Exercise therapy is carried out in preschool age(from 3 to 7 years old) in kindergartens in the form of small-group lessons from 3 to 5 times a week with junior group(3-4 years) - 15 minutes, with the middle (4-5 years) - 20 minutes, with the older (5-6 years) - 25 minutes, with the preparatory (6-7 years) - 30 minutes. For children with moderate and severe cerebral palsy, exercise therapy classes are conducted individually.

In preschool institutions of the compensatory and combined type, there are specialized groups of children with cerebral pathology.

Exercise therapy classes can also be carried out in medical institutions or rehabilitation centers in various courses, including complex treatment.

The organization of health and fitness work in specialized kindergartens and schools has its own characteristics. The activity of the teacher is distinguished by its specificity, due to the nature of the disease in children. Flaw teaching materials compels leaders physical education in preschool institutions, modify the programs used in working with healthy children, or develop their own programs, while the specialist needs to be well versed in medical aspects pathology. For special educational schools of cerebral palsy in 1986, a program was developed, but only for grades 1-4. There are no physical education and exercise therapy programs for middle and senior classes. A physical education teacher and a physical education supervisor need to know the methods and principles of the sequence of the formation of motor skills in a child with cerebral palsy. When training motor functions, it is necessary to observe the principle of ontogenetic sequence. It is advisable to constantly adapt the skills being trained to the daily life of the child. First of all, it is necessary to develop the reactions of straightening and balance.

• 1. Workout retention heads. In the supine position, the ability to raise the head and turn it to the sides is developed. This is important for mastering the next motor skill - turning and sitting down. In the prone position, to facilitate holding the head, a roller is placed under the head and shoulders. It is easier to raise your head when doing exercises on a large ball, swinging it back and forth. Rocking on the ball trains not only the head straightening reaction, but also the balance reaction.
• 2. Workout turns torso. Turns from back to side and from back to stomach stimulate head elevation, inhibit the influence of cervical tonic reflexes, develop coordination of movements, balance. In the lateral position, the child sees his hands, which contributes to the development of hand-eye coordination. In addition, rotational movements are necessary to maintain balance.
• 3. Workout crawls on all fours. First, you should train the lifting of the head and support on the forearms and hands in the prone position. In the position on all fours, the ability to correctly hold the posture is trained, leaning on the open hands and knees, the balance reaction is practiced, for training turns, the transfer of body weight, leaning on one arm or one leg, then on the other. In this case, it is necessary to monitor the correct (unbent) position of the head. To crawl on all fours, you need to correctly move the center of gravity, maintain balance and make reciprocal movements of the limbs.
• 4. Workout seating. Sitting requires good control of the head, extension of straightening responses to the trunk, balance responses and protective arm function. In addition, the correction of pathological postures is important. Stability in the sitting position facilitates free movement of the arms, while the back should be straightened, the head should be raised.
• 5. Workout standing. The ability to stand is based on mastering sitting and kneeling. In the kneeling position, it is easier than in the standing position, the reactions of balance of the trunk are trained, since, due to the larger area, the reaction of fear of falling is less pronounced. Kneeling training strengthens the reciprocal function of the limb muscles necessary for vertical walking. The training of the standing function provides for the formation of uniform support on the feet, control of the vertical posture of the trunk and the maintenance of balance reactions.
• 6. Workout walk. For gait training, a vertical installation of the head and body is required, a shift of the center of gravity to the supporting leg, the movement of the unsupported leg, correct positioning of the feet, the ability to maintain a standing posture with support on each leg, an even distribution of body weight on both feet, right direction movement and rhythm. First, the child is taught to walk with support (with the hands of an adult, parallel bars, a rope, a suspended road, Swedish wall etc.). Then the child learns to walk independently.

Along with the formation of basic motor skills and abilities, it is necessary to solve such problems as:

• - normalization of voluntary movements in the joints of the upper and lower extremities;
• - skill formation correct posture and the correct installation of the feet;
• - correction of sensory disorders;
• - correction of coordination disorders ( fine motor skills hand, static and dynamic balance, rhythm of movements, orientation in space);
• - training of muscular-articular feeling;
• - prevention and correction of contractures;
• - activation of mental processes and cognitive activity.
• - normalization of respiratory function

The ability to breathe correctly increases physical performance, improves metabolism, helps to restore speech. With cerebral palsy, breathing is weak, shallow, movements are poorly combined with breathing, speech is impaired. In this regard, for children with cerebral pathology, it is important to choose the correct starting position for performing exercises, i.e. breathing conditions also change depending on the position of the body. So, for example, in the supine position, inhalation is difficult on the support side, while sitting - lower thoracic breathing prevails, and diaphragmatic (abdominal) breathing is difficult, while standing - upper chest breathing prevails. B exercise therapy use both static and dynamic breathing exercises in different starting positions with different tempo, rhythm, with an emphasis on inhaling or exhaling, using various objects (inflating balloons, blowing soap bubbles, playing wind instruments, etc.). Breathing is also associated with speech, therefore, they use sound-speech gymnastics and with posture, therefore, breathing training is combined with posture correction.

Posture correction

With cerebral palsy, as a result of the action of postural reflexes, the formation of pathological synergies and muscle imbalance the most often formed is a violation of posture in the frontal plane, a round back (kyphosis and kyphoscoliosis). To normalize posture, it is necessary to solve such problems as the formation of the skill of correct posture, the creation of a muscle corset (predominantly strengthening muscles abdominal and extensors of the back in the thoracic spine) and correction of existing deformities (kyphosis, scoliosis). Exercise therapy is carried out according to the method of correcting posture disorders in the frontal and sagittal planes and the method of correcting scoliosis.

Normalization of voluntary movements in the joints of the upper and lower extremities.

P.F. Lesgaft said that elementary movements in the joints are the alphabet of any complex movements. For children with cerebral pathology, the work of the joints of the upper and lower extremities begins with the simplest movements, from lightened starting positions in combination with other methods (massage, thermal procedures, orthopedic styling, etc.). It is necessary to achieve a gradual increase in the range of motion in the joints of the extremities, to work out all possible movements in each joint. In this case, resistance exercises can be used in combination with relaxation and swinging movements. You can also use various items ( gymnastic stick, ball, rope for the upper limb, gymnastic wall, track tracks, parallel bars for the lower limbs).

Particular attention should be paid to the development of limited movements - extension and abduction in the shoulder joint, extension and supination in elbow joint, extension of the fingers and abduction of the thumb in the hand, extension and abduction in the hip joint, extension in knee joint, ankle extension and full foot support.

