[Cerebral palsy in children--motor function and new treatment strategies].
Substantial changes have taken place in the management of motor function in children with cerebral palsy during the last decade. The objective of this article is to describe some of these changes. The article is based on search of databases and own clinical experiences. New treatment methods have been introduced and the management is more specialised and individualised. No single treatment method has proven to be sufficient alone and the challenge is to find the best combination of methods. This requires the ability to cooperate across disciplines. Medical treatment of spasticity (botulinum toxin A, intrathecal baclofen) may be an alternative or a supplement to orthopaedic surgery. For children who can walk, preoperative gait analysis has made it easier to find the right time for an operation and to choice the right type of intervention. Physiotherapy has become task oriented and specifically goal directed, based on documented principles of motor learning, strength and fitness training. Correct choose and use of orthosis is an essential part of the treatment. The different types of cerebral palsy have different natural progressions, risk factors and needs of follow-up. A multidisciplinary clinical evaluation is therefore needed as a basis for choosing the right management strategy. Given the complexity of this disorder, priority between various focus areas for different age groups is a challenge. A close collaboration with the parents is therefore essential. Children with cerebral palsy are a relatively small group, and the increased specialisation may indicate that parts of the treatment should be centralised.
Lofterød
Bjørn
B
Barnenevrologisk seksjon, Barneklinikken, Rikshospitalet, 0027 Oslo, Norway. bjorn.lofterod@rikshospitalet.no
Jahnsen
Reidun
R
Terjesen
Terje
T
D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D002648:Child; D006801:Humans; D009048:Motor Skills / Q000502:physiology; D009128:Muscle Spasticity / Q000188:drug therapy; D009989:Orthotic Devices; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D011597:Psychomotor Performance / Q000502:physiology; D013514:Surgical Procedures, Operative