Social rehabilitation of children with cerebral palsy. Causes of the disease and risk factors. Early signs of cerebral palsy

ICR "Children" is a modern rehabilitation center for children with cerebral palsy in Moscow. We work with patients different ages using advanced techniques tested by Western and Israeli doctors. Every second child suffering from cerebral palsy (ICP) needs our help, because without the necessary support, such people develop not only motor, but also mental disorders.

What do our patients get?

The Interdisciplinary Center implements comprehensive program, which includes hardware and drug treatment and subsequent psychological rehabilitation children with cerebral palsy. Her goal is evolution strengths affected by an illness and restoration of body functions lost due to cerebral palsy. To do this, we use advanced medical technologies, involving both the patient and his family members in the work.

We rely on our own method of physical and social rehabilitation of children with cerebral palsy, offering best practices the patient's urge to vigorous activity. The main task of the team of specialists is to develop and stimulate the desire to achieve physical, creative and mental activity.

Experienced doctors - rehabilitation therapists, psychologists, physiotherapists, neurologists, speech therapists, massage therapists and art therapists - are busy providing this aspiration. Children are assisted by a multidisciplinary team capable of developing and implementing an individual rehabilitation plan.

Our experts truly offer effective methods psychological and motor rehabilitation of children with cerebral palsy in Moscow, therefore positive reviews about the work of the ICR "Children" you will see in any in social networks or on thematic forums.

The main directions of the rehabilitation program

The ICR "Children" practices individual, group and mixed approaches to the recovery of preschoolers and adolescents with cerebral palsy who receive comprehensive assistance:

• drug and movement therapy;
• development of self-service skills;
• stimulation of the cognitive sphere, speech and hearing skills;
• joint overcoming of difficulties in socialization.

The medical institution uses innovative technical means and unique simulators for the rehabilitation of disabled children with cerebral palsy. Our medical center has hardware and software systems with feedback, fitness equipment, modern massage tables and other equipment.

Features of group work

After development individual plan the child is offered classes in a group. This approach to therapy increases socialization and improves the results of interaction with a speech therapist, psychologist and movement therapist.

Meetings are held from 9:00 to 14:00 on Mondays, Wednesdays and Fridays and from 15:00 to 19:00 on Tuesdays, Thursdays and Saturdays, which allows you to choose a schedule that is convenient for children and their parents. The composition of the group does not exceed five people, and in difficult cases it can include only two babies.

Family support

Parents of our patients receive the help of psychologists. During group classes, people accompanying children and schoolchildren with cerebral palsy are in comfortable waiting areas. They can influence scheduling by choosing convenient time visit to the doctor. Our managers will help with the choice of a charitable organization that is ready to solve the financial difficulties of the patient's parents.

How to make an appointment

The interdisciplinary center "Children" is ready to work with patients of any age. We are engaged medical rehabilitation children with cerebral palsy up to a year, the preparation of preschoolers and interaction with adolescents. For registration on initial appointment to a defectologist, it is enough to indicate the phone number in the feedback form (it is located at the bottom of this page). Our consultants will contact you within 30 minutes and answer all your questions.

Rehabilitation is a complex of medical, psychological, pedagogical, professional and legal measures to restore autonomy, working capacity and health of persons with physical and mental disabilities as a result of past (rehabilitation) or congenital (habilitation) diseases, as well as injuries.

Rehabilitation of children with cerebral palsy consists of 4 stages. (appendix 2)

Therapy of cerebral palsy should be complex and multidisciplinary. Treatment and rehabilitation started as early as possible in some cases makes it possible to avoid persistent disability in patients with cerebral palsy and improve their quality of life. Basic complex therapy Cerebral palsy is a "team" approach using drug and non-drug methods.

