Comprehensive non-pharmacological rehabilitation in infantile cerebral palsy
Our Centre is engaged in medical non-pharmacological rehabilitation of children with serious neurological and pulmonary disorders, such as infantile cerebral palsy, central and peripheral nervous system disorders, bronchial asthma, and broncho-pulmonary diseases. Developed by Mr. G.N. Romanov, the remedial techniques and technologies include elements from both European and Eastern medicine.
A specially trained team of doctors provides the comprehensive and intensive rehabilitation needed to bring the patient’s health as close as possible to that of children of the same age, as well as to ensure that the child can sit, stand and walk without assistance.
Rehabilitation is realized in accordance with a plan that is designed individually for each child. The duration of rehabilitation depends on the specific goal as well as on the state of the patient’s health. While a patient is practicing his exercises, the state of his health is monitored with state-of-the-art diagnostic equipment. Our center has a podiatric workshop, where orthopedic items such as ankle braces, orthopedic corsets, spinal supports, and insoles are manufactured.
A typical course of rehabilitation takes three weeks, but effective rehabilitation may take longer. Effective rehabilitation of a child who cannot sit, stand or walk is not considered to have been achieved until the child can actually sit, stand and walk.
The rehabilitation course involves the routine practice of various manipulations like therapeutic massage, remedial gymnastics, etc. Here we should clearly understand what specifically can be done and what it is necessary to do for achievement of the goals at this stage.
In cooperation with the child's parents we must do everything possible to ensure that the child achieves his potential to sit, stand and walk.
Let us review what Infantile Cerebral Palsy really is.
The expression “Infantile Cerebral Paralysis” was first used in the nineteenth century, but the conditions it is used to refer to have presumably occurred throughout human history. In spite of its long history, up to the present day there is little consensus about this problem.
After Dr. William John Little, a British orthopedic surgeon, published his paper “On the influence of abnormal parturition, difficult labours, premature birth, and asphyxia neonatorum, on the mental and physical condition of the child, especially in relation to deformities” in 1861, the expression “Little's disease” began to be used to refer to postpartum motor and mental disorders. In 1889 the famous Canadian physician William Osler published his monograph on The Cerebral Palsies of Children, which popularized the expression “cerebral palsy.” In the eighteen-nineties Sigmund Freud distinguished “Infantile Cerebral Paralysis” as a separate nosological category that combined diverse motor disturbances of cerebral origin.
In his monograph on the subject, Sigmund Freud explained that the term “Infantile Cerebral Paralysis” combines “those pathological conditions that have long been known in which muscular rigidity or spontaneous muscular twitching prevails over paralysis”.
Freud suggested using this term even in the complete absence of paralysis, for example, in cases of epilepsy or mental retardation.
Freud may have suggested combining these various motor disturbances in children into one nosological category for want of any better way of organizing this complex area of child neurology.
Many doctors continue by force of habit to combine into one diagnostic category conditions that differ significantly in terms of cause, character, extent of damage and therapeutic possibilities. But already in 2004, participants in an international workshop on the Definition and Classification of Cerebral Palsy held in Bethesda, Maryland had concluded that the phrase “infantile cerebral palsy” should be considered simply a clinical description with no etiological or diagnostic significance.
In our work we begin with the premise that each child must be evaluated individually to determine what specific damage he or she may have suffered. Such individual characteristics must be taken into account if the child is to gain the ability to sit, stand and walk without assistance.
How can that be accomplished? We deal with children whose health is compromised by various distortions of their locomotor apparatus: dysplasias, dislocations and subluxations of joints, alteration of joint form and congruence of joint planes, asymmetry in bone length and dimensions of the left and right halves of the body. Our mission is to help correct these disturbances as well as to restore the locomotor capabilities of each child. Establishment of our own podiatric workshop and employment of Acoustic Osteoreparation are just two examples of how we address such problems.
We apply various techniques of manipulative therapy in order to change the child’s functional status and prepare the young organism to withstand weight loadings that will help set the child on his feet. Even greater modifications of the functional status of the cardiovascular, endocrine, and locomotor systems can be accomplished subsequently with the help of remedial gymnastics
Ensuring that the results achieved are maintained is accomplished by fixing them in the central nervous system with the vast arsenal of reflexotherapy.
Remedial rehabilitation will be successful only when a child who is already able to stand on his feet is provided with sufficient age-specific physical loading exercises.
But how can the child be motivated to perform such exercises? Here the “rockodrome” rock -climbing game and an obstacle course come to our aid.