当前对小儿脑性瘫痪的体位管理方式

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

摘要
简介。康复是小儿脑性瘫痪治疗的基本要素之一,目的在对抗继发性的肌肉骨骼畸形,运用各种技术及功能促进以将姿势错误最小化被称为体位管理,包括患者躺卧、坐着及站着时的适当定位并结合物理疗法。
目标。研究目的在呈现以文献评析为基础的当前体位管理方式。
结论。截止目前为止,体位协助计划中未就躺卧、坐姿及站立等姿势制定普遍可接受的建议,该领域的大多数研究都是针对少数群体进行,观察时间短,因此难以评估体位计划的有效性,尽管部分研究结果显示其为对抗髋关节神经原性脱位为有希望的方法。一般认为适当的姿势支撑有助于开展活动并协助小儿脑性瘫痪者参与,增强其能力感并鼓励其行动。由于设备的结构变化及市场上新解决方案的引入,在该领域进行进一步研究的需要格外迫切。

关键词:
体位管理、小儿脑性瘫痪

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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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