The congenital disease cerebral palsy is a paralysis of the central nervous system that can occur in a child due to damage to certain parts of the brain. Impaired motor functions may begin to progress in the prenatal or childbirth period, as well as in the first days of life. With cerebral palsy, spastic syndrome is often encountered - a painful increase in muscle tone and tendon reflexes. You can reduce the negative consequences of the disorder at home with the help of gymnastic exercises recommended for cerebral palsy.

Therapeutic effect of exercise

Therapeutic physical education (PT) helps you learn to control your body. By doing special therapeutic exercises for children with cerebral palsy, you can improve coordination, inhibition processes, and motor amplitude. The technique is an integral part of an integral complex aimed at reducing the manifestations of the disease caused by cerebral disorders.

Therapeutic effects of exercise therapy on the body:

1. Strengthens the tissues and organs of the child's body.
2. Activates weakened muscles.
3. Improves posture.
4. Normalizes metabolism.
5. Improves the functioning of the brain and circulatory system.
6. Promotes overall health.

With regular training, you can achieve the following results:

• developing the child’s necessary basic skills;
• mastering simple work activities;
• servicing yourself without outside help.

It is necessary to begin exercise therapy as early as possible, in the first days of life, gradually complicating the exercises. Moreover, physical education must be carried out if the newborn has no symptoms of cerebral palsy, but is predisposed to its development.

Basic principles of the technique

1. Physical therapy is based on a number of basic principles:
2. Classes are held regularly, without absences or long breaks.
3. Gradual increase physical activity.
4. Individual approach.
5. Conducting classes taking into account the stage of the disease, age, and mental state.

Along with exercise therapy, correctional and educational measures must be carried out to compensate for functional impairments.

Types of exercises and features of classes

I love it health-improving gymnastics should be selected taking into account the needs of each individual patient. However, each exercise program includes the following types of exercises:

• relaxing;
• helping to improve dynamics;
• stimulating motor activity;
• performed lying down;
• performed while sitting;
• having a gaming orientation.

If gait is difficult, or the patient is unable to walk, the exercise should be carried out near bars or rigid support. At the next stage, the lesson continues near the wall. In order for the center of gravity to be equally distributed on both sides of the body, actions are performed first with some limbs, for example, the right arm or leg, then with others. For more weak side a greater load is given. Squats should not be performed deeply; most often they are performed only at a distance from the knee to the foot (half squat).

Exercises for the development of the musculoskeletal system

If the central or peripheral nervous system is damaged, disturbances in the movement of the upper or lower limbs- tetraparesis. Relevant gymnastic exercises it is possible to strengthen the motor skills of disabled children and increase the level of control over their actions.

Exercises that improve motor activity:

1. Starting position - sitting on your heels. The adult conducting physical therapy puts his palms on his shoulders, then holds the child in the hip area, gradually pushing him to kneel.
2. At first, the child sits on his lap. Holding him in the armpit area, you should start moving from side to side so that he learns to independently transfer his body weight to one leg. He tries to lift his other leg away from the fulcrum and spread his arms to the sides.
3. You need to turn to face the child sitting on the chair. An adult fixes his legs on the floor with his own and takes him by the hands. The arms are extended forward and upward, so the patient with cerebral palsy will learn to stand up on their own.
4. Starting position - standing, feet placed in one line (one after another). You need to take turns lightly pushing the little patient in the back, then in the chest. Such actions will teach him to maintain balance.
5. Starting position - standing. Holding the child by the hand, you need to swing him in different directions so that he tries to step on his own.

Position lying on your back, with a wall or other support nearby. You should try to press your feet onto a hard surface, training your ability to stand firmly on the ground.

Exercises to strengthen joints

With cerebral palsy, various joint pathologies, cramps and joint pain are common. Exercises necessary for their development:

1. The exercise is performed lying down. One leg needs to be straightened and fixed, the other gradually bent at the knee. If possible, the thigh should be pressed to the stomach, then pulled back.
2. While on your side and keeping your knee bent, you need to slowly begin to abduct your hip.
3. You need to lean your stomach against the table so that your legs can hang freely, then gradually straighten them.
4. The starting position is on your back. First you need to bend your knee, then straighten it as far as possible.
5. The starting position is lying on your stomach, with a cushion placed under your chest. Holding the patient's hands, you need to lift top part body, making slightly jerky springy movements.
6. The arm of a child lying on his back must be bent so that his face remains turned in the same direction. Then the limb bends when turning the head in the other direction.

Strengthening your abdominal muscles

As part of exercise therapy, classes are conducted that develop and strengthen a group of muscles located in the abdominal cavity:

1. The child needs to be placed on his knees, pressing his back to your chest, and then you need to bend down with him. In the next step, the legs and pelvic area of ​​the small patient are fixed so that he can rise on his own.
2. Starting position - lying on your back, arms pressed to your body. Making swinging movements and not helping yourself with your hands, you should try to roll onto your stomach and back.
3. Lying on your back, inhale and exhale, drawing in your stomach as you exhale.

Improved stretching

Activities that increase stretching and flexibility help achieve the following results:

• the severity of pathologies of the back and spine decreases;
• the condition of the spinal cord and spinal nerve endings improves;
• the muscles of the limbs are strengthened.

Sitting on the floor, you need to straighten your legs, while your body should form a right angle with them. While inhaling, you should extend your arms in front of you. As you exhale, you should try to bend down to reach your toes with your hands. An adult can help by lowering the body even further so that the forehead also touches the legs.

Starting position - on your stomach, arms extended along the body. The emphasis is placed on the palms, with a gradual rise of the chest. It is important to ensure that your head is thrown back and your breathing is even.

Lying on your back, your legs, without bending at the knees, are connected and raised above your head. You should try to reach the floor above the top of your head with your toes. Hands should not be lifted off the floor.

From a sitting position on the floor, you need to bend right leg so that the heel reaches the left thigh. The left foot should be on the right side of the other knee joint.

The right hand is moved around the left knee, it needs to hold left leg. After completing these steps left hand retracts behind the back to the other side of the waist. At the same time, the head is turned to the left side, a tilt is made to touch the chin to the left shoulder. The right knee remains pressed to the floor.

