Atonic-astatic form of cerebral palsy is a pathological process that occurs against the background of congenital diseases. This is a severe form of the disease that is difficult to treat. In pathology, there are failures in coordination of movements and low muscle tone.

The occurrence of an atonic-astatic form of cerebral palsy is observed under the influence of various causes. Most often, pathology occurs during violations or during childbirth. The astatic type of the disease develops when:

• Hypoxia. The disease is characterized by insufficient supply of oxygen to the child's brain. It occurs when the mother has bad habits during pregnancy - smoking, alcohol, drug addiction. With diabetes mellitus or a critical decrease in hemoglobin in the blood, the patient is diagnosed with hypoxia.

• Birth trauma. If a woman has an excessively narrow pelvis and at the same time a large fetus, then this leads to injury during the birth process. Children of older women are at risk. The disease develops with premature birth or overbearing of the child. Weak attempts and damage to the pelvic area lead to pathology. Most often, trauma is considered as a factor that exacerbates the disease.
• Hemolytic disease of the fetus. The disease develops when the blood of mother and child is incompatible. The immune system of a woman destroys the child's red blood cells, which excludes the possibility of its full development. This leads to severe brain toxicity. If the child survives, then he has impaired brain function.

• Bacterial, viral and non-infectious diseases. During the course of the disease, intrauterine disorders in the development of the fetus are noted. At risk are the children of women who suffered from toxoplasmosis, rubella measles, herpes, cytomegalovirus infection. Pathology develops with heart disease, nervous strain, anemia, etc.
• Taking medicines. If during pregnancy the patient is taking antibiotics, non-steroidal anti-inflammatory drugs, antidepressants, second-generation anxiolytics, aspirin, antiepileptic drugs, lithium preparations without consulting a doctor, this leads to the development of the disease.
• Heredity. If the unborn child in the family has people with this form of the disease, then he is at risk.
• Prematurity. If a premature baby has a small. Body weight, then pathology can be diagnosed in him.

There are various reasons for the development of the pathological process, which a woman should familiarize herself with during the planning period for a child.

Symptoms of the disease

The atonic type of the disease is characterized by pronounced symptoms, which makes it possible to determine it almost immediately after the birth of the crumbs. If you pull the hands when the child is sick, then muscle tension will not be observed. He will remain passive. The baby's head is tilted back.

If you put the child on his back, he will not seek to move, which is explained by a significant decrease in the tone of the muscular system. In the muscles of the upper extremities, the working capacity is higher than in the lower ones. During the course of the disease, the child observes stereotypical motor activity. The pathological process is accompanied by an intense expression of tendon reflexes.

With a disease, the child begins to hold his head only after 6 months after birth. In the prone position, the baby does not strive to reach for the toy. Even when reaching the required age, the child cannot roll over on his own. If you lay the baby on his stomach, then he can hold the head and rest on the handles.

The baby learns to sit without support after 7 months. Such children begin to walk only when they reach the age of 6-8 years. At preschool age, the onset of mental deviations and aggression is noted. The disease is accompanied by convulsions, strabismus, nystagmus, glaucoma.

Due to the pronounced symptoms of the disease, it is possible to detect it in a timely manner. When the first signs of illness appear, parents should show the child to a pediatrician who will correctly diagnose and prescribe effective therapy.

Features treatment

Treatment of the atonic form of the disease does not bring the desired results. During the course of the pathology, rehabilitation measures are recommended. Patients are prescribed:

• physiotherapy;
• acupuncture;

Patients must perform daily. He is shown regular classes with a speech therapist. All of the above methods are characterized by a small positive effect. They help to increase the activity of the baby.

Medicines do not bring the desired therapeutic effect, so they are used to eliminate unpleasant symptoms. In order to reduce intracranial pressure, the patient is recommended to take vasodilator drugs and diuretics. Improvement of metabolic processes in the brain is provided by nootropic drugs.

Reduce child aggression sedative medications. The selection of certain medications should be carried out only by a doctor in accordance with the characteristics of the pathology and the age of the patient.

Sometimes children are prescribed surgery. A specific rehabilitation method is hippotherapy. Thanks to the interaction with the horse, the mood of the baby is improved and the mental and physical condition is stabilized. This provides an increase in the chances of social adaptation in the future.

Should be selected by a doctor after examining the child, which will ensure an improvement in his condition.

Complications

In the absence of rehabilitation measures during the course of the pathological process, the patient may be diagnosed with the appearance of complications. Most often they appear as:

• Seizures. The development of epilepsy is observed in 50 percent of patients. This complication negatively affects the development of the baby. In epilepsy, there is an increase in the severity of other symptoms, which reduces the effectiveness of rehabilitation methods.
• Orthopedic disorders. With the disease, excessive muscle weakness is noted, which leads to the development of various curvatures of the spine - scoliosis, lordosis, kyphosis. In pathology, there is an inconsistency in the work of the muscles and disturbances in the blood supply. With age, the progression of complications is diagnosed.
• mental retardation. Complications are observed in almost all children, which negatively affects rehabilitation. Adult children have difficulty communicating with others, so they close in on themselves.
• Digestive disorders. Against the background of low physical activity, disorders in the digestive system are diagnosed. The most common is chronic constipation. In pathology, obesity of patients is observed.

Complications are manifested in the form of salivation and enuresis. In patients with pathology, visual and auditory function is impaired.

The atonic form of cerebral palsy is a complex pathological process that leads to a variety of undesirable effects. The symptomatology of the pathology is pronounced, which makes it possible to detect it in a timely manner. Since there is no scheme for effective treatment of pathology, it is recommended to carry out its prevention, which consists in careful planning of pregnancy.

double hemiplegia

This is the most severe form of cerebral palsy occurs with significant brain damage in the period of intrauterine life.

Movement disorders are detected already in the neonatal period, as a rule, there is no protective reflex, all tonic reflexes are sharply expressed.

The functions of the arms and legs are practically absent. The mental development of children is usually at the level of mental retardation in a moderate or severe degree.

Spastic diplegia

This is the most common form of cerebral palsy, known as Little's disease or syndrome. In terms of the prevalence of motor disorders, spastic diplegia is tetraparesis (i.e., the arms and legs are affected), but the lower limbs are affected to a much greater extent.

In children with spastic diplegia, secondary mental retardation is often observed, 30-35% of children suffer from mild mental retardation. 70% have speech disorders in the form of dysarthria, much less often in the form of motor alalia.

Depending on the severity of motor disorders, there are severe, moderate and mild degrees of spastic diplegia.

Hemiparetic form

With this form, one side of the body is affected, the left side with a right-sided brain lesion and the right side with a left-sided one. With this form of cerebral palsy, the upper limb is usually more severely affected. Right-sided hemiparesis is more common than left-sided.

Hyperkinetic form

Atonic-astatic form

mixed form

With it, there are combinations of all the above forms: spastic-hyperkinetic, hyperkinetic-cerebellar, etc. Speech and intellect disorders occur with the same frequency.

