Motricite Cerebrale最新文献

The prevention of swallowing disorders in the disabled person requires the neck to be flexed throughout the meal and the food and drink textures to be adapted to the person's abilities. This simple but complete assessment allows the collection of all the information that will enable the observation during the meals to be refined in order to adjust this installation and these textures. Easily achievable and reproducible, it can be redone as soon as the professional and family carers who participate in the meals realize that the person is not eating with pleasure, comfort and safety.

Adults with severe cerebral palsy and restricted autonomy are able to engage in meaningful activities suitable for their locomotor abilities and appropriate to stimulate their cognitive skills. Experimental assistive mobility with an electric wheelchair is one example. Here, we present seven case reports of adults with multiple and severe disabilities, living in institutions. They were proposed training sessions, guided by a multidisciplinary team and dedicated to the discovery of using an electric wheelchair. We show that the learning milestones that are described in children with motor deficiency when beginning to use an electric wheelchair are also observed in our adults. For each individual, depending on the severity of his/her neurological damage, this experiment revealed the level (exploratory or operative) of cognitive ability that was reached after training. For all of them, the discovery of a self-initiated mobility was a source of intense emotional and attentional mobilisation.

Neuromotor therapies, without belonging to a consensual definition, designate a heterogeneous set of rehabilitation proposals and are known and practiced by the majority of therapists working with children suffering from cerebral palsy. These therapies also sometimes simply inspire and complete the therapist's proposals. Nowadays, the evidence based practice model is challenging the use of these rehabilitative therapies. Indeed, the choice of a therapy is made according to a triptych made up of the skills and aspirations of the professional, but also according to the wishes of the parents and the child with cerebral palsy and the best available research data. The current scientific trends are not yet clear concerning the interest of these therapies for young children. There is a lack of evidence, due to the paucity of consensus concerning the description and practical implementation of the therapies, and also due to the deficiency of rigorous studies on which to base recommendations.

This case study follows the literature review entitled “What use of intermittent positive-pressure breathing in severe cerebral palsy?” published in Revue Motricité Cérébrale 434 (2022) 45–50. It aims to confront the results of literature and clinic on the impact of the use of intermittent positive-pressure breathing in severe cerebral palsy. The literature review didn’t allow clear-cut conclusions. However, it let us think that, in severe cerebral palsy, the use of intermittent positive-pressure breathing at suitable pressure levels could improve and maintain over time lung compliance, mobilize the patient's rib cage, ventilate poorly ventilated lung areas and remove atelectasis. It could also facilitate bronchial drainage by increasing the volume of air mobilized when using chest physiotherapy technics. Therefore, this clinical case study seeks to assess the impact of intermittent positive-pressure breathing in a patient with severe cerebral palsy, on his chronic bronchial congestion, his respiratory volumes, his ability to cope with an increase in the respiratory load and his quality of life as well than that of his parents.