A Current Approach to Postural Care for Patients with Cerebral Palsy

Agata Michalska, Zbigniew Śliwiński, Justyna Pogorzelska, Marek Grabski

Agata Michalska, Zbigniew Śliwiński, Justyna Pogorzelska, Marek Grabski – A Current Approach to Postural Care for Patients with Cerebral Palsy. Fizjoterapia Polska 2018; 18(3); 102-112

 

Abstract
Introduction. Rehabilitation is an essential component of therapeutic treatment in cerebral palsy (CP). One of its objectives is to prevent secondary musculoskeletal deformities. The use of various techniques to minimize postural abnormalities and enhance functions is defined as postural care (or postural management). It encompasses proper patient positioning in the lying, sitting and standing positions combined with physical therapy.
Purpose. The purpose of the study is to present a current approach to postural care based on the review of source literature.
Conclusions. No generally accepted recommendations on supporting lying, sitting and standing positions have not been developed under the postural management programme so far. The majority of studies related to this field are conducted on not very numerous groups, with short periods of observations only. Thence it is difficult to assess the effectiveness of the postural management programme, although some study results indicate it as the promising method of neurogenic hip dislocation prevention. Appropriate postural support is deemed to facilitate CP patients’ activity and participation, improve their sense of competency and motivate them to act. Due to changes in equipment designs and new solutions launched, there is an urgent need to continue related research.

Key words:
postural managment, cerebral palsy

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Application of the Polysensory Stimulation and the General Movement Patterns in Patients with the Serious Traumatic Brain Injury

Wojciech Kiebzak, Anna Wysocka, Arkadiusz Żurawski, Marek Kiljański, Justyna Pogorzelska

W. Kiebzak, A. Wysocka, A. Żurawski, M. Kiljański, J. Pogorzelska – Application of the Polysensory Stimulation and the General Movement Patterns in Patients with the Serious Traumatic Brain Injury. FP 2015; 15(2); 6-20

Abstract

Introduction. Traumatic brain injuries are among the major causes of disabilities and deaths in children. They cause motor performance disorders and neuropsychological dysfunctions. All the above require the maximum reduction of any iatrogenic effects.
Goal. The goal of this paper is to present a rehabilitation program for the patient after severe traumatic brain injury.
Case Study. As the result of a traffic accident, the 15 years old boy had suffered a severe overall trauma, including the traumatic brain injury. He was deeply unconscious, his score in the Glasgow Coma Scale – 4 points. The patient had undergone a 2 months rehabilitation program, while hospitalized. The polysensory stimulation and elements of the following methods had been applied: Vojta method (Reflex locomotion), NDT-Bobath, PNF, Castillo-Morales and Kinesiology Taping. A high degree of the patient’s self-reliance had been achieved, including the ability to walk, with only a slight support.
Discussion. Within the recent – dozen or so – years, numerous studies regarding the physiotherapy treatment in patients with the traumatic brain injury have been published. More often than not, success of the rehabilitation process depends on the early start and the proper orientation of the rehabilitation treatment. Still, in available research, there is very few studies dedicated to the formalized early treatment methods. Hence the need to define the best possible physiotherapy procedures.
Conclusions. The most important issue in the physiotherapy treatment, in patients after the traumatic brain injury, is the interdisciplinary rehabilitation, based on the polysensory stimulation and on the general movement patterns, which combines the techniques of the various methods. Planning of a physiotherapy program should be founded on the basic principles of continuity, comprehensiveness and regularity, but most of all – on the early start of the rehabilitation process. The competent physiotherapy treatment plays an important role in restoration of the cognitive-emotional functions and an achievement of the optimum level of the patient’s psychomotor performance.

Key words:
traumatic brain injury, craniocerebral injury, physiotherapy treatment, polysensory stimulation, general movement patterns

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