Pediatric Rehabilitation in Children with Cerebral Palsy: General Management, Classification of Motor Disorders

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Abstract

Cerebral palsy (CP) is the most common physical disability in childhood. The motor impairment syndrome is obligatory for the diagnosis, but a broad range of neurological deficits can be present as well. Professionals in pediatric rehabilitation are faced with a diversity of problems in the child and family (physical, psychological, communicative, and social), so a multidisciplinary approach for treatment is needed. The International Classification of Functioning offers a framework for team management in the treatment of children with CP. Based on this concept, an instrument for team conferences, the Children’s Rehabilitation Activities Profile is described. This instrument can be used for systematic evaluation of the needs of the children and parents, the total development and evaluation of the goals of rehabilitation on the level of activities. In children with CP, three main kinds of motor disorders are seen: spastic paresis; ataxic paresis, and dyskinetic paresis. In the most common disorder, spastic paresis, many different impairments of muscle function are described. Spasticity is only one of the components of a spastic paresis. The clinical consequences of these differences are discussed. In children with walking ability, the walking pattern is related to the functional prognosis of ambulation at adulthood. A classification of walking patterns is presented that can be used as a framework for treatment programs.

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