Exercise therapy for cerebral palsy: types of exercises, step-by-step instructions for their implementation, training program schedule, load calculation for people with cerebral palsy and the necessary sports equipment

Health is the most important, most fragile, most necessary value in the life of any person. The fact that not everyone is fully aware of the importance of a healthy organism does not in any way detract from its significance. At the present time, people with good health and the absence of painful sensations and a disease state treat this very frivolously. It is not surprising: nothing hurts, nothing bothers - that means there’s nothing to think about. But this does not apply to those who were born already sick person. This frivolity is not understood by those who were not allowed to enjoy their health and full normal functioning. This does not apply to people with cerebral palsy.

The essence of the diagnosis of cerebral palsy

Cerebral palsy (cerebral palsy) is a chronic disease that does not belong to the progressive group, but requires constant and regular treatment due to pathologies of the brain in its cortex or subcortical areas, trunk or capsules. This disease manifests itself mainly in the partial physical and intellectual psychological insolvency of a person, as well as the inability to fully control his body. This failure is explained by the fact that the patient’s brain does not send a signal to the muscles for motor activity, so he cannot control most of his movements. The reason for this diagnosis is often an abnormal intrauterine development, childbirth with complications, birth hypoxia or asphyxia, as well as endocrine or infectious diseases suffered by the mother of a sick baby during pregnancy. Children with cerebral palsy later begin to hold their heads, turn over from their backs to their stomachs, sit, walk. Very many of them cannot walk, already being at the stage of growing up.

But there is one positive point in all this sad story: cerebral palsy is not a sentence. There are a lot of all kinds of techniques, therapeutic measures, various medical methods that contribute to the partial restoration of the child’s health and bring it closer to normal life.

Timely treatment of the parents of a child with cerebral palsy to a neuropathologist for a consultation can contribute to their earlier intervention in the course of the disease process and rehabilitation of the poor state of health of the baby through certain procedures. Inadequate medicine offers all kinds of ways to improve the well-being of a child with this diagnosis in the form of massages, medical gymnastics, classes on special simulators, physiotherapy, magnetotherapy, electroreflexotherapy, Bobat therapy, Voight's method, classes with speech therapists and psychologists, and the use of auxiliary equipment. And not the last place in this chain is occupied by physical therapy (LFK) with cerebral palsy.

Healing Fitness

It's no secret that sport is the key to a healthy body and a healthy mind. Playing sports gives a person the opportunity to actively spend time on the move, develop all groups of his muscles, get a boost of energy and vitality, give his body aesthetically beautiful bends and shapes, maintain himself in an excellent mood and high spirits. You can list the benefits of playing sports indefinitely, as well as name all kinds of sports activities. But a special place in this list should be given to physical therapy.

Exercise therapy is a complex of special therapeutic techniques with the use of physical exercises that contribute to improving the condition and partial restoration of the health of patients and disabled people, as well as used as a prophylaxis against possible diseases. Physical therapy in itself is considered a medical discipline with pedagogical features, since this is not only the implementation of separate physical exercises, but also the education in the patient of self-confidence and confidence that success will come and health will return. It is not surprising that as one of the rehabilitation methods in the case of children with cerebral palsy, it is precisely the exercise therapy complex used in cerebral palsy. After all, the parents of an unfortunate baby are ready to perform any classes, follow all possible gymnastic complexes and undergo all kinds of therapies just to make their child at least partially feel the joy of a full life.

The value of therapeutic exercises in cerebral palsy

What is the peculiarity of the influence of exercise therapy exercises in cerebral palsy? What causes the remission of individual muscle groups in the body of a child affected by cerebral palsy? And how does the exercise therapy complex work with cerebral palsy? To answer these questions, you need to understand what are the goals, objectives and principles of the methodology of physical therapy, which helps to rehabilitate the health lost by the baby in the prenatal, birth or postpartum period.

The main goal of exercise therapy for cerebral palsy in children is to develop the ability to voluntarily slow down movements, as well as lowering muscle hypertonicity, improving motor coordination, increasing amplitude movements in the joints. For children whose muscle activity is inhibited and does not allow them to function normally physically, this is a very important aspect of rehabilitation.