5. Etiology and pathogenesis of cerebral palsy

The term "cerebral palsy" combines syndromes of movement disorders resulting from brain damage in the early stages of ontogenesis.

Pathogenesis of cerebral palsy

Structural changes in the brain in children with cerebral palsy are divided into two groups:

Nonspecific changes in the cells themselves;

Changes associated with impaired brain development, i.e., with dysontogenesis.

The most vulnerable are those processes that are more active at the moment. This can explain the variety of observed morphological changes in the brain of deceased children with cerebral palsy.

There is a relationship between the severity of cerebral cortex impairment and clinical manifestations of movement disorders.

Cerebral palsy is a residual condition, i.e. does not have a progressive course. However, as the child develops, various manifestations of insufficiency of motor, speech and other mental functions may change, which is associated with the age-related dynamics of the morphological and functional relationships of the pathologically developing brain. In addition, more pronounced manifestations of decompensation may be determined by the growing discrepancy between the capabilities of the damaged central nervous system and the requirements of the environment as the child grows. The phenomena of decompensation can also increase with the complication of motor disorders by various pathological neurological and psychopathological syndromes. Among them, the most important are: hypertensive-hydrocephalic syndrome, convulsive syndrome, syndrome of vegetative-visceral dysfunctions, persistent cerebrasthenic syndrome.

The basis of cerebral palsy is intrauterine or perinatal damage to the child's brain under the influence of various adverse factors that acted during the intrauterine period of development and (or) at the time of birth. In more rare cases (about 2-3%), a genetic factor may play a role in the occurrence of cerebral palsy.

Prenatal factors

There are usually 3 groups of these factors:

1. the state of health of the mother;

2. deviations during pregnancy;

3. factors that disrupt the development of the fetus.

Postnatal factors

At the postnatal stage, the following causes of deviations are distinguished:

Injuries: skull and bones, subdural hematomas, etc.;

Infections: meningitis, encephalitis, brain abscess;

Intoxication: drugs, antibiotics (streptomycin), lead, arsenic, etc.;

Oxygen deficiency: suffocation, drowning
and etc.;

With neoplasms and other acquired abnormalities in the brain: brain tumors, cysts, hydrocephalus, etc.

A significant number of cases of cerebral palsy are classified as a group with unknown etiology (according to some authors, up to 30% of cases).

6. Spastic diplegia. Clinical characteristics

This is the most common form of cerebral palsy, known as Little's disease or syndrome. In terms of the prevalence of motor disorders, spastic diplegia is tetraparesis (i.e., the arms and legs are affected), but the lower limbs are affected to a much greater extent.

In children with spastic diplegia, secondary mental retardation is often observed, which can be eliminated by the age of 6-8 if treatment is started early and properly carried out; 30-35% of children with spastic diplegia suffer from mild mental retardation. 70% have speech disorders in the form of dysarthria, much less often in the form of motor alalia.

The severity of speech, mental and motor disorders varies widely. This is due to the time and strength of the action of harmful factors. Depending on the severity of the brain damage, already in the neonatal period, congenital motor reflexes are weakly expressed or do not appear at all: protective, crawling, supports, stepping movements of the newborn, etc., i.e., the basis is violated, on the basis of which the installation reflexes are formed. The grasping reflex, on the contrary, is most often strengthened, as well as tonic reflexes: cervical, labyrinth; and the degree of their severity can increase by 2-4 months. life.

The tone of the muscles of the tongue is sharply increased, so that it is brought to the root, and its mobility is sharply limited. The child's eyes go up. Thus, the functions of vision and speech are drawn into a vicious circle.

With the severity of the symmetrical neck-tonic reflex, when the head is bent, a flexion posture occurs in the arms and an extensor posture in the legs, and when the head is extended, on the contrary, the arms are extended and the legs are bent. This rigid connection of tonic reflexes with muscles by 2-3 years leads to the formation of persistent pathological synergies and, as a result, to persistent vicious postures and attitudes.

By the age of 2-3, vicious postures and attitudes become persistent, and from that time on, depending on the severity of motor disorders, severe, moderate and mild degrees of spastic diplegia are distinguished.

Children with severe unable to move independently or using crutches. The manipulative activity of their hands is significantly reduced. These children do not serve themselves or serve partially. They relatively quickly develop contractures and deformities in all joints of the lower extremities. 70-80% of children have speech disorders, 50-60% - mental retardation, 25-35% - mental retardation. In these children, for 3-7 years or more, tonic reflexes are not reduced and adjusting rectifying reflexes are hardly formed.

Children from medium degree the severity of the motor lesion moves independently, although with a defective posture. They have a well-developed manipulative activity of the hands. Tonic reflexes are expressed slightly. Contractures and deformities develop to a lesser extent. Speech disorders are observed in 65-75% of children, mental retardation - in 45-55%, in 15-25% - mental retardation.

Children with mild degree The severity of motor damage is noted by awkwardness and slowness of the pace of movements in the hands, a relatively slight limitation of the volume of active movements in the legs, mainly in the ankle joints, a slight increase in muscle tone. Children move independently, but their gait remains somewhat defective. Speech disorders are observed in 40-50% of children, mental retardation - in 20-30%, mental retardation - in 5%.

Prognostically, spastic diplegia is a favorable form of the disease in relation to overcoming mental and speech disorders and less favorable in relation to the formation of locomotion.

7. Double hemiplegia. Clinical characteristics

This is the most severe form of cerebral palsy occurs with significant brain damage in the period of intrauterine life. All clinical manifestations are associated with pronounced destructive-atrophic changes, expansion of the subarachnoid spaces and the ventricular system of the brain. There is a pseudobulbar symptom, salivation, etc. All the most important human functions are severely impaired: motor, mental, speech.

Motor disorders are detected already in the neonatal period, as a rule, there is no protective reflex, all tonic reflexes are sharply expressed: labyrinthine, cervical, reflex from the head to the body and from the pelvis to the body. Chain setting reflexes do not develop; the child cannot learn to sit, stand and walk independently.

The functions of the arms and legs are practically absent. Rigidity of the muscles always predominates, aggravated under the influence of 1 remaining intense tonic reflexes (cervical and labyrinthine). Due to the increased activity of tonic reflexes, the child in the position on the stomach or back has a pronounced flexion or extension posture (see Fig. 1). When supported in an upright position, as a rule, there is an extensor posture with the head hanging down. All tendon reflexes are very high, muscle tone in the arms and legs is sharply impaired. Voluntary motor skills are completely or almost not developed [T.G. Shamarin, G.I. Belova, 1999].

The mental development of children is usually at the level of mental retardation in a moderate or severe degree.

No speech: anartria or severe dysarthria.

The prognosis for the further development of motor, speech and mental functions is extremely unfavorable. The diagnosis of "double hemiplegia" indicates the complete disability of the child.

