1.Upper limb training
The main training purpose is to inhibit the internal rotation of the upper limb, thumb internal rotation, fist clenching, elbow flexion, shoulder joint retraction, and maintain good posture and posture, and its specific training techniques are as follows.
1)Thumb key point control training.
2) Passive finger flexion and extension training.
3)Upper limb with key point control, double upper limb abduction and external rotation, supination.
4)Holding ball position.
5) Bobath ball or roller training, supine on it to promote the whole body extension posture. Supine side and hold the leg to inhibit head dorsal bending, prone on it to promote head lifting and hand support.
6) Twisting towel type training to correct internal rotation and back extension.
7)Promotion of midline activity.
8)Use of finger tensioner.
In order to better train the finger ability of children with cerebral palsy, we can use finger pullers in cerebral palsy rehabilitation: fix one side of the puller and use the fingers of both hands to pull straight or cross; we can also let the child stand at different angles to pull, so that the extensor and retractor muscles can adduct and abduct, and the extension and retraction can be well coordinated.
2.Lower limb training
The main training purpose is to inhibit the inward cross of the lower limbs, knee flexion and hip flexion, pointed foot, foot inward and outward turning, specific training methods are as follows.
1) Double lower limbs interactive movement training, to reduce muscle tone, leg lifting stride are helpful.
2)Abduction and external rotation training of both lower limbs to correct the internal cross.
3)Relaxation and massage of bilateral adductor muscles.
4)Ride across the roller, peanut ball or with the help of hip abduction training chair.
5)Correction of internal and external rotation of the foot using manipulation and internal and external rotation correction board.
6)Training of cochlea muscle retraction.
7)Iliopsoas muscle tension training.
8)Retraction training of Achilles tendon and maintenance training of foot dorsiflexion to correct acromegaly.
9)Hip extension training to correct hip flexion.
10) Bridge exercises to promote pelvic extension and strengthen the muscles of the low back.
3. Joint mobility improvement training and stability and coordination training.
1) Passive joint mobility training for major joints.
2) For severe ankle clonus or muscle tension, it can be combined with spastic muscle therapy instrument treatment.
3) Hand-mouth-eye and hand-foot-mouth coordination training.
4)Double upper limb support training (to promote both hand support and finger extension, head lift, and hip extension): passive support on training bed; training on wedge-shaped mat; training on roller.
5) Standing promotion board training to promote standing and strengthen the stability of the lower limbs.
6) Those who are over 3 years old can use bicycles and treadmills to enhance lower limb training. The use of quadriceps trainer can not only strengthen the lower limb muscle strength, but also promote the perfection of lower limb separation movement.
7) Use recreational gymnastics to improve the joint activities of lateral lifting, up lifting and abduction of the upper limbs.
8) Finger training can be used to pinch small food, play with blocks, fold paper, hold pencil tracing, wooden nail plate training, etc.
4.Enhance the body axis rotation ability and body stem mobility training.
1) Body axis gyration mode (lying, sitting, standing).
2)Lie down on the roller and use the rotation of the roller to make the child’s lower limbs, hip joints, trunk and neck and back appear in an extended position, or slowly rotate the roller to shift the child’s center of gravity to the left or right side, and repeat the operation to let the child feel the change of the center of gravity.
3) Turning training: reflex turning; hand-controlled turning; leg-controlled turning; head-controlled turning.
5. Sitting and sitting balance training.
Sitting balance depends on the position of the head, trunk muscle weight-bearing ability, and the coordination ability between the head trunk and limbs.
1) First, the sitting position maintenance training.
2) can sit alone after the front, left, right and rear balance, weight transfer, recovery of the sensory training, can be trained with the help of Bobath ball, balance board to enhance the training difficulty.
6.Crawling training.
1) four crawl position to maintain.
2) four-point, three-point, two-point support weight-bearing balance training.
3) training crawling.
7, kneeling position training.
1) holding objects double knee training.
2) not holding objects double kneeling.
3) single-leg kneeling training.
8, standing and standing balance training.
Sitting position to standing; kneeling position to standing; single-leg stand; squatting and standing training; standing balance training.
9, walking training.
Walking requires a certain degree of balance, the ability to shift the center of gravity and active hip flexion and knee flexion and foot dorsiflexion function. After the completion of the solo station, you can use walkers, walking ladders, parallel bars to practice walking, if there is a double lower limb cross can use the abductor walking board for training.