Improving the availability and quality of medical care and rehabilitation in children with cerebral palsy

Nowdays, cerebral palsy is a leader in the structure of chronic diseases of childhood. The earliest start of the rehabilitation of children with cerebral palsy, continuity and phasing their implementation, systematic and comprehensive, individual approach provide children with cerebral palsy to attain optimal physical, intellectual, psychological and/or social functional levels and to support it, thereby giving them tools designed to change their lives and expand their independence According to the latest scientific data in Russia today more than 40 % of newborns have various health disorders. Disease of the newborn, threatening the formation of cerebral palsy in almost half of cases partially or completely curable, but it requires time to diagnose them and begin proper rehabilitation treatment. It was in early childhood may successfully correct the existing neurological and orthopedic disorders, minimizing the effects of damage to the central nervous system. Introduction to the complex rehabilitation of patients with cerebral palsy high-tech methods of rehabilitation treatment will provide for pathogenetic treatment and significantly increase the speed of recovery of disturbed functions that will significantly reduce the degree of disability of such patients. Existing conditions of medical care and rehabilitation can not fully ensure a continuous process of complex rehabilitation of children with cerebral palsy. It is necessary to further improve the quality of treatment and rehabilitation, and their accessibility to children with cerebral palsy.

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Rehabilitation Route for a Child with Cerebral Palsy: the Experience of Chuvashia

Physical and rehabilitation medicine, medical rehabilitation ◽

10.36425/rehab46598 ◽

2021 ◽

Vol 3 (1) ◽

pp. 149-158

Author(s):

Svetlana K. Yakovleva ◽

Vera E. Andreeva ◽

Elena V. Preobrazhenskaya ◽

Roza V. Petrova ◽

Oksana I. Milova ◽

...

Keyword(s):

Cerebral Palsy ◽

Conservative Treatment ◽

Medical Care ◽

Risk Groups ◽

High Tech ◽

Highly Qualified ◽

Gait Quality ◽

Children With Cerebral Palsy ◽

Chuvash Republic ◽

The Moment

The most common cause of neurological disability in childhood is cerebral palsy. The objectives of the treatment of children with cerebral palsy are the acquisition and maintenance of new motor skills; prevention of the development of contractures and other secondary orthopedic complications; decrease in the level of pain; improving the level of childcare. At the same time, the provision of treatment and rehabilitation assistance to children with cerebral palsy requires an integrated, systematic approach. The article describes the route of rehabilitation of children with cerebral palsy in the Chuvash Republic from the moment of diagnosis until reaching the age of 18. The study was carried out on the basis of an analysis of data from the regional register of children with cerebral palsy at all stages of treatment and rehabilitation (habilitation). The first stage includes the identification of risk groups for cerebral palsy, conservative, surgical specialized medical care. The register of children with cerebral palsy made it possible to keep records of patients at the stages of treatment and rehabilitation with an assessment of the results. At the second stage, high-tech conservative and surgical treatment is carried out. After operations, patients are sent for rehabilitation to a 24-hour hospital or to a Rehabilitation Center for Children (over 3 years, 1.5 thousand children were treated, 25.7% after operations). The third stage is organized at the outpatient clinic level and in specialized sanatoriums. For 20142018 the coverage of children with cerebral palsy with conservative treatment increased 1.9 times, with botulinum therapy 2.6 times, the proportion of those who received surgery decreased to 22.4%. 92.7% of patients of the Register are covered by conservative treatment. 33.3% of operated children were referred for sanatorium-resort treatment. The control section of the rehabilitation results showed an increase in the proportion of children with improved gait quality, the ability to stand independently, walk (with support), and an increase in the average level of physical activity. A multi-level system of interagency interaction in the provision of treatment and rehabilitation assistance to children with cerebral palsy in Chuvash Republic made it possible to ensure a sufficient amount of basic and availability of highly qualified medical care, effective management and control of the stages of rehabilitation.