8. Hemiparetic form of cerebral palsy. Clinical characteristics

This form of the disease is characterized by lesions of one-sided arms and legs. In 80% of cases, it develops in a child in the early postnatal period, when, due to injuries, infections, etc., the emerging pyramidal pathways of the brain are affected. With this form, one side of the body is affected, the left side with a right-sided brain lesion and the right side with a left-sided one. With this form of cerebral palsy, the upper limb is usually more severely affected. Right-sided hemiparesis is more common than left-sided. Apparently, the left hemisphere, when exposed to harmful factors, suffers primarily as a younger phylogenetically, the functions of which are the most complex and diverse. 25-35% of children have a mild degree of mental retardation, 45-50% have secondary mental retardation, which can be overcome with timely rehabilitation therapy. Speech disorders are observed in 20-35% of children, more often by the type of pseudobulbar dysarthria, less often by motor alalia.

After the birth of a child with this form of cerebral palsy, all innate motor reflexes are formed. However, already in the first weeks of life, limitation of spontaneous movements and high tendon reflexes in the affected limbs can be detected; the support reflex, stepping movements, crawling are worse expressed in the paretic leg. The grasp reflex is less pronounced in the affected hand. The child begins to sit on time or with a slight delay, while the posture is asymmetrical, which can lead to scoliosis.

Manifestations of hemiparesis are formed, as a rule, by 6-10 months of a child's life, which gradually increase (Fig. 3). Starting from 2-3 years of age, the main symptoms of the disease do not progress, they are in many ways similar to those observed in adults. Movement disorders are persistent, despite ongoing therapy.

There are 3 degrees of severity of the hemiparetic form of cerebral palsy: severe, moderate, mild.

At severe lesions of the upper and lower limbs, pronounced violations of muscle tone are observed according to the type of spasticity and rigidity. The volume of active movements, especially in the forearm, hand, fingers and foot, is minimal. Manipulative activity of the upper limb is practically absent. The hand, the length of all phalanges of the fingers, the shoulder blade, and the foot are reduced. In the paretic arm and leg, muscle hypotrophy and bone growth retardation are noted. Children begin to walk on their own only from 3-3.5 years, while there is a gross violation of posture, scoliosis of the spinal column and pelvic tilt are formed. In 25-35% of children, mental retardation is detected, in 55-60% - speech disorders, in 40-50% - convulsive syndrome.

At moderate lesions of the motor function, violations of muscle tone, trophic disorders, limitation of the volume of active movements are less pronounced. The function of the upper limb is significantly impaired, but the patient can take objects with his hand. Children begin to walk independently from 1.5-2.5 years old, limping on a sore leg, relying on the forefoot. 20-30% of children have mental retardation, 15-20% have mental retardation, 40-50% have speech disorders, and 20-30% have convulsive syndrome.

At mild degree lesions of violation of muscle tone and trophism are insignificant, the volume of active movements in the hand is preserved, but awkwardness of movements is noted. Children begin to walk independently from 1 year 1 month. - 1 year 3 months without rolling the foot in the affected leg. In 25-30% of children, mental retardation is noted, in 5% - mental retardation, in 25-30% - speech disorders.

9. Hyperkinetic form of cerebral palsy. Clinical characteristics

The cause of this form of cerebral palsy is most often bilirubin encephalopathy as a result of hemolytic disease of the newborn. Less commonly, the cause may be prematurity followed by traumatic brain injury during childbirth, in which there is a rupture of the arteries that supply blood to the subcortical nuclei.

In the neurological status of these patients, hyperkinesias (violent movements), muscle rigidity of the neck, trunk, and legs are observed. Despite the severe motor defect, the limited possibility of self-service, the level of intellectual development in this form of cerebral palsy is higher than in the previous ones.

After the birth of such a child, congenital motor reflexes are disturbed: congenital movements are sluggish and limited. The sucking reflex is weakened, coordination of sucking, swallowing, breathing is disturbed. In some cases, muscle tone is reduced. At 2-3 months, sudden muscle spasms may occur. Reduced tone is replaced by dystonia. Adjusting chain reflexes are significantly delayed in their formation. The delay in the formation of adjusting reflexes, muscular dystonia, and subsequently hyperkinesis disrupt the formation of normal postures and lead to the fact that the child cannot learn to sit, stand and walk independently for a long time. Very rarely, a child begins to walk independently from 2-3 years old, most often independent movement becomes possible at 4-7 years old, sometimes only at 9-12 years old.

In the hyperkinetic form of cerebral palsy, hyperkinesis of a different nature can be observed, they are most often polymorphic.

There are types of hyperkinesis: choreiform, athetoid, choreatetosis, parkinsonian tremor. Choreiform hyperkinesis is characterized by fast and jerky movements, most often it is more pronounced in the proximal limbs (see Fig. 4). Athetosis is characterized by slow, worm-like movements that occur simultaneously in the flexors and extensors, and is observed predominantly in the distal extremities.

Hyperkinesis occurs from 3-4 months of a child's life in the muscles of the tongue and only by 10-18 months appears in other parts of the body, reaching its maximum development by 2-3 years of age. The intensity of hyperkinesis increases under the influence of exteroceptive, proprioceptive and especially emotional stimuli. At rest, hyperkinesis is significantly reduced and almost completely disappears during sleep.

Violation of muscle tone is manifested by dystonia. Often, many children have ataxia, which is masked by hyperkinesis and is detected during its reduction. Many children have a decrease in facial expressions, paralysis of the abducens and facial nerves. Almost all children have expressed vegetative disorders, significantly reduced body weight.

Speech dysfunction occurs in 90% of patients, more often in the form of hyperkinetic dysarthria, mental retardation - in 50%, hearing loss - in 25-30%.

Intelligence in most cases develops quite satisfactorily, and learning difficulties can be associated with severe disorders of speech and voluntary motor skills due to hyperkinesis.

Prognostically, this is a completely favorable form in terms of learning and social adaptation. The prognosis of the disease depends on the nature and intensity of hyperkinesis: with choreic - children, as a rule, master independent movement by 2-3 years; with double athetosis, the prognosis is extremely unfavorable.

10. Atonic-astatic form of cerebral palsy. Clinical characteristics

This form of cerebral palsy is much less common than other forms, characterized by paresis, low muscle tone in the presence of pathological tonic reflexes, impaired coordination of movements, balance.

From the moment of birth, the failure of congenital motor reflexes is revealed: there are no support reflexes, automatic gait, crawling, weakly expressed or absent, protective and grasping reflexes (see Fig. 6). Reduced muscle tone (hypotension). Chain adjusting reflexes are significantly delayed in development. Such patients begin to sit independently by 1-2 years, walk -6 years.

By the age of 3-5, with systematic, directed treatment, children, as a rule, master the possibility of voluntary movements. Speech disorders in the form of cerebellar or pseudobulbar dysarthria are observed in 60-75% of children, there is a mental retardation.