Relaxation exercises

There are exercises for the upper and lower extremities:

1. To give your upper limbs a rest, you need to lie down, then fix your head, arm and leg on one side using weights, for example, sandbags.
2. The free arm is bent at the elbow joint, the forearm is held by the adult conducting the gymnastics. The hand must be fixed until the muscle tone decreases, after which the hand is shaken, then it must be alternately bent, rotated and moved to the side.
3. In the lying position, the fixed arms and legs are in contact with the stomach. An adult holds his shins, abducting his legs at the hip joint. After fixing one leg, you should make circular movements, trying to pull the leg. Legs need to be alternated.

Breathing exercises

All actions must be performed lying on your back, sitting down some time later, then moving to a standing position. Gymnastics that correct breathing:

1. The child needs to be shown how to take a deep breath and exhale through the nose and mouth. You can inflate balls, rubber toys, soap bubbles.
2. Different vowel sounds are pronounced at different volumes. You can alternate with singing and playing wind instruments.
3. On the count of one, raise your arms up, inhale, and on the count of two, extend your arms down and exhale. The exercise will be more difficult if, as you exhale, your head plunges into the water.

Game exercises

Such elements of exercise therapy help maintain interest in the activity, while at the same time promoting relaxation. Game elements of exercise therapy:

Destroyer of towers. For this game, special soft modules or ordinary pillows can be used. If a child is able to build a tower, he does it himself; if not, adults help him. the main task- destroy the tower.

Get out quickly. You'll need pillows again. This time the child lies on a gymnastics mat, the adult puts about 6 pillows on it and explains that on the count of three he needs to free himself.

Folding knife. Starting position - fetal position. The command is given: “the knife opens”: at the same time you need to pull your arms up and your legs down, remaining on your side. The action is performed at a measured pace. Then the “knife” must be folded. Slowly, the arms are pulled up to the chest, and the legs are pulled up to the stomach. The “knife” is complicated. The exercise is repeated three times on each side.

Sausage. The starting position is lying on your back. The adult carefully grabs the baby's ankles and begins to slowly turn the child in different directions. Gradually the pace accelerates.

Lion on the hunt. Good for group classes. Children sit on their heels with emphasis on their knees around a large soft module (you can purchase a special one or use gymnastic mats as an “island”). An adult tells a short story about a lion: “Once upon a time there lived a lion. He was brave and dexterous, and he also liked hunting. He waited in ambush for prey so that no one could see him (children should, without straining, group themselves with their heads on their palms pressed to their knees). Then he quietly crept (they show how a lion sharpens its claws and stretches its back) and jumped (they rise on their hands, helping themselves with their legs, and fall onto a soft surface).”

It is impossible to say in advance exactly when improvements will occur. Much depends on the degree of damage and how severe the spastic syndrome is. To achieve a significant reduction in the manifestations of cerebral palsy, exercise therapy with such children needs to be done regularly, gradually and listening to the personal needs of each of them.

Exercise therapy for paralysis.

Paralysis- is the loss or impairment of movements in one or more parts of the body, caused by damage to the motor centers of the spinal cord and brain, as well as the pathways of the central or peripheral nervous system.
Paralysis is not a separate disease and does not occur due to any one factor; it is a symptom of many organic diseases of the nervous system. Thus, any damage to the nervous system can cause disruption of the body’s motor function.
The cause of paralysis can be: circulatory disorders, inflammatory processes, injuries, tumors of the nervous system. Also, a special type of paralysis can be observed during hysteria.

Causes of paralysis.
Paralysis should be distinguished from movement disorders that occur due to muscle inflammation or damage to the musculoskeletal system, which mechanically limit the range of movements. Paralysis can be observed in one muscle, one limb (monoplegia), in the arm and leg on one side (hemiplegia), in both arms or both legs (paraplegia), etc.
Injuries, multiple sclerosis, infections, intoxications, metabolic disorders, nutritional disorders, vascular lesions, malignant neoplasms, congenital or hereditary factors - all of this refers to organic causes of paralysis. Paralysis also often develops with infectious diseases such as syphilis, tuberculosis, polio, viral encephalitis, and meningitis. Toxic or nutritional causes include beriberi disease (vitamin B1 deficiency), pellagra (niacin deficiency), alcoholic neuritis, and heavy metal poisoning (particularly lead). Congenital, hereditary and degenerative diseases of the central nervous system are also usually accompanied by movement disorders.
Paralysis can also occur as a result of birth trauma - this can also be paralysis due to damage to the brachial plexus. In addition, a number of diseases of unknown etiology (for example, multiple sclerosis) are characterized by motor disorders of varying degrees. Injuries, such as wounds and fractures, can have the same consequences if they are associated with damage to the motor pathways or directly to the motor centers. It must be said that in many cases, paralysis is of a psychogenic nature and is a manifestation of hysteria - such patients can benefit from treatment with a psychiatrist ra.
The variety of causative factors cannot but be reflected in pathomorphological changes, which in turn can have a very different character and location. Pathological changes in nervous tissue such as destruction, degeneration, inflammation, formation of lesions (plaques), sclerosis, demyelination are the most typical variants detected during paralysis. From an anatomical point of view, a distinction is made between paralysis caused by damage to the central nervous system (brain or spinal cord) - spastic paralysis, and paralysis associated with damage to peripheral nerves (flaccid paralysis). The former, in turn, are divided into cerebral and spinal types. Cerebral palsy can be of cortical, subcortical, capsular or bulbar origin. Spinal paralysis is a consequence of diseases affecting central and/or peripheral motor neurons. Peripheral paralysis can occur when nerve roots, plexuses, nerves or muscles are affected.
Central paralysis is characterized not by a complete loss of motor functions, but by their dissociation - the loss of some and the strengthening of others. With central paralysis, the motor function of the body as a whole usually suffers, but not individual muscles. Paralyzed muscles are spastic (convulsively tense), but do not undergo atrophy (it can only be a consequence of inactivity), and there are no electrophysiological signs of degeneration. In paralyzed limbs, deep tendon reflexes are preserved or enhanced, and clonus (rapid spastic contractions) are often detected. Abdominal reflexes on the paralyzed side are reduced or absent. In case of paralysis of the lower extremities, there is such a sign of damage to the brain or spinal cord as the Babinski reflex (dorsiflexion thumb foot in response to irritation of the outer edge of the sole).
With peripheral paralysis, there is a complete lack of movement; instead of increasing muscle tone, it decreases. Individual muscles are affected, in which atrophy and an electrophysiological reaction of degeneration are detected. In a paralyzed limb, deep reflexes are reduced or completely absent, and clonus are absent. Abdominal reflexes are preserved, and the Babinski reflex is not evoked. Also in case of defeat peripheral nerve or plexuses that contain both motor and sensory fibers, sensory disorders are also detected.
The main cause of central paralysis is stroke. Therefore, the treatment of stroke will simultaneously be the treatment of paralysis. It should be noted that the density of nerve conductors in various areas brain is not the same: somewhere they are extremely concentrated, and somewhere their density is quite low. Therefore, there are often cases when a defect in brain tissue of significant size leads to minor motor disorders (paralysis and paresis), and a small defect causes deep disability in a person. The internal capsule contains all motor conductors in a concentrated form, and damage to this capsule leads to paralysis of the entire opposite half of the body.
Paralysis may manifest as absence or impairment of spontaneous movements or decreased muscle strength which is revealed upon examination. Paralysis is also characterized by the inability to perform movements against the doctor’s resistance or to hold a certain position for a long time, resisting gravity, for example, outstretched arms or raised legs (Barre test).
As a result of damage to the subcortical structures of the brain, extrapyramidal paralysis occurs, friendly and automated movements disappear, and motor initiative is absent (akinesis). Muscle tone is characterized by plasticity - the limb is held in a passive position given to it.
Diagnosis of paralysis includes examination by a neurologist, x-ray, myography, and neurosonography. Reflexes from the lower extremities are also tested: knee reflex, Achilles reflex, Jendraszek maneuver, plantar reflex.
As for the treatment of paralysis, before considering it, it is necessary to emphasize the fact that paralysis is not an independent disease, it is a reflection of other diseases and pathological processes. Therefore, treatment must first of all be causal, that is, it must be directed against the underlying disease: suturing a peripheral nerve in case of traumatic damage, restorative therapy for stroke, surgical removal of tumors compressing nerve structures, etc. But along with causal therapy, symptomatic therapy is also necessary, since this is a significant additional and necessary preventive measure, because without movement, muscle tissue atrophies. Special methods are used to restore limb function, such as massage for paralysis, exercise therapy for paralysis, therapeutic exercises for paralysis and etc.

