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 can be made, it can be cured or normalized, except for extremely severe cases. Early treatment is effective because the brain tissue is not yet mature during infancy and is still in the rapid and growing stage, while the brain injury is also in the early stage and the abnormal posture and movement are not yet fixed. 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.
Prognosis assessment of cerebral palsy rehabilitation:
①Most of the children with hemiplegia will walk at 18-21 months;
②87% of those with parachute reflex before 24 months can walk, and the walking ability reaches a plateau at 7 years old
③The inability to sit at 4 years old or to kneel independently at 6 years old is a reliable indicator of the inability to walk independently in the future;
④ Prognosis was evaluated with the following 6 items at age ≥ 12 months: a ATNR, b, cervical rollover reflex, c, STNR, d, extensor extensor reflex, e, tense vagus reflex, f, foot placement reflex. For each of the above 6 items, 1 point for each response, 2 points or more for poor prognosis, 0 points for good prognosis, and 1 point for prognosis should be considered carefully.
⑤ If the child has not formed a dominant hand or the upper limb still cannot move beyond the midline of the trunk before the age of 3, the prognosis of upper limb function is poor, and intelligence is balanced with the index of upper limb function;
⑥The younger the age, the better the prognosis, generally not older than nine years;
(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 outcome and poor prognosis.
② Long rehabilitation period and poor prognosis for post-nuclear jaundice.
(③) Poor outcome in children with hand-footed cerebral palsy aged 3 years or older;
③Severe abnormal postural reflexes ATNR, abnormal motor patterns for a long time have a poor prognosis;
④Poorly nourished, poor physical condition, sweating and fatigue-prone children have poor rehabilitation effect;
(⑤) Cerebral palsy children with recurrent respiratory tract infections have poor outcome;
(6) Poor prognosis for children with epilepsy, such as infantile spasms.
(vii) Poor results in children with secondary tendon contractures, knee retroflexion, and joint deformation with long rehabilitation time;
(8) Poor outcome in patients with severe mental retardation or language development disorders;
⑨ with visual impairment (such as optic nerve atrophy) is poor;
(⑩) Cerebral palsy children with severe overstimulation and irritation have poor results.