Rehabilitative training effects of severe mixed-type cerebral palsy in children One case report

摘要

It has often been thought that severe spastic and athetoid cerebral palsy children respond poorly to rehabilitative training effects and have a poor prognosis after school age. The present study included a nine-year-old severe spastic and athetoid cerebral palsy boy, who 收稿日期 2 years of physical therapy, supplemented with drugs and orthotic devices and who acquired good therapeutic effects. The beneficial rehabilitative effects were as follows: After discharge, primitive reflex disappeared, and both vertical reflex and parachute reflex were found; In the establishment of balance reflex, sitting position was rated as level Ⅲ, and standing position was rated as level Ⅱ. The boy could independently walk for 30-50 meters. In the assessment of muscle tone, the level was rated according to the Modified Ashworth Scale and was decreased from three, four to one, two, and the level rated according to the Clonus Scale decreased from Ⅴ to Ⅱ. Motor function was noticeably improved. The level was rated according to the Gross Motor Function Classification System and was decreased from Ⅴ to Ⅱ. The total score of 88 items of the Gross Motor Function Measure was increased from 6.1% to 72.2%. The Berg Balance Scale score increased from 0 to 42. The Holden Walking Functional Classification level increased from 0 to 3. The score of activities of daily living increased from 9.5 to 70. The symptoms of dysarthria were alleviated from severe to moderate, and those of salivation were alleviated from level Ⅴ to level Ⅰ. These results demonstrated that after systemic and scientific treatment and training, the spastic and athetoid cerebral palsy boy had the ability to walk independently and to care for himself.