Physiotherapy of a child with Down syndrome and congenital heart disease – case study

Agnieszka Adameczek, Bożena Werner

Agnieszka Adameczek, Bożena Werner – Physiotherapy of a child with Down syndrome and congenital heart disease – case study. Fizjoterapia Polska 2008; 8(1); 72-82

Abstract
Background. Children with Down Syndrome operated for organ defects in the first months of life and undergoing early regular physiotherapy develop better than children who are so treated at an older age. This paper presents the psychomotor development and outcomes of comprehensive rehabilitation during the first two years of life of a boy with Down syndrome and a congential heart defect. Case description. The boy had Down syndrome and a congenital heart anomaly in the form ventricular and atrial septal defect. The boy underwent regular rehabilitation from the second month of life. Initially, the Vojta method was used, followed by pulmonary rehabilitation in the perioperative period, and the NDT-Bobath, Sherborne, and sensory integration methods were introduced in the tenth month of life. Gross motor skills (head lifting, turning, sitting, pulling oneself to stand up, crawling on all fours, walking with assistance and walking unassisted, running), social skills, self-sufficiency (smilling at parents, eating solids, drinking from a cup, following objects with the eyes, grasping a hanging rattle) and communication skills were traced until the 27th month of life. Conclusions. Children with Down syndrome who undergo regular rehabilitation commenced in the first months of life and receive proper care achieve better psychomotor developmental outcomes owing to the developmental plasticity, memory plasticity and regeneration possibilities of humen nervous tissue.
Key words:
child physiotherapy, psychomotor development, Down syndrome
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Manual Ability Classification System for children with cerebral palsy

Roksana Malak, Ewa Gajewska, Magdalena Sobieska, Włodzimierz Samborski

Roksana Malak, Ewa Gajewska, Magdalena Sobieska, Włodzimierz Samborski – Manual Ability Classification System for children with cerebral palsy. Fizjoterapia Polska 2010; 10(1); 69-77

Abstract
Background. The Manual Ability Classification System is a five-level scale for evaluating the manual ability of children with cerebral palsy aged 4-18 years. The aim of the study was to determine how the manual ability of cerebral palsied children and youth is influenced by the type of cerebral palsy and daily activities indicating various levels of psychomotor development. Material and methods. The study involved a group of 40 children with cerebral palsy aged 4-18 years attending Special Education School Complex No. 103 and Special Education Kindergarten No. 164 in Poznań. The research tool was a questionnaire containing the Manual Ability Classification System filled in by the parents. ICP type according to the Ingram classification was determined together with the level of psychomotor development.Results. Children with bilateral hemiplegia (16) represented the poorest manual abilities compared to children with spastic diplegia (13) or spastic hemiplegia (11). There was a correlation between the ease of handling everyday objects and the ability to crawl (F (1.38) = 21.466, p = 0.0004) and between the ability to stand up unassisted and the ability to stand unassisted(F(1.38)=35.894,p=. 00000).Conclusions. 1. Children with bilateral hemiplegia were most limited in their ability to handle everyday objects. 2. The ability to crawl, stand up unassisted and stand unassisted were correlated with good object handling skills.
Key words:
manual ability, infantile cerebral palsy, psychomotor development
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