The tasks of the exercise therapy complex at cerebral palsy include several main areas:

• the implementation of a restorative and health-improving effect on the body;
• assistance in restoring the health of the body;
• normalization of blood circulation and metabolism in the affected area;
• full or partial settlement of metabolic and neurovascular disorders;
• preventing the appearance of adhesions in the area between nearby tissues and nerve membranes;
• replacement of already formed adhesions with tissue adaptability to such formations by means of special exercises;
• strengthening weak muscle tissue;
• development of coordination of movements;
• help in the fight against concomitant anomalies - curvature of the spine, impaired mobility, and so on.

And this list is not final. Exercise therapy techniques for cerebral palsy provide for the construction of a set of exercises on the principles of regularity, systematicity, continuity of classes, an individual approach to each patient, paying attention to his age and mental development, taking into account the severity and stage of the disease. All these aspects together determine a positive result from the procedures that are being carried out, which determines the importance of this kind of physical therapy for children with deviations of the nervous and mental system.

Types of exercises

What are the main variations in exercise therapy for cerebral palsy during the rehabilitation of patients?

1. A fixed position is a model of a therapeutic exercise based on the fixation of limbs in a special tire or splint.
2. Muscular stretching - involves swinging in all joints of the limbs with an amplitude of oscillation, designed for a gradual increase.
3. Muscular relaxation - provides for the alternate fixation of the arms and legs to reduce the number of involuntary movements performed by a sick child, as well as weakening of increased tone.
4. Walking - makes it possible to develop a motor apparatus for higher mobility capabilities.
5. Exercises with stimulation of muscle activity and muscle inhibition - are alternate flexion-extension of joints with parallel muscle massage.
6. Climbing on a surface with a slope - is carried out with an instructor and makes it possible to train, as far as possible, the press and muscles of the legs, keep balance and maintain balance.
7. Stamina exercises.

Exercise therapy for the activation of the musculoskeletal system

In the complex of exercise therapy exercises for children with cerebral palsy, priority exercises are provided for the most important area of ​​rehabilitation - the motor apparatus. Indeed, many children with cerebral palsy are not able to walk, they need help, they need to be taught this. In cases where the central or peripheral nervous system is damaged, there may be a problem with the movement of the upper or lower extremities. This problem is referred to in medicine as tetraparesis. In order to strengthen motor and coordination skills in children with disabilities, as well as increase their degree of control over their own actions, appropriate gymnastic exercises are provided.

• In the initial position, sitting on the heels, the baby tries to kneel under the influence of the movements of the instructor (or parent), who takes the child by the shoulders, holding him in parallel in the hip.
• Sitting on his knees, under the influence of the movements of an adult, who holds him in the axillary zone, the child begins to move from side to side in order to be able to transfer his body weight to one leg. At the same time, he tries to tear off the second leg of the baby from the support himself, spreading his arms to the sides.
• Turning to face a small patient with cerebral palsy sitting on a chair, an exercise instructor in the person of a specialist or a parent fixes his legs on the floor with his own hands and gently grabs them by the handles. At the same time, the brushes are pulled forward and up to give the child the opportunity to learn how to stand up independently.
• In the initial position, standing the child’s feet are placed in one foot to each other in a line one after the other, with the hands of an adult light shocks are made first in the back, then in the chest - this is how the concept of maintaining balance is formed in the baby.
• In this initial position, you need to try to swing the child to the sides so that he tries to take a step on his own.

Similar exercises for children with cerebral palsy can increase the physical activity of the baby and give him a chance to learn how to walk.

Exercise therapy for the development of joints

It is equally important to teach the child how to control his movements and strengthen his joints. The peculiarity of this moment is that children suffering from cerebral palsy are characterized by pain in the joints, convulsive pains and related pathologies. To develop the joints of the limbs, you need to pay attention to a number of physical therapy exercises aimed at strengthening them in cerebral palsy.