As a rule, with this form of cerebral palsy, the fronto-iosto-cerebellar pathway, frontal lobes and cerebellum are affected. Characteristic symptoms are ataxia, hypermetria, intentional tremor. In those cases where there is a pronounced immaturity of the brain as a whole, and the pathological process extends mainly to its anterior sections, mental retardation is found more often in mild, less often moderate severity, euphoria, fussiness, and disinhibition are observed.

This form is prognostically severe.

11. Early diagnosis and prognosis of the development of children with cerebral palsy

Establishing an early diagnosis of cerebral palsy is very important for the effectiveness of its subsequent treatment. Such a diagnosis is rather complicated, which, unfortunately, is facilitated by the fact that such a diagnosis is not given sufficient importance.

Usually, the assumption of the presence of cerebral palsy is confirmed in the second half of the first year of life, when movement disorders become noticeable. At the same time, it showed that when examining children aged 1, 6, 8, 12 months. in high-risk groups using sensorimotor indicators on the appropriate scale by 6 months, highly informative data on the possible course of further development of cerebral palsy can be obtained. An analysis of individual indicators of deviations showed that if by 8 months there are three or more altered indicators of development, then the possibility of developing cerebral palsy is high.

At the same time, compared with healthy children, already at the age of 4 months, children with cerebral palsy have significantly reduced indicators of the development of intellectual abilities. As a symptom suspicious of the presence of cerebral palsy, a change in muscle tone, the state of "childish" reflexes, a delay in the development of movement, and atypical movements are usually considered.

Even in children with relatively mild manifestations of motor disorders, there is a delay in mental and speech development in the first years of life. In some patients, this condition is further smoothed out, but in some children certain disorders of mental development and speech remain of varying degrees of severity. Most patients with cerebral palsy have disorders of vision, kinesthesia, vestibular system, body scheme, which entails a pathology of spatial representations, and hence reading and writing disorders, a restriction in the choice of profession.

Some children with cerebral palsy have a strong decrease in activity, a lack of motivation to act and communicate with others, impaired development of cognitive activity, emotional and volitional disorders, and there are certain attention disorders: low activity, inertia, difficulty in engaging in purposeful activities, high distractibility, etc. d.

In the syndrome of cerebral palsy, intellectual disorders are of great importance, which are characterized by a dissociated development of mental functions. Such violations are different in nature and degree in various forms of cerebral palsy.

Damage to still immature brain structures significantly affects the further development of cognitive processes and the personality of children with cerebral palsy. It is known that dead nerve cells are not capable of recovery, but the extraordinary functional plasticity of the child's nervous tissue contributes to the development of compensatory capabilities. Therefore, corrective work started in a timely manner with sick children is important in overcoming speech disorders, visual-spatial functions, and personal development.

Long-term experience of domestic and foreign specialists working with children with cerebral palsy has shown that the earlier the medical, psychological and pedagogical rehabilitation of these children is started, the more effective it is and the better its results.

Of particular difficulty is the prognostic assessment of the psychomotor development of children with cerebral palsy. A favorable prognosis is most likely in spastic diplegia and hemiparetic forms of cerebral palsy.

12. Clinical symptoms of damage to the motor sphere in cerebral palsy

It is possible to identify the broken links common to all forms of cerebral palsy, which constitute the structure of the motor defect in cerebral palsy.

1. The presence of paralysis and paresis.

Central paralysis - complete inability to make voluntary movements Paresis - a weak form of paralysis, which is expressed in limiting the ability to make voluntary movements (limitation of range of motion, decreased muscle strength, etc.). Central paralysis and paresis are caused by damage to the motor areas and motor pathways of the brain.

2. Violation of muscle tone.

Spasticity, muscle hypertension - increased muscle tone.

Muscular dystonia - variability in muscle tone.

Muscular hypotension - muscles are characterized by weakness, flabbiness, lethargy.

3. Increased tendon and periosteal (periosteal) reflexes (hyperreflexia) .

Tendon and periosteal reflexes are increased, the zone of their induction (reflexogenic zone) is expanded. The extreme degree is manifested by clonus - rhythmic, long-lasting contractions of a muscle that occur after its sharp stretching.

4. Synkinesis (friendly movements) .

Synkinesias are involuntary movements accompanying voluntary ones. There are physiological and pathological synkinesis.

5. Insufficient development of chain rectifying reflexes .

With underdevelopment of these reflexes, it is difficult for a child to keep the head and torso in the desired position.

6. Unformed reactions of balance and coordination of movements.

The balance of the body is the state of a stable position of the body in space. There is a static balance of the body (when standing) and a dynamic balance (when moving).

Disturbances in body balance and coordination of movements are manifested in an abnormal gait, which is observed in various forms of cerebral palsy.

7. Violation of the sensation of movements (kinesthesia).

In all forms of cerebral palsy, kinesthetic sensitivity is disturbed, which leads to difficulties in determining the position of one's own body in space, to difficulties in maintaining balance and maintaining a posture, to impaired coordination of movements, etc. Many children have a distorted perception of the direction of movement. For example, the movement of the hand forward in a straight line is felt by them as a movement to the side.

8. Violent movements.

Violent movements are expressed in hyperkinesis. Violent movements significantly complicate the implementation of arbitrary motor acts.

9. Protective reflexes.

Symptoms of damage to the pyramidal system, manifested in central paralysis. Protective reflexes are involuntary movements, expressed in flexion or extension of a paralyzed limb when it is stimulated.

10. Pathological reflexes (flexion and extension).

Pathological reflexes are called, which in an adult healthy person are not caused, but appear only with lesions of the nervous system.

Pathological reflexes are divided into flexion and extensor (for limbs). 11.Pozotonic reflexes.

Pozotonic reflexes are congenital unconditionally reflex motor automatisms. With normal development by 3 months. In life, these reflexes already fade away and do not appear, which creates optimal conditions for the development of voluntary movements. Preservation of postural reflexes is a symptom of CNS damage, a symptom of cerebral palsy.

13. Characteristics of motor functions in children with cerebral palsy

In children with cerebral palsy, the formation of all motor functions is delayed or impaired: holding the head, skills of sitting, standing, walking, and manipulative activity. Large variations in the timing of the development of motor functions are associated with the form and severity of the disease, the state of intelligence, with the time of the beginning of systematic treatment and correction work.

For children with cerebral palsy in the first five months of life, a strong lag in the development of their motor functions is characteristic.

Only a small part of children can hold their head by 5 months. They have a pathological condition of the hands, characterized by bringing the first finger to the palm and tightly clenching the fists. In some cases, the brush is paretic, hanging down. The vast majority of children lack hand-eye coordination. The position of the child's body in some cases is forced with the head thrown back, which limits the child's field of vision and is one of the reasons for the delay in his mental development from the first months of life. The general muscle tone is pathologically changed, in most cases with a tendency to increase it. Already at this age, a delay in motor development is combined with a lag in the development of voice activity and orienting-cognitive activity of the child.

