Associated problems in cerebral palsy like speech, vision and convulsion are very common. it is better if these are dealt with as early as possible, preferably below two years of age while brain is still immature. There is great hope of improvement if specific treatment starts at the earliest possible. so it is advisable not to delay .speech therapy should start as early as possible, preferably below two years of age. it not only improves speech but also controls drooling. Vision problems like squint can be treated as any other child having squint but if vision is poor then child needs sensory integration as early as possible . Every episode of convulsions delay the improvement and hinder in treatment progress . Most of the time convulsions can be kept well under control with modern medicines which should be continued for long duration. it is seen that proper control of associated medical problems helps a lot in getting faster functional recovery. it changes overall outlook of the child and also affects the treatment outcome to a great extent.more update about latest development in mx of cerebral palsy log to http://www.trishlafoundation.com & you tube trishla foundation cerebral palsy
The day of a child with cerebral palsy and his/her family is not as normal as others. it begins with everyday challenges for activities of daily living.starting from defecation to brushing bathing feeding and of course walking. plenty of assistive devices are available to make their lives easy. often we get them and start using but to get full benefit it is very important to use them properly and also maintain them. some rules for caring of these devices are 1)Proper cleaning and drying 2)Use of assistive devices during daily activities. not only to walk during a time of exercise but to use them for every activity and maximize their abilities 3)Help them make independent as much as possible 4)Regular repairing 5)Regular use of orthotics as advised.
it is also important that starting from whatever is the capacity of child we should go on reducing the dependency and change the type of device as per advice. like moving from walker to crutches and then to sticks. more update about latest development in mx of cerebral palsy log to http://www.trishlafoundation.com & you tube trishla foundation cerebral palsy
Maintaining nutrition in children with cerebral palsy is not so easy task. The difficulties are multiple; it can be because of constipation, unbalanced diet, under nutrition or overfeeding, difficulty in chewing and swallowing, hyper or hyposensitivity to touch around mouth.
Parents have to make sure that they should make child sit for defecation at the same time everyday even if they don’t pass stool for few days. This sets their biological clock. They should be comfortable while sitting on commode otherwise they can be afraid to it. diet should include more fiber to facilitate defecation and care should also be taken for sufficient fluid intake. Besides this we have to be very vigilant about a balanced diet containing all the nutrients in right proportion like cereals, pulses, green vegetables, fruits etc.if the child is undernourished then he/she shall have low immunity and if overweight then it will further make mobility difficult. Since these children are mostly confined to homes they are very much prone to develop rickets/ osteomalacia. Exposure to sunlight and supplementation of Vit D are also essential for its prevention. Dental care is very important because many times it lead to dental carries, cavity which eventually affects chewing. So brushing twice daily has to be ensured. oro-pharyngeal exercise(like blowing balloons) helps a lot in swallowing and chewing. if child is sensitive to touch then make sure to use brush with soft bristles. Apart from this hypersensitive child reacts touching of food around mouth and hyposensitive does not feel it. We have to be cautious that with hypersensitive child touch should be very soft and conversely and temperature also should be normal not too hot nor too cold. avoid spilling of food material. On the other hand with hyposensitive child we have to introduce touching with different temperature and texture food items at a time for example solid to liquid, hot to cold.
