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Therapy for a Child with
Hydranencephaly
For children with Hydranencephaly, the
main purposes of Physical Therapy are:
- to maintain or improve function of all
limbs
- to prevent deformities and contractures
- and to help your child be as
comfortable as possible.
- to help them learn to play and have fun
What Physical Therapy Looks like in a child with Hydranencephaly:
Physical Therapy (PT, or Physio) in a
child with Hydranencephaly will have a number of components.
- preventing deformities by doing range
of motion exercises (called stretches or ROM).
- using splints, braces, etc to maintain
a good position in each of the limbs.
- teaching you how to position your child
to prevent deformities and to maximize comfort. This is done using a wide
variety of pieces of equipment.
- Using different methods such as
hydrotherapy, Hippo Therapy (Horse back riding), massage to relax tight
muscles and improve function
- Using medications to reduce spasticity
- Surgery to prevent or repair damage
from the spasticity.
To do that, many different strategies
can be used, including both treatment and positioning. In this section are some
suggestions based on the experiences of families including treatments and
equipment used.
Neuro-developmental
Treatment is the form of therapy most often used for our children.
Physical therapy: NDT-trained (neuro-developmental
treatment), for gross motor skills. Considered one of the mainstay therapies for
cp, it is used to decrease spasticity, strengthen underlying muscles, and teach
proper or functional motor patterns. A good PT will also teach the
family/care-givers how to help the person with cp to help themselves.
What is Neuro-Developmental
Treatment?
Neuro-Developmental Treatment (NDT) is a therapeutic approach used in
working with people who have central nervous system insult that create
difficulties in controlling movement. Berta and Karel Bobath of London, England,
a therapist/physician team, developed the NDT approach in the 1940’s. Originally
working with children with cerebral palsy and adults with stroke, they believed
in treating the many complex problems with control of movement caused by central
nervous system insult. Persons having minimal to severe motor difficulties can
benefit from the Neuro-Developmental Treatment approach.
Theory of Neuro-Developmental
Treatment
While the practice of the NDT approach is supported by research in the
movement sciences and psychology, the understanding of how and why Neuro-Developmental
Treatment works is constantly updated and refined. As the understanding in the
sciences changes, NDT theory is modified and enhanced. There are currently four
broad statements of belief in NDT theory:
·
A person’s ability to function is a result of their
many body systems working together smoothly and efficiently. Additionally, parts
of those systems such as a muscle, sensory process or respiratory pattern assist
with the movements in the person’s unique daily environment.
·
Those who use the NDT approach base efficient movement
on the study of motor control, motor development and motor learning. There are
consistent ways that people learn and lose motor skills throughout their lives.
This can be studied and compared to people who have movement problems that
interfere with learning motor skills.
·
People with central nervous system insult exhibit some
predictable difficulties with their movement that results in loss of function.
·
Treatment begins with an assessment of the person’s
functional performance. It then focuses on building the person’s abilities while
addressing the movement problems. The goal of NDT is to help the person achieve
functional skills by addressing movement difficulties.
The Practice of Neuro-Developmental
Treatment
Therapists who use the NDT approach believe that early treatment can be
instrumental to success. However, the approach also works with individuals who
have long-term disabilities, but have the potential to gain new functional
skills. To assist people in learning functional skills, the therapist first
observes the movements the person can do. They then analyze the areas in which
there are movement difficulties. The therapist observes the movement, often
putting his/her hands on the person to feel how the person moves, i.e., what
muscles are working and how they work. By guiding the correct movement with
his/her hands on the person, the therapist often finds that more functional
movements can begin.
Guidance is removed as the person is
able to perform the skill more independently and efficiently. Carefully planned
verbal instructions or other forms of guidance may be used by the therapist to
help people learn new skills.
In addition to this direct treatment,
therapists who use the NDT approach believe that the person being treated is
best served by a team. This could include their family, physicians, other
therapists, teachers, nurses, orthotists or others.
Neuro-Developmental Treatment
Association
1550 South Coast Hwy., Suite 201
Laguna Beach, CA 92651
800/869-9295
Fax: 949/376-3456
www.ndta.org
Other pages in this section:
Cerebral Palsy
Orthopedic Considerations
Medical Treatments for Spasticity
Orthopedic Surgery links and
resources
Orthopedic Surgery Personal Experiences
Range of Motion Therapy
Other Types of Therapy
Principals of Positioning
Positioning:
Orthotics and Splints
Orthotics and Splints Experiences
Equipment
Wheelchairs
Alternate Positioning
Standers
Personal Care: Practical
Information
Practical Care: Transportation
Practical Care: Carrying and Lifting
Sleeping Medications
Glossary
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