Correction of fine motor skills and manipulative function of the hands

The main function of the hand is to manipulate objects. Even anatomical structure the muscles of the hands involve fine, fine, differentiated work. The manipulative function is important for the child's self-care and for mastering professional skills. In this case, the most important is the oppositional grip of the thumb. There are the following types of hand grips: spherical, cylindrical, hook-shaped, interdigital and oppositional. In exercise therapy classes, it is necessary to work out all types of grips. To train the kinesthetic sense, it is important to adapt the child's hand to the shape of various objects when learning to grip. To practice self-service skills, the child trains to grab a spoon, fork, button up buttons and buttons on clothes, fold cubes, mosaic, draw, turn on the light, dial a phone number, turn the tap, comb, etc. various games and activities in the form of sewing, gluing, scissoring, typing. After the development of differentiated finger activity, it is especially important to start learning to write.

Correction of sensory disorders

The success of physical, mental and aesthetic education depends on the level of sensory development of children, i.e. on how perfectly the child hears, sees, perceives and how accurately he can express it in speech (Levchenko I.Yu., Prikhodko O.G., 2001). In connection with motor impairment in children, manipulative-objective activity is limited, perception of objects by touch is difficult, and hand-eye coordination is underdeveloped. To correct sensory disorders, it is necessary to develop all types of perception, to form sensory standards of color, shape, size of objects, to develop muscular-articular feeling, to develop speech and higher mental functions (attention, memory, thinking).

Prevention and correction of contractures

Abnormal distribution muscle tone quickly leads to the development of contractures and deformities, inhibits the formation of voluntary motor skills. Prevention and correction of contractures can be carried out both with the help of physical exercises and with the help of aids. Of the exercises, exercises in relaxation, stretching, shaking (according to Phelps) are most appropriate, and of the aids that help maintain the correct position of various parts of the body, splints, splints, splints, collars, rollers, weights, etc. are used. unloading (Shants collar, corsets), and for the correction of pathological postures (braces, splints, apparatus). They are used 3-4 times a day, the duration of stay in special styling depends on the severity of the lesion and the tolerance of the procedure. Auxiliary agents help to inhibit pathological tonic activity, normalize reciprocal relationships of antagonist muscles. The orthopedic regimen should be alternated with different types remedial gymnastics to combat contractures.

Activation of mental processes and cognitive activity

B psychological correction Special attention should be directed to the formation of design activity, since as a result, the perception of the form, size of objects and their spatial relationships is improved. Psychocorrection of memory is important in connection with a decrease in the volume of visual, auditory and tactile memory, as well as the formation of visual-figurative thinking in the process of design and visual activity. In addition, it is necessary to carry out psychological correction of emotional disorders and speech.

Thus, exercise therapy is the most important part of the general system of adaptive physical culture. The main means are dosed physical exercises. Tasks, content, methodological techniques in the exercise therapy classes are connected with the plan of treatment, correction, education and upbringing of the child and depend on his condition and the dynamics of the results achieved. Exercise therapy classes can be small-group or individual, depending on age, diagnosis and severity. The results obtained in the exercise therapy classes are consolidated in physical education lessons. For each child, it is necessary to draw up a plan of correctional work and evaluate the effectiveness of correction. For a successful treatment and pedagogical process, it is important to interact between a neurologist, an exercise therapy doctor, a speech therapist, a psychologist, an educator, a teacher, and also parents.

Respiration normalization

The ability to breathe correctly with various physical exertion ensures an increase in the body's performance, improves metabolism, strengthens health and helps to restore speech in sick children. Children with cerebral palsy usually have weak, shallow breathing. They do not combine movement with breathing well, and many suffer from speech disorders closely related to the lack of correct setting breathing. Therefore, patient education correct breathing is very significant not only from the point of view of improving it general condition , but also for the solution of special treatment problems. So, in a child trained in deep rhythmic breathing, the spastic muscles and, first of all, the muscles of the trunk relax, which contributes to the teaching of his movements and correct speech. When teaching a child to breathe, it is important to choose the starting position correctly, since the conditions for breathing change depending on the position of the body. In the supine position, exhalation is somewhat difficult and must be done with some effort, contracting the abdominal muscles. In the prone position, the mobility of the lower ribs prevails.When lying on the side, breathing movements from the support side are limited and free on the opposite side, while exhalation is more free than inhalation. In a standing position, the vital capacity of the lungs reaches its maximum values. In a sitting position with relaxed abdominal muscles, lower chest breathing prevails, and abdominal breathing is difficult. When sitting with a straightened body, upper chest breathing prevails, etc. The way of breathing is closely related to posture, just as posture affects the way of breathing. Therefore, teaching normal breathing must be combined with teaching the correct positioning of all parts of the body in various starting positions. Before choosing special exercises, you need to check how the child breathes and how he knows how to control his breathing. In milder cases, when there are no special abnormalities in breathing, the patient will be able, after showing, to freely identify the main types of breathing. But even in the mildest cases, as a rule, he does not know how to combine movement with breathing. It is necessary to pay special attention to this, making the main task of training consciously controlled breathing with various movements. In the work of M. Machek, I. Shtefanova and B. Shvetsarova (1964) very valuable exercises are given, which we have successfully tested in practice. So, they recommend counting exercises with different speeds and durations of inhalation and exhalation, performed smoothly, quickly, in various combinations. For example: 1) inhalation is fast, sharp for 1-2 counts; exhale slowly in 4 counts; 2) inhale slow for 4 counts, exhale fast for 1-2 counts; 3) inhale calmly for 2-4 counts; exhale too; 4) inhalation with stops 2-3 times; exhalation is calm, slow, without stopping, etc. These exercises are recommended to be carried out in different starting positions: lying, sitting, standing, arms along the body or on a support. In the future, it is recommended to give exercises with hand movements corresponding to breathing; the combination of inhalation and exhalation with certain movements performed quickly, slowly, sharply, smoothly; with the movement of any objects - with a ball throw, etc. etc., as well as in combination with rhythmic movements of the arms and legs - when walking in place, etc. For example: 1) inhale - lying on your back, arms to the sides for 3 counts; exhalation - lowering the hands by 4 counts; 2) inhale - while sitting, bending your arms at the elbows, placing the ends of the fingers to the shoulders, in 2 counts; exhale - lower your hands down for 2 counts; 3) inhalation and exhalation during rhythmic movements (like walking or its imitation). The task is given to inhale and exhale for a certain number of counts. In case of more severe disorders of coordination of movements, in the absence of complete breathing and inability to isolate certain types of breathing, they resort to such techniques. 1. The task is given not for performing inhalation and exhalation, but for some specific action that cannot be performed without active inhalation or exhalation. For example: inflation of a ball, rubber toy, "playing" on a flute, pipe, harmonica, etc. 2. The patient has not yet learned to distinguish certain types of breathing, although he voluntarily performs inhalation and exhalation. In these cases, it is recommended to provide resistance in the corresponding areas of the chest. The strength of the pressure changes with the breathing movements. At the beginning of inhalation and at the end of exhalation, the pressure increases, and in the final phase of inhalation and at the beginning of exhalation, it weakens. When the upper thoracic breathing is released, stimulation in the form of resistance can be provided under the collarbones or at the sternum. For lower thoracic breathing, resistance is applied to the lower ribs from the sides or from the edge of the costal arch, closer to the middle. With unilateral spasticity of the muscles of the trunk and shoulder girdle you can give exercises in breathing with resistance in the initial position of the patient lying on the opposite ("healthy") side.

