Handling the Child with Cerebral Palsy: Difference between revisions

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=== Introduction ===
=== Introduction ===
[[File:Handling .png|thumb]]
[[File:Handling .png|thumb]]
Children with cerebral palsy have abnormal muscle tone and movement, resulting in abnormal posture that makes it difficult for them to handle<ref>Nancy Finnie,Handling the Young Child with Cerebral Palsy at Home, 4th Edition edited by  Eva Bower, Annabel Milne, 2008</ref>. When working with children with [[Cerebral Palsy Introduction|cerebral palsy]], parents, caregivers, or therapists must be knowledgeable about handling skills. Children with cerebral palsy show atypical movements that restrict the child's ability to develop<ref>Archie Hinchcliffe, Children with cerebral palsy: A manual for therapists, parents and community workers, second edition published in 2007.</ref>, and if the child remains in an atypical position for a long time, deformities may occur, which can lead to a permanent disability. Handling skills are important in all [[Cerebral Palsy Interventions|interventions for cerebral palsy]]. Good handling facilitates more purposeful active movements for a child with cerebral palsy<ref>Freeman Miller, MD, Cerebral Palsy, 2005, ISBN 0-387-20437-7</ref>.
Children with cerebral palsy have abnormal muscle tone and movement, resulting in abnormal posture that makes it difficult for them to handle<ref name=":0">Nancy Finnie,Handling the Young Child with Cerebral Palsy at Home, 4th Edition edited by  Eva Bower, Annabel Milne, 2008</ref>. When working with children with [[Cerebral Palsy Introduction|cerebral palsy]], parents, caregivers, or therapists must be knowledgeable about handling skills. Children with cerebral palsy show atypical movements that restrict the child's ability to develop<ref name=":1">Archie Hinchcliffe, Children with cerebral palsy: A manual for therapists, parents and community workers, second edition published in 2007.</ref>, and if the child remains in an atypical position for a long time, deformities may occur, which can lead to a permanent disability<ref>Pérez-de la Cruz S. Parálisis cerebral infantil y el uso de sistemas de posicionamiento para el control postural : estado actual delarte.Neurología.2017;32:610—615.</ref>. Handling skills are important in all [[Cerebral Palsy Interventions|interventions for cerebral palsy]]. Good handling facilitates more purposeful active movements for a child with cerebral palsy<ref>Freeman Miller, MD, Cerebral Palsy, 2005, ISBN 0-387-20437-7</ref>.


== What is Handling? ==
== What is Handling? ==
Handling is the ability of a person to position, carry/hold, and move a child with cerebral palsy or other neurodevelopmental disability in such a way that his/her body achieves [[Positioning the Child with Cerebral Palsy|postural control]].  
Handling is the ability of a person to position, carry/hold, and move a child with cerebral palsy <ref name=":0" />or other neurodevelopmental disability in such a way that his/her body achieves [[Positioning the Child with Cerebral Palsy|postural control]].  
[[File:Handling a child.png|alt=|border|thumb]]
[[File:Handling a child.png|alt=|border|thumb]]


It is necessary for both parents and caregivers, to have the knowledge, and handling skills, as they stay with them almost many hours per day. Proper handling will help a child to do more purposeful activities and help the brain learn typical posture.<ref name=":1" />.


It is necessary for both parents and caregivers, to have knowledge of handling children with cerebral palsy, as they stay with them almost many hours per day. Proper handling will help a child to do more purposeful activities and help the brain learn typical posture. Handling can be done using hands, or other equipment.
Different research has highlighted the importance of different handling techniques that are used in handling children with cerebral palsy and their effect on muscle activation<ref>Paludo, T., Zardo, F., de Mattos, B. T. P., Frata, B., Ling, C. C., de Castro Barroso, G., & Cechetti, F. (2022). Measuring muscle activation using electromyography during neurodevelopmental treatment in individuals with severe cerebral palsy. ''Journal of back and musculoskeletal rehabilitation'', 10.3233/BMR-220113. Advance online publication. <nowiki>https://doi.org/10.3233/BMR-220113</nowiki></ref>, and promoting postural control, among children with Cerebral Palsy<ref>Bain K, Chapparo C. The impact of neurodevelopmental treatment on the performance of daily living tasks by children with cerebral palsy. Developmental medicine and child neurology, 2012, 54, 51 | added to CENTRAL: 31 October 2014 | 2014 Issue 10
                                                        {{#ev:youtube|c9LyCzhvFPE}}
 
