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PEDIASUIT PERFORMANCE

 

Learn more about this intensive therapy that provides faster results than conventional therapies.

 

CEREBRAL PALSY AND THE THERAPY WITH ORTHOPEDIC THERAPEUTIC OVERALL

 

Patients with cerebral palsy make up the largest number of attendances in the intensive care program using orthopedic therapeutic overalls.

 

Cerebral palsy (CP) is the most common developmental neurological disorder, occurring in 2 or 3 cases per 1000 live births. PC describes a group of permanent disorders of the development of movement and posture secondary to non-progressive damage to the immature brain.

 

Children with cerebral palsy often demonstrate problems with body functions and structures, such as reduced muscle strength, limited passive joint mobility, altered motor control and poor postural alignment, which affects their activities.

 

Children with cerebral palsy have the potential to improve their function due to the plasticity of the central nervous system. Plasticity is the brain's ability to learn, remember, and forget, as well as the ability to reorganize and recover from injury.

Bower et al. (1996) administered short periods of intensive therapy (3 weeks) to 44 children with cerebral palsy, emphasizing the acquisition of motor skills. Intensive therapy resulted in the acquisition of significant skills when compared to conventional therapy sessions.

 

Many therapists are reluctant to use muscle-strengthening exercises with neurological patients for fear of increasing spasticity and abnormal movement patterns. However, some studies have shown that increasing isolated muscle strength with resistance does not increase spasticity. The importance of muscle strength in children with CP is the direct relationship between strength and motor function.

 

For all the reasons mentioned above, intensive therapy combined with the use of therapeutic orthopedic overalls is of great benefit to children with cerebral palsy.

 

 

BONE CHANGES IN CEREBRAL PALSY

 

Bone and joint changes in patients with cerebral palsy result from spasticity and muscle contracture. The spine and lower limbs are most commonly affected.

 

Scoliosis can progress rapidly and continue to evolve after skeletal maturity. Increased thoracic kyphosis and lumbar lordosis, spondylolisthesis, spondylolysis, and pelvic obliquity may accompany scoliosis. Progressive hip flexion and adduction can lead to deformities, increased femoral rotation, apparent coxa valga, subluxation, femoral head deformities, hip dislocation, and the formation of a pseudoacetabulum. In the knee, flexion contracture, patella alta, patellar fragmentation and recurvato are the most common abnormalities. Progressive equinus and equivalgus of the foot and ankle are associated with "rocker>botton" deformity and subluxation of the talonavicular joint.

 

The prevalence of scoliosis in patients with spastic cerebral palsy ranges from 15% - 61%. Vertebral curvature is typically less than 40 degrees, but can range from 10 to 146 degrees. The incidence increases with age and walking ability decreases, with men being more affected than women. In most cases, there is progression of the postural deformity to the fixed form.

 

Hip subluxation and dislocation are the second most common deformity in patients with spastic cerebral palsy with a predominance of 28%. The spastic adult and iliopsoas muscles predominate over the weak hip abductors and extensors, resulting in a scissor gait or slipping deformity. This deformity is often caused by an adduction contracture on one hip and an abduction contracture on the opposite hip.

 

Femoral anteversion (the angle of the femoral neck is in a transverse plane with the femoral condyles) is usually increased in children with CP. Normal femoral anteversion is 30 to 50 degrees in infants and decreases throughout childhood. CP patients have persistently increased femoral anteversion due to delayed weight bearing and muscle imbalances. In patients with spastic CP, the mean anteversion angle is 55 degrees in ambulatory patients and 57 degrees in patients who cannot walk.

 

Femoral subluxation can progress to dislocation in an average of seven years. Chronic subluxation and dislocation can result in acetabular dysplasia and secondary degenerative diseases. As the subluxation progresses, either medial or lateral flattening of the femoral head may occur and if both occur, a triangular shape of the femoral head will be seen on X-ray. ilium.

 

These postural deformities can result in secondary problems such as pain, loss of independence, pressure ulcers, cardiovascular and respiratory problems, swallowing difficulties and sleep disturbances.

 

 

Early recognition of these progressive deformities is essential. Therapy with the orthopedic therapeutic overalls, combined with intensive therapy are a great tool to treat and prevent irreversible postural changes in children with cerebral palsy.