Main directions and tasks of rehabilitation

1. Preparation

2. Development of a rehabilitation program and its implementation

3. Correction of rehabilitation measures

4. Evaluation of the effectiveness of rehabilitation

5. Recovery right system starting afferentation and reflex activity.

6. Prevention of increased muscle tone, alignment of its asymmetry.

7. Prevention of formation of resistant pathological conditions and pathological motor stereotypes.

8. Prevention of contractures and deformities.

9. Development of amplitude and accuracy of movements.

10. Concentration of attention on the correct and consistent “inclusion” of muscles in a motor act.

11. Basic principles of neurorehabilitation: early start, continuity, adequacy, complexity, stages, continuity.

12. Rehab

Basic principles and directions of rehabilitation measures (Shabalina N. B. et al., 1988):

l adaptation of patients to life in conditions of a severe defect;

l timeliness, interconnectedness, continuity of rehabilitation measures (treatment, career guidance, socio-psychological assistance);

- an appeal to the personality of the patient, the education of his volitional qualities, purposefulness;

l staging of social and medical care for patients with cerebral palsy depending on age:

l specialized nursery-kindergarten, boarding school, vocational school, technical school;

outpatient, inpatient, spa treatment(including neurological, orthopedic hospital, prosthetic enterprise, etc.);

l multidisciplinary participation of specialists of various profiles: a rehabilitation doctor, a psychologist, a neuropathologist, a pediatrician, a speech therapist, etc.).

Types of rehabilitation

Physiotherapy

Taking into account the specifics movement disorders with cerebral palsy physiotherapy has the following main tasks:

The development of straightening and balance, that is, the so-called postural mechanism that ensures the correct control of the head in space and in relation to the body.

Development of hand function and object-manipulative activity.

Development of hand-eye coordination.

Braking and overcoming incorrect postures and positions.

Prevention of the formation of a secondary motor stereotype.

Under the influence of therapeutic exercises in the muscles of a child with cerebral palsy, adequate motor sensations arise. In the process of therapeutic exercises, postures and positions of the limbs are normalized, muscle tone is reduced, violent movements are reduced or overcome. The child begins to correctly feel postures and movements, which is a powerful incentive for the development and improvement of his motor functions and skills.

Children with cerebral palsy must perform the following physical exercises:

v stretching;

v relaxation of muscles and decrease in tone;

v increase in amplitude and range of muscle movements various parts body;

v strengthening the muscles involved in the movements of various parts of the body;

v exercises to develop muscle endurance;

v training of a normal muscle stereotype for correct walking;

v balance training by walking on inclined planes;

v exercises to increase muscle strength.

Spa treatment

Krasnodar region

Evpatoria

Zheleznovodsk

Pyatigorsk

Kislovodsk

Hippotherapy is special kind physical therapy, where treatment is carried out with the help of a horse, is a recognized means of rehabilitating effects on patients with somatic, mental illness. Consists of 4 sections:

· Theoretical lessons with patients.

Training in communication with horses

· LVE including with exercise

Horse care, including grooming, bathing, feeding

Ergotherapy is aimed at developing or restoring previously lost elementary skills, including motor functions. This is a kind of therapeutic gymnastics, which allows you to train coordination of movements and fine motor skills. She is able to adapt a person to Everyday life, achieve independence in actions, adapt to everyday life, namely, household chores, cooking, self-care.

The Bobath technique was developed by Berta Bobath back in the 30s of the last century, an immigrant from Germany, together with her husband, a neurologist. The approach is based on stimulation various movements body with the help of special positions of the body and limbs. As a result, there is a strengthening weak muscles, improving joint movement, reducing imbalances in body proportions. Such restorative rehabilitation allows you to expand motor skills and improve balance.

Vojta therapy - the main idea is the impact on certain parts of the body with the help of graduated pressure. This helps the nervous system to maximize the activation of the muscles of the body. It also involves facial expressions, the movement of the eyeballs, skeletal muscle, intestinal muscles and Bladder. Such stimuli contribute to the formation of motor rehabilitation, which means the normalization of body movements.

Hydrotherapy - It is based on warm water, and the therapy itself is aimed at relaxing certain muscle groups. Such a course has several sets of exercises for relaxation, stretching and strengthening of muscles. The procedures themselves are performed in swimming pools. This type of rehabilitation, together with other methods, allows to increase the effectiveness of the treatment of patients with cerebral palsy, and improve coordination, a sense of balance, and develop muscle strength.

