Motricite Cerebrale最新文献

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.

Gravity has captured the attention of thinkers since Aristote. Scientists are always trying to more understand the physical mechanisms and their impacts on terrestrial and extraterrestrial life. Despite all the progress in scientific and clinical research, we still don’t know certain mechanisms of functions and the extraordinary powers of this gravity. Moreover, man is one of the living beings that is directly linked to this gravity. Scientific studies prove the impact of this gravity on height and weight development, the functions of vital organs due to inactivity, and the socio-cultural behavior of human beings. From the neurophysiological point of view, the biomechanics of man in connection with the sensory-motor vectors are intimately linked to the vector of the vertical. This vector is in perpetual change during the passage of the man from the lying position to the standing one and obviously during the walk-in order to build a trajectory and a direction to the movement. However, little scientific and clinical evidence has been revealed on the effect of gravity in the field of Cerebral Palsy and in particular that of multiple disabilities. The complex and heterogeneous clinical picture raises the limits of research in the field of multiple disabilities. However, international consensus and studies are gradually emerging trying to better understand the importance of this severity on the health of people with multiple disabilities. This case study of a child with multiple disabilities highlights the news in the literature review. The Physiotherapist evokes this clinical and scientific problem of the device and its link with gravity by proposing an installation which he calls “MOBIVERT” to put the child in charge in a course of listening, observation and sharing. of experience with the medical, paramedical, psycho-educational and social fields.

Aim

This article is a case study of an early rehabilitation of the upper limb of children under twelve months of age at risk of unilateral cerebral palsy. The aim is to propose a constraint-induced movement therapy in a private practice, to analyze its benefits and to confront it with the existing literature on the subject.

Method

After a selection of articles from the scientific literature, it is introduced the case of a child who has had a stroke at the second day of life, and the early rehabilitation established with the Baby-CIMT tool in private practice and the family support in the home rehabilitation.

Results

This technique, adaptated to the private practice, allowed to promote the activity and participation of the child and her family, it also promoted the use of the affected upper limb.

Discussion and conclusions

It seems that despite the contributions allowed by the Baby-CIMT, the transfer of competences toward bimanual activities is not really effective. This could be achieved by coupling this therapy with daily life activities or bimanual therapy. However, the involvement of the family seems to be directly related to the functional outcome of the child.

Introduction

Internships in a professional environment, school holidays, lockdowns… As a physiotherapist, ensuring care continuity of teenagers and young adults with Cerebral Palsy (CP), within medico-social structures, requires permanent adaptability to avoid any lasting period with no activities of physical therapy.

Method

This work is a case study using a digital home program (smartphone app) of goal-oriented exercises and carried out during a transitional downtime of an eight-week physiotherapy care.

Results

The compliance achieved by the subject is equal to 75% over the entire period.

Conclusion

Home-program, with specific environmental factors associated with personally favoring factors, was a way for the therapist to ensure continuity during a period of transitional interruption of physiotherapy management.

After recalling the factors that make complex the assessment of visual skills in people with profound intellectual and multiple disabilities, this article presents the results of a survey conducted among several expert services in Europe, as well as those of a systematic review of the literature aimed at identifying the tools and procedures that can be used and are used with that population. The consultation of fifteen centers, as well as a systematic review of the scientific literature carried out in six databases, made it possible to highlight a set of procedures, tests and clinical material, most of which have been validated and of great clinical interest. Two links are available in the article, one leads to the recommendations for optimal assessment conditions provided by the centers, the other to a more detailed description of the procedures, tests and clinical materials identified. It should be noted, however, that much of the material identified is not yet available in French and that a translation effort could be considered in order to enrich the French toolbox in the field.

Introduction

“Polyhandicap” is a French term used since the 1960s originally in the context of medico-social institutions. Its closest english translation is “Profound Intellectual and Multiple Disabilities” but these terms may reflect a slightly different approach. Recent recommendations were issued by the French “Haute Autorité de santé”. The objective of this study is to explore the representations of different french stakeholders associated with “polyhandicap”, in order to better define the concept and facilitate international publications.

Methods

This study is based on 33 semi-structured interviews conducted from January to April 2021 with medical doctors, rehabilitation workers, caregivers, and administrative staff involved with such patients. The interview explored the respondents’ opinion regarding the definition, assessment and management of “polyhandicap”.

Results

Forty-five percent of the respondents include profound intellectual disability in the core-definition of “polyhandicap”. Other respondents highlight the variability of the importance of mental retardation and some associate this item to the difficulties encountered in communication. Coexisting disabilities are more or less extensively listed. Fifty-eight percent of the respondents state that the term of “polyhandicap” should not be restricted to injuries taking place during early brain development. Fifty-five percent consider that the needs of such patients are not adequately met.

Discussion

These multiple representations, source of confusion, can be detrimental to people with “polyhandicap”. This French concept, comprising three levels of analysis (medical, functional and social), and imperfectly covering other terms used abroad, is difficult to transpose internationally.