The leading role in symptomatic treatment is played by physiotherapy, which helps restore movement and prevents the appearance of contractures and deformities.
Exercise therapy complex for paralysis consists of the following elements:
- placing the paralyzed limb in the correct position
- massage
- passive movements
- active movements.

With central paralysis, the limbs must be given a special position that prevents the formation of contractures. Starting from the second week, the patient is prescribed a massage. Muscles with increased tone are lightly stroked. The remaining muscles are massaged using the usual techniques; of course, it is necessary to take into account the state of the paralyzed person. In conjunction with these events, it is held physiotherapy which should include active and passive exercises for paralysis.
Passive movements should begin depending on the patient’s condition, preferably at the end of the first week. At first, exercises are limited to a few minutes. Exercises are performed at a slow pace and in full in all joints of the paralyzed limbs. With the help of these exercises they also try to prevent incorrect positions limbs - excessive flexion, adduction or extension.

Therapeutic exercises for central paralysis:
1. Passive shoulder movements
2. Passive abduction of the shoulder forward, upward and to the side
3. Extension of the arm at the elbow joint with abduction of the straightened arm to the side
4. Extension of the elbow joint in the position of supination and outward rotation of the shoulder
5. Supination and pronation of the forearm
6. Rotation of the femur at the hip joint
7. Hip adduction and abduction
8. Flexion of the knee joint with the hip extended while lying on the side
9. Passive flexion and extension of the leg in knee joint
10. Passive movements in the ankle joint
11. Holding the affected hand in its given position
12. Keeping the affected foot in its assigned position
13. Easier raising and lowering of the affected arm with the healthy arm using a cord and a block (the exercise can be combined with abduction and adduction of the arm in an elevated position)
14. Easier raising and lowering of the affected leg by hand using a cord and a block


As for active exercises, their choice in each individual case depends on the group of affected muscles.
Starting from the 2nd - 3rd week (for weak and elderly patients this should be done more gradually), the patient should be transferred to a semi-sitting position for 1-2 hours a day.
By the end of the 3rd – 4th week, you can spend most of the day in a comfortable chair.
When learning to walk, it is necessary first of all to teach the patient to step on the paralyzed leg. In this case, you need to pay attention to correcting the abnormal position of the flexors and muscles that rotate the leg outward.
When walking, it is necessary to lift the paralyzed leg high using the pelvic muscles so as not to touch the floor with the toe. At first, the patient can walk with outside help, and then - leaning on a stick.

With peripheral paralysis in the first days, the limbs and torso are also given a position that subsequently prevents the development of contractures. Perhaps the massage begins a little earlier, which should also be selective. Paretic muscles are massaged using all techniques, while antagonist muscles are only stroked. Simultaneously with the massage, passive movements begin to be performed. As movements appear, they are gradually added active exercises. Gymnastics in the pool, as well as in a bath with warm water, is very useful.

Drug treatment is carried out as prescribed and under the supervision of a neurologist. From medicines for paralysis, the following are used: prozerin, dibazol, intramuscular injections of thiamine chloride. For paralysis with increased muscle tone - melliktin.