Sadovaya Therapy - Essence therapy is the interaction of the child with nature. So, on the territory of all clinics in Germany there are beautiful parks. In addition to their aesthetic function, they also serve as relaxation for patients. As a result, they have an improvement in physical and mental condition. In such parks there are places for walking and solitude. All patients are given special shoes for walking. The entire territory of the park is equipped in such a way that it has many natural simulators - steps, slopes and various surfaces (grass, sand, wood, crushed stone). For the rehabilitation of children, there are play areas made from natural materials. These are caves, hills and other attractions.

Dolphin therapy is another kind rehabilitation treatment for children diagnosed with cerebral palsy. Interaction with the animal takes place under the careful guidance of several specialists - a trainer, a psychologist, a psychotherapist, a specialist in physical therapy, a defectologist.

Only specially trained dolphins are used for contact. The learning process is based on the principle of the game. AT this case there is an active stimulation of tactile, visual, emotional contact between the child and the dolphin, which leads to the development of speech and motor skills.

An important factor in the use of dolphin therapy is the increased interest and positive emotional attitude of children towards these animals, which reduces the internal psychological communication barrier and, as a result, stiffness of movements. In addition, in the application of this therapy, it is very important tactile sensations. By influencing biologically active points on the child's body, the dolphin stimulates the necessary specific zones nervous system responsible for the corresponding reflexes. In some cases, the therapist offers the patient to touch the animal with his hands or feet if violations of the upper or lower extremities, respectively, have been identified.

Another, no less important effect in this therapy is a kind of hydromassage of the skin and internal organs. This is due to the fact that the dolphin, with the help of its tail fin, creates a certain movement of water around the child, which significantly reduces the load on the joints and actively trains the muscles.

Although a child with cerebral palsy is not like other children, he also wants to enjoy life, play, learn and have friends. Therefore, it is so important to start the process of rehabilitation of children with cerebral palsy in a timely manner, especially since this disease- this is not a verdict. And although it is impossible to return brain cells that died as a result of hypoxia, under suitable conditions, their functions can eventually be taken over by other departments.

Physical rehabilitation of children with cerebral palsy

Cerebral palsy is a chronic illness resulting from injury various departments the brain, which entails dysfunction of motor and muscle activity. Together with various diseases of the nervous system, cerebral palsy is the most common cause child disability.

This disease develops in utero, during childbirth or in early infancy as a result of damage to one or more parts of the brain. Moreover, cerebral palsy is not hereditary or infectious disease, does not progress and does not give relapses. Children older than four weeks can no longer develop cerebral palsy, although it is also impossible to cure it completely. Rehabilitation of children with cerebral palsy comes down mainly to improving general condition child, provision suitable conditions to realize its potential.

Creating such conditions is painstaking, persistent, daily labor doctors, parents and the baby himself. The efforts of doctors without the help of the family will not give a great result, since with such a pathology, drug treatment is not the most important thing. Moreover, the rehabilitation of children with cerebral palsy should begin as early as possible, since it is in the first years of life that treatment can most effectively compensate for existing brain damage and minimize the manifestations of muscle spasticity. This allows in the future to reduce the deformation of the skeleton and contractures, increase the ability to maintain balance, normal operation muscles and movement.

Currently, there are many rehabilitation centers for children with cerebral palsy around the world, where various specialists work with patients - neurologists, orthopedists, pediatricians, psychologists, speech therapists, chiropractors and parents undergo a course of rehabilitation of the child at home. After all, even simple game in dolls allows you to improve coordination of movements, muscle function, suppresses pathological reflexes.

Cerebral palsy can present with a range of symptoms, such as:

• Clumsiness, awkwardness of movements;
• Decreased concentration;
• restlessness;
• Dislike for drawing or coloring;
• Inability to catch the ball or kick it;
• Inability to jump on one or two legs, jump over an obstacle;
• Difficulty walking.

Physical rehabilitation of children with cerebral palsy, first of all, consists of taking medicines(antispasmodics, painkillers, antidepressants, tranquilizers), constant exercise physical therapy, surgical and orthopedic methods combined with massage. Good results can be achieved by physiotherapeutic methods: electrical stimulation of nerves and muscles, thermal and mud treatment, electrophoresis. For severe contractures, apply surgery, during which lengthening of muscles, bones is carried out, and to relieve spasticity - cutting of tendons.