By 12 months, only a small number of children hold their heads, mostly children cannot sit on their own, which negatively affects the development of their cognitive activity. Most children have a pathological condition of the hands, insufficiency or lack of visual-motor coordination and manipulative activity.

Only some children can stand at the support, and many have a forced position of the body, the impossibility of turning from side to side, pathological support when trying to put them on their feet.

By the age of two, some children still do not hold their heads well, do not know how to freely turn it and look at their surroundings. They are not able to turn and change the position of their body, sit independently, grab and hold toys. In most cases, the children's hands are clenched into fists, the first finger is tightly brought to the palm, and its participation is impossible when grasping toys. Only very few children have access to objective activities with the help of an adult. In all cases, there is a pathological change in muscle tone.

Only some children can stand at the support, step over with support by the hands. As a rule, disorders of voluntary motor skills are combined with a pronounced pathology of the articulatory apparatus, voice, and breathing. At the same time, a number of children have a rather high level of emotional reactions and cognitive activity in general. In children with a pronounced pathology of the motor sphere and articulatory apparatus, pre-speech vocal activity is practically absent in this age period.

14. Sensory disorders in children with cerebral palsy.

Perception in children with cerebral palsy differs significantly from the perception of normally developing children, and here we can talk about a quantitative lag behind age standards, and about a qualitative originality in the formation of this mental function.

In a child with cerebral palsy, to an optical and sound stimulus, general movements are inhibited. At the same time, there is no motor component of the orienting reaction, i.e. turning the head towards the source of sound or light. In some children, instead of orienting reactions, protective-defensive reactions occur: startle, crying, fright.

In children with cerebral palsy, impaired visual perception (gnosis) makes it difficult to recognize complicated variants of subject images (crossed out, superimposed on each other, “noisy”, etc.). Significant difficulties are observed in the perception of conflicting composite figures (for example, a duck and a hare). Some children often retain a visual trace from the previous image for a long time, which interferes with further perception. There is a fuzzy perception of pictures: children can “recognize” the same picture with a familiar object in different ways.

Violation of visual perception may be associated with visual impairment, which is often observed in children with cerebral palsy.

Some children with cerebral palsy have hearing loss, which negatively affects the formation and development of auditory perception, including phonemic (indistinguishability of words similar in title: "goat" - "spit", "house" - "tom"). Any violation of the hearing of perception leads to a delay in speech development. Errors caused by a violation of phonemic perception are most clearly manifested in writing.

A weak sense of one's movements and difficulties in carrying out actions with objects are the reasons for the lack of active tactile perception in children with cerebral palsy, including recognition of objects by touch (stereognosis). It is known that in a healthy child, the first acquaintance with objects of the surrounding world takes place by feeling objects with his hands. Stereognosis is an innate property, and is acquired in the process of subject-practical activity of the child. In most children with cerebral palsy, there is a limitation in object-practical activity, groping movements of the hands are weak, tactile recognition of objects by touch is difficult.

15. Violation of visual-motor coordination in children with cerebral palsy.

For the formation of subject-practical and cognitive activity, the coordination of hand and eye movements is important. At first, a healthy child, moving his hand within the field of vision, does not pay attention to it. Further, the gaze begins to follow the hand, and then direct the movements of the hand.

In children with cerebral palsy, as a result of damage to the motor sphere, as well as the muscular apparatus of the eyes, the coordinated movements of the hand and eye are underdeveloped. In this case, children are unable to follow their movements with their eyes, which prevents the development of manipulative activity, design and drawing, and further inhibits the formation of learning skills (reading, writing) and cognitive activity.

Visual-motor coordination is especially important at the initial stage of learning to read, when the child traces the movement of the finger with the eye, indicates and determines the sequence of letters, syllables, words. The technique and fluency of reading are formed on this basis. Such students do not keep the working line in a notebook or while reading, because they slip from one line to another, as a result of which they cannot understand the meaning of what they read and check their letter.

The lack of formation of visual-motor coordination is manifested not only in reading and writing, but also in mastering self-service skills and other labor and educational skills.

For the same reason, the process of forming self-service skills slows down. The inability to follow the actions of their hands with their eyes, to coordinate the movements of the hand and the eye leads to insufficient organization of a voluntary motor act in physical education classes: children cannot keep a target, they find it difficult to throw and catch the ball, to master the skills and abilities in other sports games.

16. Violation of spatial analysis and synthesis in children with cerebral palsy.

In children with impaired fixation of the gaze, with insufficient tracking of the object and limitation of the field of view, pronounced spatial disturbances can be observed. Children especially find it difficult to determine the right and left sides of their body and the body of a friend, in showing its parts. The necessary knowledge for the formation of spatial concepts of “left” and “right” is developed on the basis of a preserved perception of the body scheme. In children with cerebral palsy, violations of the body scheme are often noted, they are especially pronounced when the left limbs are affected. The child hardly perceives, remembers parts of his body, gets confused for a long time in determining the direction.

At the initial stages of schooling, it turns out, as a rule, that other spatial representations, such as “above”, “below”, “left”, “right”, “behind”, are not assimilated by children.

Spatial analysis is carried out by a whole complex of analyzers, although the main role belongs to the motor analyzer, which is the main broken link in cerebral palsy. Due to motor insufficiency, limited field of vision, impaired gaze fixation, speech defect, the development of orientation in space may be delayed, and by school age, children

Fundamentals of intensive rehabilitation. Cerebral palsy Vladimir Aleksandrovich Kachesov

7.1. ATONIC-ASTATIC FORM of cerebral palsy

Example rehabilitation of a 5-year-old child with atonic-astatic cerebral palsy (from the author's video archive).

Boy Yura, 5 years old, was admitted for rehabilitation due to atonic-astatic form of cerebral palsy.

The boy from the first pregnancy, which proceeded without complications in the mother of 27 years. Delivery is urgent. Long dry period. Stimulation of labor activity. The child was born in blue asphyxia. Apgar score - 5 points. Resuscitation within 5 minutes. Then for a month he was in the department for nursing newborns. After being discharged home, there was a decrease in the tone of all muscle groups. The child did not hold his head. When the body was verticalized, the eyes rolled under the forehead. From the moment he was discharged home, he received nootropics, cerebrolysin, vitamins, massage, and acupuncture. Repeatedly annually he was treated in various rehabilitation centers in Ukraine and Russia. There were no positive dynamics. The child was recognized as unpromising in terms of rehabilitation. Parents were repeatedly offered to take their child to a nursing home.