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An Interdisciplinary Model of Treatment of Children with Cerebral Palsy in Poland. Recommendations of the Paediatric Rehabilitation Section of the Polish Rehabilitation Society

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0014.0641 ◽

2020 ◽

Vol 22 (1) ◽

pp. 51-59 ◽

Cited By ~ 1

Author(s):

Jolanta Taczała ◽

Olga Wolińska ◽

Jules Becher ◽

Piotr Majcher

Keyword(s):

Cerebral Palsy ◽

Medical Care ◽

Medical Rehabilitation ◽

Treatment Team ◽

Rehabilitation Team ◽

Leading Role ◽

Children With Cerebral Palsy ◽

Paediatric Rehabilitation ◽

Good Medical Care

Medical rehabilitation plays an important leading role in the treatment of children with cerebral palsy (CP). Collaboration between specialists in medical rehabilitation and the rehabilitation team is a prerequisite for good medical care. The quality of medical services for children with CP depends chiefly on the level of expertise of the treatment team. Through training of specialists and sharing of knowledge, we can help more patients. This idea was developed and implemented by Dr Ewa Kooyman-Piskorz, the founder and president of Wandafonds Foundation. Between 2003 and 2014, Dutch specialists working with children with CP conducted a number of training workshops in Poland under the supervision of the Polish Rehabilitation Society and Prof. Jules Becher, a world-famous expert in the rehabilitation of children. Based on these experiences, we present the recommendations of the Paediatric Rehabilitation Section of the Polish Rehabilitation Society regarding an interdisciplinary model of treatment of children with CP in Poland.

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The interdisciplinarity and innovativeness of methods in rehabilitation of children with cerebral palsy

Journal of Education Culture and Society ◽

10.15503/jecs20191.125.135 ◽

2019 ◽

Vol 10 (1) ◽

pp. 125-135

Author(s):

Luba Jakubowska ◽

Magdalena Kazimierska-Zając ◽

Karolina Nowak

Keyword(s):

Quality Of Life ◽

Cerebral Palsy ◽

New Technologies ◽

Holistic Approach ◽

Space Suit ◽

New Methods ◽

Children With Cerebral Palsy ◽

The Central Nervous System ◽

Unconventional Methods

Thesis. Cerebral palsy (CP) is a group of disorders resulting from damage to the central nervous system in the early stages of its development. The aim of the rehabilitation of persons with CP is to make their dependence on the assistance of others as little as possible and to improve their quality of life, as well as the quality of life of their families. New methods are developed in which new technologies are employed and a holistic approach to the patient, requiring the cooperation of specialists in various fields, is assumed. The most commonly used methods of working with children with cerebral palsy include the NDT-Bobath method and the Vojta method. Apart from them unconventional methods are also employed, including hippotherapy, virtual reality, the sensory integration method, the conductive education method, and the space suit method. Aim of the paper. The aim of the paper is to present the methods employed in increasing the agility of children with cerebral palsy. Focus has been placed on traditional and commonly used methods, as well as the unconventional methods which are currently undergoing evaluation. Results. Thanks to diversifying rehabilitation with new methods and enriching it with the experience of specialists in areas outside medicine patients with cerebral palsy are able to fully benefit from their own potential. Quality of life is improved, independence is increased, and new opportunities are discovered. Some of the newest methods may serve to supplement traditional therapies, others can substitute for them in the future. What is crucial is to focus not only on heightening the physical agility of the patients, but also to make the course of the therapy more attractive, and to work on improving the patients’ functioning in other areas of life, as well, such as social contacts or hobbies.

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Hippotherapy: benefits in children with cerebral palsy with application of the Rehabilitation Treatment Taxonomy / Equoterapia: benefícios em crianças com paralisia cerebral com a aplicação da taxonomia de tratamento em reabilitação

Brazilian Journal of Animal and Environmental Research ◽

10.34188/bjaerv4n2-078 ◽

2021 ◽

Vol 4 (2) ◽

pp. 2520-2540

Author(s):

Juliana M. P. Starling ◽

Ana Paula B. Gontijo ◽

Rosana Ferreira Sampaio ◽

Juliana Vaz de Melo Mambrini ◽

Sérgio Teixeira Da Fonseca ◽

...

