The essentials and hand techniques of home motor rehabilitation method for infants and toddlers. I. Home care: 1. Correct holding posture: Children with cerebral palsy are held by parents most of the time. They should be held correctly according to their condition to promote the control of the head and trunk and to correct the abnormal posture of the child. Spastic cerebral palsy: Let the child sit or lie on the bed with legs apart and curl the child up first. The key to this method of holding is to separate the child’s legs and flex the hip and knee joints, which can correct the abnormal posture of the child with spastic cerebral palsy such as hard extension of both lower limbs, cross and pointed feet. This can correct the abnormal posture of the child with spastic cerebral palsy such as rigid extension of both lower limbs, crossed and pointed feet. The mother’s left hand reaches under the child’s abdomen to lift the child from the bed, while her right hand presses the child’s legs toward the abdomen from the child’s N fossa to make the child bend at the hips and knees, and then holds the child toward the mother’s chest so that the child’s head and back rest on the mother’s chest and her hands are placed at the midline in front of the body. The mother uses her jaws, upper arms or shoulders to control the child’s head, so that the head is in the middle position, and slightly forward. The key to this method of holding is to keep the child’s hands and legs together and bend the hips and knees as much as possible. Legs pressed as far as possible to the abdomen, head and neck, torso slightly tilted forward. This can inhibit the coracoid and asymmetrical posture of the child and promote the stability of the head and neck. 2.Sleeping position: When the child with cerebral palsy is in supine position, the head is difficult to be placed in the center and often tends to be on one side, which can deform the head and bend the spine, so it is not advisable to sleep in supine position for a long time, and the best position is to sleep in lateral position. 3, feeding mode: for swallowing difficulties, oral closure difficulties, head and neck back and forth, left and right swing, open mouth does not close the child can appear sucking and feeding difficulties, affecting physical development, language development. The correct way to feed: position yourself, often in a semi-sitting position, with your hips and knees flexed, your upper body leaning on your mother’s chest and forearms, your head slightly bent forward, and both feet on your parents’ thighs. If you can’t suck, use a small spoon to feed, and larger children can sit in a corner, chair (corner chair) or corner of the bed. 4. Clothing: Dress loosely, not too tightly, too tightly to restrict the movement of arms and legs, which is not conducive to reducing muscle tone; sleeves and pants should not be too small, and reduce clothing as much as possible in winter. 5.Language training: Within 3 months, often speak face to face with the child, tease, cause the child to look, pronounce, laugh, after 3 months, often speak with the child, sing children’s songs, pronounce monotone, increase the child’s comprehension. Second, basic rehabilitation training 1, baby touch: an effective tactile skin training, for brain development, relieve muscle spasms are useful. 2 times a day. 15-20 minutes each time. Methods: Head and face, chest, bilateral upper limbs. Bilateral lower limbs, back waist hip. 2, muscle movement training (passive exercise): forearm flexion and extension exercise, upper arm cross exercise, lower limb flexion and extension exercise. 3, audio-visual training: sounding red ball or colored bell, 20-30cm distance, shaking swing. Train the child to gaze and chase, chase and listen and turn the head, also can speak with the child face to face, tease the child to gaze and chase. The principle of gross motor rehabilitation training: follow the normal sequence of motor development. The normal order of development: head lifting, hand support, rolling over, abdominal crawling, sitting, crawling in four positions, support standing, support walking, standing alone, kneeling, walking alone. 1, head lift training: supine head lift: hands holding the child’s shoulders, slowly pull up to 450, stay for a moment, back and forth, left and right adjustment, and then put flat. Prone head lift (elbow support): ring the bell to tease, verbal teasing, make his elbow support, parents can hold the child’s head on both sides, exercise the child’s head lift and hand support ability; also use Bobath ball training (two elbows and shoulder width, shoulder joint, elbow joint flexion 900). Ball-holding posture training: parents will be the child’s lower limbs flexed, crossed hands in a ball-holding posture, for the head dorsiflexion, limb muscle tone increased in children. 2, hand support training: parents kneel on the back side of the child, hands holding the child’s elbow joints, as far as possible to make its upper limbs and the ground vertical, hold for 3 to 5 minutes, can also lie prone on the mother’s chest, or the use of inclined plate, and can be shaken from side to side to train its balance. 3, roll over training: inhibit asymmetrical posture: trunk gyration movement: prone position, the lower limbs of the child to promote trunk gyration, supine position, the upper limbs of one side to promote trunk gyration. Hand-mouth-eye coordination training: at 4-5 months, make the child grasp the entrance of the foot with both hands, which can promote symmetrical flexion of the limbs and balance response in supine position, and promote the ability to turn over. One-armed support training: the final completion of the turning movement, must go through the one-armed support of weight and then to the two-armed support. Method: Fix one upper limb at a position of 450 with the trunk, hold the other upper limb along the direction of 450, pull the child up, first to support the weight with the elbow, then to the position of supporting the weight with the hand, and then push back to the elbow support and supine position. Inhibit head-low-hip-high posture training: train in full-body extension mode. Bridge and rowing training: Bridge: child in supine position, legs flexed, feet flat on the bed, parents hold up the hips so that the hips are raised off the bed, so that the hips are fully extended. Rowing: prone position, can four-point support position, parents hold the hip so that back and forth movement, increase hand support and balance ability. 