Social rehabilitation of children with cerebral palsy

Recovery period motor activity and social adaptation sick child consists of four stages:

• acute period. Lasts 7-12 days, during which pronounced disorders are observed locomotive system, convulsions;
• Early recovery period. Lasts up to two months of age of the child;
• Late recovery. It ends in a child at about two years of age and is characterized by the presence of a pronounced tonic reflex, which does not allow adjusting reflexes and conscious movements to develop in due time;
• Last period. It is characterized by the presence of residual effects and can last for life.

Of great importance for the successful treatment of a child with cerebral palsy are the conditions under which the recovery takes place. Rehabilitation centers for children with cerebral palsy allow using qualified specialists, quality equipment to achieve more efficient results. It is also very important to start rehabilitation as early as possible, respecting the continuity of treatment.

As a child with cerebral palsy grows older and approaches school age should be given Special attention his motor development in order to facilitate his adaptation in society. Social rehabilitation of children with cerebral palsy is the development of abilities and preparation for life in a team. Therefore, it is imperative to ensure that children aged 4 to 7 with preserved intelligence visit preschool institutions with speech therapy groups, since often motor defects are accompanied by speech disorders.

When visiting kindergarten, a child with cerebral palsy receives the necessary communication with peers, his natural need for movement increases, the number of speech contacts increases. Thus, an invaluable experience of communication of social interaction is instilled in the baby, the level of his self-esteem increases.

At the same time, physical rehabilitation should now be aimed at developing everyday life skills, teaching the child to dress, eat, and use the toilet independently. All this will help to greatly facilitate the life of the patient and increase his confidence. But the most important thing is to remember that although cerebral palsy is serious illness, however, many people with this diagnosis manage to manage normal life. At proper rehabilitation children with cerebral palsy subsequently go to school, work, get married and have children.

Special kids...

Their number is increasing every year. This is evidenced not only by dry statistics, but also by specialists who, on duty, are in contact with children - pediatricians, neurologists, psychotherapists, teachers of correctional kindergartens.

If you are a parent of a special child , then you need to understand that any person by nature has certain potential. In some cases, they are suppressed by a congenital or acquired disease. But don't give up. All your child needs is to help him adapt to society. In this regard, it is very important to understand that special children need special integrated approach to solve their problems. To conduct proper rehabilitation work with them, a lot of effort will be required from parents, teachers and doctors. Moreover, these efforts should not be episodic, but continuous.

According to statistics, about 2/3 of all disabled people in Russia are children with disorders of the nervous system and psyche. However, it is important to understand that not all special children have the status of a disabled person. Quite a few suffer from slight deviations in behavior, problems with the perception and assimilation of information, and cannot fully contact with other people and peers. If you do not find out the problem of the child in time and do not seek appropriate assistance, it is quite possible that in the future he simply will not be able to adapt in life and will receive the status of a disabled person.

What diseases make children special?

Children with neurological and psycho-neurological problems are most often called special children. This is a fairly broad category, which includes a whole range of diseases that are very different, including in terms of complexity and the possibility of overcoming them. Here are just a few of them.

Cerebral palsy (CP)) - serious disease CNS, in which the centers responsible for the development of the musculoskeletal system are affected. The nature of the lesion does not imply degenerative processes. As a rule, the appearance of the disease is associated with deviations in intrauterine development, may be a consequence birth injury and is often detected in the first year of life little man. Children, patients with cerebral palsy, in some cases have associated problems in the form of compensated hydrocephalus, autistic features and delays in psycho-speech development. At the same time, the simultaneous appearance of all the above problems at once is not at all necessary. Forms of the disease without concomitant changes are possible.

RDA (early childhood autism), Kanner's syndrome, Asperger's syndrome- diseases of this kind are expressed in violation of the development of the psycho-emotional sphere. The child has the following problems:

Extreme difficulty in interacting with other people ( mild form disease).

Limited by autistic interests - while the child reproduces stereotypical movements, his interests are narrowly limited and not of a cognitive nature.

Active denial and rejection of the environment - the child reveals extreme selectivity in relation to people, clothes, types of food. Violation of the usual way of life, deviation from the standard route can cause bouts of hysteria, sometimes turning into auto-aggression.