It is only a symptom of the disease, and not the disease itself. Treatment should be directed against the underlying disease, but symptomatic treatment should also be carried out.

The leading role in this is played by a complex of massage and therapeutic exercises, which contribute to the restoration of movement, as well as prevent the appearance of deformities and contractures.

Laying down the arms (Fig. 1) and legs (Fig. 2) with central paralysis to prevent contractures.

The complex consists of the following elements: 1) placing the paralyzed limb in the correct position; 2) massage; 3) passive movements; 4) active movements. With central paralysis, the limbs should be given a special position that prevents the formation of contractures (Fig. 1 and 2). From the beginning of the second week, massage begins. The muscles in which it is elevated are lightly stroked, the rest of the muscles are massaged with the usual methods, depending on the patient's condition. Along with this, gymnastics is carried out, including passive and active exercises (Fig. 3-17). Passive movements should be started as early as possible, preferably at the end of the first week (depending on the patient's condition). At the beginning, they can be limited to a few minutes. They need to be produced at a slow pace, but in full in all joints of the paralyzed limbs. These exercises also try to prevent abnormal limb positions (excessive flexion, adduction, or extension).

Rice. 3-17. Therapeutic exercises with central paralysis: Fig. 3 - passive movements; Figure 4 - passive shoulder abduction forward, upward and to the side; rice. 5 and 6 - extension of the arm in with the extension of the straightened arm to the side; rice. 7 - extension of the elbow joint in the supination position and rotation of the shoulder outward; rice. 8 - supination and pronation; rice. 9 - rotation of the hip in; rice. 10 - adduction and abduction of the thigh; rice. 11 - flexion with an extended hip lying on the side; rice. 12 - passive flexion and extension of the leg in the knee joint; rice. 13 - passive movements in; rice. 14 - keeping the affected hand in the given position; rice. 15 - keeping the affected foot in the given position; rice. 16 - facilitated raising and lowering of the affected arm with a healthy hand using a cord and a block (the exercise can be combined with abduction and adduction of the arm in a raised position); rice. 17 - facilitated raising and lowering of the affected leg by hand using a cord and a block.

When voluntary movements appear, the patient should be explained the need for their active and frequent repetition. The choice of active exercises in each case depends on the group of affected muscles. From the 2-3rd week (in elderly and weak patients, this should be done more gradually), the patient should be transferred to a semi-sitting position for 1-2 hours a day. By the end of the 3-4th week, you can spend most of the day in a comfortable chair. When teaching to walk, the patient should first of all be taught to step on a paralyzed leg. At the same time, attention should be paid to correcting the abnormal position of the flexors and muscles that rotate the leg outward. When walking, raise the paralyzed leg high using the pelvic muscles so as not to touch the floor with the toe. Initially, the patient can walk with assistance, and then leaning on a stick.

With peripheral paralysis in the early days, the trunk and limbs are also given a position that prevents further development contractures. Perhaps the massage begins earlier, which should also be selective; paretic muscles are massaged with all methods, and the antagonists only stroke. Passive movements begin at the same time as the massage. When movements appear, active exercises are added. Gymnastics in a bath, a pool with warm water is useful.

Medical treatment is carried out according to the prescription of a neuropathologist. Of the drugs for paralysis, 0.01-0.015 g are used orally 3 times a day or subcutaneously, 1 ml of a 0.05% solution daily, dibazol 0.015 g 3 times a day, intramuscular injections - 5% solution, 1 ml daily. In case of paralysis with increased muscles - melliktin 0.02 g 3 times a day before meals.

Only a timely detected cerebral palsy and immediately started treatment give the child a chance for at least partial recovery and social adaptation. To determine cerebral palsy in infants, there are a number of tests, some of which parents can conduct on their own. Well, when confirming the diagnosis, it is worth stocking up on courage and patience: the treatment will be long, requiring complete dedication on the part of adults.

Cerebral palsy: classification of the disease

Cerebral palsy (cerebral palsy)- This is one of the most severe forms of motor cerebral (brain) disorders in children, arising from various reasons (there are up to 400 of them, which means that the real cause is not known) during pregnancy and childbirth. Cerebral palsy is, first of all, impaired muscle tone and improper coordination of movements, and this is a disability. Unfortunately, this disease is becoming more common. It occurs in children from 3 months to 3 years old (untreated children with this pathology live for more than 3 years very rarely). However, if one or another form of cerebral palsy (cerebral palsy) is detected in a timely manner, and treatment is started without delay, then the child has the opportunity to socially adapt in the future (to have a job and a family). The good news is that the disease does not progress, and as the child grows, the symptoms of the disease may decrease.

In what form infantile cerebral palsy proceeds, the neuropathologist should determine.

When classifying infantile cerebral palsy during the course of the disease, according to different specialists, there are 3 to 4 periods:

acute period, or early stage(7-14 days, up to 2-3 months), when the disease manifests itself in the form of syndromes:

• syndrome of cerebrovascular accident - there is a groan, convulsions, sudden excitement of the child with a shrill cry, respiratory failure;
• syndrome of increased intracranial pressure (hydrocephalic-hypertensive) - the fontanel is tense or bulging, the size of the head is rapidly increasing, it can be;
• convulsive syndrome - convulsions occur several times a day;
• syndrome of suppression of unconditioned (inborn) reflexes - grasping, automatic gait, etc. Incorrect settings of the trunk and limbs are formed;
• diencephalic syndrome - there is a small increase in weight, growth retardation, sleep disturbance, temperature;

recovery period:

• early recovery period (initial chronically residual stage) - begins after the abatement of acute manifestations of cerebral hemorrhage. According to various authors, this period lasts from 2 to 5 months. It is at this time that the doctor can determine the form of cerebral palsy. More often it is mixed and includes various movement disorders;
• late recovery period - lasts up to 1-2 years;

the period of residual effects, or the final residual stage, - begins at the age of 2 and lasts the entire period of childhood and adolescence. Children 4-7 years old with intact intelligence attend speech therapy groups kindergartens (movement disorders are combined with speech disorders). Exercise therapy classes with a methodologist are held every other day, all other days the child is engaged with his parents. A two-year-old child with cerebral palsy can be on the move for up to 2.5 hours a day, at 3-7 years old - up to 6 hours.

The photo of infantile cerebral palsy shows how the disease proceeds at different periods:

Cerebral Palsy Definition: Symptoms in Newborn Infants

The task of parents and a pediatrician is to identify the symptoms of cerebral palsy in newborns as early as possible, for this there are special tests. Considering that during the neonatal period, the child's muscle tone is normally increased, it is possible to determine changes in muscle tone by indirect signs only from the end of the first month: with an increased tone, the child does not attempt to raise his head from a prone position and set it along the midline.

