Guide to Interpretation of Cerebral Palsy
摘要
Starting from the current definition, the different elements that connote the clinical picture of cerebral palsy (CP) are considered: (1) concept of paralysis in relation to elements such as strength or weakness, muscle tone (spasticity) and posture (hypotonia), type of muscle contraction, movement (gesture) and forms (patterns), but also sensorial information necessary for motor control, and finally active participation of child during recovery process. Neurological semiotics that describes the lesion is presented in contrast to rehabilitative semiotics that explores the different development of adaptive functions. “Fixity” of the lesion is contraposed to the possibilities of an adaptive recovery favored by re-education. Neuromotor development of CP children is not only influenced by an unbridgeable delay, but destined to follow a different path, i.e. the natural history of palsy, against which the results achieved by re-education must be measured, rather than in terms of recovered normality. Defects and deficits produced by the lesion of the central nervous system and by primitive and secondary alteration of the locomotor system have to be compared with the spared (conserved) and available resources: those of children themselves, their families, the community, social and cultural context and the physical environment.