Reconstruction of Developmental rehabilitation of cerebral palsy
Kodama, Kazuo MD
(National Rehabilitation Center for Disabled Children, Japan)
Also in Japan as in the world, the rehabilitation of cerebral palsied children had been developed by early diagnosis and treatment. About twenty years ago it was expected we could reduce markedly the number of typical cerebral palsy by early diagnosis and treatment. However, contrary to our expectation the prevalence rate of cerebral palsy , especially spastic diplegia group has been increasing after 1980. And several reports were published criticizing the effectiveness of early treatment.
On the other hand MRI findings show the range of PVL=PeriVentricular Leukomalacia in preterm born infant and now for some extent we can prospect the degree of future level of motor dysfunction or cognitive problems in spastic diplegia. With those information now we can analyze more precisely the mechanisms of brain damage and the pathogenesis of cerebral palsy. Some doctors have tried new approach such as selective posterior rhizotomy based on several neurological theories and findings.
We know that in adult persons with cerebral palsy, there are some serious problems such as cervical damages in athetoid group. We must learn from those facts before construct the rehabilitation program for children.
Combining these scientific analysis, clinical assessments and long term life courses we should reconstruct the strategy of developmental rehabilitation programs throughout childhood period. More scientific, more comprehensive and more effective program---this is the main concept of my report.
STUDY OF POSTURAL DEVELOPMENT
Vlasta Tosnerova (Charles University Hospital, Hradec Kralove, Czech Republic)
Both the gait and grip represent the very basic motor activities in man and their development which assume posture stability, can be traced from early infancy.
Abnormalities in the development of these activities may result in several pathologies manifested already in the childhood. Since an early diagnosis and rehabilitation of the posture abnormalities are important with respect to the achievable quality of life, objective methods for the early diagnostics of them are important. The following study attempts to elucidate the development of the posture and current approaches to the diagnostics of its pathology and rehabilitation.