Nursing care for cerebral palsy patients:

 

• Cleanliness: regular bath, and timely change of clothes, sheets, bedding, etc.
   
• Cerebral palsy daily care to clean requirements are particularly strict, especially the family can not be ignored.
   
• Indoor environment: the indoor air of cerebral palsy patients should be fresh, well ventilated, and there should be sufficient sunshine and appropriate temperature.
   
• Regular ultraviolet radiation disinfection, to ensure cerebral palsy patients indoor cleanliness.
• Diet nursing: need to supply the food of high protein, high quantity of heat and rich vitamin.
• Diet training should be conducted for patients who have difficulty in eating independently, and their head should be kept in the mid-line position when feeding. Eating with their head back may cause foreign body inhalation.
   
• Strengthen physical exercise: The strength and flexibility of the body is a standard to measure people's health, so some appropriate physical exercise for cerebral palsy patients will help them develop self-care ability, so that the family can get proper physical and mental relaxation.
   
• Pay attention to safety: cerebral palsy patients because of developmental delay, mobility, exercise ability is weaker than ordinary people. So there should be someone to protect it. Always pay attention to safety, so as not to cause accidental injury.

Treatment plans should aim to maximize the child's function and quality of life, minimize secondary joint malformations and soft tissue contracture, and delay or avoid surgical treatment as much as possible.

 

Application of orthoses:

Orthoses are often used in rehabilitation therapy to limit abnormal joint activities, improve stability, assist in controlling muscle spasm, maintain muscle length, prevent malformation and assist in improving exercise function.

The key to the application of orthosis is to choose the best time and type of wearing according to the individual situation of the child, so it should be decided by the rehabilitation physician, therapist and orthosis.

 

Psychotherapy:

Children with cerebral palsy are sometimes accompanied by abnormal psychological and behavioral problems, such as autism, hyperactivity, emotional instability and other symptoms.

A healthy family environment, increased interaction with children of the same age and early intervention are the key to the prevention and treatment of mental behavior disorders.

 

Family Training Program:

The therapist should develop a family training program for children and their parents.

The plan should focus on improving function and preventing secondary impairment, but for particularly severe children, facilitating care and reducing the burden on the family should be the main objectives.

Usually include: understanding of the child's condition and the arrangement of daily life;

Targeted muscle strength and range of motion training;

The treatment of spasm muscle stretching;

Intensive training of functional active activities;

Use of AIDS such as orthoses, chairs, standups and wheelchairs, etc.

 

Medication:

Commonly used drugs are brain neurotrophic drugs, muscle relaxants and so on.

Medication should only be used when necessary and should not replace functional training.

A large number of studies and clinical practice have proved that intramuscular injection of botulinum toxin TYPE A is A safe and effective treatment for spasm.

Generally, the effect of reducing spasm can be maintained for 3 to 8 months. At this time, individualized comprehensive treatment should be carried out in time, such as functional muscle strength training, soft tissue stretching, wearing orthoses, etc., to give full play to the maximum recovery opportunities brought by hypotonia.

4 to 6 months after injection, the spasm will gradually increase, but the improvement in exercise function usually does not disappear, and the injection can be reinjected if necessary.

 

Surgical treatment:

Orthopedic surgery is an option for severe muscle contracture and joint deformity, and all the areas that need to be corrected should be completed in one operation as far as possible to better improve postoperative function.

For children with extensive lower extremity muscle spasm and basically normal muscle strength, selective posterior root resection of spinal nerves can be performed.

No matter what kind of operation, before and after the operation, there should be standard rehabilitation treatment plan to match it.

In short, on the basis of fully understanding the pathologic problems and indications of various methods, it is the key to improve the curative effect to clarify the treatment purpose and correctly and reasonably formulate rehabilitation treatment plan.
 

PS：From top to bottom ; Cognitive Disorder  ;Speak with a lisp; Lack of muscle control; Lack of intestinal control
 

 

Rehabilitation training

 

Children with cerebral palsy are due to prenatal, postpartum or infant, control of the movement of the part of the brain tissue is damaged, resulting in muscle control disorders caused by the body movement and posture difficulties. Once the diagnosis of cerebral palsy in children is confirmed by medical institutions, rehabilitation training should be carried out as soon as possible. The first is the correct holding posture, that is, the child's legs straddle the recovery personnel's waist. In order to strengthen the control of the child's head, it can be made prone with both hands to support the head, chest or supine when the double upper limbs stretch, slowly pull from supine to sitting position. When the child sits on the bed surface, it should be induced to reach forward and side, and gradually appear all directions of protective response, in order to enhance the stability of the sitting position. For children who cannot turn over, when lying supine, bend the lower limbs of the flip side, and assist the flexion leg to drive the body to rotate or hold the upper limbs of the flip side to extend and adduct, and drive the trunk to turn over. Learning to crawl is one of the prerequisites for walking. Children need double upper limb extension support, lower limbs to knee joint support trunk and thigh into 90°. After the posture is stable, a toy with sound and bright color can be placed in front of the child to induce it to reach forward alternately and grasp. At the same time, it can push forward the sole of the child's feet to assist it to move forward. For children who cannot land on the heel when standing, the trainer can hold the heel with four fingers and press the palm to the foot center while lying on their back, so that the foot is back to the calf and the Angle between the foot and the calf is less than 90° as far as possible. Foot and ankle orthoses can also be worn to help correct the pointy foot, stabilize the ankle joint, and better conduct standing and walking training. Some children clench their fists, can not grasp, the trainer should insist on doing passive finger stretching activities, the thumb outreach extension, other fingers are easy to extend. At the same time of sports training, we should also strengthen language training.Use brightly colored toys to attract children's attention and try to imitate the trainer's sound and pronunciation. Create a good speech environment and correct abnormal pronunciation in time. When the muscle tension of the limbs is significantly increased or the involuntary movement of the limbs interferes with the activities of the children, it can be considered to use antispasmodic or bradycardia drugs, such as diazepam, Liolisol, antan, mdopa, etc. Traditional Chinese massage can reduce the tension of spastic muscles and expand the range of motion of limbs and joints; Acupuncture and moxibustion can be taken with head needles in the exercise and language areas to improve the function of the area.