Upon admission to us for rehabilitation in November 1994, there was a sharp lag in weight, height, and other age-related parametric data. Teeth: 2 upper and 2 lower incisors. At the age of 5, the child looked like one and a half year old children in terms of height and weight. Active movements in the extremities are sluggish, low-amplitude. During the verticalization of the body, a short-term fixation of the eyes in the middle position for 2-3 seconds was noted, then the eyes rolled under the upper edge of the orbits. The head was held by the child for 1-2 minutes in a vertical position. In a horizontal position, lying on his stomach, the child tried to raise his head, but could not turn it. I tried to bend my legs at the hip joints and crawl, but I didn’t have enough strength. Pacifier feeding. The child, according to the mother, never cried in all 5 years of her life. All reflexes are sharply reduced. According to the parents, the last year the child began to periodically make weak sounds. During the inspection period, he did not make a sound. CT scan of the brain showed no gross pathology.

Rehabilitation. Nootropics and cerebrolysin were canceled for the child from the first day. Eleutherococcus was prescribed 10 drops once in the morning for a month. Vitamin "C" 0.25 g, "calcine" 3 times a day. It is recommended to give the child more water, juices. At the same time, procedures were started according to the author's technology (see description of procedures) 2 times a day, in the morning and in the evening. General intensive massage of the whole body and limbs. Interestingly, on the second day in the evening after three procedures, the child was able to raise his head and roll over in bed on his own. On the third day, he was already crying and actively resisting the procedures, although he was still very weak. The mother noted a sharp increase in the child's appetite. By the end of the week, the child was able to sit up on his own without support in bed, actively cooed and made various sounds. He began to reach for bright toys. The tone in the legs and arms sharply increased, by the end of the second week the child actively tried to crawl, rolled from back to stomach, from stomach to back, tried to rise in the crib. By the end of the second week, the mother noted the eruption of new teeth. Discharged after 2 weeks for admission to the continuation of rehabilitation after 3 months.

Three months after the first course of intensive rehabilitation, the parametric characteristics of the child (height, weight) corresponded to the age of 3 years. The number of teeth increased to 15. The movements in the arms were in full, some hypertonicity of the flexors of the upper and lower extremities was determined. Eats on its own. Can walk, the trunk holds straight, but there is a predominance of flexor tone and rotation of the feet inward. He speaks tongue-tied, but the vocabulary is large. Reads poetry. The child has a good memory. It is amazing that the child is trying to tell with emotions and details about the first days of rehabilitation.

The 2nd course of rehabilitation lasted for 2 weeks with the use of a medical suit DK (see description in the following chapters). The child began to speak more clearly, count up to 20. He learned to ride a 3-wheeled bicycle, which he did all day long. During the rehabilitation period, the legs stretched out, straightened, but a slight rotation of the feet inward remained.

During the year, the child's parents used the DK medical suit. Follow-up after a year showed that the child is developing rapidly. At the time of examination, the child was one year behind his peers in terms of height and weight. The intelligence of the child was even higher than that of peers. Knows a lot of poetry, can read, write in block letters, count up to a thousand. Walks and runs freely, but remains a slight rotation of the feet inward.

This example convincingly indicates that atonic-astatic forms of cerebral palsy can be corrected even faster than spastic forms. During the first course of rehabilitation measures for children with atonic-astatic form of cerebral palsy, it is necessary to prescribe a hard general massage of the whole body and limbs. At a certain stage of recovery, such a child will have a clinic that resembles a spastic form of cerebral palsy with predominant lower paraparesis. But this clinic will differ from the true form of spastic paraplegia by the absence of spastic, uncontrolled movements, the absence of hyperreflexia and hyperesthesia. This clinic can be explained by the “shortened muscle syndrome”, which develops due to the rapid growth of bones and the lag in the growth and development of the abductor and extensor muscles. Physiotherapy, massage, exercise therapy lead to accelerated development of muscles, normalize the balance of muscles, align posture, eliminate growth deformities of long tubular bones. Accelerated growth and teething in the first month of rehabilitation are an objective criterion for the positive dynamics of the rehabilitation process and the development of the body.

This text is an introductory piece.

FORM AND FIELD At the beginning of the 20th century, the German embryologist Hans Adolf Edvard Driesch performed an experiment that went down in history. Divided in half the egg of a sea urchin, a simple creature that has a spherical shape. Since the sea urchin is a relatively primitive organism, this

Hebephrenic form Seemingly opposite to the simple form is the hebephrenic form. If, in simple schizophrenia, apathy and inactivity of the patient are striking, then here - over-initiative and over-mobility, which, however, differ in their specificity.

Catatonic form While emptiness is the main feature of the simple and hebephrenic forms of schizophrenia, motor dynamics highlight the catatonic form. In the animal world, as well as in humans, two extreme forms of motor expression are observed: freezing in

The delusional form An essential feature of the delusional form is a change in the structure of both one's own (internal) and the surrounding world. In principle, this is characteristic of any form of schizophrenia. An outstanding modern French psychiatrist G. Hey (8) considers delirium to be axial

II. Perfect Shape I once went to a yoga class where a male teacher showed students a picture of a beefy bodybuilder and made fun of his physique. The message was clear and unequivocal: yoga makes people more perfect physically, the burden on these

FORM OF USE In medicine, a dry, peeled root is usually used in the form of an infusion or decoction, and ginger tea is also widely used. For the treatment of skin diseases, ginger powder mixed with other substances until it turns into a pulp can be used. AT

Form and emptiness A man has a penis, a woman has a vagina. The penis is fullness, the form, the vagina is emptiness. There is always emptiness around the form, through this emptiness the form defines itself. Therefore, a man always needs a woman - so that he can define himself. Female

The form of emptiness Once upon a time, all the things around us were dual pairs, that is, emptiness, that is, they had no form. Speaking in terms of linear time, this was when the world did not yet exist, it was just about to be born. The egg and sperm are also

The shape of the hand It is believed: the wider the palm, the stronger the health. However, people with wide palms and short fingers are prone to disorders in the circulatory system, primarily to hypertension. Narrow palms with thin long fingers and pale skin, as a rule, occur in people

Nail shape There are 5 basic nail shapes: round, oval, square, rounded square and pointed. The shape of the nails indicates not only the profession, but also indicates the state of health, so women with age should monitor their

FORM OF COMMUNICATION If there are no objections, we will continue to communicate on "you". In the manner in which friends or close people communicate. It is a direct, open and trusting form of communication. It emphasizes the inner unity of the teacher with the student. It excludes the possibility of ambiguities,

Athlete Uniform Athletes are required to compete in a uniform that must be clean, smart and meet the following criteria: - the suit may consist of one or two pieces, but must completely cover the body of the athlete; - sports or cycling shorts,

Outstanding form I returned from a European tour shattered, thinking more about the upcoming survey for the title of land surveyor than about running. However, I was constantly haunted by the thought that the selection for the team for the British Games was coming up in the summer and that at these Games,

Form 7 "Raise the ball" There are options: "Keep the ball in front of you at shoulder level" (although there is no static at all) or "Raise the ball with one hand", as well as an obvious riddle - "Pull the ball in front of the shoulders." Execution A smooth transition from "Boats ...". When the next