Keyword(s):

Quality Of Life ◽

Cerebral Palsy ◽

Primary Outcome ◽

Age Groups ◽

Older Children ◽

Rehabilitation Treatment ◽

Longitudinal Measurements ◽

Children With Cerebral Palsy ◽

Secondary Outcomes

Purpose: To explore the effects of hippotherapy for children with cerebral palsy (CP) with different ages, topographies and severities. Method: Before-after study with three longitudinal measurements: (T1) initial, (T2) 3-months, (T3) 6-months after T1. CP children (n=31) stratified by age (4-7; 8-12 years), severity (mild, moderate, severe), topography (hemiplegia, diplegia, quadriplegia), previous hippotherapy time (3-6m, 6 months) undertook their individual weekly 30-minute hippotherapy sessions. Postural control and balance (PCB) was the primary outcome; gross-motor function (GMF) and quality of life (QL) were the secondary outcomes. Results: Changes in PCB associated with changes in GMF. Older children, with mild severity and diplegia had higher PCB and GMF scores between T1 and T3. Age groups’ initial differences in QL disappeared after 6 months. The Rehabilitation Treatment Taxonomy (RTT) guided interpretation of effects. Conclusion: The positive changes in motor and psychosocial outcomes depended on children’s age, time in rehabilitation and type of CP.

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Medical and social portrait of families raising children with cerebral palsy

Kazan medical journal ◽

10.17750/kmj2017-1040 ◽

2017 ◽

Vol 98 (6) ◽

pp. 1040-1043

Author(s):

E S Tkachenko

Keyword(s):

Cerebral Palsy ◽

Medical Care ◽

Family Relationships ◽

Epidemiologic Study ◽

Cross Sectional ◽

Material Wealth ◽

Raising Children ◽

Children With Cerebral Palsy ◽

Quality Of Medical Care

Aim. To perform medical and social characterization of families raising children with cerebral palsy. Methods. The study was performed among families raising children with cerebral palsy and living in Omsk. It is a cross-sectional epidemiologic study. Survey of parents based on our developed questionnaire was performed. A total of 324 families took part in the study. The following factors were evaluated: family structure, character of relationship between members, social and living conditions, satisfaction with the quality of medical care. Results. Medical and social characterization was performed in families raising children with cerebral palsy. In 77% of cases a child was brought up in a traditional family (but in about half of the families after developing apparent abnormalities in a child and making a diagnosis of cerebral palsy, worsening of family relationships occurs). Due to necessity for taking care of the child with cerebral palsy, most of mothers are forced to quit their job that negatively affects the level of material wealth. Availability of their own accommodation was revealed in 64% of responders. Mother’s age at the time of birth of a child with cerebral palsy was primarily in the range from 25 to 29 years. A number of factors adversely affecting the health of children, both in the period of prenatal development and the newborn period: pregnancy with complications, acute respiratory viral infection during pregnancy, smoking during early pregnancy. Role of these factors in developing cerebral palsy was detected by a number of researchers. A number of difficulties met by the family members after bearing a child with developmental disabilities were identified (deterioration of family relationships, decline in material wealth, dissatisfaction with the quality of medical care). Conclusion. After making a diagnosis, family relationships worsen; most families have houses not adapted for defects of a child with cerebral palsy; some features of medical organizations service are revealed that might negatively affect the quality of medical care for children with cerebral palsy.

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Somatoneurological and psycho-pedagogical features of children with cerebral palsy in the context of their readiness for training in Paralympic sports

L.O. Badalyan Neurological Journal ◽

10.46563/2686-8997-2021-2-4-173-188 ◽

2021 ◽

Vol 2 (4) ◽

pp. 173-188

Author(s):

Lale A. Pak ◽

Svetlana B. Lazurenko ◽

Svetlana B. Makarova ◽

Tatyana V. Sviridova ◽

Lyudmila M. Kuzenkova ◽

...

