Hemiparesis in children: massage and exercise therapy

Hemiparesis in children is one of the forms of cerebral palsy, cerebral palsy. The prefix “hemi” indicates the right or left half of the body; “paresis” is incomplete damage to the nerves with partial loss of function. The term “hemiplegia” is complete paralysis of half the body. It must be said that this is not the most severe form of the disease, but it also depends on the severity of the brain damage. With a mild lesion, an adult child may not understand that he was given such a diagnosis. In severe cases, the child cannot use the right or left half of the body, i.e. the arm and leg are constrained by spasticity and movements in them are extremely limited. With such a diagnosis, there may be disturbances not only in the muscles of the limbs and torso, but also in the speech apparatus and intellect. Based on localization, left-sided and right-sided hemiparesis are distinguished. Causes of hemiparesis in children : usually this diagnosis is caused by brain injuries during childbirth through hemorrhage, prolonged or acute intrauterine hypoxia, asphyxia, ischemia, and combinations of these conditions. Often the cause may be infections, viruses, medical errors during childbirth, fetal development abnormalities, and brain underdevelopment. Extremely premature and low birth weight babies are at risk. The human brain is very sensitive to the lack of oxygen; if it is not supplied through the blood within 15-20 minutes, then the brain cells begin to die. Therefore, states of oxygen starvation are very dangerous for humans, and especially for the developing fetus. We can distinguish the main groups of factors leading to oxygen deficiency:

mechanical, compression of the arteries by the umbilical cord when passing through the birth canal.
hemorrhagic, with rupture of blood vessels in the brain.

How can you tell if your child has hemiparesis?

What symptoms may alert parents and become a reason to see a doctor? Upon examination, the specific posture of the child immediately attracts attention; on one side, the limbs are more tense, tucked in, brought closer to the body, less mobile, lagging behind the Moro reflex (this is when the child suddenly throws his arms to the sides and back, as if he was scared) Palpation and In passive movements of the limbs, tension and resistance from the muscles are felt. The child manipulates the tense half of the body much less. In such cases, you need to consult a doctor and explain the cause of your concern. It is the neurologist who makes such diagnoses; in other cases, these are only suspicions that need to be checked. Hemiparesis is similar to hemisyndrome, so the doctor will make this diagnosis last. Usually, a diagnosis of cerebral palsy is not made until one year of age; if the baby is at risk, then before the diagnosis is made, he is actively rehabilitated with medication, massage, exercise therapy, physiotherapy, etc. As a rule, specialists even before a year can already understand that making a diagnosis is a matter of time, but they write the threat of cerebral palsy as a type of hemiparesis. Experienced massage therapists can distinguish spasticity from tone, but according to the rules, you must first carry out therapeutic measures in order to eliminate the (so desired) error. At such moments, the doctor really wants to be wrong in his suspicions and the parents really hope for this.

Treatment of spastic hemiparesis in children

Therapeutic measures will be somewhat different in the early recovery period, late, and in the period of residual effects. The greatest intensity of treatment is in the first 2-3 years, hence the prognosis for future prospects. Many sources repeat that the earlier treatment is started, the greater the results. Of course this is true, but no less important is the correctly selected treatment methods and the quality of their implementation. You also need to understand that hemiparesis is not completely cured; it is only possible to partially restore lost functions. For most people, the diagnosis of cerebral palsy sounds scary, like a death sentence, in part this may be so, but I recommend that parents do not waste time and energy on despondency, but focus on the quality and regularity of treatment. Treatment of spastic hemiparesis in children is a long and expensive matter. The rehabilitation process is complex, usually in the first stages it is carried out in neurological hospitals, but after discharge it continues at home as prescribed by a doctor. Treatment is medicinal, massage, exercise therapy, physiotherapy, after 1.5-2 years speech therapists, psychologists, speech pathologists, orthopedic solutions are added.

Epilepsy attacks in infants and their characteristics

The manifestation of epilepsy in infants is significantly different from seizures that occur in adults. The manifestation of epilepsy in an infant can easily be confused with normal physical activity. This factor makes diagnosis difficult.

