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Brain damage, the cause of
Cerebral Palsy, is irreversible. There is no cure for it either.
Its only that life can be made more bearable, more meaningful
for the child. Early diagnosis and an immediate therapy regimen
will help reduce the impact of the disabilities and discomfort
caused by CP. It’s an ongoing process. The line of treatment and
therapy is highly individualized depending upon the specific
needs of the child. No two persons respond to it with the same
degree of success. What works for one may not work for another.
Each case has to have its own correct mix of therapies and the
involvement of all concerned- medical experts, parents, teachers
and caregivers. Experts from different disciplines have to
coordinate, because a child will show signs of more than one
disorder each needing a specific therapy to help the child
develop specific skills. There has to be a comprehensive
treatment that looks at the physical, mental, emotional and
social rehabilitation of a CP child. The line of treatment aims
at increasing the child’s’ functioning to a maximum and his
contractures to a minimum. This is the physical aspect. It also
takes into account the medical and surgical corrections, and
emotional, behavioral, social and educational rehabilitation of
the child.
Normally, muscles, tendons and bones stretch and grow together.
In CP, because of spasticity, they may not do so. Also, very
often, a child’s muscular tissue begins to deteriorate out of
disuse (muscle atrophy), making the muscles stiff and frozen in
awkward positions (muscle contracture), thereby loosing their
motor ability. Physical therapy must start as soon as a
diagnosis is made. The idea is to increase muscle strength,
flexibility and control, stretch spastic muscles and improve
motor functions through a specially designed regimen of
exercises. If contracture, a common disability in CP, is treated
long enough with physical therapy, there may not even be a need
for surgery.
Physical therapies, need to be adjusted to suit the changing
needs of the Child. For e.g. when the child starts school,
physical therapy includes exercise, which improves the child’s
ability to sit, move independently and perform small tasks like
using the bathroom and dressing.
Seizures and spasticity are the most common discomforts of
Cerebral Palsy. Drug therapy reduces these discomforts and
prevents any escalation. But, since its not just one
complication that is being looked at, there is not one single
drug that will work best. It’s normally a combination of drugs
that work, and this too differs from patient to patient. For
seizures, anti-convalescents work well, while muscle relaxants
are prescribed for spasticity. The drugs for spasticity alter or
inhibit the chemical processes in the Central Nervous System and
relax the muscles. Once the muscles are relaxed, it gives
therapists a chance to stretch and lengthen them with physical
therapy or with special supporting aids like braces or casts.
But, medication normally has side effects and is thus considered
a short-term option.
Surgery is recommended as a last resort to handle extreme
contractures, which can inhibit movement, balance and
coordination. A seemingly simple movement like walking requires
as many as 30-different muscles to work in unison. The affected
muscles are carefully identified and surgically lengthened to
reduce contractures.
Apart from the physical rehabilitation, it’s behavioral
rehabilitation, which also assumes great significance in cases
of CP. Most of this behavioral handling has to be done at home,
between the caregiver and the family. This therapy banks on
psychological techniques to reduce destructive and non-compliant
behaviour, and increase self-reliance through motivation.
Occupational therapy works at improving the child’s simple
physical skills, which make him more independent as in feeding,
dressing etc. while speech therapy helps develop muscles of the
mouth and tongue to improve speech. Improved speech helps a
child with hearing impairment as well.
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- editor Sunayana Sadarangani .Copyright©2000.Indianchild.com.
Category recommended
India site :
http://www.nrcissi.org/ - The National Resource Centre for
Inclusion. - The Spastics
Society of India. |
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