چکیده:
Hypertonicity is the most common type of cerebral palsy consists of 85% of the affected children. It has a very complex nature making intervention and management very difficult. This article tries to make reader familiar with various types of intervention and introduce a new intervention process to help clinicians decide better. Literature was reviewed with two criteria including: identifying various interventions and their effects on upper limb hypertonicity and level ofinvasiveness of each intervention. This paper suggested a new way of looking at hypertonicitybased on its two components (i.e., neural and biomechanical) and effectiveness of each intervention on these components. In the treatment and management of hypertonicity, clinicians are required tolook at all aspects of hypertonicity and then based on the provided decision tree, decide which kind of treatment to be used for the child.
خلاصه ماشینی:
Iranian Rehabilitation Journal, Vol. 11, No. 18, October 2013 Reviews/Short communication Upper Limb Hypertonicity in Children with Cerebral Palsy: A review study on Medical and Rehabilitative Management Rassafiani, Mehdi1, PhD.
Management of the negative symptoms of the neural component differ, and include neuro- developmental treatment, biomechanical approach and constraint-induced movement therapy.
presents an overview of the hypertonicity management process based on the works of Barnes (2001) and Copley and Kuipers (1999) that helps therapists in their clinical decision- making by asking key questions (7).
The Intervention Methods and Their Influences on the Components of Hypertonicity / / / / 1Neruo-developmental treatment; 2 Biomechanical approach; 3Splinting; 4Casting; 5Constraint-induced movement therapy; 6 Antispastic Drug; 7 Botulinum Toxin-A; 8 Itrathecal Baclofen; 9 Surgery.
Various managements of hypertonicity from the least invasive (hands on techniques) to the most invasive (surgery) 1- Neuro-Developmental Treatment; 2- Constraint-Induced Movement Therapy; 3- Botulinum Toxin-A; 4- Selective Dorsal Rihzotomy Figure 2.
NDT was previously based on two important principles: (1) the use of reflex inhibiting postures (RIP) aimed at decreasing muscle tone by the use of postures to oppose the primitive reflex patterns typically assumed by the child and, (2) the facilitation of normal motor development through righting and equilibrium reactions (11).
(1997) investigated the effectiveness of NDT plus casting and occupational therapy on the hand function of 50 children with CP aged between 18 months and 4 years (16).
Methods of constraint- induced movement therapy for children with hemiplegic cerebral palsy: development of a child-friendly intervention for improving upper-extremity function.
Effects of botulinum toxin A on upper limb spasticity in children with cerebral palsy.