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Compliance with the developmental principle as a problem of selection of approach to the therapy of children with cerebral palsy

100%
Matyja M., Czupryna K., Nowotny J.
Medical Rehabilitation
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2005
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vol. 9(4)
19-25
EN
The developmental principle is the most typical and probably a superior principle in improvement of children with cerebral palsy. This principle is described as management according to the physiological sequence of development. However, the developmental principle, considered as a simple teaching of successive “milestones” during the therapy is neither a positive nor a proper solution. Literal and simplified understanding of the developmental principle cannot be valid any longer. It cannot be seen as the necessity to achieve successive “milestone” according to their occurrence during the normal development. The developmental principle should monitor the approach to children’s problems and determine the frame of the procedure on the basis of normal and pathological development. Management complying with the developmental principle should be based on cause and effect analysis of growth deficits and mechanisms of abnormal motor behaviour formation. The understanding and application of this principle changes with the advancement of knowledge. The developmental principle should be used in a flexible manner taking into account not only motor development sequence but also other aspects. During the treatment of cerebral palsied children, there are many situations when a decision must be made by considering other elements rather than those connected with posture-motor aspects, such as nursing care, orthopaedic, psychological, pedagogical, social and logopedic ones. At present, this principle could be described as the necessity to consider in the therapy process mechanisms of acquisition and accumulation of proper sensorimotor experiences by the child, which provide a chance to generate the most proper movment patterns in the central nervous system. The interpretation of the developmental principle has always required that a child should not be pushed to overpass its motor abilities. Such a view is correct but has to be shown in a different light since such management can lead to a “trap”. Taking into consideration different aspects of cerebral palsy children care, it should be thought over, if and how the developmental principle is to be kept and whether it is really indispensable. Emphasizing the complexity of a problem, the author of this study discusses some dilemmas regarding the application of the developmental principle within the aspect of the diagnosis of motor disturbances, nursing care, psychological, pedagogical, logopedic indications, orthopaedic indications and child’s daily living and therapy. The necessity of detecting both present and remote functional needs of children with cerebral palsy has also been highlighted.
2
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Respiratory system stimulation in children with infantile cerebral palsy

100%
Osiadło G., Matyja M., Nowak Z., Plewa M.
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2008
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vol. 16
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issue 1
73-84
PL
W pracy przedstawiono możliwości stymulacji układu oddechowego w mózgowym porażeniu dziecięcym (m.p.dz.). Ukazano odrębności anatomiczne, a także fizjologiczne układu oddechowego dzieci w porównaniu z osobami dorosłymi oraz ich wpływ na wentylację płuc, zwłaszcza u niemowląt. Opisano zalety oddychania nosem w stosunku do oddychania przez usta, a także podjęto temat nieprawidłowości wentylacyjnych występujących u dzieci z m.p.dz. W mózgowym porażeniu z racji zaburzeń wielkości i rozkładu napięcia mięśniowego blokady funkcjonalne pojawiające się w obrębie kluczowych punktów ciała (głowy i szyi, obręczy barkowej i biodrowej) zaburzają rozwój różnorodnych funkcji organizmu, w tym także pracę układu oddechowego. Mając na uwadze konsekwencje oddechowe, wynikające z występującej u omawianych dzieci hipotonii posturalnej, poświęcono uwagę takim zagadnieniom, jak: efektywne odkrztuszanie, techniki wspomagające oddychanie, kinezyterapia oddechowa, a także możliwość stymulacji prawidłowego wzorca oddychania w trakcie usprawniania neurorozwojowego (metody rehabilitacji dzieci: NDT-Bobath, Vojta, Doman-Delacato). Opisano też elementy terapii logopedycznej bardzo istotnej w usprawnianiu funkcji układu oddechowego ze względu na wspomaganie czynności mięśni gardła, jamy ustnej i twarzy, a tym samym ograniczanie oddechu przez otwarte usta.
EN
This study shows possibilities of stimulation of the respiratory system in children with infantile cerebral palsy (ICP). Initially, it presents distinctive anatomic and physiological characteristics of the respiratory system of children comparing them to adult respiratory system and their impact on lungs ventilation, especially in infants. It describes the advantages of nasal versus mouth respiration and the issue ventilatory disorders occurring in children with ICP. ICP due to disorders of value and distribution of muscular tension causes functional blockages of the key points of the body (head and neck, shoulder and pelvic girdles), which disturb development of various functions of the body, including the functioning of the respiratory system. Taking into consideration the respiratory consequences that arise from the postural hypotonia, this study concentrates on the following issues: effective coughing techniques, assistive respiratory techniques, respiratory kinesitherapy as well as a possibility of stimulation of a proper respiratory pattern as a part of neuro-developmental therapy (infants' rehabilitation methods: NDT-Bobath, Vojta, Doman-Delacato). Elements of speech therapy have been presented as well. This type of therapy is highly important for improving function of the respiratory system as it stimulates throat, oral cavity and facial muscles, thus reducing the pattern of mouth ventilation.
3
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Dyspraksja w zespole Downa – aspekt neurorozwojowy

