All external CP treatments. Those that are either in direct contact with skin, such as tape or garments, as well as all activities and interaction with the environment that are useful in core strength building and being active. In alphabetical order.
Developed in the Soviet Union in the 1970s the suit was designed to allow cosmonauts to exercise in the weightlessness of outer space. In 1991 it was introduced as a treatment for cerebral palsy. The Adeli suit uses a system of pulleys and elastic bungee bands that offer resistance to the body in order to prevent muscular atrophy.
The Adeli suit is used for trunk and leg work only. The connecting elements of the suit mirror the human musculature system: flexors, extensors, abductors and rotators of both the trunk and the legs.
The Adeli suit is made up of a vest (or shoulder pads), a wide belt or shorts, knee covers, and specially modified shoes. There are attachments for auxiliary modifications. All the pieces are attached together with a series of bungee cords.
The cords are adjustable to allow for different levels of tension to any particular area. The bungee cords are used to keep the body in proper alignment and to promote movement.
The suit does not restrict a user’s movement, but it challenges the person to exert slightly more effort for a particular movement. The adjustable tensions of the bungee cords allow for greater variation for users.
By using the Adeli suit the brain is stimulated differently and is retrained to understand, ultimately initiate, better muscle movement. In correct posture alignment the movement will re-educate the brain due to neuroplasticity.
There is a proprioceptive improvement in motor control using the Adeli suit. And once relearned the learned paths are usually retained.
Any changes to the suit during usage must be done by the therapist, or another person. This means that the suit can not be used without assistance.
Dohsa hou is a psychological habilitation training method created in Japan. It focuses on improving motor difficulties of children with cerebral palsy. It teaches the CP child movement therapy to maintain correct stable posture as well as improve sleep by self-relaxation. Each movement is a psychological activity, where the desired movement is called goal directed striving.
“Dohsa-hou, a Japanese psychorehabilitation method for motor training, was introduced to 10 subjects with cerebral palsy in a pre-post (6-wk.) design. Four expert raters were asked to judge the improvement in range of motion, ease and smoothness of movement, correctness of posture) of these subjects. Findings suggest that the training method had a significant effect on body movement as compared to body posture. Since the effect may be peculiar to this subject group, further studies are suggested.”
From: Psycho-Rehabilitation Method (Dohsa-Hou) and Quality of Life in Children with Cerebral Palsy.
By A. Dadkhah
Come back soon to read more!
Hippotherapy is a medical therapy used in the treatment of individuals with mental and/or physical disabilities. It involves horse riding! The horse’s movement has been proven to positively influence sensory, neuromotor and cognitive ability.
Riding a horse is excellent for building core strength… not to mention fun!
Hydrotherapy / Aqua Therapy
Hydrotherapy is the medical treatment used to relax and support the body while doing exercises in warm, shallow water. The warm water of the pool eases muscle pain and helps relax muscles and joints. The water also supports the person’s body weight.
The Kinesio Taping Method as a system used to help in postural control. It involves using different thicknesses and widths of Kinesio Tape, at varying levels of tension depending on the desired effect. Kineso Tape can be used to assist the body in directing limbs or ‘reminding’ the trunk or neck stay upright for example. It improves proprioceptive understanding.
Lycra / Elastomeric Fabric
Lycra orthotics/garments are used in the treatment and management of neurological dysfunctions such as cerebral palsy. As the name implies, they are made of spandex (Lycra is a ® name!).
Each lycra orthotic is made bespoke and is formfitting. A lycra garment is made of several different thicknesses of lycra. Depending on the person’s need, the lycra is layered and reinforced differently.
Over the basic form of the garment, differently sized cuts of different thicknesses (ie. Strengths) of lycra are superimposed on top to assist the person into a more normal posture.
A scissored gait for example can be adjusted naturally by using thicker lycra sections to assist the abductors and give them a stronger chance against the adductors. And because they are bespoke, each person’s unique gait pattern can be addressed very specifically.
Lycra garments can come as gloves, sleeves, full bodysuit, shorts, or socks.
Besides improving postural control the movement, lycra garments also contribute to an improved proprioceptive understanding.
Orthotics focuses on the design, fabrication and use of devices which are instrumental in the management of cerebral palsy. Orthotics deals with braces, splints, insoles, supports, heel inserts, AFOs (Ankle Foot Orthoses) and any device used externally to make life easier for the individual.
My view: I’ve always found AFOs quite medieval…possibly even barbaric. To keep Julian’s feet in the correct position, and stop him from tiptoeing, it was consistently advised that he wear them all day.
However, because AFOs immobilise the ankle, preventing any movement, that presented a problem on many fronts. Their restrictive design completely inhibits normal ankle flexion. Not to mention zero muscle usage below the knee. And then of course, there is the fact that they stabilise and completely support the lower leg, preventing it from developing that strength and ability naturally.
So, understanding how absolutely important AFOs were in helping Julian maintain correct foot posture… we were presented with a catch-22 decision. Should we prevent him from tiptoeing all the time by wearing the AFOs? Or, should we allow him to develop and grow as naturally as possible without them?
Without the support of his AFO’s Julian would stand still by shuffling from leg to leg. Even tiptoed, as he shuffled, he would occasionally heel strike… that was a good enough sign for us. So, contrary to medical advice we decided to play it by ear everyday as to when he would wear them. In the morning, when we did our morning stretch before school, we would see how his feet managed. If he seemed flexibile that morning, he would go to school without his AFO’s. If he seemed tighter, but not seriously so, he was allowed to take them off at lunch. If however, he was having a particularly tight day, they would stay on until he came home.
I need to stress here however, that we allowed ourselves this choice because Julian has a very strict regime of physio and always does after-school physio to keep track. So we are always on top of it.
Sensory Integration Therapy
Sensory integration therapy helps individuals with sensory dysfunction build a proper mental and physical framework within their nervous system to better understand sensory input. A person with sensory dysfunction can often seem clumsy. The condition can also cause under-sensitivity or over-sensitivity which can lead to mental and physical distraction and fatigue.
Sensory integration therapy is used to help the child understand or sensory input.
A Therasuit (ie. Therapy Suit) is a soft canvas suit with bungee cords. Used in tandem with the universal exercise cage (I.e. Spider Cage), better patterns of movement through strengthening and improving motor function ability. The Therasuit method improves balance, coordination and motor skills, as well as general body awareness. (same as Adeli Suit above)
Vojta therapy is a type of physiotherapy originally developed for children with cerebral palsy. It is a dynamic neuromuscular treatment in the principles of reflex-locomotion. It works on the assumption that movement spastic child is subject to functional barriers.
From the vojta.com website:
“In Vojta Therapy, movement functions, such as grasping, rolling over from the back onto the stomach or walking, are not practised. Rather, the therapeutic activation of reflex locomotion facilitates access, via the central nervous system, to the individual segmental patterns of movement necessary for a specific movement or activity.
After Vojta treatment, these segmental patterns are more available spontaneously to the patient. Regular repetition of the “normal movement” stored in the brain prevents evasion movements being practised. In any case, these would only be a substitute for the actual, and therefore desired, normal movement.”