Today, cerebral palsy remains a complex disease characterized by lesions of many body systems, complex motor disorders with the gradual development of joint contractures and limb deformities.
One of the areas of medical rehabilitation for children with CP is orthopedic surgery. Timely surgical intervention can improve the patient’s condition, increase the range of motion, improve the ability to move, sit, perform hygienic procedures, and eliminate pain. The most common surgeries are those aimed at eliminating muscle contractions and bone deformities.
Examples of such surgeries are:
- Selective dorsal rhizotomy;
- One-stage multilevel tenomyotomy;
- The method of prolonged injection of Baclofen into the spinal canal.
Before referring a child with CKD for orthopedic surgery, the multidisciplinary rehabilitation team must evaluate and discuss with the patient and parents the surgical options, outcomes, risks, and postoperative rehabilitation program. The decision to perform orthopedic surgery in children with CKD should be based on a thorough preoperative assessment of functional activity and walking analysis. If a child with CKD needs several different interventions at different anatomic sites, they should be performed simultaneously if possible.
Physical therapy as a method of medical rehabilitation for cerebral palsy after surgical interventions
One of the most important methods of medical rehabilitation for children with cerebral palsy after orthopedic surgery is physical therapy. First and foremost, physical therapists aim to restore lost functions after surgical interventions. The main areas of physical rehabilitation for cerebral palsy are the training of movement, pacing, positioning the patient, endurance, balance, strengthening muscle strength, and increasing the amplitude of movement in the joints.
Modern rehabilitation methods for children with cerebral palsy include various exercises aimed at improving overall motor activity, improving the function of the cardiovascular and respiratory systems, and improving posture. In their work, physical therapists at our rehabilitation center use standing bars, treadmill training, and exercises with mobility aids and orthoses. In addition, the Center conducts physical therapy in the water using whirlpool massage, which significantly reduces spasticity and pain.
The best results of orthopedic surgical treatment can be expected within 1 to 2 years after surgery, provided physical rehabilitation treatment is mandatory.
This article was prepared by the medical director
Olga ZELENINA, Medical Director of the St. John’s Center