To check the muscle tone and body symmetry of a child from 2 months: lay it on a flat and firm surface on your stomach and lift both legs with your right hand about 15-20 °. Firmly holding the outstretched legs, with your left hand stroke the back from the tailbone to the neck along the spine with light pressure (so that the baby bends slightly). If your left hand does not feel resistance, and the line of movement along the spine is even (straight), then the child's muscle tone is normal. If muscle tone and body asymmetry are disturbed, your hand will sharply change direction on its way; the child's body at this moment will bend to the side (and not down); at the same time, you will clearly feel the muscle tension at hand; the baby's legs will be bent at the knee and hip joints.

At the same age, a child can notice such signs of cerebral palsy as tilting the head, tension in the back of the head. With support under the armpits, he does not rest on his full foot, but on the tips of his toes ("on tiptoes").

In healthy children, congenital reflexes begin to disappear from 3 months. If the grasping, searching reflexes, the automatic gait reflex do not disappear after 4 months, but even intensify, then there is a high probability of having an increased muscle tone. In the prone position, such a child bends his arms, legs and raises the pelvis.

A newborn baby normally performs rhythmic automatic movements. If the baby lies motionless, the handles are clenched into fists, brought to the body, thumb squeezed inward, and the legs are crossed, this is very similar to spastic paresis of the upper and lower extremities.

If the movements are performed, but at the same time the child is lethargic, "flattened", the palm is unbent, the hand hangs down, and the legs are in the "frog" position, then a sluggish paresis of the limbs can be suspected.

How else can you suspect something was wrong? If for 1-3 months the baby is dominated by negative emotions (frequent crying), there is no "humming", then the attention of the pediatrician should be paid to this.

Testing children for the detection of cerebral palsy

Testing of children with cerebral palsy should be done only by a doctor, but it is useful for parents to know about the basic principles of such tests.

Tests for children to detect cerebral palsy in the supine position:

• the doctor places his arm under the child's head and tries to bend it. Normally, the head bends easily, and with cerebral palsy, the head presses on the arm;
• the doctor takes the baby by the hands and pulls on himself. Normally, the child bends his head and tries to sit up.

As you can see in the photo, in children with cerebral palsy, the head is thrown back:

• the child's hands are lifted up parallel to the head (taken to the sides, crossed). With cerebral palsy, the baby resists these movements;
• the doctor unbends the child's legs, grabs them under the knees and bends them towards the stomach. With the disease, infantile cerebral palsy is determined by the resistance to this movement.

Tests in the prone position:

• the doctor grabs the child's hand and tries to place his hands on both sides of the head (pulls his hands out from under the chest). With cerebral palsy, resistance is felt.
• To diagnose cerebral palsy, the doctor places his hand under the baby's chin and tries to raise his head. In children with infantile cerebral palsy, the chin presses on the doctor's hand. Normally, by 5 months, the baby independently raises his head in a prone position, while resting on his hands.

Tests for children to identify signs of cerebral palsy (cerebral palsy)

The spine of an adult resembles a spring with several bends (lordosis) - cervical and lumbar. It is they that allow you to maintain an upright body position. The newborn does not have these curves, that is, his spine is almost straight. The cervical bend (lordosis) appears at 2.5 months, which allows the child to hold his head in an upright position. With the spastic form of infantile cerebral palsy in infants, the neck is inserted into the shoulders ("short neck"), and the formation of cervical lordosis is late.

With cerebral palsy (increased muscle tone of the back), a newborn can hold his head from a prone position earlier than 2 months. To understand this, you need to put the child on the back and try to lift him by the arms (test 2) - the head will hang down.

Lumbar lordosis should be formed at 6 months, after which the baby begins to sit on its own. If the lumbar bend is insufficient, then the trunk is tilted forward, which disturbs balance (support on the legs). Excessive lumbar bending (hyperlordosis) leads to stiffness (contracture) of the hip joints (one or both), due to which the gait changes greatly: oscillatory movements appear when walking (from side to side or front and back).

Tests to determine correct lumbar lordosis

1. Starting position - lying on your back. Pull the baby's knee up to the chest. If the other leg at this time rises so that it cannot be pressed down, this is evidence that the hip flexor muscles are shortened.

2. Starting position - lying on your stomach. Bring the child's heel to the buttock. When shortening the rectus femoris muscle, this cannot be done.

Treatment of children diagnosed with cerebral palsy (cerebral palsy)

When diagnosing cerebral palsy, treatment is carried out comprehensively, aimed at teaching movement, restoring impaired functions, which is achieved by the tireless (selfless!) Work of the parents. According to statistics, a significant improvement is noted in 25% of patients, and some mitigation of defects - in 50%. Another 25% of children do not have any positive dynamics.

The difficulty of treating infantile cerebral palsy in infants lies in the fact that drugs can accelerate the process of "maturation" of nerve fibers, normalize muscle tone, but do not in any way affect muscle and articular contractures, which prevent the child from gaining experience of normal postures and movements. Daily physiotherapy and massage can help the baby develop normally. In any case, reconciliation with disability is not the solution to this problem. The beginning of physical therapy at any age gives positive changes: the child's emotional state improves, muscle contractures decrease (or disappear).

In the initial stage of cerebral palsy, treatment of children with position (laying) is carried out after a relaxing massage and relaxing exercises.

In order to give the body a physiologically correct (symmetrical) position, use special rollers with sand, tires with a soft inner lining. The child can stay in such styling for 2 hours, then rest for 1-2 hours follows, and the shanks are applied again.

At an older age, a position is used with the maximum convergence of the muscle attachment points.

Pose lying on your back: put a roller (pillow) under your head so that the head is practically lowered to the chest. Bend your arms at the elbows or cross over your chest. It is necessary to bend the hip and knee joints (put a roller under the knees), the angle of flexion is selected individually. Put your feet on a support, open your hips freely.

Exercise for children with infantile cerebral palsy

During the rehabilitation of infantile cerebral palsy, the main goals of exercise therapy are:

• normalization of muscle tone so that the child can perform arbitrary movements;
• age-appropriate motor skills training; strengthening the sense of posture, training the vestibular apparatus. It should be remembered that any intense (careless) effect can lead to an increase in muscle tone (pain increases muscle tone). Exercise therapy should be started immediately, as soon as the symptoms of increased intracranial pressure subside and the seizures stop.

Classes with children with cerebral palsy to normalize increased muscle tone.

Exercise 1. Designed to identify and eliminate the asymmetry of the trunk, increased muscle tone of the back, occiput (forms a cervical bend and reveals abnormalities in the hip joints).

Such exercises for children with cerebral palsy are performed no earlier than 2 months of age (during the formation of cervical lordosis). If there are indications of injury in cervical spine spine, then the exercise is performed only after the therapeutic massage procedure.

