Therapeutic massage with cerebral palsy
Neurology / / August 12, 2017
Massage as a kind of passive gymnastics - has long been recognized as a means, it is widely used in medical practice.The special and popular literature describes in detail not only the leading classic manual massage, but also its variants: segmental, reflex point, etc .;all kinds of massage incorporates the general principle of local and reflex action through the mechanoreceptors in the central nervous system.As a result of complex physiological processes in it are formed responses, which are used with treatment-and-prophylactic purposes.Classic massage and its variety - down method
So far there is no consensus on the appropriateness of widespread use of a recognized classic massage in cerebral pathology in general and cerebral palsy in particular.Practice has shown that the use of most of the massage techniques without regard to strict selectivity causes increased muscle tone, especially in the spastic muscle tension.The most adversely affected by it in the treatment of young childr
However, these same techniques, but performed in the downstream direction (from the center to the periphery), do not cause such a reaction, but rather promote relaxation.So there was another kind of classical massage - downward.
Descending massage, especially when combined with the classic technique shaking, and sometimes in combination with a reflex point massage (braking method, which will be discussed below), a well reduces the increased muscle tone and reduces hyperkinesis.
Classic massage with cerebral palsy should be carried out on parts of the body, sufficiently distant from the spastic muscle tension, and especially where the need to have sufficient strength to ensure timely and correct vertical posture and walking child.
Usually it back muscles, especially catches the blades from the vertebral line, abdominal muscles, gluteal region.To avoid possible reflex increase in tone of the spastic muscle tension in arms or legs, be sure to perform a few special moves downward in conjunction with massage by shaking.Without any restrictions classic massage is used to strengthen the weakened muscles of the leg and foot when ploskovalgusnoy deformation form of hypotonic cerebral palsy, as well as in cases where a high muscle tone persists and the need to strengthen the weakened muscles and their antagonists.
Classic massage - a rather complicated technically kind of treatment.Therefore, in practice, errors still occur if a number of techniques, which naturally reduces the efficiency of the procedure.
Outlining the technique to perform basic techniques of classical massage, note the typical mistakes and give recommendations for their use in infantile cerebral paralysis.
Reception stroking mainly used to improve circulation (venous) and lymphatic drainage, skin condition and other. You are receiving the palm or the back surface of the brush, but can use other areas of the hands, such as fingers.Stroking surfactant produced when motion directed longitudinally, laterally, spiral, etc., And deeply when movement directed strictly along the lymphatic vessels (from the periphery to the center).This is the only technique which may be sliding on the surface of the skin.Reception begins stroking massage treatment, it is used after other techniques, it usually ends up massage.
Typical errors are loose contact with the palm of a masseur massaged surface and quick, short movement of the hand.When cerebral pathology method is used to improve the trophic (metabolic) functions, while descending a massage - with the goal of removing the high muscle tone.
Reception grinding used to remove scarring and adhesions in the skin, various deposits in the muscles, tendons and joints.Reception usually runs his fingers, but on the back or hips you can produce base of the palm or the back of the phalanges of the fingers bent.Grinding is done in a longitudinal or transverse direction, particularly good place to be massaged muscle attachment.When the receiving arm is in contact with the skin surface and moves along with it.It is an error surface receptions, causing rubbing not be under the skin formations and rubbing of the latter.
When cerebral pathology rubbing is applied to strengthen the weak, not tight muscles and strengthen joints.
Reception kneading is used to improve the functional state of muscles and blood flow in the deep veins.Reception is done with one or two hands move longitudinally or transversely of the muscle fibers.
The main errors are not deep enough, and the seizure of muscles massaged poor contact with the surface, allowing slippage massaging hands.When cerebral pathology kneading is used to strengthen the muscles of the back, abdomen, buttocks and other body areas, where there is a high tone or when it returned to normal.
Vibrating receptions - hack, effleurage, pat - used to improve muscle tone and improved contractile capacity.Chopped made ulnar edge of the hand with fingers wide apart.When striking the massaged area the fingers should fit closely.
Reception hack is only performed longitudinally, along the muscle fibers.Errors should include a reception performance when the movement of the hand is performed not at the wrist and at the elbow and when the hack is perpendicular to the direction of the muscle fibers.And pat tapotement performed wrist collected in a fist or a handful, wherein movement performed at the wrist joint and can be performed in any direction.
All three are receiving intermittent vibrations when hitting one after another.During the massage the back projection of the kidneys, these techniques are not applicable.When cerebral pathology use them with great caution.
most commonly with cerebral palsy used Uninterruptible vibration - receiving shaking, which is as follows: Capture a relaxing hand or foot segment performed above.For example, to relax the forearm grip arm;relaxing the calf, thigh and seize t. n.
All the basic techniques of classical massage are a number of support that complement and diversify their operation.
Method finger impact on certain areas of the body in order to improve motor activity is used for the treatment of neurological patients for many years.In newborns and infants acupressure not only stimulates the reflex activity, but also contributes to the immediate motor reaction to the desired correction.
two methods differ depending on the equipment performing acupressure: excitatory and inhibitory.
Brake method executes the first three fingers (one or two at a time, for example, paravertebrally or exit points of the sciatic nerve in the large gluteal muscles);wherein rotational movement produced by either a clockwise direction or a pressing duration of 30 s to 1 min.This method is used to reduce muscle tension and create favorable conditions for the coordinated interaction of the antagonist muscle.If the brake method is applied directly to the muscle-razgibatelts in the joint, then a massage causes the simultaneous reduction in flexor tone and increased activity in the muscles, the extensor joint.
excitation method is also carried out by one or more fingers.Technically, this is done as in the previous method, but the exposure time is less than 5 seconds.Typically, this method is used when there is no high or tone has been reduced.
If acupressure is performed on a group of pixels (the area of the back, the abdomen, the blade locks), the total exposure time should not exceed 1 m for braking and 10-15 for the excitation method.
Based on the fact that any movement is the result of a complex interaction of a whole group of muscles rather than individual muscles, developed and successfully applied the so-called systematic method of stimulating acupressure.Technically, it is the same as that described acupressure, but exposure is performed simultaneously on several points of action, and on the body - by two arms disposed symmetrically in points.As with the method of stimulating the point, this massage is performed on muscles only after removal of the high tone.
During the acupressure starting position of the child selected individually to best eliminate the influence of tonic reflexes, affecting muscle tone.
If after several repetitions of techniques of acupressure is not the desired result, you should look for other points or a combination thereof.Reflexology acupressure is more effective at an early age, when the sick child has no fixed contractures and reflex sphere of the most malleable.