detection of abnormalities and early intervention and treatment can achieve the best rehabilitation results. Early detection of abnormalities does not mean that a diagnosis of cerebral palsy must be made in a hurry, but early intervention should be made. Currently, it is considered that a diagnosis f before 3 months of age after birth is an ultra-early diagnosis, and a diagnosis before 6 months of age is an early diagnosis, and a diagnosis should be made at the latest around 1 year of age. For many children with cerebral palsy, improvement of abnormal muscle tone and normalization of reflexes and reactions have some potential in infancy and early childhood; early exposure to the rehabilitation environment, with communication and care from parents and family and support from people and events around the child for rehabilitation, functional progress will be faster.  (2) Early functional rehabilitation is closely related to the restoration of walking ability later. According to the observation, those who can sit alone before the age of 2 can always return to walking alone later, while those who cannot sit alone by the age of 4 are less likely to return to walking later. Rehabilitation training has a certain effect on preventing the overtime presence of primitive reflexes, thus helping to restore walking. Most of the children who eventually recovered to walk independently had less than 3 primitive reflexes at 1.5 years of age.  (3) There are two forms of early rehabilitation: first, direct multi-disciplinary intervention by rehabilitation staff (movement therapy therapist, occupational therapy therapist, speech therapy therapist, orthopedist, social worker, etc.) in a professional rehabilitation medical institution; second, implementation of a family rehabilitation or community rehabilitation program, with individual rehabilitation medical staff or community rehabilitation counselors guiding the rehabilitation. The ideal is to combine the above two approaches, and then to have a detailed examination and evaluation by the rehabilitation institution, draw up a rehabilitation plan, and carry out rehabilitation treatment for a period of time, and then transfer to family or community rehabilitation, and then after a period of time, go to the rehabilitation institution again for a review and a period of treatment, and then return to the family and community again. Include pediatric cerebral palsy rehabilitation in the prevention and treatment system of social pediatrics: carry out community rehabilitation and guide parents’ rehabilitation in the family, combine with community medical care, community services and women and children’s health care, and also combine with education, social environment transformation as well as social activities such as propaganda and education and changing people’s ideology, gradually forming a pediatric cerebral palsy rehabilitation model with Chinese characteristics.  Comprehensive rehabilitation treatment According to the performance of functional disorders and the needs of rehabilitation, children with cerebral palsy often need to receive rehabilitation treatment from multiple specialties at the same time or successively. With the child as the center, specialists from various disciplines, therapists, nurses and teachers are organized to jointly develop rehabilitation training plans and conduct comprehensive rehabilitation services in cooperation with each other. Combining Chinese and Western medicine, treatment should be combined with effective medication and necessary surgery.  1.Long-term or even lifelong rehabilitation In the developmental stages of children and adolescents, in order to cooperate with the recovery of motor ability, so that the development and growth of muscles can be synchronized with the growth of bones, as well as in order to make the growth of the affected side and the healthy side of the limb symmetrical, rehabilitation exercises should be insisted on throughout the developmental period, and even in adulthood, in order to continue to maintain and improve health and limb motor functions, long-term exercises should also be insisted on. For long-term rehabilitation, both parents and children should have patience. Progress is usually slow, sometimes even temporarily stagnant or regressive (due to illness or developmental problems), but the general trend is that long-term, effective, active and comprehensive rehabilitation treatment will bring about gradual functional improvement and development.  2.On-demand rehabilitation rehabilitation treatment should be individualized and the training content individualized. Based on the child’s dysfunction, living environment, family environment, rehabilitation resources and other specific needs, the rehabilitation staff should work out an individual rehabilitation treatment plan with the parents.  3. Rehabilitation treatment should be combined with games and play, with education, and with daily life: since the abnormal movement and posture patterns of children with cerebral palsy are reflected in daily life, rehabilitation must be closely integrated with daily life movements.  4. Rehabilitation goals should be realistic and the quality of rehabilitation should be evaluated regularly. Both parents and rehabilitation personnel should have in-depth understanding and full application of all rehabilitation resources, timely referral or referral when necessary, and for the treatment of older children, a close link between rehabilitation medical-educational-social children’s institutions-community should be established.