Starting position - lying on your back. The instructor brings the child into a flexion position ("fetal position"): the arms are crossed over the chest, the legs bent at the knees lead to the stomach and bend the head to the chest. The baby's knees should be bent and as close to the head as possible along the midline of the body (with dysplasia of the hip joints and the symptom " short neck(It fails and the child performs an easy exercise). Hold the baby in this position for several seconds, making rocking movements.

The flexion position is natural for a healthy child and is not difficult to perform. If the child has an increased tone (rigidity) of the muscles of the back and neck, then he will cry. Under no circumstances should the child bend with great force!

In case of hip dysplasia, the baby will "slip" out of the instructor's hands, trying to free himself and tilt in the other direction.

This exercise for children with cerebral palsy helps in 14 days 5-8-month-old children with increased tone of the muscles of the neck and back, who cannot keep their head, roll over and sit down.

Exercise 2. Designed to determine and eliminate the increased tone of the muscles of the thighs, the formation of the lumbar curvature of the spine. It is shown to children who, when performing an automatic gait, do not rely on the entire foot, but on their toes. It is performed no earlier than at the age of 6 months (at the beginning of the formation of lumbar lordosis), after consulting an orthopedic doctor. The exercise promotes internal rotation of the hip, and therefore, before doing it, you need to make sure that the child does not have (if any, eliminate) dysplasia or subluxation of the hip joint.

The starting position for this exercise is from complex exercise therapy for children with cerebral palsy - the child sits between the heels on the legs bent at the knees, the feet are shoulder-width apart, turned up. The instructor tilts the baby back so that the head, shoulders, back touch the table surface. The instructor's right hand pulls down the head and shoulders, and the left hand fixes the knees. A child with normal muscle tone can easily and happily remain in this position.

If the thigh muscles are tense, the child will try to free himself from the unpleasant position as soon as possible, and sharply straighten his legs. In this case, you should do a warming massage of the lower extremities and repeat the exercise, trying to overcome muscle resistance. As soon as the baby begins to perform this exercise therapy exercise for children with cerebral palsy without resistance, he will be able to stand up on the entire foot (the tone of the thigh muscles is normalized), and then sit down on his own (the exercise forms lumbar lordosis).

How to deal with children with cerebral palsy

You need to work with children with cerebral palsy every day, this is the only way to achieve progress.

Complex exercise therapy for children with cerebral palsy, helping to develop motor skills.

Exercise 1. The starting position is sitting on your heels. Stand in front of the child, put his hands on your shoulders and, fixing him in the pelvic area, stimulate kneeling.

Exercise 2. Starting position - kneeling. Supporting the child under the armpits, move him from side to side, so that he learns to independently transfer the weight of the body on one leg, the other leg tore off the support and spread his arms.

Exercise 3. The starting position of the child is squatting. Stand behind the baby, pressing on your knees. Move the child's torso forward, straightening his knees.

Exercise 4. The starting position of the child is sitting on a chair. Stand facing the child, fix his legs to the floor with your feet, take his hands. While doing this physical exercise for children with cerebral palsy, you need to pull the child's hands forward and upward, prompting them to stand up on their own.

Exercise 5. The starting position of the child is standing, one leg in front of the other. Alternately push the baby into the back, then into the chest so as to teach him to maintain balance.

Exercise 6. The starting position is standing. Doing gymnastics for children with cerebral palsy, you need to take the baby by the hand, pull and push in different directions, prompting him to take a step.

Exercise 7. Starting position - lying on your back. Press with your feet on a firm support (exercise improves support).

Joint gymnastics for children with cerebral palsy and exercise videos

Joint gymnastics for children with cerebral palsy is an important stage in physical rehabilitation.

Exercise therapy complex for children with cerebral palsy for the development of joints.

Exercise 1. The child's starting position is lying on his back. Hold one leg of the child in the extension position, the other gradually bend in the hip and knee joints. If possible, bring the thigh to the stomach, and then slowly abduct it.

Exercise 2. Starting position - lying on your side. Slowly abduct the hip with the knee bent.

Exercise 3. Starting position - lying on your stomach on the edge of the table so that your legs hang down. Gradually unbend the limbs.

Exercise 4. Starting position - lying on your back. Bend the knee, then straighten it as much as possible.

Exercise 5. The initial position of the child is lying on his stomach, a roller is placed under the chest. Raise the baby by the outstretched arms, with light jerks, making springy extension movements of the upper body.

Exercise 6. The child's starting position is lying on his back. Bend the child's arm so that his face is turned towards the bent arm. After that, bend the arm with the head in the opposite direction.

Watch a video of gymnastics for children with cerebral palsy aimed at training joints:

Physical rehabilitation of children with cerebral palsy: exercise therapy classes

Exercise therapy for children with cerebral palsy also includes exercises for the abdominal muscles and stretching exercises.

Rehabilitation of children with cerebral palsy: exercises for the abdominal muscles.

Exercise 1. Starting position - the child sits on the lap of the mother. Press the back of the baby to your breast and tilt with him (so that the baby feels confident). Fix the legs and pelvis of the baby so that he can lift himself. If lifting is difficult, the mother should help him to rise.

Exercise 2. The initial position of the child is lying on his back, hands are pressed to the body. With the help of the swinging movement of the leg, he must make an attempt to turn from back to stomach and back without using his hands.

Exercise 3. Starting position - lying on your back. Breathe in and out while drawing in the abdomen as you exhale.

Physical rehabilitation of children with cerebral palsy: stretching exercises.

Exercise 1. Starting position - sitting on the floor. Stretch the legs forward so that the body is at a right angle. Stretch your arms in front of you (parallel to the support), inhale. As you exhale, bend your body forward so that your palms touch your toes. Tilt the baby's torso more and more until the forehead touches the legs. Exercise removes stiffness in the muscles in the back, making the spine flexible, improving blood circulation and spinal nerve function.

Exercise 2. Starting position - lying on your stomach, arms along the body. Resting on the palms, slowly raise chest up (the body from the waist to the feet should be in contact with the support). At the same time, the head is thrown back, legs and feet together. Breathing is slow and deep. Throughout the entire spine, the tone of muscles and ligaments increases, the function of the nerve trunks and blood vessels improves.

Exercise 3. Starting position - lying on your back, legs together. Raise the child's straight legs above your head, do not bend your knees, and keep your hands on the floor. Try to touch the floor above your head with your fingertips. Slowly return to starting position. Exercise is beneficial not only for the spine, spinal cord, all spinal nerves, but also for the muscles in the arms and legs.

Exercise 4. Starting position - sitting on the floor. Bend right leg so that the heel touches the opposite thigh. Place the left foot on the floor on the right side of the right knee, move the right hand around the left knee and hold the foot of the left leg with it. Place your left hand behind your back to right side waist as far as possible, turn your head to the left and tilt so that your chin touches the left shoulder, while the right knee should not come off the floor. The exercise corrects defects in the back along its entire length. Toddlers can do the exercise with the help of adults who can help them maintain their position.