It should be noted that now in Western medicine the following method of treating paralysis is gaining momentum: by mobilizing the patient’s inner will, with the help of a mirror or videos, the patient is given “mirror therapy,” which consists of presenting the patient in front of a patient suffering from partial or complete paralysis of one of the arms , place the mirror with its edge to the vertical axis of the body, and the reflective surface towards the healthy arm. The patient looks in the mirror towards his sore arm, and sees his healthy arm in it. In this position, at the doctor’s command, the patient tries to perform synchronous movements with both hands. In the event that the patient suffers from complete or partial paralysis, the doctor standing behind the mirror helps the paralyzed arm perform synchronous movements in relation to the healthy arm. Thus, the patient is created with the illusion of a healthy hand, and this helps him to activate his internal forces to control the diseased hand.
Another similar method consists of watching videos that record the movements of the patient’s hands in front of a mirror, which is located in the same way as in the experiment described above. When watching such a video, thanks to a healthy mirrored hand, the patient gets the impression of synchronous movement of both hands. The patient looks at himself on TV as if from the outside, and tries to imagine that both his hands are healthy. After watching the video, the patient tries to repeat his own movements seen on TV. Then he watches the video again and again tries to perform the movements he saw. That is, in this case, as in the “mirror method,” doctors are trying to mobilize the power of the patient’s self-hypnosis - self-hypnosis. And self-hypnosis is very effective method in the treatment of paralysis. The main thing is to believe in your strength, work on yourself and then, sooner or later, recovery will come.

People have not yet found a treatment that can restore the damaged brain. However, if you work according to a scientifically based program, then the nervous system, which is in an intact state, can perform all its functions, and also take on some of the functions of the damaged areas. Programs for physical education play a leading role in the comprehensive rehabilitation of children with cerebral palsy. One of the main elements of almost any treatment program is therapeutic physical education (PT), and other types of therapy based on movement - kinesiotherapy, Bobath therapy, Vojta therapy and others.

As a term, exercise therapy refers to a branch of medicine that studies the treatment and prevention of diseases using physical education methods. In addition, exercise therapy is an independent scientific discipline, officially recognized in many countries of the world, including Russia.

On the other hand, it is a medical procedure that is used for restorative rehabilitation and treatment of sick and disabled people, as well as the prevention of various diseases. The main means of exercise therapy is physical activity in various forms.

The main therapeutic method of exercise therapy is therapeutic exercises - physical exercise, individually selected for each specific case. For children, play forms of exercises are most often used, for example, using a ball. This helps stimulate the child’s interest and direct his desire for physical activity in the right direction.

​ History of therapeutic physical culture​​​​

In ancient China, even in ancient times - several thousand years BC, physical exercise was used to improve health. In those days, there were medical gymnastics schools, where they taught therapeutic gymnastics and massage, and used them in the process of treating patients. In Chinese medical and gymnastic schools, diseases of the heart, lungs, curvature of the spine, bone fractures and dislocations were treated. In the VI century. n. e. For the first time in the world, a state medical institute was created in China, where they taught massotherapy and gymnastics as a compulsory discipline. Since then, various gymnastics, adapted for individual recreational activities, in various combinations are widely used in Chinese sanatoriums and rest homes as the main form of exercise therapy.

The famous ancient Chinese physician Hua Tuo, who lived in the second century AD, the founder of Chinese hygienic gymnastics, stated: “The body requires exercise, but not to the point of exhaustion, for exercise is designed to remove evil spirits from the body, promote blood circulation and prevent illness.” “If the door handle moves frequently, it will not rust. Likewise, if a person moves a lot, he doesn’t get sick.” Two thousand years have passed since the life of the doctor, but the principle of Chinese physical culture is still the same - the search for health in physical activity: from morning exercises to martial art.

Exercise therapy for cerebral palsy

Therapeutic physical education is one of the most effective and popular means of rehabilitation of children with cerebral palsy of various forms. The main goals of exercise therapy for cerebral palsy are: reducing muscle hypertonicity, improving coordination, increasing the range of motion in joints, training weakened muscles, and consolidating correct motor stereotypes.

When doing exercise therapy, it is necessary to take into account an important circumstance - children with cerebral palsy, as a rule, get tired much faster than their healthy peers. Therefore, it is important to alternate exercises with high and low loads, and give a short rest after the procedure. It is not forbidden to send your child for a massage after exercise therapy, or do it yourself. In general, a combination of several procedures (read: types of therapeutic effects) can significantly increase the overall effectiveness of rehabilitation.

Speaking about the features of exercise therapy for cerebral palsy, it is important to follow the following conditions:

• Use an individual approach

• Maintain consistency and systematicity

• Gradually and measuredly increase the load

Physical activity during exercise therapy classes is calculated taking into account the individual capabilities and characteristics of the child. Over time, as the musculoskeletal system develops, it should increase.

If a patient has a hyperkinetic form of cerebral palsy, then...

In this case, physical therapy aims to achieve normalization of the patient’s postures and movements, improve coordination of movements, inhibit hyperkinesis, and also provide training in everyday skills.

In the atonic-astatic form of cerebral palsy...

With double hemiplegia...

Must be given Special attention exercises in which the hand works are exercises for extending the hand, grasping small objects, and also exercises with abduction of the lower extremities. Moreover, easier conditions are created for performing these exercises.

As for spastic diplegia, then...

For this disease, coordination and balance exercises, relaxation exercises, and positional treatment are widely used. Teaching patients to walk is of no small importance.

If a child is given a neurological diagnosis of cerebral palsy, it is extremely important to begin correctional and educational work as early as possible. This is due to the peculiarities of physical development - the high plasticity of the child’s brain, and its ability to compensate for impaired and lost functions. It is important to understand that neurological problems and delays in physical development body, also entail a significant delay in the psychomotor development of the child. It must be remembered that physical therapy alone is unable to cope with such a serious illness as cerebral palsy. Rehabilitation work with children with cerebral palsy must be comprehensive; limiting oneself to one procedure or one course of treatment per year will be ineffective. Every parent of a special child must be aware of the need for ongoing comprehensive treatment.

It is important to know that in case of a hyperkinetic form of cerebral palsy, when doing exercise therapy, it is necessary to avoid some restrictions, namely: limit exercise on exercise machines, exercises with dumbbells and other heavy objects, as well as jumping exercises, running short distances. All these exercises help to further increase muscle tone, so they must be approached with caution. In general, it must be said that sick children should not exercise on exercise equipment. As the child ages, the formation of contractures increases, muscle tone. And training on exercise machines leads to even greater contractures, muscles become clogged, and coordination of movements is impaired. There is also an increase in muscle spasticity, and this often contributes to the appearance of pain; the muscles cannot be relaxed. Considering all these factors, it is better for children with cerebral palsy to refrain from exercising on exercise equipment. Children with cerebral palsy are contraindicated for exercising on most sports equipment, except those that have been specially designed for these purposes. These include, for example, a hippo simulator or a Motomed simulator.

