P-2-10-06
IMPROVEMENT OF LOCOMOTOR CONTROL IN PARETIC CHILDREN BY PROGRAMMED MULTICHANNEL PERIPHERAL ELECTRICAL STIMULATION
Zoran Radicevic, Radojica Radicevic and Marko Furlan, Department for Psicho- Physiological Disturbances, Belgrade, Srbija, Yugoslavia
Experience over the last 30 years had pointed to the undoubted efficiency of one-channel systems of FES in restoration of equinovarus patterns in many adult patients and children with hemiparesis due to upper motor neuron lesions.
The approach to multichannel FES in paretic children (both legs) during the last 10 years demands a reliable selection of gait patterns in every child and stimulation programme to harmonize with gait characteristics in time and space.
In this article we discuss the results of the treatment of 26 diplegic children (aged 3-5) in the continuous (everyday) FES treatment within two years in realtion to the next characteristics: (1) the mode of stimulation insertion according to the neurophysiological and kinematic characteristics of gait pattern, (2) compared to the results of the single neurophisiological patterns and (3) in realtion to stimulation influences on the pathological co-contraction in the "push-off" subphase of stance phase of the gait cycle.
The complete clinical, kinematic and neurophysiological data fully justify the application of the habilitation mode in locomotion disturbances in spastic paresis.
P-2-10-07
Application of Augmentative and Alternative Communication (AAC) for a 9-year-old child with Cerebral Palsy.
Maki Taguchi, Chitose Izumi, Aya Kasai, Tadashi Hatakenaka, Junko Koike, Toshiyuki Ito (Yokohama Rehabilitation Center, Yokohama, Japan)
This case report investigated the key factors in the success of AAC oriented remediation for a cerebral palsied child carried out in a habilitation center. The subject was a 9-year-old boy with severe language disorder who had not yet spoken a single word. As the child also needed intervention to improve hand control and sitting posture, the habilitation team consisted of an OT and PT as well as a physician, ST, and rehabilitation engineer. The communication remediation followed a systematic 3 step program in which different AAC means were introduced: Stage 1 Gestural Symbol; Stage 2 Visual-graphic Symbol Notebook; Stage 3 Voice Output Communication Aid (VOCA). To facilitate the development of communication, therapy was conducted along with the close collaboration with the special school teachers and the parents. Hand control was improved due to modification of a seating system. In spite of the rather late start of intervention, in 4 years the child was able to express 3-word sentences voluntarily using the Symbol Notebook or VOCA while he remained non-verbal. From the results it appeared that the following three points were the key factors for the successful implementation of the AAC oriented remediation: 1) multidisciplinary identification of potential in the use of AAC, 2) implementation of a systematic team approach coordinated by a physician for each step of the child's overall development; 3) carry-over of utilization of communication means in real settings (home, school).
