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Treatment Methods for Spastic Children
There is no way to completely correct the damage to the spastic child's brain. The child's problems are addressed individually and there are solutions (s) for each of them. A single person cannot overcome these problems; Because each child has different problems, the treatment program will be different.
The treatment program may need to be continued more intensively at the beginning and then infrequently for years, sometimes with lifelong controls.
Drug treatment is also arranged separately for each child. Various drugs can be used for epilepsy seizures, muscular spasticity, slobbering problems. Drug treatment should be under the control of the doctor. The drug is initiated by the doctor, is not stopped without consulting the doctor or the dose is not changed. In case of side effects, the doctor is definitely notified.
Botulinum Toxin A
Walking at the fingertips, shear of the legs, knees bend, arms and hands can not be used completely because of spasticity treatment is a method used. This drug prevents the passage between the muscles and the nerve for a certain period of time. Thus, spasticity is reduced, functions such as walking, holding are better performed.
This medication can only be prescribed by doctors and is administered by an experienced physician. It is given to certain points of the spastic muscle with a suitable injector. If multiple injections are not to be administered, the child does not need to be anesthetized.
The effect of this drug is 3-12 months. Physiotherapy increases the duration of action. Repeatable if necessary. The relaxant effect on muscle starts after 1-2 weeks, and occurs exactly in 6 weeks. The child's walking becomes better. It is very important to have appropriate physiotherapy after injection and to give the device if necessary.
The side effect of the drug is extremely low. Pain at the site of the needle may be a general muscle weakness. Rarely, fever may occur in the legs. All of these side effects are temporary.
It can be applied to children over 2 years of age due to its negligible side effects and positive effects such as affecting only injected muscle.
Not applicable to children with severe spasticity throughout the body.
In children with diffuse spasticity, if oral medications do not provide adequate relaxation in the muscles, baclofen is given directly into the cerebrospinal fluid to provide relaxation. The drug in a computer-controlled pump placed under the abdomen skin is introduced into the spinal fluid with a catheter, also subcutaneously advanced. The medication in this pump is refilled as it is discharged. Thus, the whole body of the child is given relaxation. It is easy to maintain and can sit. You can walk thanks to a good exercise program. Children with this pump should be followed up regularly by the doctor. Infrequently seen, infection may occur and the catheter may come out of the spinal fluid. Severe muscle contractions may occur if baclofen is stopped suddenly.
Physiotherapy with this application is very important. In such an expensive method, the longer the effect can be extended, the greater the utilization.
The most important problem that makes movement difficult in spastic children is spasticity.
In the treatment of spasticity, firstly, the increasing causes should be eliminated. These; Filled bladder, pressure sores, ingrown toenail, constipation, infection may be. In addition, extreme heat or cold, sudden changes in temperature and excitement increase spasticity. Spasticity has some disadvantages and some wounds. Helps the child to stand by keeping the legs upright. Prevents weak bones.
Physical therapy and rehabilitation applications:
Cold application should be done for at least 20 minutes. Initially, muscle stiffness may increase, but decreases if application continues. The effect obtained by cold applications is longer than hot application.
Hot application provides general relaxation as well as muscle relaxation. Pain is a factor that increases spasticity. Decreasing spasticity also has a role in the pain relieving effect of cold and hot applications. In cold application, ice massage, ice bag, ice water bath, spray, in hot application hot packs, paraffin, pebble water bath, ultrasound can be used.
Continuous current reduces spasticity.
It is a technique that teaches the control of certain events that happen normally or become abnormal in the human body, such as visual, auditory stimuli generated using electronic devices. Success is achieved through training to reduce spasticity.
It is applied externally with the aim of keeping it in a certain position, the aim is to increase the function, prevent disorders and provide support. It is chosen according to the child's age and ability to move. As the child grows and develops, there may be no need or change over time.
The aim is to uncover, develop, organize and gain existing talents, to prepare for adulthood, to provide normal movement, to prevent disorders, to gain activities of daily living.
There are various methods in exercise. In all, the aim is to increase functions. Raising the child, ensuring balance, normal posture and walking are the main objectives.
Stretching, strengthening, joint range of motion and adaptation techniques are used.
It is aimed to develop hand skills suitable for the age of the child and to gain the activities of daily life.