Form 22 Fencing off Movement One Penetrating Hand and Arm Rotation 1. Turn the palm of your left hand up and from a position under your right wrist, move your left hand forward. Following this, open your right fist and turn your hand up. Performed

Form 23 Crossing Arms Movement One Trunk Rotation and Foot Retraction 1. Bend your right knee and squat back, shifting your body weight onto your right leg. Turn your torso to the right, direction - to the south. Turn the front of your left foot

Collection output:

ATONIC-ASTATIC FORM OF CHILDHOOD CEREBRAL PALSY. CORRECTION OF MOTOR AND SPEECH DISORDERS

Dementieva Elena Valerievna

neurologist, CJSC STK Reacenter, Samara

Ukhanova Tatyana Alekseevna

cand. honey. Sci., Leading Neurologist, CJSC STK Reacenter, Samara

In the atonic-astatic form of infantile cerebral palsy (ICP), muscle tone, unlike other forms of this disease, is classified as hypotension, but their characteristic static and dynamic ataxia, hypermetry and intentional tremor significantly complicate the acquisition of new motor skills. Patients with atonic-astatic form of cerebral palsy initially find it difficult to maintain balance and master the creation and inclusion of physiological synergies in the process of movement. In most cases, morphological studies indicate underdevelopment of the cerebellum, its atrophy or dysplasia in patients with this group of cerebral palsy. However, vestibular functions, and above all, the sphere of coordination of movements and maintaining posture, are subject to positive changes as a result of targeted training and comprehensive rehabilitation. With the localization of the pathological process in the frontal lobes of the brain in the clinical picture, mental retardation prevails over delayed motor development with pronounced motor demotivation. In these cases, an integrated approach is required in the treatment and rehabilitation of patients in order to improve vestibular functions and increase the functional activity of motor zones located in the frontal sections of the cerebral cortex. In recent years, in the rehabilitation of patients suffering from atonic-astatic form of cerebral palsy, modern methods of treatment have been used that not only correct muscle tone and reflex activity, but also have a direct impact on the restoration of neurophysiological functions of the brain due to the normalizing effect on cerebral metabolism and fine neurochemical regulation. To correct motor and speech disorders, the effect of microcurrent reflex therapy (MTRT) on the muscles of the musculoskeletal and articulatory apparatus, which are in a state of hypotonicity, is actively used. Exposure to a stimulating alternating current allows you to activate trophic processes and start the mechanism of reinnervation of the hypotonic muscles of the musculoskeletal system. The impact on the zones of craniotherapy with a current of the microampere range improves the functional activity of the frontal cortex affected by hypoxia. Providing a therapeutic effect on corporal biologically active points (BAP) of the craniospinal region contributes to the stabilization of the reflex activity of the cerebellum.

In conditions of oxygen and energy deficiency that occurs with cerebrovascular lesions, the drug Actovegin is of particular value - an antioxidant, a deproteinized extract of the blood of young calves. Its main action is to improve the utilization of oxygen and glucose. Under the influence of the drug, oxygen diffusion in neuronal structures is significantly improved, which makes it possible to reduce the severity of secondary trophic disorders, cerebral and peripheral microcirculation is significantly improved against the background of improved aerobic energy exchange of vascular walls and the release of prostacyclin and nitric oxide. The use of Actovegin also contributes to an increase in the concentration of acetylcholine in the structures of the brain, which is a necessary factor for improving neuromuscular transmission. Thus, the use of the drug Actovegin will also increase the effectiveness of stimulation of hypotonic muscles using MTRT by restoring the balance of the neurotransmitter acetylcholine in the body.

However, to date, no clinical trials have been conducted to evaluate the effectiveness of Actovegin in the complex treatment of patients with atonic-astatic form of cerebral palsy.

To study the effectiveness of complex treatment in the form of a combination of Actovegin with MTRT in patients with a diagnosis of cerebral palsy, atonic-astatic form, chronic residual stage, 46 children aged 3 to 7 years were examined and treated. The treatment was carried out on an outpatient basis at the Children's Department of Neurology and Reflexology of the Samara Therapeutic Complex "Reacenter".

All 46 patients underwent preliminary magnetic resonance imaging (MRI) of the brain and electroencephalogram (EEG). MRI revealed signs of organic brain damage in the form of combined hydrocephalus with a predominance of the external form, with a characteristic expansion of the subarachnoid cerebrospinal fluid spaces along the convex, up to atrophy of the frontal lobes; identified areas of demyelination and/or cystic changes in the white matter of the frontal areas of the cerebral hemispheres of the cortex; hypo- or dysplasia of the vermis and cerebellar hemispheres, expansion of the large occipital cistern or the presence of a retrocerebellar cyst. The EEG revealed signs of disorganization of the cortical rhythm, a slowdown in the development of the bioelectrical activity of the brain, the presence of dysfunction of the mid-stem structures of the brain, and, in some cases, a decrease in the threshold of convulsive readiness.

All patients in the study of neurological status underwent palpation examination of muscle tone, as well as observation of the motor activity of the child in a familiar environment to assess the volume of active movements in the limbs. In all 46 patients, neurological examination revealed signs of static and dynamic ataxia, dysmetria, intentional tremor, severe hypotension of the muscles of the upper and lower extremities. In 18 patients, signs of static ataxia predominated - balancing movements of the head and torso were noted, the children did not sit or stand on their own, when they were deprived of support, the protective reaction of the hands and compensatory movements of the torso aimed at maintaining balance were absent. In 16 patients, motor skills were formed - the children held their heads, sat independently and stood at the support, however, they had signs of dynamic ataxia (shaky gait, legs wide apart, jerky, excessive, awkward movements). In 12 patients with a predominance of organic damage to the frontal parts of the cerebral hemispheres, a sharp decrease in motor, mental and speech initiatives was also noted. In all patients, during a standard speech therapy examination, a general speech underdevelopment with elements of cerebellar dysarthria was revealed: asynergy of the muscles of the speech apparatus with characteristic signs - a weak air stream, chanted speech, and in severe cases, pronunciation of only the first syllable from the word. All 46 patients received basic treatment: MTRT, repeated courses of manual limb massage with elements of exercise therapy. They were randomized into 2 groups. The first group included 24 patients who received, against the background of the basic treatment, repeated course treatment with Actovegin according to the method described below. In the second - 22 patients who received basic treatment.

To conduct microcurrent reflexology, we used a device approved for serial production and use in medical practice “Microcurrent electroacupuncture computer stimulator “MEKS”, which allows you to use the required number of acupuncture points per treatment session, since when an acupuncture point is exposed to a constant alternating current of microampere range, there is no destruction of the structures of biologically active points (BAP), which is characteristic of acupuncture. The use of MTRT allows you to control the location of the BAP. As a monitoring of the treatment process, electropuncture diagnostics according to I. Nakatani is used, with the help of which the state of acupuncture meridians is assessed and control points are selected based on objective data on the state of the patient's autonomic nervous system.