4, sitting training: the developmental sequence of sitting: support sitting, forward leaning position sitting (arch back sitting) straight back sitting straight waist, cross-legged sitting, split-legged sitting (to relieve lower limb muscle spasm) side seat training: respectively from supine, prone position to side sitting for conversion training. Support sitting training: the child’s legs are separated, the parent holds the child’s shoulder back, one hand presses the lower limbs, so that the child becomes a straight sitting position, both hip joints are flexed, abducted, externally rotated, the foot is not crossed, the back of the leg is straightened, and the general knee joint is straightened in an extended leg seat. Sitting percussion training: The child sits in a forward leaning position, supported by both arms, the parent holds the shoulder with one hand and gently percusses the child’s waist and back with the other hand, so that the child gradually sits in a straight-backed position, slowly releasing the hands holding the shoulder and continuing to percuss to train the straight-backed sitting position. Sitting alone training: Let the child sit on the corner chair, or lean on the back of the chair, reduce the support to sit, and slowly become sitting alone. Sitting balance training: Take a sitting position with extended legs, the parent is located on the front side of the child, hold the child’s ankle with both hands, lift and lower the lower limbs, so that the child’s center of gravity moves back and forth, left and right, inducing the direction of the child’s upper limbs to extend the action. You can also sit on the roller and roll slightly from side to side to experience the feeling of moving the center of gravity and maintain body balance. 5, crawl training: hand support training: the same as the head lift training section. Four crawl position spine, pelvic separation training: boat-sliding exercise. Lateral position one-handed support training: make the child lie on his side to lower limb hip lower side, upper limb elbow joint two points to support the weight, upper side lower limb flexion, upper side lower limb extension. Lower limb interactive movement training: three-point, two-point support: set up a four-crawl position, so that one side of the upper limb lifted into a three-point support, weight-holding, cross two-point weight-holding. Lateral sitting – four crawl position – lateral sitting training: posture change adjustment training. Lateral weight shifting training: child in prone position, both arms extended forward, parent at the side of the child, one hand holding the shoulder. One hand holds the leg, push the child to the left and right respectively, so that its weight moves left and right, the upper limb on the weight-bearing side is externally rotated and internally rotated, the lower limb is internally rotated and internally rotated, and the head is lightly dorsally curved, alternating between left and right. Support crawling training: let the child crawl, parents bend the child’s knee on one side and against the abdomen, the other lower limb straight, gently press the hip on the knee bending side, let his hip touch the heel, first one side, then practice the other lower limb, then simultaneously. Then the four limbs interacting movement pattern is completed, the standard crawling movement must be one side of the upper limb and the opposite side of the lower limb at the same time to extend and flex, alternating between the two sides. 6.Standing and walking training: crawling training is required when crawling is not perfect: crawling is a necessary prerequisite stage for standing. From sitting to standing training: from sitting to standing training Standing balance training: hold the pelvis to promote correct standing, and then move the center of gravity back and forth to induce the child to actively maintain balance. Kneeling balance training: hold the weight on both knees, kneel steadily, then suddenly let go, and when it’s time to fall, then help, repeatedly. (Straight kneeling, single-legged kneeling, kneeling forward training) Help stand, stand alone and help walk training: make the child stand with both hands holding the bed rail, the back of the chair and other objects, after holding both hands for 10 seconds on, stand with one hand holding the object, then stand alone training, in help walk training, then walk alone training, then cross the obstacle training. Fourth, fine motor training 1, reach training: visual object reach training, teasing with bright toys, shaking in front of the child 15 ~ 20cm, can lead the child’s gaze, and then touch the back of the child’s hand with the toy, to induce it to reach, such as no reach action, parents can hold their elbow to help the hand to the toy, repeatedly. (3 to 4 months of age) 2, finger grasping training: pull hood training: when the child is awake, gently cover the face with a hood, let the child use his hands to pull the hood down, causing the child to laugh, repeatedly. Thin-handled toys for children to grasp training: use thin-handled toys to touch their hands or wrists and let children grasp. Grasping small pills into the bottle training: at 6 months. Grasp object import training: At 6 months. Building block training: Around 1 year old.