• The starting position of the child is lying on his back. One leg is unbent and fixed by an adult under its own weight of the body or under the rest of the arm, and the second gradually bends at the knee. In this case, the thigh is pressed against the abdomen as much as possible, after which it is smoothly retracted back to its original position.
• The starting position of the baby is lying on its side. The knee is kept bent, the thigh is alternately retracted, then returns to its original position.
• The primary position of the body is standing facing the table right next to it. It is necessary to lean the stomach against it so that the legs hang freely, and then alternately then straighten them, extending the knees, then return to a suspended state.
• Lying on his back, the child with the help of an adult bends the leg at the knee, after which, if possible, straightens it as evenly as possible.
• Having placed a child with cerebral palsy on the stomach, an adult or an instructor places a roller under his chest, after which, holding the baby by the arms, he raises the upper part of his body, jerkingly and springingly making movements up and down.
• The starting position of the baby is lying on his back. The arms are bent at the elbow so that the face remains motionless and turned to the side. After that, the adult helps to bend the child's limb, turning his head in a different direction.

Stretch exercise therapy

The complex of exercise therapy exercises for children with cerebral palsy for stretching also helps to increase flexibility. It allows you to reduce the severity of the pathological condition of the back and spine, improves the condition of the affected spinal cord, as well as its nerve endings. Moreover, this kind of exercise therapy for children with cerebral palsy allows you to strengthen the muscles of the limbs, which, of course, affects more confident movements of the arms and legs.

• The child needs to be seated in the initial position on the floor so that the legs are straightened, and the body along with them creates a right angle and is perpendicular to the floor. When exhaling, the baby should try to bend so as to be able to reach your toes with your fingers. At the same time, the help of the physical therapy instructor for children with cerebral palsy in this exercise is that it helps lower the body even lower by making gentle pressure on the back so that the child's forehead also touches the legs.
• Being in a prone position, the child extends his arms along the body. Then he turns his hands to the floor and focuses on them. Gradually resting on his hands and raising his chest above the floor, the baby trains the stretching of the biceps muscles, simulating the push-ups of a healthy person. An adult should ensure that the child does not throw his head back and that his breathing is calm, even.
• The following exercise is reminiscent of a press of the lower press with throwing legs in the complex of occupations of a healthy person. Starting position - a child with cerebral palsy lies on his back, arms are extended along the body. On the count of “times”, he slowly and smoothly raises straight legs above his head and leads them up behind his head, touching the floor with his toes over his crown and without bending them at the knees, on the count of “two” he returns them just as slowly to their original position. Throughout the exercise, the adult controls the process and ensures that his hands do not come off the floor.
• Starting position - sitting on the floor with legs apart. The first movement is bending the right leg so that its heel touches the inner femoral part of the left leg, the second movement is the approach of the left foot to the knee joint of the right leg. After carrying out these manipulations, the right hand moves to the left knee in girth with the support of the left leg, and the movement of the left hand moves it to the opposite side of the waist behind the back. The adult turns the child’s head to the left side and tilts it so that the chin touches the left shoulder. In this case, the right knee constantly remains in the position pressed to the floor.

Such a set of exercise therapy exercises for children with cerebral palsy, with its regular implementation every day, contributes to a significant improvement in the condition of a small patient. Such therapeutic gymnastics is especially effective when it is carried out at an early stage of growing up a child. And the sooner the better.

Exercise therapy for relaxation

It is noteworthy that classes on exercise therapy in cerebral palsy in adults as well as in children, contribute to the rehabilitation process. But in adults this is much slower than in children, because the child’s body is much more malleable. Therefore, it is impossible to delay with exercise therapy in children with cerebral palsy.

Based on the fact that a frequent symptom of cerebral palsy is severe muscle hypertonicity, medicine provides for special exercises to relax them.