<nowiki>https://doi.org/10.1111/j.1469-8749.2012.04289.x</nowiki></ref><ref>Acar, G., Ejraei, N., Turkdoğan, D., Enver, N., Öztürk, G., & Aktaş, G. (2022). The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. ''Dysphagia'', ''37''(4), 800–811. <nowiki>https://doi.org/10.1007/s00455-021-10329-w</nowiki></ref><ref>Ejraei, N., Ozer, A. Y., Aydogdu, O., Turkdogan, D., & Polat, M. G. (2021). The effect of neck-trunk stabilization exercises in cerebral palsy: randomized controlled trial. ''Minerva pediatrics'', 10.23736/S2724-5276.21.06206-6. Advance online publication. <nowiki>https://doi.org/10.23736/S2724-5276.21.06206-6</nowiki></ref>.  
{{#ev:youtube|c9LyCzhvFPE}}
== '''Effect of Handling on human body''' ==
== '''Effect of Handling on human body''' ==
Our body changes the position according to external sensory feedback, and this is called [[Positioning the Child with Cerebral Palsy|system sensory feedback versus feed forward control]]. It is necessary to observe the child, prior to handling, because any sensory feedback from hands, or equipment will result in typical or atypical movement. The knowledge on [[Postural Control|neurologic control of musculoskeletal system]] is necessary to master appropriate handling .
Our body changes the position according to external sensory feedback, and this is called [[Positioning the Child with Cerebral Palsy|system sensory feedback versus feed forward control]]. It is necessary to observe the child, prior to handling, because any sensory feedback from hands, or equipment will result in typical or atypical movement. The knowledge on [[Postural Control|neurologic control of musculoskeletal system]] is necessary to master appropriate handling .

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Introduction[edit | edit source]

Handling .png

Children with cerebral palsy have abnormal muscle tone and movement, resulting in abnormal posture that makes it difficult for them to handle[1]. When working with children with cerebral palsy, parents, caregivers, or therapists must be knowledgeable about handling skills. Children with cerebral palsy show atypical movements that restrict the child's ability to develop[2], and if the child remains in an atypical position for a long time, deformities may occur, which can lead to a permanent disability[3]. Handling skills are important in all interventions for cerebral palsy. Good handling facilitates more purposeful active movements for a child with cerebral palsy[4].

What is Handling?[edit | edit source]

Handling is the ability of a person to position, carry/hold, and move a child with cerebral palsy [1]or other neurodevelopmental disability in such a way that his/her body achieves postural control.

It is necessary for both parents and caregivers, to have the knowledge, and handling skills, as they stay with them almost many hours per day. Proper handling will help a child to do more purposeful activities and help the brain learn typical posture.[2].

Different research has highlighted the importance of different handling techniques that are used in handling children with cerebral palsy and their effect on muscle activation[5], and promoting postural control, among children with Cerebral Palsy[6][7][8].

Effect of Handling on human body[edit | edit source]

Our body changes the position according to external sensory feedback, and this is called system sensory feedback versus feed forward control. It is necessary to observe the child, prior to handling, because any sensory feedback from hands, or equipment will result in typical or atypical movement. The knowledge on neurologic control of musculoskeletal system is necessary to master appropriate handling .

