Motricite Cerebrale最新文献

How do parents of children with PIMD understand and experience their child's orthopaedic issues ? How do they perceive and approach the various treatments proposed during their child's growth? Surgical indications are almost systematically part of the journey for children and adolescents with polyhandicap. How do parents receive these proposals and how do they navigate with professionals, their child, and their siblings during these significant periods? These are the questions that we discussed with three parents during this roundtable discussion.

The occupational therapist plays a central role in the development of an assistive device. They are in contact with the individual with PIMD for whom the assistive device project arises, their family, and the medical-educational teams. They accompany the orthoprosthetist from the molding stage to the delivery of the device. They contribute by proposing additions and potential new positioning devices to enhance the manufactured device. Each assistive device project is unique, and we will illustrate this diversity through several objectives related to clinical situations: limiting deformities, reducing risk situations, promoting well-being, enhancing participation in daily activities, managing pathological contractions to improve function, and improving cause-and-effect relationships.

The management of orthopaedic disorders in individuals with PIMD has been evolving rapidly in recent years. Knowledge related to polyhandicap is expanding, and our understanding of the interplay between the orthopaedic disorder itself and the neurological condition is leading to new therapeutic approaches. Reference texts on the support and care of individuals with PIMD have been published. The context of healthcare organization is also changing, prompting our institutions to adapt their operations. The role of families is also shifting access to a wealth of information about care and methods has diverse effects, ranging from dispersion to the development of expertise. These current developments represent challenges to be addressed in order to continue improving the quality of life and the future of children with PIMD and their families.

The Multihandicap Resource Center (CRMH) is dedicated to polyhandicap. The CRMH carries out activities aimed at families and professionals and is involved in various institutional and associative groups. Orthopedic disorders caused by neurological impairments significantly impact the quality of life of children with polyhandicap. Therefore, we have chosen this theme for the 2023 day of sharing and reflection. The purpose of this meeting is to enhance the care of individuals with PIMD.

The medical management of orthopedic disorders in children with polyhandicap is inseparable from the care provided for all aspects of their general health. Cutaneous, oral-dental, digestive, respiratory, bladder, and intestinal disorders are intricately linked to the neuro-orthopedic condition of the individual. Therefore, it is essential to assess the state of these organs and the functioning of these functions in order to unravel the cause-and-effect relationships of these impairments. Orthopedic disorders develop in their own right. The primary disorder generates secondary impairments. The pursuit of functional strategies may further deteriorate the orthopedic condition in the long run. Various rehabilitative approaches, combined with the use of orthoses, can help prevent or limit deterioration of the body's physical capabilities. Medical and surgical interventions aim to minimize the expression of spasticity and restore orthopedic function (joint mobility and muscle length) as much as possible. All proposed therapies should be part of the individualized plan for the person with PIMD.