Adaptive physiotherapy exercises for children with cerebral palsy

An important place in exercise therapy for children with cerebral palsy is given to exercises for the upper and lower extremities, trunk and neck.

Exercises to relax the muscles of the upper limbs.

Exercise 1. Starting position - lying on your back, the head is located strictly along the midline, the arm and leg on one side are fixed with sandbags. The free arm is bent at the elbow, the instructor (mother) fixes the forearm. The instructor (mother) holds the child's hand until the increased muscle tone (hypertonicity) is weakened, and then shakes the child's hand alternating with passive movements in the wrist joint (flexion, extension, abduction, adduction, rotation).

With the help of acupressure, carried out in parallel, it is possible to stimulate active flexion and extension of the hand.

At the end of the exercise, shaking and laying the forearm and hand in the middle position are performed with fixation with shafts or rollers with sand.

Exercise 2. Starting position - lying on your stomach, head in the middle position, arms out to the sides, forearms lowered from the couch, a pillow is placed under the body, legs and pelvis are fixed. The instructor (mother) holds the child's shoulder until involuntary movements disappear (weaken), then shakes and shakes the forearm, conducts passive flexion and extension in the elbow joint. It stimulates active movements in the elbow joint of the child with massage techniques, swings the forearm again and finally fixes the hand in the middle position.

Exercises of physiotherapy exercises for children with cerebral palsy for the lower extremities.

Exercise 1. The starting position is lying on your back, the head is in the middle position, the arms are fixed, the legs are bent so that they touch the abdomen. The instructor (mother), holding the lower legs in the upper third of the anterior surface, produces abductions in the hip joints. Then, fixing one leg, he conducts circular movements with leg extension (for each leg).

Exercise 2. Starting position - lying on your stomach. The instructor (mother) fixes the child's pelvis with one hand, with the other hand supports the leg by the lower third of the thigh. The pelvis is fixed with sandbags. The instructor (mother) with one hand supports the leg by the lower third of the thigh, with the other hand he performs a stimulating massage to contract a large gluteus muscle... At the end of the exercise, the child's leg should "fall" on a soft support.

During adaptive physical education for children with cerebral palsy, at the next stage, the instructor performs passive extensions in the hip joint, after which the child holds the leg on his own for a certain account. Then the leg falls freely onto a soft support.

Exercises for the muscles of the trunk and neck.

Exercise 1. Starting position - lying on your back, head in the middle position. The instructor (mother), holding the child's torso on both sides, gently sways the body from side to side, making sure that the child does not offer resistance.

Then the instructor (mother), holding the child's head, shakes it freely, alternating rocking with turns of the head (without resistance).

Exercise 2. Starting position - lying on the right (left) side, the right (left) hand is under the head, the left (right) is along the body. The instructor (mother) gently pushes the child so that he falls on his back or stomach. The kid must hold the starting position when pushing, relaxing the muscles and falling only at the instructor's signal.

Exercise 3. Starting position - sitting in a chair, hands on the armrests, head down on the chest. The instructor (mother) conducts passive bends, head turns, flexion-extension (without resistance from the child). The child must fix the head during passive movements, then actively relax the muscles so that the head "falls" on the chest.

Respiratory gymnastics for children with cerebral palsy

Respiratory gymnastics for children with cerebral palsy is also included in the complex of rehabilitation exercises.

Exercises to correct breathing.

The starting position when performing any exercise is lying on your back, with a gradual transition to a sitting and standing position.

Exercise 1. The child needs to be shown how to take a deep breath and a deep breath through the nose and mouth, and then invite him to exhale on thin paper (feather, flag), his palm. During breathing exercises for children with cerebral palsy, you can inflate toys and blow bubbles.

Exercise 2. To improve the respiratory functions, it is necessary to teach the child as he exhales to pronounce sounds with different volumes, to whistle the whistle, play the harmonica, and sing.

Exercise 3. Inhale on the count “one, two, three”, while raising your hands up, and exhale on the count “four, five, six”, lowering your hands down. Breathe out into the water, lowering your head into a bath of water.

Developmental activities for children with cerebral palsy: games and exercises

During developmental activities for children with cerebral palsy, it is necessary to perform mimic exercises. The problem of recognition (identification) of feelings is relevant not only for children with cerebral palsy. In other words, this is not even a "childish" problem at all - not every adult can answer the question: "What are you feeling now?" Not to mention the fact that the ability to respond to certain negative emotions in a form that is safe for oneself and others is the key to not only peace of mind, but also physical health.

Teach the child to simulate various emotional states in order to distinguish them later in everyday life, and with the help facial muscles to discharge these emotions is the task of psycho-gymnastics.

Games and mimic exercises for children with cerebral palsy, aimed at training emotions.

Interest, attention: show the child how a dog sniffs, how a fox overhears, how the commander studies the map. Ask him to repeat the sketches.

Astonishment: make round eyes.

Joy, pleasure: ask the child to show how the kitten behaves when petted; ask to smile; imagine that Carlson arrived (Santa Claus came) and brought delicious sweets (toys).

Suffering: show the child how the stomach hurts; how a baby cries; how cold it gets in the cold.

Disgust: ask the child to imagine drinking salty soda water.

Anger: ask the child to show how angry the grandmother (mom, dad, grandfather) is.

Fear: ask the child to imagine how the fox lost its home.

Guilt and Shame: ask the child to remember how he lost his beloved mother's (grandmother's, grandfather's, father's) thing; To apologize.

After completing these exercises for babies with cerebral palsy, you need to ask the child to repeat the sketches several times.

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Cerebral palsy is a pathology that consists in paralysis of the central nervous system, which has arisen due to damage to several or one part of the human brain. The disease can begin to form while the fetus is in the womb, immediately after childbirth, or for a short time after that. In order to prevent the continuation of the development of pathology, use various techniques and therapy, among which games for children with cerebral palsy are a very effective way.

What is exercise therapy

Exercise therapy - physiotherapy exercises, which is aimed at restoring the functions of the human body. Special exercises for children with cerebral palsy help to inhibit the paralysis of the central nervous system. A set of physiotherapy exercises will allow children to gradually return control over their movements, significantly improve coordination, as well as the frequency of limb movements.

The main tasks and goals of the exercise therapy program are aimed at teaching a sick child with cerebral palsy in ordinary household skills that will make their life easier. Also, a set of exercises will allow sick children to learn simple labor activities, and to carry out self-care without outside help(nannies, parents and others).
As a result of the exercise therapy complex, new skills are gradually developed, the movements become more accurate and correct.

Parents should know that a course of exercise therapy should be prescribed immediately after the detection of pathology in a child. With a gradual increase in the complexity of physical activity, therapy should be started immediately to avoid the transition to a more severe form. Exercise therapy is also prescribed for children who do not have physical abnormalities, but there are prerequisites for this or a predisposition (for example, heredity).
The method of restoring the physical activity of disabled children is based on several principles:

• patients do not have long breaks between performing special exercises;
• therapy takes place regularly and systematically;
• a gradual build-up of physical activity is necessary to strengthen muscle tissue and tendons;
• individual appointment of preventive exercises, which are focused on only one patient with certain physical disabilities;
• the age of the child is taken into account when prescribing a course of exercise therapy, the psychological state of the patient and the stage of the pathology.