Signs of epilepsy:

Epilepsy is associated with seizures. During an attack, all the muscles of the body tense, and breathing stops for a short time. Then convulsions begin, varying in duration and intensity. The bladder empties spontaneously. After some time, the convulsions end, the child calms down and falls asleep.
Epilepsy can occur without seizures. The child seems to freeze, his gaze is glassy. Twitching of the eyelids, closing of the eyes and tilting of the head back may be observed. This attack lasts about 20 seconds. After such a seizure, the baby continues his usual actions. Parents may not notice such an attack.
Loss of consciousness and muscle relaxation are characteristic signs of an atonic attack. This attack resembles fainting. A doctor's consultation is necessary if the child frequently loses consciousness.
A spasm occurs, accompanied by involuntary pulling of the arms to the chest, bowing of the head and straightening of the legs. Such actions can often be observed after waking up.

There are other symptoms of epilepsy. The child may have disturbing dreams. He can move around the apartment without reacting to the speech of an adult. There is also a severe headache accompanied by vomiting.

Massage and exercise therapy for hemiparesis in children

Massage for hemiparesis is done classically, has its own characteristics in plan, and the procedure also includes techniques from exercise therapy, passive ones aimed at stretching spastic muscle groups, and active ones aimed at strengthening the healthy half of the body and developing skills. The duration of the procedure depends on the age of the child. It is better to rely on the child’s patience, but even if the baby is able to endure a long procedure, I still do not recommend doing it for more than 40-50 minutes for children under one year old and 60-70 minutes for babies after one year. The massage is done every day, you can stop on weekends, the course is up to a maximum of 25 sessions, then a break for at least 2-3 weeks. Exercise therapy can be done every day without breaks. The massage can begin with the back and neck area, in order to work on the reflex zones and segments innervating the limbs. We use classic techniques. In tense areas such as the shoulder girdle, buttock area, the massage is done deeper and more slowly. We carefully process the paravertebral lines from bottom to top using spiral rubbing. The child should not be in pain, but the pressure must be strong to achieve the effect. In a position lying on his stomach, it is advisable for the child to lie supported on his elbows; if the baby does not succeed in this, then the mother sits and holds the child’s hands in this position. Reliance on the elbows is practiced for children up to 5 months old; older children, who can already lean on their elbows without support, can, if desired, place their heads on the table. Massage of the arms and legs for hemiparesis in children is done in a classic way, but passive movements in the joints are necessarily added in order to stretch tense muscles. Kneading at a slow pace and deeply in spastic areas. To improve the quality of kneading, the muscle can be stretched by movement in the joint through which it is thrown, and massaged in a stretched position. Physical therapy (physical therapy) for hemiparesis in children is of great importance in rehabilitation in all age groups. For infants there is a lot of passive and reflex gymnastics, but less active, due to the newborn’s inability to perform many active exercises. As they grow older, the emphasis and set of exercises gradually changes towards more complex ones that require the involvement and active participation of the child in the process.

Parents' actions during an attack. First aid

If the attack was short, then there is no need for special measures. During an attack accompanied by severe seizures, parents must do everything to prevent the child from injuring himself.

First aid includes the following:

Hold the baby's torso and head;
Remove constrictive clothing;
Open the window, give access to oxygen;
If breathing stops, perform artificial ventilation.
Do not leave the child, stay nearby.
You can give medicine to your child only after he comes to his senses.

If such an attack occurs for the first time and lasts more than 5 minutes, then you need to call an ambulance.

After a seizure, the child falls deeply asleep. Monitoring the child after a seizure is of great importance, as seizures may recur. If the child slept peacefully for two hours, this means that the attack is over.

What should be the result after massage and exercise therapy for hemiparesis?