Importance of Appropriate Handling[edit | edit source]

Appropriate handling of a child with cerebral Palsy leads to postural control:

  1. Normalization of tone or reduction of its abnormal influence on the body
  2. Maintenance of skeletal alignment and prevent future deformities.
  3. Providing a stable base of support to promote maximum functioning.
  4. Promoting tolerance to the desired position
  5. Promoting comfort and relaxation
  6. Facilitation of normal movement patterns or control of abnormal movement patterns
  7. Regulating pressure or preventing the development of pressure sores
  8. Reduction of fatigue
  9. Improving autonomic nervous system function (cardiac, digestive, and respiratory)
  10. Facilitation of maximum function with minimal pathology

Points to Consider while Handling a Child with Cerebral Palsy.[edit | edit source]

Handling a child with Cerebral Palsy needs to take into consideration the followings:

1. Observing the child first:[edit | edit source]

Through Observation, the person has information on atypical movement patterns and the presentation of the child in general.

2. Have Knowledge about the Physiopathology of Cerebral Palsy.[edit | edit source]

It is very important to know why abnormal movement patterns occur in a child with cerebral palsy and what you can do to influence the near-normal movement pattern. This knowledge will also help you make sense of what you observe and where to start while placing your hands through handling. It is also good to understand that you will not take away Cerebral palsy, but you can help the child to learn and develop to their full potential and continue to leave and enjoy life like other children without cerebral Palsy.

3. Feel the movement using your hands:[edit | edit source]

After observing a child, the person places the hands cautiously to feel the movement and see the reaction of the child.

'Talk to the child while handling him/her: It is necessary to talk to the child while handling him/her because physical, communicative, and intellectual skills cannot be learned in isolation.

4. Help the child to practice![edit | edit source]

It is important to allow the child to practice the skill learned through playing and while doing all their activities of daily living such as bathing, combing, dressing, eating, toileting, etc. to master appropriate movement and posture.

5. Don't Remove support if the child has not yet mastered the skills.[edit | edit source]

Even if the child can maintain a good posture for some time, you must understand that what you have accomplished in one session will not necessarily continue when you take your hands away. It takes time and needs to be practiced in the child's daily life.

6. Make handling Fun and Active![edit | edit source]

In a natural way, children learn while they are playing, it is necessary for making the handling playful to help the child maximize their learning, and actively participate in the activity.

  1. ↑ 1.0 1.1 Nancy Finnie,Handling the Young Child with Cerebral Palsy at Home, 4th Edition edited by Eva Bower, Annabel Milne, 2008
  2. ↑ 2.0 2.1 Archie Hinchcliffe, Children with cerebral palsy: A manual for therapists, parents and community workers, second edition published in 2007.
  3. ↑ Pérez-de la Cruz S. Parálisis cerebral infantil y el uso de sistemas de posicionamiento para el control postural : estado actual delarte.Neurología.2017;32:610—615.
  4. ↑ Freeman Miller, MD, Cerebral Palsy, 2005, ISBN 0-387-20437-7
  5. ↑ Paludo, T., Zardo, F., de Mattos, B. T. P., Frata, B., Ling, C. C., de Castro Barroso, G., & Cechetti, F. (2022). Measuring muscle activation using electromyography during neurodevelopmental treatment in individuals with severe cerebral palsy. Journal of back and musculoskeletal rehabilitation, 10.3233/BMR-220113. Advance online publication. https://doi.org/10.3233/BMR-220113
  6. ↑ Bain K, Chapparo C. The impact of neurodevelopmental treatment on the performance of daily living tasks by children with cerebral palsy. Developmental medicine and child neurology, 2012, 54, 51 | added to CENTRAL: 31 October 2014 | 2014 Issue 10 https://doi.org/10.1111/j.1469-8749.2012.04289.x
  7. ↑ Acar, G., Ejraei, N., Turkdoğan, D., Enver, N., Öztürk, G., & Aktaş, G. (2022). The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. Dysphagia, 37(4), 800–811. https://doi.org/10.1007/s00455-021-10329-w
  8. ↑ Ejraei, N., Ozer, A. Y., Aydogdu, O., Turkdogan, D., & Polat, M. G. (2021). The effect of neck-trunk stabilization exercises in cerebral palsy: randomized controlled trial. Minerva pediatrics, 10.23736/S2724-5276.21.06206-6. Advance online publication. https://doi.org/10.23736/S2724-5276.21.06206-6
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