Correctional and educational work is very important for children, which is aimed at compensating for all disturbed body functions. In this regard, doctors strongly recommend to carry out exercise therapy from the most early years... It is important to remember that the earlier prevention begins, the better it is for a young organism. At an early age, children are more malleable to correct the musculoskeletal system.

Exercise types

Since a mobile exercise therapy complex for a child with cerebral palsy should be selected individually, depending on the manifestation of pathology, doctors may prescribe different types therapeutic exercises... For the treatment of the disease, classes can be aimed at stimulating the musculoskeletal system in the form of special gymnastics or swimming in the pool.

People with disabilities are prescribed exercises to stretch the ligaments, to relax the muscles and joints. Classes with children will be held in a sitting position and lying down. It should also be said that patients with cerebral palsy are more willing to undergo a course of therapy if it is in the form of a role-playing game or with toys.

Classes for stimulating the motor apparatus are aimed at developing and strengthening the motor ability of a child with cerebral palsy. First of all, the child must sit on his heels so that the foot is completely on the floor. Then mom or dad should stand in front of him, put his arms on his shoulders, fixing the patient in the pelvic area. After that, you need to begin to gradually tilt him so that he gets up on his knees.

When the patient kneels, he needs to be supported in the armpit area in order to move him in different directions. After a while, you need to weaken the support so that the child gradually gets used to transferring the center of mass of his body from one leg to the other on his own. When the center of gravity is shifted to the left leg, the right leg should be torn off the floor. Over time, you need to start spreading your arms to the sides, practicing to keep balance.

Then you can put the baby on a chair, facing him. With your feet, you need to fix the patient's legs at the floor, taking him by the hands. Then you need to pull them towards you and up. This exercise will teach you how to stand up unaided. Another exercise from the exercise therapy complex should help a child with impaired musculoskeletal system to maintain balance correctly. To do this, you need to stand so that one foot is in front of the other, but on the same line. It is necessary to alternately push the baby in the back and chest so that he feels how his body weight is distributed in this position.

Also, for this, you can put it in front of you, and, taking the hand, push and pull in different directions so that the patient makes a step on his own. This will allow him to independently find a fulcrum. To develop support ability, you need to lie on your back and then press on a solid surface with your feet. These sessions are very effective if done regularly and on schedule.

Video "Exercises for the spine"

For stretching

To improve limb stretching and increase flexibility, you need to do specific exercises on a regular basis. The patient should sit on the floor, stretch the legs straight in front of him so that his body is at an angle of 90 degrees. Next, the child should begin to stretch his arms in front of him, taking a breath. When inhaling, he should bend his body, trying to reach the tips of his toes with his palms. If initially it is not possible to do this, then you need to gradually increase the load, tilting the patient to the legs.

Over time, the load can be increased so that he reaches his forehead to the feet. Also, the baby can lie on his stomach, put his hands along his body. The patient should raise his chest, resting his palms on the floor. It is important that his head is thrown back as much as possible, slowly inhaling air. In the starting position (on your back), you need to connect your legs together. The extended legs should be raised above the head, keeping the body in a supine position. The knees should not be bent and the hands should be kept on the floor. Ideally, you should reach with your toes to the floor behind your head.

Another exercise will improve your stretching. To do this, sit on the floor, bend your right leg so that the heel of your foot reaches inside left thigh. The left foot should reach to the right knee. Right hand you need to move around the left knee, holding left foot... Next, you need to put the left handle behind your back from the opposite side at the waist, and turn your head to the left, tilting so as to reach the left shoulder with your chin. It is important that the right knee does not come off the floor.

Such developmental gymnastics is aimed at correcting defects in the back and spine. Also, this technique allows you to strengthen spinal cord and nerve endings, muscle tissue of the legs and arms.

For relaxation

To relax the upper extremities, it is necessary to put the patient on their back, and then secure the leg and arm on one side with a load (for example, sandbags). The free arm should be bent at the elbow, and the parents will fix the forearm. So you need to hold the patient until the muscles relax. You can shake the brushes, bend and rotate them.

To relax lower limbs you need to fix your hands, and bring your legs to the abdomen. A parent will hold the boot leg by moving the hip joint to the sides. Further, fixing one leg, it is made Roundabout Circulation the other limb, gradually unbending it. Such gymnastics relieves tension from the muscles, let's get the opportunity to weaken the tone. This is very important, since in case of pathology, they can involuntarily contract or be in tension.

For joints

Exercise therapy to strengthen joints is very important for the recovery of a child with cerebral palsy. Most of the exercises from the complex are carried out in the supine position. When the patient lies on his back, one of the legs should be kept straightened, and the other should be slowly bent at the knee joint. If at an early age he has good flexibility in the body, then if possible, bending the leg, you need to bring the thigh to the abdomen, and then abduct.

Next, the patient should lie on his side, and gradually raise the hip up. At the same time, knees and legs should be in bent position... Do not overstrain the ligaments.
Next exercise- the child lies on his stomach (preferably on a hard table) so that his feet hang over the table top. Then the parents should help slowly unbend and bend his limbs.

Lying on your back, you need to bend your knees alternately and unbend them as much as possible.
When the baby is lying on his stomach, a special roller should be placed under his chest. It will be necessary to lift it with outstretched arms, making springy movements with gradual soft jerks. Such exercises help strengthen the joints of the upper body.

The child can lie on its back. Then his arm must be bent so that the patient's face is turned in the appropriate direction. Then the procedure is repeated, turning the head to the other side.

Among the more mobile exercises of medical gymnastics, there are those that are carried out in the pool or with the use of role-playing games. When using various toys during physiotherapy exercises or role-playing games, children are more willing to do gymnastics. Toys allow you to create interest around the action without feeling discomfort. Role-playing games with various toys are closely intertwined with the main brain activity child. The process itself is important in this.

The role-playing game can be called with confidence effective way therapy, as it improves the imagination of children, shows imagination. Role-playing games develop memory well, allow you to think in a simulated situation.
Role-playing games for young children are inspiring. Using toys in story games will stimulate the brain, increasing its activity. In story games, it is best to include life situations in a simplified form so that it is easy for children to perceive information.

Even without plot games, individual toys that are dear to a child can have a very powerful effect. Toys usually evoke a range of emotions that a sick child experiences. And it also affects the work of his brain. Thus, toys can have a positive effect on the psyche, even without using them in a story-based role-playing game.

Pool exercises are good for those who can walk on their own, but abnormalities are observed. With this therapy, the patient will learn to swim in the pool, as well as improve their health. Classes in the pool should be conducted by a specialized instructor who knows the methods of treating cerebral palsy and correcting the musculoskeletal system in young children.