76%
Doroniewicz I., Durmała J., Matyja M., Myśliwiec A., Suszyński K., Kwiek S. J., Wilewska K.
Annales Academiae Medicae Silesiensis
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2014
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vol. 68
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issue 5
368–374
EN
The ccurrence of Sensory Processing Disorder (SPD) symptoms, including problems with motor planning, among children with Down Syndrome is primarily attributed to intellectual disability. The article attempts to analyse the neurode-velopmental determinants of a child with Down. Syndrome in terms of forming the basis of sensory processing in order to understand the purposefulness of neurodevelopmental treatment, of both the Bobath Concept and Sensory Integration.
PL
Występowanie objawów zaburzeń przetwarzania sensorycznego, w tym deficytu w postaci zaburzenia planowania motorycznego u dzieci z zespołem Downa, jest przypisywane przede wszystkim niepełnosprawności intelektualnej. Artykuł stanowi próbę analizy uwarunkowań neurorozwojowych dziecka z zespołem Downa w aspekcie kształtowania się podstaw przetwarzania sensorycznego oraz zrozumienia celowości stosowania terapii neurorozwojowej, zarówno koncepcji NDT-Bobath, jak i Integracji Sensorycznej.
4
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An Assessment of Rotational Mobility of the Trunk among Teenagers with Faulty Posture

64%
Matyja M., Saulicz E., Saulicz M., Kokosz M., Gnat R., Kuszewski M., Bereszko J., Gogola A.
Journal of Human Kinetics
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2010
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vol. 24
43-50
EN
Body posture is determined by many factors, including central regulation connected with anti-gravitational mechanism which develops in ontogenesis. Postural disorders arise as a result of a compensatory anti-gravitational mechanism, in which the main component is reduced postural tone (volume and distribution disorders). Compensation mechanisms consist in improper alignment of particular body segments (distribution disorders) (e.g., increase or decrease of spinal curvatures, external or internal rotation of the lower limbs, valgus and varus deformity of the knees and feet). Such disorders may constitute a reason for abnormal component development, thus limiting trunk rotational mobility.An aim of the study was to assess the range of trunk rotational mobility.Pupils (n=123) aged 13-15 underwent the following parameter evaluations: 1. Posture according to Kasperczyk's scoring method, 2. Postural tone volume by analysis of pelvis control in the long sitting, 3. Range of trunk rotation with use of upper tension test (muscle latissimus dorsi and thoracolumbar fascia).Positive tension test was recorded in 32 children (21 unilateral and 11 bilateral). Diversification of statistical averages of scoring for body posture, from the lowest (x=6.41) in 91 subjects with negative tension test, to the highest (x=7.72) in 11 subjects with double-sided positive result was recorded. Statistical analyzes confirmed significance of correlation between body posture's quality and trunk's rotational mobility (r=0.286 at p=0.001), as well as between volume of postural tone and range of trunk's rotational mobility. Coefficients of correlation amount to, respectively, for tension test and free sitting position r=0.187, p=0.038; and for tension test and corrected sitting position r=0.253, p=0.05. Disorders of muscle tone volume and distribution cause limitation of trunk rotational mobility development.
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