​ Children and teenagers around school age with cerebral palsy, doing physical therapy, they train certain work skills and self-care skills. Many parents do not realize the importance of teaching their child to take care of himself first.

Exercise therapy for various diseases and paralysis of the nervous system sets itself the following tasks:

• Providing a healing and restorative effect on the body
• Improving blood circulation and metabolic processes in problem areas
• Improvement and stimulation of metabolic processes in the body
• Combating the formation of adhesions between nerve sheaths and surrounding tissues
• Strengthening weakened muscles, increasing range of motion and amplitude, restoring coordination of movements
• Combating related problems and disorders of cerebral palsy - spinal curvature, spasticity and many others.

The purpose of the exercises is to relieve muscle tension, expand the range of motion and develop the musculoskeletal system.

At the First Step medical center you can sign up for therapeutic classes physical culture more than 5 different specialists, and also choose a Russian or Chinese instructor.

Each instructor has extensive experience working with children and his own profile - some have received additional training in Vojta therapy, others in Bobath therapy or in other areas. Regardless of their specialization, they all get along well with children and know their job very well.

Signing up for exercise therapy in Kazan is very simple - just contact the First Step medical center. To do this, call us toll-free at 8-800-500-54-86, or request a call back. In addition, our online consultant can answer all your questions.

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Cerebral palsy is a pathology that consists of paralysis of the central nervous system caused by damage to several or one part of the human brain. The disease can begin to form while the fetus is in the womb, immediately after birth or for a short time after that. In order to prevent the continued development of pathology, various methods and therapies are used, among which games for children with cerebral palsy are a very effective method.

What is exercise therapy

Exercise therapy is physical therapy, which is aimed at restoring the functions of the human body. Special exercises for children with cerebral palsy, they help inhibit paralysis of the central nervous system. A set of physical therapy exercises will allow children to gradually regain control over their movements, significantly improve coordination, as well as the frequency of limb movements.

The main tasks and goals of the exercise therapy program are aimed at teaching a sick child with cerebral palsy ordinary everyday skills that will make their life easier. Also, a set of exercises will allow sick children to learn simple work activities and carry out self-care without outside help (nurses, parents and others).
As a result of the exercise therapy complex, new skills are gradually developed, movements become more accurate and correct.

Parents should know that a course of exercise therapy should be prescribed immediately after a pathology is detected in a child. If physical activity gradually becomes more difficult, therapy should be started immediately to avoid progression to a more severe form. Exercise therapy is also prescribed for children who do not have physical abnormalities, but have prerequisites for this or a predisposition (for example, heredity).
The method of restoring the physical activity of disabled children is based on several principles:

• patients have no long breaks between performing special exercises;
• therapy is carried out regularly and systematically;
• a gradual increase in physical activity is necessary to strengthen muscle tissue and tendons;
• individual prescription of preventive exercises, which are focused only on one patient with certain physical disabilities;
• The age of the child is taken into account when prescribing a course of exercise therapy, the psychological state of the patient and the stage of the pathology.

Correctional and educational work is very important for children, which is aimed at compensating for all impaired body functions. In this regard, doctors strongly recommend carrying out exercise therapy from the very early years. It is important to remember that the sooner prevention begins, the better it is for the young body. At an early age, children are more amenable to correction of the musculoskeletal system.

Types of exercises

Since a mobile exercise therapy complex for a child with cerebral palsy must be selected individually, depending on the manifestation of the pathology, doctors can prescribe different types therapeutic exercises. To treat the disease, classes can be aimed at stimulating the musculoskeletal system in the form of special gymnastics or swimming in the pool.

Disabled people are prescribed exercises to stretch ligaments and relax muscle tissue and joints. Classes for children will be held in sitting position and lying down. It should also be said that patients with cerebral palsy are more willing to undergo therapy if it is in the form of role-playing games or with toys.

Classes to stimulate the musculoskeletal system are aimed at developing and strengthening motor ability child with cerebral palsy. First of all, the child should sit on his heels so that the foot is completely on the floor. Then mom or dad should stand in front of him, put his arms on his shoulders, fixing the patient in the pelvic area. After this, you need to begin to gradually tilt him so that he gets up on his knees.

When the patient kneels, he must be supported in the armpit area to move him in different directions. After some time, you need to loosen the support so that the child gradually gets used to independently transferring the center of mass of his body from one leg to the other. When the center of gravity shifts to the left leg, the right leg should be lifted off the floor. Over time, you need to begin to spread your arms to the sides, training to maintain balance.

Then you can sit the baby on a chair, facing him. With your feet you need to fix the patient’s legs to the floor, holding his hands. Then you need to pull them towards you and up. This exercise will allow you to learn how to stand up without assistance. Another exercise from the exercise therapy complex should help a child with impaired musculoskeletal system maintain balance correctly. To do this, you need to stand so that one foot is in front of the other, but on the same line. It is necessary to alternately push the baby in the back and chest so that he feels how his body weight is distributed in this position.

To do this, you can also place it in front of you, and, taking your hand, push and pull in different directions so that the patient takes a step on his own. This will allow him to independently find a foothold. To develop support ability, you need to lie on your back and then press on a solid surface with your feet. Such classes are very effective if they are carried out regularly without disrupting your schedule.

Video “Exercises for the spine”

For stretching

To improve stretching of the limbs and increase flexibility, you need to regularly perform special exercises. The patient should sit on the floor, stretch his legs straight out in front of him so that his body is located at an angle of 90 degrees. Next, the child should begin to stretch his arms in front of him, inhaling. When inhaling, he should bend his body, trying to reach the tips of his toes with his palms. If this cannot be done initially, then you need to gradually increase the load, tilting the patient towards his feet.

