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Physical Medicine
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Kinesitherapy
 Kinesitherapy It
is main method in the treatment of children with CP of all ages. It has best
effect when it is started in the nurseling age. Then is recommended to stimulate
the co-ordination of the movements by the Vojta and/or Bobath’s methods, preferring
Vojta’s. After the child grow up at 2 years calendar age or motor age more than
9 months (independent creeping) the methods of Bobath and sensoric-integrational
therapy are more used. To them are added some elements of the Vojta’s method.
In the children after 5th year are included also analytic physical exercises.
After the age of 7 mechanotherapy, supported by analytic physical exercises
are mainly applied.
The kinesitherapy is daily applied.
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| Low-frequency elctrotherapy |
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- Electrostimulations – They are applied in local and reflex manner.
The local type is applied in relatively weaken muscles, antagonists of the
spastic ones, as when indicated there could be applied in the nurseling age
yet. The reflex type is applied in the area of the cervical and/or lumbal
thickening of the spinal cord depending on the child’s diagnosis, his/her
motor abilities and the stage of the muscular hypertonus. There are carried
out 4-6 courses per year with 10-15 procedures each.
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- Electrophoresis – It is applied mainly to children with damages of
the peripheral nerves or muscles. It is obligatory applied before the electrostimulations,
is there are such ones prescribed. The electrophoresis is carried out with
Nivalin, Dibazol and other medicines.
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| Magnetic-fieldtherapy – In this therapy
are applying low-frequent impulsive magnetic field – transcerebrally. Magnetic
field improves brain metabolism by activation of oxidative process and blood flow
in it and stimulate its development. It carries out 2-4 courses yearly with 15-20
procedures trough first year. |
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Termotherapy -  It
includes heat application by paraffin, gel or cold applications with gel, ice
or cold air. The procedures have well expressed myorelaxing effect. They are
applied to children after 2-years age with spastically increased muscular tone
and when indicated to smaller too. The cryo-therapy is less applied and more
in the summer period since the children with CP are predisposed to common cold.
The heat applications are used mainly during the cold months and they should
be carefully applied to avoid overheating of children with epilepsy. The cryo-therapy
has rapid and short-lasting effect while the heat-therapy has slow and long-lasting
effect.
There are carried out 8-10 courses per year with 10-20 procedures each.
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| Hydrotherapy - In this therapy applies underwater jot
massage, which has well expressed myorelaxing effect in dependence of the dosage.
Also it applies to children from 1 to 3 years old and takes big part in body build
scheme creation. This therapy applies mainly at summer time because of the children
with cerebral palsy often suffer from common cold diseases. It carries out 2-3
courses yearly with 10-15 procedures. |
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| Mechanotherapy - This therapy executes in school time
in order to strength definite muscles and muscles groups by analytical way. For
this therapy are used Ketler's equipment. |
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| Phono-foresis - It applies with drugs (fibrinolitic ungvents)
below acute phase after post-surgical rehabilitation. It is contributes better
scattering round swelling and tendon’s block. It is conducts 1-2 courses with
15-20 procedures. |
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Position therapy - This therapy conducts by vertical tables and static
splints and other devices. The equipment allow detaining passive range of motion
in the joints, reached after myorelaxing procedures and kinesitherapy. This
therapy applies under lap and according to individual child's state, mainly
after first year.
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