It is very difficult to treat children & adult affected with dyskinetic cerebral palsy. Our aim of treatment in these children is to control abnormal movement & posture. It can only be possible with proper therapeutic technique and brace. Wrong and excessive exercise can do lots of harm to these children. We should avoid use of any muscle stretching & joint mobilization. Any type of surgery & botulinum toxin is not useful in these children. We have only few medicine that helps upto some extent but is not so effective in every case. It is also remember that these children should not be blame for any abnormal activity and avoid any loud sound and fall of any object on the ground in front of him. Anxiety & pain should be managed. Beside this general guideline, therapy in the form of TRP, MRP, Yoga, meditation helps upto great extent in these children. Muscle relaxation Posture (MRP) is a technique for learning to monitor and control the state of muscular tension. It was developed by american physician Edmund Jacobson in the early 1920s. It Control environmental and sensory influences by Inhibition of primitive reflexes, Facilitation of movement through space, Maintenance of body alignment and muscle length. Purpose of this technique is to maintain body alignment, prevention of abnormal posture & deformities, to maintain stabilization of body parts & provide weight-bearing experiences, To promote active participation in meaningful activity, To allow mobility, Normalize posture, Break-up involuntary patterns. In this technique we use key points of control & mid line orientation programme. We start this postural technique by powder massage & relaxation of child. We should maintain trunk in correct posture, knee in flexed position & keeping load close to body. We should use all activity like painting, drawing and use of key board which improve mind to limb coordination. If child is not able sit from supine position then we should also promote w sitting. Padmasana (Lotus position) is excellent means to control abnormal tone in lower limb & spine. Other yoga position also helps a lot but we should be cautious in using other yoga position for children affected with athetoid cerebral palsy. trishla foundation provide good therapeutic facility to children affected with cerebral palsy.
Dr Jitendra Kumar Jain
Secretary & pediatric orthopedic surgeon
Samvedna, Allahabad, UP, India
http://www.trishlafoundation.com & http://www.samvednatrust.com
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