Patient's question:
My daughter is two and a half years old. She was born with asphyxia and had two hematomas on her head. Now she cannot speak and walks unsteadily, and has had a few episodes of seizures.Doctor's answer:
Hello: Before treatment, it is necessary to assess the motor function of children with cerebral palsy. In addition to the conventional rehabilitation assessment (100 assessment items), the assessment should also be conducted according to the developmental program of children's motor function. This approach includes evaluating initial reflexes and automatic responses, as well as assessing developmental stages based on motor development milestones.Scissor gait and foot drop are two common clinical signs in children with cerebral palsy. These signs are caused by three main reasons: first, primitive reflexes have not disappeared and normal reflexes have not been established; second, abnormal muscle contractions; third, muscle contractures. In a relaxed state, scissor gait and foot drop can be corrected. During movement, if scissor gait and foot drop appear, they are usually caused by abnormal muscle contractions. Manual correction during training generally yields effective results.
When a child exhibits scissor gait or foot drop in a relaxed or moving state, and the symptoms disappear during movement, this is due to the disappearance of primitive reflexes. However, if scissor gait or foot drop is still present in a relaxed state and does not improve with movement, it is caused by muscle contractures. In such cases, the meridian massage method is required to correct the condition.
A child who has good sitting balance and can crawl and roll over may be able to walk independently within three months with the of medical treatment. Taking walking into account, it can be divided into two stages: the first stage is initiating steps, where the child can walk 20–50 meters with support and has good balance. The second stage is correcting posture, which is more challenging and requires good overall base function in the child to allow for effective control and coordination. At this stage, the child's step width, step count, and gait improve, and they can climb stairs (15 cm high). This stage requires a longer duration and is prone to setbacks, so each movement must be practiced repeatedly.
Joint mobilization should be used to massage each joint for 20 minutes daily (as believes "joints are used for movement"). This is necessary to achieve the ideal effect of the second stage, which is the final step in cerebral palsy recovery. The better the posture is corrected, the higher the quality of life for the child with cerebral palsy, and the stronger their ability to reintegrate into society.
Recovery of motor function alone is insufficient. Cerebral palsy is a holistic condition, affecting 70% of children's intelligence and 30–40% of their language abilities. Therefore, physical rehabilitation must be synchronized with intellectual and language rehabilitation to achieve true recovery, enhance the child's quality of life, and enable them to reintegrate into society earlier, reducing the burden on both families and society.
Unlocking the immense potential of children with cerebral palsy requires the joint effort of family members and medical staff. The language disorders, intellectual impairments, and deafness in children with cerebral palsy are entirely different concepts. Their language function is not absent but has been functionally underutilized due to a lack of long-term guidance. Many parents desperately seek quick fixes while neglecting early language rehabilitation training.
The principle of language training is that parents and medical staff guide the child's movements while using language. Long-term language guidance can increase the child's brain's information feedback, form simple reflex pathways, and guide conscious voluntary movements into unconscious reflex actions. This creates logical reflex pathways in the brain and forms memories in the central nervous system. Many children experience improvements in intelligence and language alongside their motor function. Only through this synchronization can we achieve the ultimate goal of four-skill synchronization in recovery: walking (sitting, standing, squatting, moving); grasping (extending, flexing, grasping, releasing); speaking (single sounds, speaking, continuous sounds, singing); and recognizing letters (listening, knowing, learning, reading).
Therefore, as long as active treatment is pursued, there is no problem.