Of course, these methods are not a panacea. The benefits of massage with gymnastics in the prevention of contractures, the consequences of congestion, atrophy, training and maintaining muscles, nerves, blood vessels, bones and ligaments. After all, without stress, muscles weaken, ligaments become thinner, bones become thinner and more fragile. The functions of the musculoskeletal system must be preserved at least until the child grows to an age when he will more consciously work with a physical therapy instructor and perform increasingly complex exercises that will form the skills necessary for life.

Forecasts

So far, no supermethods or specialists have cured a single child from cerebral palsy with deep damage and, as a consequence, central spasticity. The diagnosis can be removed, but if the child had a mild degree of brain damage, in which many functions are preserved. If we are talking about deep and extensive damage to the brain tissue, then nothing can be done to force the brain to restore dead cells again, too many of them die, the structure is complex, and besides, the body quickly replaces the dead areas with connective tissue. Therefore, everything that can be restored bypassing the lost areas in childhood will be the result of treatment for hemiparesis. But with this form, one half of the body is working and this means a lot for the future formation of skills.

Cause of epilepsy in a newborn

Parents of sick children wonder why this happened to their child and what are the causes of this disease.
Let's consider the factors that cause the appearance of epilepsy:

Perhaps during the period of intrauterine development there was a failure in the formation of the brain. The reasons for this failure may be the use of alcohol and drugs during pregnancy, as well as smoking. If, while carrying a child, the expectant mother suffered from viral diseases (flu, herpes, colds), then the risk of developing epilepsy increases.
The older a woman is, the higher the risk of having a child with pathologies.
The prenatal process plays an important role. If a child is in the womb for a long time without amniotic fluid, entwined with an umbilical cord, and labor lasts a very long time, then the likelihood of having a child with developmental disabilities increases.
Nervous system disorders, as well as bacterial and colds, accompanied by high fever and seizures, can cause epilepsy.
Epileptic factors also include injuries, falls and concussions.
Low levels of the hormone dopamine lead to inhibition of chemical processes in the brain.
Deficiency of microelements and vitamins. In 1973, American scientists discovered that a lack of minerals in the body is associated with seizures. Parents should monitor the level of zinc and magnesium in the body. When stressful situations occur, as well as an increase in body temperature and increased physical activity, a rapid decrease in the amount of magnesium in the body occurs.
A benign or malignant brain tumor can cause the development of pathology.
Cryptogenic causes in which it is impossible to determine the factor causing epilepsy.

How to select specialists for the rehabilitation of a child with hemiparesis?

Usually the parents of such children are ready to do anything and believe everything in order to restore their children’s health. Unfortunately, there are unscrupulous people who try to sell useless services to parents who find themselves in difficult life situations. We have accumulated some experience in interacting with such children and their parents. Based on this, we would like to give advice to parents: for medical rehabilitation, select specialists with medical education, massage therapists, exercise therapy instructors, etc. From time to time it is advisable to undergo complex treatment and rehabilitation in specialized medical facilities. centers, hospitals. During the break between such courses of treatment, you can work with the child by inviting specialists to your home. If it so happens that your baby has hemiparesis and you don’t know anything about it, don’t hesitate to ask mothers who already have experience in the rehabilitation, care and education of such children. They can be found on the Internet on forums and social networks. Children with the same diagnosis are still individual and have their own characteristics. But in general, information exchange with such parents will help you choose suitable correctional teachers-speech pathologists for your child, a feeding system, a diet, developmental activities, gradually trying what was useful for others, you will select for your baby the most effective activities, methods, and methods in your case. etc. It is better to look for speech pathologists and other teachers in specialized institutions where such children are cared for. For questions about massage and exercise therapy for children with hemiparesis, write to me on WhatsApp +79266057470 Alexey. The author of the article is massage therapist Alexey Matrosov.

Impact of epilepsy on child development

The diagnosis of epilepsy frightens most parents. It should be noted that this pathology is not genetically determined. It has no effect on the psyche. The child is not at risk of mental retardation and aggression.

Some parents believe that strong medications are harmful to the child. But in fact, it is the lack of therapy that causes more harm.

Epilepsy is a well-studied disease. There are effective methods to combat this pathology. The disease is not an obstacle to normal life.