Over time, the load can be increased so that his forehead reaches his feet. The baby can also lie on his stomach and place his arms along his body. The patient must lift chest, resting your palms on the floor. It is important that his head is thrown back as far as possible, slowly inhaling air. IN starting position(on your back), you need to connect your legs together. You should raise your extended legs above your head, keeping your body in supine position. The knees should not be bent and the hands should be kept on the floor. Ideally, you should reach the tips of your toes to the floor behind your head.

One more exercise will improve your stretching. To do this, sit on the floor, bend your right leg so that the heel of your foot reaches inside left thigh. The left foot should reach the right knee. The right hand needs to be moved around the left knee, holding the left foot. Next, you need to place your left arm behind your back on the opposite side at the waist, and turn your head to the left, tilting it so that your chin reaches your left shoulder. It is important that the right knee does not leave the floor.

Such developmental gymnastics is aimed at correcting defects in the back and spine. This technique also helps strengthen the spinal cord and nerve endings, muscle tissue legs and arms.

For relaxation

To relax the upper limbs, it is necessary to place the patient on his back, and then secure the leg and arm on one side with a weight (for example, sandbags). The free arm should be bent at the elbow, and the parents will fix the forearm. This is how you need to hold the patient until the muscles relax. You can shake the brushes, bend and rotate them.

To relax the lower limbs, you need to fix your arms and bring your legs to your stomach. One of the parents will hold the boot, moving it to the sides hip joint. Next, fixing one leg, it is done Roundabout Circulation the other limb, gradually straightening it. Such gymnastics relieves tension from the muscles, giving you the opportunity to loosen your tone. This is very important, since with pathology they can involuntarily contract or be tense.

For joints

Exercise therapy to strengthen joints is very important for the recovery of a child with cerebral palsy. Most of the exercises from the complex are performed in a lying position. When the patient lies on his back, one leg should be kept straightened, and the other should be slowly bent at the knee joint. If at an early age he has good flexibility in the body, then, if possible, bending the leg, you need to bring the thigh to the stomach and then abduct it.

Next, the patient should lie on his side and gradually raise his thigh up. The knees and legs should be in a bent position. Do not overstrain the ligaments.
Next exercise– the child lies on his stomach (preferably on a hard table) so that his feet hang over the tabletop. Then parents should help slowly straighten and bend his limbs.

Lying on your back, you need to bend your knees alternately and straighten them as much as possible.
When the child lies on his stomach, a special cushion should be placed under his chest. You will need to lift it with outstretched arms, making springy movements with gradual soft jerks. Such exercises allow you to strengthen the joints of the upper body.

The child can lie on his back. Then his arm needs to be bent so that the patient's face is turned in the appropriate direction. Next, the procedure is repeated, turning the head in the other direction.

Among the more active exercises therapeutic exercises There are those that are held in the pool or using role-playing games. When using various toys during physical therapy or role-playing games, children are more willing to perform gymnastics. Toys allow you to create interest around a given activity without feeling discomfort. Role-playing games with various toys are closely intertwined with the child’s basic brain activity. The process itself is important in this.

A role-playing game can confidently be called effective way therapy, as it improves children's imagination and shows imagination. Role-playing games develop memory well and allow you to think in a simulated situation.
Role-playing games for young children are an inspiring factor. Using toys in story games ah will stimulate the brain, increasing its activity. In story games, it is best to include life situations in a simplified form so that children can easily perceive the information.

Even without story games, individual toys that are dear to a child can have a very powerful effect. Toys usually evoke a range of emotions that a sick child experiences. And this also affects the functioning of his brain. Thus, toys can have a positive effect on the psyche, even without using them in role-playing games.

Pool exercises are good for those who can walk independently, but deviations are observed. With this therapy, the patient will learn to swim in the pool, as well as improve his health. Classes in the pool should be conducted by a specialized instructor who knows the methods of treating cerebral palsy and correcting the musculoskeletal system in young children.

Water helps relax the body, tones muscles, and energizes you. This therapy is called hydrokinesitherapy. Very often, children with obvious signs of cerebral palsy have problems with their emotional state. For this purpose, there are also separate psycho-gymnastic exercises that an adult should help carry out.

Video “A set of exercise therapy exercises for children with cerebral palsy”

This video guide will help you create a rehabilitation program for children suffering from cerebral palsy. Visual and easy-to-follow exercises will help you cure your child.

This set of exercises was given by Lena (Ex-unregistered) at the “Other Children” conference on 7ya, she literally put her daughter on her feet.
Perhaps many are already doing such exercises, but for some it will be something new, so, I quote Lena verbatim:
Indeed, it would probably be easier to post these exercises here rather than send them personally to everyone. I would like to write a little more about the treatment. We were diagnosed early, within a month. At the clinic, the neurologist saw nothing. But we had a double intestinal infection from the maternity hospital - staphylococcus and E. coli. We were sent for a month's consultation to the Institute of Children's Infections, and there we found a wonderful doctor. He literally turned the child over in his hands for 5 minutes and said that first of all we would go to their chief neurologist. And half an hour later I came out with my hair standing on end... So we started studying right away. We were treated at Hospital No. 25 on Gavrskaya. Of course, it was scary to go to bed with such a little one, but the fear of the diagnosis was overwhelming. I believe that we have very qualified specialists in this hospital in St. Petersburg. ICP was treated at Raufhus by neurosurgery, since there was a terrible relapse at 2 years old; at first we were told that there was a “massive process” - this is how they delicately called a brain tumor. Speech therapy techniques were also given to us by a speech therapist at Hospital No. 25; between courses we studied at home all the time. When the girl started talking at 2 years old, it became clear that she had a very bad memory. Poems were taught every day. I also re-read a bunch of books on defectology and I liked the idea that when dealing with PVMR you need to be proactive. They were so ahead that she went to school at the age of 6 straight into 2nd grade. True, later this turned out to have many disadvantages and we regretted it. The diagnosis was removed when we were 4.5 years old; the residual diagnosis was MCD in the form of left-sided hemisyndrome. This was also dealt with with a massage. Yes, I did massage myself from the age of 2, completed special courses with an emphasis on this pathology, and until I was 2 years old we had a very good masseuse. She showed me acupressure, and during exercise therapy I myself relieved spasticity - we had spasticity against the background of an atonic-astatic form in individual muscles. As I understand from a lot of re-read literature, the most important (and difficult) thing with cerebral palsy is to achieve proper development and changes in reflexes. You can normalize the tone, but if the tonic reflexes do not fade and the adjustment reflexes develop, motor skills will still not develop. I send the exercises in the form in which I have already sent them to other parents; it takes too long to retype them. Courage and success to everyone. Don’t go to healers, it’s just a waste of money and time. And by the way, Orthodox Church this condemns...Everything doesn’t go through at once, I send it in pieces.
Complex for extinguishing tonic reflexes.
The labyrinthine tonic reflex (LTR) manifests itself in two positions - on the back and on the stomach. On the back, LTR is manifested by an increase in tone in all extensor muscles of the body. This leads to
the spine and legs are straightened, the tone in the adductor and inward rotating muscles of the thighs reflexively increases. The arms can be abducted or bent and brought towards the body. The child cannot raise his head, move his shoulders forward, and subsequently he cannot roll over and sit down. To eliminate this reflex good result gives "fetal position".
1. Using constant light shaking, the patient’s limbs are grouped into a position of maximum flexion, the head is brought to the chest in the middle position, the arms are bent on the chest, and the legs are either brought to the stomach, or, with high tone of the adductor muscles, slightly spread. This position helps to stretch previously shortened muscles, and additional constant rocking in this position helps to relax and normalize muscle tone.
2. On big ball. The child lies with his stomach on the ball, his arms are extended along the ball, his legs are extended along the ball and spread apart. Swinging on the ball back and forth, from side to side.

