PHYSIOTHERAPY FOR CHILDREN WITH CEREBRAL PALSY

Cerebralna paraliza je klinički entitet koji karakterizira poremećaj pokreta i položaja uzrokovan neprogresivnim oštećenjem nezrelog mozga. Mnogo je etioloških faktora zbog kojih dolazi do oštećenja mozga koje može uzrokovati cerebralnu paralizu. Posljedice oštećenja utječu na motoričku funkciju te mišićno-koštani i kognitivni razvoj, a javlja se i niz drugih pridruženih zdravstvenih poteškoća. Kada se govori o cerebralnoj paralizi uvijek treba naglasiti da cerebralna paraliza predstavlja ne samo medicinski problem, nego i psihološki i socijalni problem. Dijagnoza se postavlja kod djece kod koje je uočen usporeni razvoj motorike, koji se potvrđuje nalazima magnetske rezonancije. Terapija djeteta sa cerebralnom paralizom usmjerena je na ostvarivanje zadanog cilja. Dva glavna cilja su smanjiti komplikacije uzrokovane cerebralnom paralizom i poboljšati sposobnost usvajanja novih vještina. Dodatni ciljevi su edukacija roditelja, smanjenje tjelesnih deformacija i poboljšanje pokretljivosti. Cerebralna paraliza zahtijeva interdisciplinarni pristup te ima velik utjecaj i na dijete i na čitavu obitelj i život njenih članova. Svaki terapijski pristup bazira se na individualnom pristupu. Vrlo je bitno terapiju započeti što ranije jer ranija terapija olakšava razvoj djeteta i pridonosi boljem ishodu terapije i kvaliteti života. Terapija cerebralne paralize ne treba biti usmjerena samo na motoričke tretmane, već i na tretmane i drugih poremećaja od kojih dijete pati. Rijetko se kad terapija oslanja na samo jedan, a najčešće se primjenjuje kombinacija terapijskih postupaka. Takav pristup omogućava fleksibilnost i individualizaciju, kako bi se ostvarili ciljevi postavljeni za dijete i obitelj.Cerebral palsy is a clinical entity characterized by disorder of movement and posture caused by a non-progressive injury to the immature brain. There are many etiological factors that may cause brain injury that result in cerebral palsy. The consequences of brain injury may have an effect on motor function, musculoskeletal and cognitive development as well as on a range of other associated health issues. Also, when it comes to cerebral palsy, it should always be noted that it is not merely about a medical problem, but also the psychological and social components have to be taken into account. Diagnosis is made in children with slow motor development and is comfimed with findings from magnetic resonance imaging. In children with cerebral palsy, the treatment is aimed at achieving two main goals: reduce complications of cerebral palsy and improve the ability to acquire new skills. Additional goals are represented by parent education, reduction of body deformations and mobility improvement. Cerebral palsy has a major impact on the child, the whole family and their life, thus an interdisciplinary approach is required. It is important to begin the therapy as early as possible in order to facilitate the patient’s development and contribute to a better treatment outcome in terms of quality of life. Cerebral palsy treatment should not be focused only on improvement of motor skills; attention should be pointed at every kind of impairment from which the child suffers. In this view, a wide range of therapeutic approaches is available and a combination of therapeutic procedures is usually employed. This multimodal approach allows flexibility and treatment individualization toward achievement of specific goals set for the child and family