Popular Science | A Guide to Rehabilitation and Treatment for Children with Cerebral Palsy

For children with cerebral palsy, life can be challenging. However, clinical research has shown that with timely surgery, rehabilitation therapy, and continuous psychological support from parents, their motor functions can improve, their ability to live independently can be enhanced, and they may even reintegrate into society and lead fulfilling lives.

What are the rehabilitation guidelines for children with cerebral palsy? Rehabilitation and Treatment Guide for Children with Cerebral Palsy

We divide the treatment for children with cerebral palsy into several stages based on their characteristics. In each stage, we will outline what parents should do.

Discovery Stage  
0-1 Year:
It is often said that "children typically roll over at three months, sit up at six months, crawl at seven months, and walk at eight months." If a child at home significantly deviates from this developmental timeline, parents should be cautious and vigilant about the possibility of cerebral palsy. Particularly if the child exhibits symptoms such as overall weakness, tight limbs, a rigid body, difficulty feeding, exaggerated startle reflexes, or a weak cry, it is important to seek a comprehensive evaluation at a hospital promptly.

Generally speaking, the first six months are considered the golden rehabilitation period for children with cerebral palsy. If parents can identify and treat the condition early, there is a good chance that some children with cerebral palsy will achieve significant rehabilitation results, ideally before the age of one. Treatment within the first year primarily focuses on neuroprotective medications and rehabilitation therapy, which are essential for meaningfully improving the child's symptoms.

Early Rehabilitation Stage  
1-2.6 Years:

During this period, children with cerebral palsy can usually receive a definitive diagnosis. Once diagnosed, it is crucial to begin treatment promptly, focusing primarily on rehabilitation training. The first step is to help them learn to maintain correct postures. As the child develops better trunk control and feeding abilities, speech training can be initiated, while also preparing for any necessary future surgeries.

Key Rehabilitation Points

The level of motor function before surgery varies among children with cerebral palsy, which means that the severity of the condition is different, and this affects long-term outcomes. For example, children who cannot sit or stand before surgery will experience different levels of functional improvement compared to those who can sit, stand, or walk prior to the procedure.

Muscle Tone Variations: High Tone, Low Tone, Normal Tone

1. Preoperative Rehabilitation:
The primary focus of preoperative rehabilitation is to reduce muscle tone and stretch tendons and ligaments. This approach can yield short-term effects, but it does not truly resolve the child's underlying issues. Generally, once rehabilitation is paused for a period, the problems tend to recur, and this may lead to a continuous deterioration of the condition, resulting in more severe limb deformities.

2. Adhere to a structured rehabilitation program to prevent the occurrence of limb deformities.

3. Follow a daily routine with set times and quantities, progressing gradually. Avoid inconsistent approaches that lead to alternating periods of intense effort and neglect.

Surgical Treatment Stage
Surgical treatment addresses certain physical issues that cannot be resolved through rehabilitation training alone, such as excessive muscle tone and muscle spasms. For children with spastic cerebral palsy, they often remain in a state of high tension and rigidity for extended periods, leading to tendon shortening and joint contractures. As a result, they may walk on their toes rather than placing their heels on the ground like typical individuals.

Additionally, due to high muscle tone, these children often lack the ability to self-regulate. The most common issues they face include joint contractures, deformities, muscle atrophy, and shortening. They often present with quadriplegia, diplegia, or hemiplegia, frequently accompanied by movement disorders. Similarly, because of the excessive muscle tone, children with spastic cerebral palsy experience various movement disorders, such as crossing their legs while walking or walking on their toes. They often report that their limbs feel "stiffer" than those of typical individuals and have a smaller range of motion.

Due to excessively high muscle tone, children with this condition often have stiff muscles in their limbs. When standing or walking, they may exhibit overall body tension, with both upper limbs often flexed, making it difficult for them to fully extend their arms. Their lower limbs frequently display a cross-stepping gait, commonly referred to as a "scissors gait." At this point, the treatment focus shifts to a comprehensive approach combining surgery and rehabilitation. Preoperative rehabilitation is aimed at laying a solid foundation for the surgical treatment, while postoperative rehabilitation is designed to further consolidate the results of the surgery and promote the recovery of various functions.