Continuation:
On the abdomen, LTR is manifested by tension in the flexor muscles of the body. The head and arms are bent towards the chest, and the legs are brought towards the stomach. The child cannot raise his head, straighten his arms, or straighten his torso. This deprives him of the opportunity to lean, rise, and then sit down and stand up.
3. On the ball. The child lies on his back, legs extended along the ball (hold with hand). The head is thrown back, the arms are relaxed and thrown back behind the head. Rolling the ball back and forth.
Tonic cervical symmetrical (TSC) - when tilting the head forward and down
muscle tone increases - upper flexors and lower extensors
limbs. The child cannot alternately bend and straighten his legs, cannot move his head in isolation, without causing cooperative movements of the limbs.
4. To slow down the TSR in the initial position on the stomach, with a pillow placed under the chest, the child is held in the middle position and passively straightening the arms resting on the palm.
5. In the starting position, lying on your back. The legs are spread as far apart as possible and
turned outward and resting on the hips of the practitioner, performing passive sittings.
6. Starting position on all fours with a ball or roller under the chest. If the child has pronounced plantar flexion of the feet, they should be lowered beyond the edge of the support. The head is flexed passively, keeping the arms straight and legs bent.
7. In the starting position on all fours with a ball or roller under the chest with straightened legs and bent in elbow joints hands, passive extension of the head and holding bent arms and straightened legs.
The tonic cervical asymmetric reflex depends on rotational movements in cervical spine spine. Rotation of the head to the side increases the tone of the extensors of the limbs on the side where the face is turned and the tone of the flexors on the side where the back of the head is turned. It is extinguished by the development of an asymmetrical righting reflex.
8. The child stands on the table with his back to the instructor so that the heel hangs down. One leg is bent at the knee and held in this position by the instructor. Then the child is tilted down with a sharp turn of the body by the arm of the same name as the leg. The child reflexively makes a reverse turn of the body and, straightening his leg, rises.
9. The child lies on his back. Following the passive turn of the child's head, his shoulders and torso are slowly turned in the same direction.
10. Lying on his back. Following the passive rotation of the lower limbs and pelvis, the shoulders are slowly turned in the same direction.
11. The child hangs face down from the table at waist level. Holding the pelvis, first give the body the following position: the head is raised, the child is looking forward and upward, the body is bent upward in an arc (“fish”). The arms can first be brought towards the body, and as you master this pose, ensure that they are extended forward or spread out to the sides. Raising the head is achieved by stimulating the neck muscles and rectus dorsi muscles (along the spine).
12. The child is hanging from the table bottom bodies. The head is raised (as in the previous exercise), the hands rest on the table at shoulder level. Before performing the exercise, relax your legs. Stimulate abdominal muscles and back muscles, give the back half of the body an upward curved position (“fish with legs”). At first, these movements are performed by the instructor for the child; gradually, you need to achieve independent holding of the pose when giving the child the starting position.
Continuation:
13. "Fish on its side." The child hangs sideways over the edge of the table. Arms extended forward, strive (at first passively, then actively) to raise the head up, upper leg at the same time it should also rise up.
14. The same on the ball when rocking back and forth and from side to side.
15. The same when soaring (the child is held in the air by the waist). They move on to this exercise after mastering the previous ones.
Moro reflex, Babinski reflex and Perez-Galant reflex are extinguished
With exercises of the complex aimed at developing motor skills, thermal procedures also help well. We made azokerite (medicinal mud) at home. The oral reflex gradually goes away on its own; I observed it in one child until he was 6 years old.
Complex for the development of motor skills.
With spastic tetraplegia, it is very important to relieve tone constantly,
It would be good for you to find a massage therapist who knows acupressure so that he can show you the main points for relieving tone. Then, in the process of studying with
As a child, you could relieve spasticity yourself. Points can be
ask the massage therapist to mark, for example, with brilliant green, until you yourself
learn to find them. Gentle shaking also relieves tone well.
like vibration, with arms and legs. During classes, you need to pay attention
so that the limbs, especially the hands, are not clamped, but open.
You can shake and stroke your hands to achieve their relaxation and
openness. For classes you need to purchase several inflatable balls
appropriate size (will be clear from the description of the exercises).
Exercises on the ball are very important - they allow you to develop support in
limbs and train the ability to maintain balance, without it
the child will not sit down and will not master the position on all fours, and this is the basis
development of further motor skills. You don’t need to walk yet, since you have
stepping over. We didn’t have a stepover until a year ago.
For classes you need a large table, it would be good to cover it for a while
doing something prickly, so that when developing support, she gets irritated
skin on the palms and soles. Classes start and end
training in the fetal position (you know?).
So, exercises to teach movements.
1. Training turns from a supine position. Bend the child's left leg at the knee, press the foot with one hand to the table so that the child feels support on this leg. Pressing the foot with the elbow, hand
take the left hand, force the child to bend the hand at the elbow, press
his hand to the table at waist level. This creates a support for
movements. In this case, you use one hand. Take with your other hand
the child’s right hand and make him reach with this hand to his elbow
left hand. Grasping your right hand with your other hand, quickly grab the
right foot and stretch it towards the table next to the left foot resting on
table. Thus, the right arm and leg do almost simultaneously
cross motion, and the child turns over onto his stomach. The description makes it seem difficult, but you'll get the hang of it quickly. In the same way, train turning to the right, relying on your right arm and leg. If during an exercise the child “squeezes”, you need to achieve relaxation; the feet and hands should be open with full support.
