Rehabilitation and Physiotherapy
Factors influencing rehabilitation outcome

• Treatment team :   Productive interaction ,  Basic understanding
• Medical problems : Respiratory, Convulsions, Dysphagia, Depression, Gastroesophageal reflux, Sleep disorders, Visual and hearing deficits, Mental retardation, Sensation, Communication
• Child’s character :  Motivation to move, Temperament, Behaviour/cooperation, Willingness to take risks
• The family Resources : Quality of home environment, Support, Expectations

Treatment team

The pediatrician provides diagnosis and preventive health care. The orthopaedic surgeon tries to minimise static and dynamic contractures to improve mobility. The pediatric physiatrist evaluates the child’s overall medical, surgical and therapy options and helps the child and the family to set functional, achievable goals. Together, the rehabilitation team works to
assist the person with CP to achieve his place in the society. A productive interaction between the physicians and the therapists is essential for the maximum benefit of the child. All those involved with the child must have a basic understanding on the diagnosis, family expectations, degree of motor dysfunction, functional goals and the therapy program.

Medical problems of the child

The rehabilitation physician and the team must be prepared to anticipate certain acute and chronic problems during the rehabilitation of the child with CP.

Medical problems of the child which prevent rehabilitation

• Respiratory problems
• Epileptic seizures
• Dysphagia
• Depression
• Gastroesophageal reflux
• Sleep disorders
• Visual and hearing deficits
• Mental retardation
• Cortical sensory deficits
• Communication deficits

The disabled child is more prone than his able-bodied peers to respiratory problems, convulsions, dysphagia, depression, gastroesophageal reflux and sleep disorders. Total body and some severely involved diplegics have visual and hearing deficits, mental retardation, cortical sensory deficits and communication deficits that prevent the child from reaching his maximum potential.

The child’s character

The motivation to move, temperament, behavior/cooperation and the willingness to take risks are important determinants of rehabilitation outcome. These personality characteristics of the child are independent of impairment or disability.

The family

Some families provide their children with ample experiences and opportunities that enrich their environment and increase their ability to achieve new skills. Family resources, quality of home environment, family support and parent/caregiver expectations guide the plans of long-term care for the disabled child.

Physiotherapy

Physiotherapy helps improve mobility. It is the basic treatment in all children with CP. It consists of exercises, bracing and activities towards reaching specific functional goals. It aims to bring the child to an erect position, give the child independent mobility and prevent deformity. Organize physiotherapy to fit into the family’s lifestyle.