All cerebral palsied children are retarded in motor development of the postural balance mechanisms or postural reflexes disturb the motor development. Another common feature is the possible appearance of certain abnormal reflexes which have no predilection for any specific type of cerebral palsy.
AIMS OF REHABILITATION:
- To develop forms of communication like gesture, speech, typing and with signs.
- To develop independence with daily activities to eating, drinking, dressing, washing, toileting and general self-care.
- To play and develop recreational activities.
- To develop form of locomotion and independent mobility this may include wheel chair, electronic mobile buggies or driving motor vehicles.
(1) Lifting and Carrying:
The therapist needs to instruct the parents or caregivers to carry the child in a special way in order to prevent worsening of deformity.
- Supine – a pillow is placed under the head and shoulders often promote symmetry.
- Prone- children are often more symmetrical in this but they usually need to be reused off the floor. Such as an a wedge in order to use their hands and head.
- Floor-Sitting types-
- w.sitting (encouraged in some patients as it encourage backward pelvic but may lead to flexion contractures of the lower limbs)
- Side sitting
- Long leg sitting
- Comer’s sitting- supporting to back to a corner or sofa will help. Leg is supported by gaiters.
- (ii)Chair Sitting-
The correct posture in chair sitting is head upright the spinal curves are supported. The person’s weight distributed evenly through the buttocks and thighs. The knee at 90 degree and the foot plantar grade.
ADAPTED EQUIPMENT AND ASSISTIVE DEVICES:
The main goal of the Occupational Therapist is to making the client independence in his Activities of Daily Living (ADL). Some of the adaptive devices are as follows,
- Toileting – Raised toilet can be used
- Bathing – Rails, Bath Board, Hand held Shower, Soap holders, etc. can make bathing easier
- Feeding –Non Slip plates, Plate guards adapted spoons, Long handled devices or utensils are used Assistive devices for Learning and Communication
COMMON DEFORMITIES IN C.P.:
(1) In Lower Limb:
- Hip- Flexion, Adduction and Internal rotation
- Knee- Flexion or Hyperextension
- Ankle and Foot- Plantar flexion, Inversion and ForeFoot Adduction, Valgus and Collapsed Arches.
(2) In Upper Limb:
- Shoulder- Flexion, Adduction and Internal rotation
- Elbow- Flexion, Pronation.
- Wrist and Fingers- Flexion