Total detachment from the world and the impossibility of interacting with it (in the most severe forms disease). Such children do not smile, do not maintain eye contact, do not possess the simplest self-care skills.

As a rule, an autistic child has multiple neurological abnormalities, and the disease itself may be the result of layering different kind root causes. Often, autistic traits go hand in hand with another serious illness like hydrocephalus or cerebral palsy. AT recent times information began to appear that some children developed autism after vaccination with drugs containing mercury salts (merthiolate or thimerosal) in their composition. Some autistic children have been identified increased concentration mercury in hair and red blood cells. For them, chelation therapy (chelation) can become one of the methods to overcome the problem.

Hydrocephalus. It is also called dropsy of the brain. The disease is associated with impaired liquorodynamics. At the same time, cerebrospinal fluid (CSF) is produced in excess, and its absorption is very slow. In extremely severe cases the circumference of the child's head becomes excessively enlarged. Children with hydrocephalus constantly experience increased intracranial pressure. Such phenomena as nausea and blood from the nose, as well as unreasonable tantrums, are not uncommon. At the same time, the child early age can rub his head with his hands, bang his head against miscellaneous items and somehow demonstrate that it is the head that hurts. Distinguish hydrocephalus in severe form and lighter compensated. If to get rid of the first, surgical intervention (bypass surgery) is necessary, then in the second case, it is enough to follow the medical prescriptions. The disease is often accompanied by such a phenomenon as ZRR or ZPRR (delayed speech or psycho-speech development). This is due to the fact that an excess of CSF depresses certain areas of the brain.

A complete list of diseases associated with disorders of the nervous and mental activity, much wider (Down's syndrome, early organic lesion brain, etc.). It is very important to diagnose the disease in time and contact the rehabilitation center. Leading neurologists warn about this - the sooner you start treating the child and working with his condition, the stronger the regenerative abilities of the brain will manifest themselves.

Rehabilitation tasks

Features of development, first of all, are expressed in the deterioration of cognitive activity and in some cases totally weaken the will of a person (autism). In this connection educational process for children should fit into the system of their rehabilitation (habilitation). It is the rehabilitation of special children that is the cornerstone on the way to their further socialization and more successful development. All rehabilitation centers, regardless of the specifics of the disease, essentially have one common task - to provide the child with the opportunity to live a completely autonomous life in the future. They have to deal with the most difficult diagnoses, helping special children prepare as much as possible for learning.

Rehabilitation for severe children will be effective only in the case of continuous work with the problem. Ideally, it should accompany the patient until the period of his adaptation in society and employment for work (if the level of development and the type of disease allow this to be achieved).

Below are some rehabilitation centers Moscow, where parents with special needs children should contact.

- federal state state-financed organization, sponsored by the Ministry of Health and Social Development, provides assistance to children from different regions of the Russian Federation with diseases of the central nervous system, musculoskeletal system and autism spectrum. On the basis of the center there is a school for parents. Rehabilitation methods used in the center:

Carrying out corrective sensorimotor disintegration;

The use of robotic equipment "Lokomat";

Classes using the Gross simulator;

Conductive therapy classes;

logorhythm;

Classes in medical suits "Atlant", "Adeli", "Phaeton";

Social adaptation;

And much more.

Payment for the accommodation of residents is charged for children over 4 years old and their accompanying persons. At the same time, its dimensions are: in the ward (ordinary) - 335 r per day; in a ward with a shower room (increased comfort) - 700 r per day, in a comfortable ward without a shower room - 600 r per day. The center provides paid services, if:

They are not included in the CHI program;

In the hands of the representatives of the child there is no direction at the expense of the budget;

The service is provided at the initiative of the patient and his voluntary desire;

The patient does not have Russian citizenship.

At the same time, the cost of one bed-day of a child in a ward with food, but without treatment, is 750 rubles. The cost of stay accompanying him - 335 rubles. The rehabilitation course for a child with cerebral palsy (21 days) will cost 56,865 rubles. The price of the initial consultation with specialists within the framework of inpatient treatment- 800 r, repeated - 500 r (each specialist separately).