Combined Treatment: Physiotherapy, Drugs, Orthoses, Functional Surgery
摘要
This chapter describes therapeutic tools mostly used in CP reeducation: physiotherapy, topical, district and systemic drugs, orthoses and aids, and functional surgery. Functional assessment scales describe CP child’s conditions in different areas: gross motor activities (GMFCS), manipulation (MACS), communication (CFCS), feeding (EADCS), and vision (VFCS). In the field of physiotherapy, stretching and its effectiveness are analyzed in relation to the structure of muscle and the presence of spasticity, muscle strengthening (method, intensity, and duration), particularly indicated after functional surgery, joint mobilization for recovery of ROM. In the field of functional surgery of joint limitations and deformities, problems related to the utilized surgical procedures and postoperative treatments are described. Orthoses can improve motor control if seen as an integral part of reeducational intervention. For this purpose, it is necessary to define geometry of device, construction process, and material used taking into account deforming forces produced by load and spasticity.