Water helps to relax the body, tone the muscles, and energize. This therapy is called hydrokinesis therapy. Very often, children with a pronounced symptom of cerebral palsy have a problem with the emotional state. For this, there are also separate psycho-gymnastic exercises that an adult should help to carry out.

Video "A set of exercise therapy exercises for children with cerebral palsy"

This video guide will help you create a rehabilitation program for children with cerebral palsy. Visual and easy-to-follow exercises will help you heal your child.

Exercise therapy for cerebral palsy can help to live a normal life, because cerebral palsy is the most severe violation of motor function that can occur for various reasons, which number about four hundred. With cerebral palsy, muscle tone and coordination are impaired. Cerebral palsy makes people disabled.

Cerebral palsy occurs in children who are less than three years old. The statistics are very sad: mostly children do not live to an older age. But still, if you start to take some measures to treat paralysis in time, then the child will have a chance for a good future.

Needed for many years. The treatment itself is aimed at restoring the functions of the locomotor system, memorizing elementary movements. This is a very, very hard work of mom and dad, as well as the child himself.

Some drugs it is impossible to cure this disease. It is necessary to constantly engage in physiotherapy exercises, which will allow the baby to learn how to move correctly. Physiotherapy exercises for cerebral palsy gives a positive result in any case. Parents of children with infantile cerebral palsy should determine the age from which it is necessary to carry out various exercises for cerebral palsy. The answer is very simple: from birth, but under the close supervision of a doctor.

The influence of exercise therapy on children's health

Physiotherapy exercises have a positive effect on the human body. It stimulates the tissues and muscles in the body to strengthen. In the body, metabolic processes are regulated. Brain activity and of cardio-vascular system much better.

But it is worth remembering that physical therapy itself is unable to cope with such a serious illness as cerebral palsy. It is necessary to create a holistic complex, which will include massage, physiotherapy exercises, manual therapy, various tempering of the body.

An individual set of exercises is developed for each baby. All complexes include the following types of activities: with a ball, lying and sitting, relaxing exercises, stimulating exercises.

Tips and tricks about the correctness of exercise therapy

Absolutely all methods, when exercise therapy for cerebral palsy is carried out, have general recommendations. Classes should be systematic in nature, they should be carried out regularly and continuously. Only such a gymnastics schedule will help you achieve good positive result... A set of exercises should be selected by a qualified specialist for each small patient individually.

In this case, it is necessary to take into account the complexity of the disease and all the features of the course of the disease. Physical exercise should gradually increase.

Exercises for children who have cerebral palsy should develop absolutely all muscles and joints. For this, the gymnastics complex should include exercises:

• for stretching muscles;
• to develop muscle strength and sensitivity;
• for the development of the sensitivity of the nervous system;
• to strengthen the main muscle groups that are involved in all movements;
• that all organs have good endurance;
• to relax muscles, relieve cramps and spasms;
• to teach a child to walk correctly;
• so that the senses are developed;
• to improve the patient's balance and sense of support.

Exercises to be carried out in order to develop movement skills

There is the most common form of cerebral palsy - atonic. It is manifested by the fact that the child's coordination is severely impaired and there is a low muscle tone. In this form of paralysis, special attention should be paid to those activities that can strengthen the muscles, especially the muscles of the trunk. After all, it is the muscular corset that is the main pivot of the human motor system as a whole.

Elementary exercises are effective in this case, for example, raising and lowering the body from starting position lying on your back. You can also perform these movements while lying on your stomach. You can make a variety of inclinations from sitting position... From the same position, you can try to make circular turns of the body. This complex can also include exercises that will strengthen the arms and legs.

It is necessary to understand that cerebral palsy also affects the functionality of the child's brain.

Physiotherapy exercises should help the brain learn to be responsible for those movements that directly depend on its work: movements of the arms and legs, crawling on all fours, squatting, running, walking. The development of the brain regions responsible for these movements is achieved through regular, multiple repetitions of the same actions.

As a result of this, the effect of "feeling" arises, after which you can perform a number of specific exercises:

1. Starting position: the child sits on the heels. It is necessary to stand in front of the baby, take his hands and put them on your shoulders. After securing the child in the pelvic region, begin to put him on his knees.
2. Starting position: the child is on his knees. It is necessary to support the baby under the armpits. Transfer the weight of his body from one leg to the other, alternately lifting them off the floor.
3. Starting position: the child is sitting on a highchair. Take the baby by the hands, and fix his legs on the floor. Encourage your child to get up by pulling his arms up and forward.
4. Starting position: the child is standing with one leg outstretched. It is very easy to push your baby in the back and chest to develop balance.
5. Starting position: the child is standing. Grab his hands and push him in different directions so that he can take a step on his own.
6. Starting position: the child lies on his back. The support ability of the baby is improved if the child presses with his feet on some hard surface.

Exercises used to develop joints

1. Starting position: the child lies on his back. One leg must be held in an extended position, and the other must be bent. It is advisable that the thigh reaches the abdomen.
2. The child lies on its side. Bend the child's leg at the knee and gently abduct the hip.
3. The child lies on his stomach on some surface with his legs hanging down. Very slowly, the limbs must be straightened.
4. The child lies on his back. You need to bend and unbend the baby's knees.

Additional exercises

Exercises that train your abdominal muscles:

1. Starting position: sit the child on your lap. Press his back to you. Make inclines with the baby, and he must rise on his own.
2. Starting position: the child lies on his back with his hands pressed to the body. The kid should try to roll over from his back to his stomach, while not using his hands.
3. Starting position: the child lies on his back. You need to take a deep breath, and as you exhale, the baby should draw in his stomach.

A set of stretching exercises:

1. The child is sitting on the floor. Stretch your legs forward, your back is straight. Stretch your arms forward parallel to your legs. The kid should take a deep breath, and on exhalation, bend over and touch his toes with his fingers.
2. Starting position: the child lies on his stomach with outstretched arms. Focusing on the palms, the baby should raise upper part body above the floor.

As for the exercises for the development of fine motor skills, then it is simply necessary to rotate the child's hand in different directions.

Ball exercises:

1. It is necessary to put the child with his back to the ball. The legs should rest on the toy. Place the child in the center of the ball and roll back a little. This exercise develops balance well.
2. Place the baby on a ball that fits the baby's belly. Hands should be extended forward. Hold the child by the hips and push the ball forward a little.
3. If you put the baby on a ball and easily swing it back and forth, then muscle tone is excellently reduced.

Exercises for the development of walking:

1. Take the child by the hips, stand behind him. Gradually turn the baby by the hips in different directions to provoke him to take an independent step.
2. Help your child do squats - 50 per day.

A great helper is special device, called a verticalizer. He can fix the baby in a standing position. It is simply irreplaceable when training or when preparing a child for self-fulfillment main functions. The verticalizer fixes the child's torso, and, if necessary, his feet and knees.