• In order for the hands and feet of a sick child to rest, he needs to lie with his back to the floor, after which the limbs on one side should be fixed in a motionless state, using weighting materials that can be made from sandbags.
• The child should bend the free hand on the other side of the body at the elbow, while his forearm helps him to hold an adult performing therapeutic exercises. The hand remains in this position until a decrease in muscle tone is felt. After that, the adult helps the child to shake the brush, periodically bending it, rotating and moving from side to side.
• The same thing needs to be done with the foot. While the fixed limbs of one side touch the baby’s abdomen, the adult helps him keep his lower legs and legs in the hip joint so that he can make circular movements to stretch the leg muscles. Accordingly, the legs alternately alternate.

Exercise therapy for breathing

The system of exercise therapy in cerebral palsy provides for the remission process only with their regular implementation. The schedule of the training program should include daily activities of the patient, every day.Only regular gymnastics and regular classes will be able to return the physiology of a sick child to a more or less acceptable form. Therefore, it is impossible to neglect the daily frequency of complex therapy of cerebral palsy.

Among other things, exercise therapy for cerebral palsy provides for the ability to breathe correctly.

• The adult shows the child how to take the right deep breath and exhale with both his mouth and nose. To do this, you can use auxiliary equipment in the form of balls, rubber toys, soap bubbles.
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Many schemes of work in exercise therapy with cerebral palsy were developed by health workers of various institutions of a corresponding nature throughout the Russian Federation. One of these can be considered the Samara Rehabilitation Children's Center “Duckling”. Here you can take children with various diseases, including cerebral palsy. So, a physical therapy trainer and a child with cerebral palsy in Samara can perfectly find a common language for spending time together in one of the two pools, for therapeutic massage, physiotherapy, hydromassage, phytoaromatherapy, and developing water games.

Exercise therapy in game exercises

As mentioned earlier, the training program for children with cerebral palsy should include the work of an adult with a child every day, all seven days a week. But in addition to this, it is necessary to take into account the rationality of the applied loads, because the child should also rest. Calculation of the loads taken as a basis in the exercise therapy complex for children with cerebral palsy should be based on the age factor, body weight and height of the sick child. In addition, the degree of the affected psyche and physiology must be taken into account, because cerebral palsy itself includes a huge number of varieties with varying degrees of severity. The more neglected the case, the more frequent and assertive training should be, but they should be performed with the utmost accuracy and only with a representative of medicine. At the same time, massage in exercise therapy for cerebral palsy is suitable for some of the children, and for some, water procedures are very individual here, depending on the specific case of the disease.

Too many children like the game technique of working with instructors. Game exercises in exercise therapy at cerebral palsy provide not only the effectiveness and efficiency of the process, but also allow you to interest the child and give him the opportunity to relax. In this case, specific auxiliary equipment can be used in the form of devices supporting the patient on their feet, all kinds of fitballs, soft modules, pillows and other equipment. What games can be attributed here?

• "Destruction of the tower" - the game involves a heap of soft gaming devices and circles one on top of another in an imitation of building a tower structure. At the same time, an adult can help a child build such a plan, and he himself must destroy it - this is the main goal of the game, to learn how to make efforts to break through the "pillow" defense of an illusory tower.
• “Get out of the rubble” - such a game exercise also involves the child’s use of efforts, only now not in a running “attack on the tower”, but in a supine position with blockages from the pillows. The child's goal is to get out of simulated rubble.
• Folding Knife is a great stretching and flexibility game for a baby with cerebral palsy. Its essence lies in the fact that the child plays the role of a folded knife when he occupies the position of the "embryo" on the floor and grabs his legs bent at the knees with his hands. On the count of “times” the knife opens - the child stretches his legs and arms as far apart as possible and remains so to lie on his side until, on the count of “two”, it will be necessary to return to the starting position. Exercise is performed at a moderate pace.
• “Sausage” is a humorous game with the original position of lying on your back on the floor. An adult in the person of a parent or instructor takes the baby by the ankles, carefully turning it by the legs, as by leverage, then one way, then the other. At the same time, the pace is gradually increasing.

Many different game procedures and exercises of physical therapy can be cited as an example - all of them are aimed at only one result. This result is a partial recovery of the baby. Partially because human health is affected by cerebral palsy not only in terms of physical disorders, but also psychological ones. But it is impossible to alter human psychology with therapeutic exercises to the extent that the body requires.