2. Training turns from a prone position. Leaning on the arm bent at the elbow, stretch back with the leg of the same side, at the same time
the opposite handle stretches forward, further behind the head to
the opposite side in a cross motion, and the leg of the same side bends at the knee and makes a pushing motion from the table with the foot. After several repetitions of these exercises, it is useful to do a cycle of turns from your back to your stomach and vice versa several times.
Continuation:
3. Squat training. Lying on his back, bend both arms at the elbows and press them to the table at waist level so that the child feels supported by his arms. Pressing one hand to the table, reach with the other hand to the knee on the opposite side, while the child should sit down, and immediately rest the hand that was reaching for the knee with the hand on the table at the level of this knee. That is, the child makes a cross movement with his hand and sits down with a turn. Repeat the same with the extremities of the other side. My girl mastered normal sitting down after all the movements, and sat down in her own way from a position on all fours. However, it is very important exercise. It allows the child to master the transition to a position on all fours.
4. Support training on the hands. The child lies on his stomach on the ball
so that his arms and legs hang freely behind and in front of the ball.
Hold the child on the ball with your left hand behind the back. Let your
right hand under the child's arms. With your left hand, swing the ball forward
At the same time, with your right hand, you seem to knock the child’s arms forward, so
so that when the child's head goes down, she throws her arms forward and
leaned on her hands. This is a very important exercise to practice.
support. Normal children, if you take them and tilt them upside down,
reflexively throw their arms forward in front of their head. Those with cerebral palsy have this
there is no movement.
5. Development of foot support. Also lying on the ball, with your right hand
swing the ball back (that is, the tilt goes towards your feet), and with your left hand
ensure that the child leans on his legs (press his feet,
fix them, move your leg on the table so that the child
a support stereotype was formed).
6. On the same ball. The exercise is aimed at training the ability to hold
equilibrium. Without this, the child will not sit down. We did it not on the table, but
on the floor. Place the child on top of the ball so that at any time
Losing her balance, she could lean against your knees. Brush
Take her hand with one hand, reach down and lean on the ball. The ball tilts in the same direction. At the same time, take the child’s head with your other hand and tilt it towards the shoulder of the opposite side. That is, the hand goes down with support on the ball, and the head tilts in the opposite direction. Do the same in the opposite direction.
7. Training the same movement on a table. The child sits with his legs dangling
down. Hold your shoulders with one hand and tilt your body to the side,
with the other hand you push out her handle and get her to lean on it
on the table.
8. On a smaller ball - balance training by supporting your feet.
The child sits on the ball, legs wide apart along the ball. With one hand, hold the child on the ball by the shoulders, at the same time tilt the ball forward, while with the other hand you take the leg and fix the foot on the table so that the child leans on this leg. Repeat with the other leg.
9. Training to move to a position on all fours. The child lies on
table on your stomach. Place one hand under her straightened arms,
force them to bend at the elbows and achieve support on the hands. With your second hand, alternately bend your knees so that she stands on her knees.
10. Crawling training. On a small ball. The child lies on the ball
stomach, hands and knees should rest against the table (fix
hands, fidget on the table, make sure the child is resting his hands).
Your right hand is extended between the ball and the child's hands. Moving
alternately with your elbow and palm, force the child to step over
the table with your hands. At the same time, move the ball forward along the table with your left hand. Thus, the child seems to crawl in his arms.
Continuation:
11. The same with the movement of the legs. Hold the child with your right hand
ball, while simultaneously moving the ball forward (sleight of hand!), and with your left hand
move her legs bent at the knees. You need to feel that
the child rests his knees on the table.
12. Another exercise for hand support. The child lies on your
left arm bent at the elbow over the table so that her arms hang down
forward. Place your right hand under her arms resting on the table
(open palms!) and, as in exercise 10, alternately moving your elbow and hand, make her move her hands along the table. Your left hand is moving above the table at this time. Those. the child seems to be walking in his arms
table. This is a very difficult exercise for a methodologist, but it is done well
dads.
13. Training leg movements when crawling. The child is kneeling on the table. Your right hand is brought under her armpits, as if hanging on your hand. With your left hand, alternately move the child’s knees along the table, while simultaneously moving your right hand with the child forward.
14. Full workout resting on the hands and feet on the ball. The child is lying
on the ball with your stomach. Swinging the ball back and forth with one hand, with the other hand
at the same time, alternately force her to lean on her hands, then
on the feet.
15. Formation of an extensor position for the lower extremities.
The child lies on the table, legs apart and turned out as far as possible
outward and rest your feet on your thighs. Take the child by the hands and
sit down with your hands resting on the table.
16. Formation of the extension position of the arms. On the ball
on your stomach, bend your head down, keeping your arms straight
position, and legs bent at the knees.
17. The development of stepping is our own invention. We put the child on our own feet and, holding him by the armpits, walk around the room.
From our experience, I realized that when you perform some movement for a child 10,000 times, a feeling arises in his brain. required chain signals and suddenly he starts doing it himself. It is better to exercise before meals. They also taught us in the hospital that even an immobile child needs space; when he sees around him not a bed, but a whole room, the motivation to move arises more easily. Therefore, we kept the child directly on the floor outside of sleep, and we ourselves entered this room, taking off our slippers at the threshold. I know from literature (and we used this) that it is easiest to focus your gaze on yellow objects. We wish everyone good luck in treatment and lots and lots of patience.