MTRT was carried out in 3 courses, consisting of 15 procedures, the duration of each procedure was 40-50 minutes. The courses of treatment were carried out intermittently: 1 month after the 1st course and 2 months after the 2nd course of treatment. The method of treatment was as follows: the impact was carried out sequentially on the BAP of the craniospinal region, on the zones of cranioacupuncture, on the BAP over the hypotonic muscles. The impact was carried out in two modes: braking mode - a constant negative current, with a power of 80 μA; excitation mode - alternating current, with a polarity reversal frequency of 0.5 Hz, with a power of 80 μA. The exposure time for each BAT is 60 sec. The inhibition mode was applied when the corporal BAPs were exposed to the classical meridians (English abbreviation) of the craniospinal region: GB20, GB21, GB12, BL11, LI15. The excitation mode was used when acting on the zones of cranioacupuncture and when acting on local BAP located in the center of the projections of the paretic muscles on the skin. During the MRI procedures, the patients were in a state of calm wakefulness, in the supine position.

Actovegin (Nycomed, Austria, 2 ml ampoules, 200 mg tablets) was used as intramuscular injections at a dose of 0.2 ml/kg/day, but not more than 5 ml once. The treatment course consisted of 10 injections once every other day in the morning. Drug treatment was carried out in 2 courses, after the completion of the 1st and 3rd courses of MTRT.

During the study, all patients with atonic-astatic form of cerebral palsy showed the following positive dynamics: a decrease in the phenomena of static and dynamic ataxia in the form of a decrease in the amplitude of balancing movements of the head and trunk, elements of overshooting and intentional tremor was noted in all 24 patients of group I and 22 patients of group II groups. At the same time, some patients developed new motor skills: 18 people (75%) from group I and 13 people (59%) from group II learned to hold their heads and sit independently, and 16 people (67% ) from group I and 12 people from group II (55%). Patients also noted an improvement in speech function: an increase in the air stream, an increase in the volume of speech and the appearance of the skill of continuous pronunciation of words, an expansion of vocabulary and the development of the skill of constructing phrases and simple sentences of 2-3 words. Thus, in group I, positive dynamics in the form of a decrease in the degree of speech underdevelopment was observed in 18 patients (75%), and in group II, in 11 patients (61%). A decrease in the degree of dysarthria, taking into account the severity of neurological dysfunction, was noted in group I from 21 ± 3 points to 7 ± 2 points, in group II from 22 ± 3 points to 17 ± 2 points.

The results of the study demonstrated the high efficiency of the combined use of actovegin and MTRT in patients with atonic-astatic form of cerebral palsy due to the correction of hypotonic muscle tone, cerebellar reflex activity, and an increase in the functional activity of the motor areas of the frontal parts of the brain.

Thus, the combined use of Actovegin with MTRT is advisable to use in the complex rehabilitation of patients with atonic-astatic form of cerebral palsy.

Bibliography:

1. Gorsheneva S.V. Guidelines for the course "Neuropsychology", Samara State Pedagogical University Samara 1999, - 115 p.
2. Kryukov N. N., Levin A. V., Ukhanova T. A., Gavrilov A. P. Electropuncture diagnostics and therapy of diseases of the nervous system and disorders of psychological development in children. Educational and methodical manual for doctors, Samara 2008, - 44 p.
3. Levina R. E. Speech and writing disorders in children. M., Arkti, 2005, - 222p.
4. Macheret E. A., Korkushko A. O. Fundamentals of electro- and acupuncture. Kyiv: "Health", 1993, - 137 p.
5. Petrukhin A.S., Neurology of childhood. M.: Medicine 2004 -783 p.
6. Portnov FG Electropuncture reflexology. Riga: "Zinatne", 1988, - 352 p.
7. Skoromets T. A. Secondary cerebral ischemia in the acute period of traumatic brain injury. Abstract of diss. … Dr. med. Sciences. - SPb., 2002, -41 p.
8. Skvortsov I. A., Ermolenko N. A. Development of the nervous system in children in normal and pathological conditions. M: "MEDpress-inform", 2003, -367p.
9. Stoyanovskiy D. N. Reflexology, Chisinau. Cartya Moldoveneasca 1987, - 381 p.
10. Ukhanova T. A., Gorbunov F. E., Levin A. V., Grishina I. G., Dementieva E. V. Microcurrent reflexology in the complex treatment of patients with cerebral palsy. Tez. All-Russian forum "Zdravnitsa 2010". Modern trends and prospects for the development of resort business in the Russian Federation. M., 2010, - 158 p.

Infantile paralysis of the central nervous system or cerebral palsy is formed against the background of damage to various parts of the brain and causes a disorder of motor functions in a child. Atonic-astatic form of cerebral palsy is one of the most severe types of the disease. Today, doctors do not have effective remedies for the treatment of serious disorders in the functioning of the nursery, but some techniques can reduce negative manifestations. These include medical treatment.

The importance of exercise therapy in cerebral palsy

1. The child goes down into the pool, takes his hands overboard. The legs are alternately laid back (5 times each). Then leg extensions are made to the sides 10 times.
2. Turning his back to the side, the baby clings to him with his hands, lifts his legs up and spreads them to the sides. Do this 10 times.
3. Having laid the patient with his back on the water, it is necessary to let him grab the side. Mom puts her hands behind the baby's back. Starts lifting both legs up (10 times), spreading them to the sides (10 times), crossing the legs (“scissors” 10 times).
4. Turn the patient over on his stomach, let him hold his hands over the side, and you support him by the stomach. Do alternating leg raises 5 times, then parting to the sides 10 times, and bending at the knees of each limb 5 times.
5. Having pressed the child with his back to the pool, ask him to take a sitting position. Then he must twist the “bicycle” with his legs in the water.

Additional simulators

To harmonize the intellectual and physical development of children with cerebral palsy, it is necessary to use, which you can buy or do it yourself. The bumpy rug is perfect for therapeutic massage and physical education, it will improve blood circulation in the limbs. In specialized pharmacies, rugs of different sizes are sold: separately for the foot, for the entire body. A rug can be placed near the baby's crib so that in the morning he can walk on it.

To eliminate spasticity of the fingers, which is often observed in patients with cerebral palsy, sew a bag and fill it with cereals (rice, buckwheat). Such a homemade expander will prepare your hands for grasping and manipulating objects. So you get a wonderful one. Useful for the limbs of the baby and classes with jumpers and walkers.

Note!

You should not buy a plastic walker for a patient with cerebral palsy, they are unstable and can harm the child.

Brain diseases that develop in babies require patience and perseverance from parents so that the life of the child is happy and rich. Of course, there can be no question of a complete cure, but the exercise therapy complexes that are created for such children can achieve a lot. They increase the physical abilities of children and make life easier for parents. Lesson programs are compiled individually, but if they are regularly performed, they provide a common success for all.

Video - An unusual exercise for children with cerebral palsy