Keyword(s):

Quality Of Life ◽

Cerebral Palsy ◽

Nutritional Status ◽

Support System ◽

Rehabilitation Treatment ◽

Rehabilitation Programs ◽

Wide Range ◽

Adaptive Physical Education ◽

Children With Cerebral Palsy

Introduction. Currently, Russia does not have a scientifically grounded medical and psychological support system for disabled children (DC), which allows involving them in classes in children and youth schools of adaptive physical education, preparing the country’s Paralympic DC reserve. Aim of the study. To develop and create a medical support system for the Paralympic DC reserve, capable of improving their quality of life and forming a medical and social lift. Materials and methods. Children aged from 1 year to 18 years had cerebral palsy (CP) with impaired motor functions of levels I and II according to the global motor function assessment system and the Manual Abilities Classification system and their families were monitored. A comprehensive assessment of the somatic, neurological, mental and nutritional status of CP children) was carried out, and a wide range of comorbid pathology was described. After the rehabilitation treatment with the use of complex personalized rehabilitation programs, dynamic monitoring of the condition of patients with cerebral palsy was carried out, followed by an assessment of the effectiveness of rehabilitation treatment and the impact on it the psychological readiness of patients, their parents to engage in Paralympic sports, as well as the socio-economic level of the family. The attitude of CP children and their parents to participate in the Paralympic movement was studied. All patients underwent a comprehensive study of somatic, neurological, orthopaedic, psychological and nutritional status. The socio-hygienic characteristics of families and the rehabilitation potential of DC and their families have been determined. Results. Children with cerebral palsy have a wide range of comorbid pathology, which requires the involvement of specialists of different profiles in the curation of patients. The use of complex personalized rehabilitation programs allows achieving positive dynamics after 14 days of rehabilitation treatment. Early introduction of botulinum therapy in the rehabilitation program of CP patients provides higher efficiency of rehabilitation treatment. Treatment of protein-energy deficiency in CP children should include correction of the diet using specialized products, metabolic therapy, enzyme and complex vitamin preparations. Differentiated medical, psychological and pedagogical counselling of parents of CP children will allow optimizing the solution of the state problem regarding the timely inclusion of persons with disabilities in adaptive physical education classes. Conclusion. The development and creation of a comprehensive medical and psychological support system solve an urgent medical and social problem, ensuring the integration of DC into society and improving the quality of life of both a sick child and his family members.

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Role and Effects of Hippotherapy in the Treatment of Children with Cerebral Palsy: A Systematic Review of the Literature

Journal of Clinical Medicine ◽

10.3390/jcm10122589 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2589

Author(s):

María José Menor-Rodríguez ◽

Mar Sevilla Martín ◽

Juan Carlos Sánchez-García ◽

María Montiel-Troya ◽

Jonathan Cortés-Martín ◽

...

Keyword(s):

Cerebral Palsy ◽

Developmental Stages ◽

Web Browser ◽

Rehabilitation Therapy ◽

Children With Cerebral Palsy ◽

The Central Nervous System ◽

Disorder Treatment ◽

Meta Analyses ◽

Main Effects

Cerebral palsy is described as a group of permanent neuromotor-type disorders caused by non-progressive injuries in the developmental stages of the central nervous system, and which have serious repercussions on the quality of life of affected children due to the physical and psychological damage it entails for them. Today, it is the leading cause of physical disability in childhood. Since there is no cure for this disorder, treatment is based on the improvement of symptoms, which is not always achieved through conventional therapies. For this reason, the need arises to investigate other alternative therapies, such as hippotherapy, to determine the main effects of hippotherapy as a rehabilitation therapy in children with cerebral palsy. The review was performed in accordance with the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and was registered under the number CRD42021233003. The databases used were PubMed, Dialnet and the web browser Google Scholar. After applying the inclusion criteria, we included 11 articles. As a conclusion, we found that hippotherapy provides benefits at physical, psychological, cognitive and social levels in children with cerebral palsy, and thus it should be considered as a complementary rehabilitation therapy to conventional treatments.

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