most important thing is that parents /caregiver must be very calm while dealing with these children otherwise their anxiety, only increases the problems than to decrease. They should be confident that there is solution to their problem. more update about latest development in mx of cerebral palsy log to http://www.trishlafoundation.com & you tube trishla foundation cerebral palsy
children with cerebral palsy are definitely not commonly having mental retardation. it is found that more than 60% of them are having normal or even above normal intelligence. only thing is that their intelligence is masked because of their motor problem and less interaction with social environment. Most of them try hard to cope with their environment and also have talent and interest in many activity like singing , sculpture playing game like carrom, chess and even some outdoor game requiring limited mobility and many other activity. these children with nearly normal IQ also do much better in schooling because of their concentration which remain unbroken because of limited mobility. severe mental retardation are found only in children with severe disability. Now days we are more focussing on inclusive education in which all these children are allowed to go mainstream schooling, which boost up their confidence and improve their personality tremendously. so we should identify those hidden talent and encourage them that boost up their morale and speeds up recovery along with therapy and other management. it is needed that we should start paying attention to their ability now. more update about latest development in mx of cerebral palsy log to http://www.trishlafoundation.com & you tube trishla foundation cerebral palsy
Upper extremity involvement in cerebral palsy interferes with proper use of hand and it is most challenging for therapist and surgeon to deal with it. In upper extremity they can have problem in shoulder, Elbow, wrist, and fingers. Problem can be of combination of lifting of upper limb above the shoulder, reaching out to object or not able to perform fine activity by hand. It is also very important that preference of hand became fixed at the age of two year so it became imperative to start therapy at earliest to get maximum outcome before the age of 2-3 year age. We have many ways of therapy for hand like Bimanual, CIMT, sensory integration & proper occupational therapy. Affected hands in cerebral palsy have manifold problem like weakness, spasticity, contracture & sensory problem. Most difficult to treat problem in upper limb is non recognition of fine motor activity by cortical center in brain so that they are not able perform activity at their own in coordinated manner. Most important problem that interferes in therapy is contracture and spasticity in extremity that is too being managed at early. In early age (2-5 year), it can be managed by botulinum toxin but child develop fixed contracture then they require surgical intervention. earlier we use to do tendon lengthening of all affected tendon require long rest of hands and rehab can be started after months and recovery was not so good every time. But with the new concept of OSSCS & SEMLOSSS we use to relieve spasticity & contracture by aponurotic (facial coverage at musculo-tendinous junction) release by this technique we can start therapy early and child regain function in very short time. Some time these children also have weakness in few group of muscle so we also utilized the concept of tendon transfer. This tendon transfer help in regaining muscle power and good functional recovery.
few children It is very important to continue therapy for log duration till complete recovery. Child should wear brace as advised their operating surgeon and therapist concerned. By use of all this modality we can give good functional recovery to child.
It is easier to manage children with cerebral palsy even in children with sever deformity(https://www.youtube.com/watch?v=waEsYsoakcc) but as their age increases their problem is proportionately increase and it became very trouble some to manage them. it is not the only that adult is affected but whole family is affected with this problem and with passage of time as their problem increase because of many factor like osteomalacia, obesity, increasing spasticity, deformity and psychological issue , it became very difficult to manage them even for their daily routine activity like transfer, toilet, bathing and feeding. so it became very important to mange all their deformity and spasticity along with other associated medical problem so their routine requirement can be managed in much easier way. now with advancement in medical science most of the medical problem can be managed much easier way. most of the adult are confined to indoor so that most of time they will have osteomalacia & osteoporosis so they should be supplemented with Vit D and calcium. some of them will have obesity and others can have malnutrition so proper nutrition should be taken care at least proper weight and heath should be maintained . overweight always their physical activity and after certain weight they can became bedridden. proper architectural design should be taken care for barrier free environment at home and at business center so that their movement should not be hampered. if any one of them have deformity of joint and extremity along with unbalanced body then they should be managed by therapeutic & surgical modality (https://www.youtube.com/watch?v=3tf_Khcc4f8) . all the persisting physical & orthopedic problem should be managed by single event multi level surgery and it can be better managed by SEMLOSSS (http://www.samvednatrust.com/cerebral-palsy/recent-advancements/).
Most of the time it has been said that child with cerebral palsy will improve on his natural progress and there is no need of any intervention but it is not true as a whole . truth is that if you are not giving proper therapy to child , child is not going to have good quality of progress. By the use of good quality of therapy, different intervention modality and judicious use of bracing can help the child with cerebral palsy in getting good functional improvement and they can change the natural progress of the child .
on of the parents rightly written on his testimonial as ——–
My son Shivansh Pandey (31/2 years) was a premature baby who could not sit, stand and walk till 21/2 yrs. Consultants in Faizabad referred him to Dr. J.K. Jain. On his advise we stayed in Allahabad for 3 months during which Shivansh was treated at Samvedna Trust. In these 3 months he has improved drastically and started sitting and crawling independently. He was further injected Botulinum Toxin followed by vigorous physiotherapy. Today Shivansh can walk 20 – 25 steps independently. Thanking Samvedna for such unbelievable results. link to you tube video of this child
Vipin Pandey – Faizabad (U.P.)