how to improve tone in the 11/2yr old atonic cp child

[gokul]

hi,
i have a patient 11/2 yr old with complete flaccid limbs and partial neck control and delay in milestones.he can't sit indepndently.he can't roll over from supine to prone.
he has congential hydrocephalus and it is reduced with out treatment.
i am treating to improve rolling activites and to strenthen trunk flexors and extensors with swiss ball.
any further suggessions regarding treatment to improve tone.

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[ramywhite]

Hello gokul,
There are many things you can use to stimulate flaccid muscles. In general, you can use:
-tapping.
-scratching.
-massage.
-joint approximation.
-positioning.
-righting reactions if possible.
-wight bearing.
-balancing exercise if possible.
Some of the above do things beside normalizing muscle tone.

[gokul]

hello ramy white,

thanks for your replay.
i will follow your suggestions.
i want u to eloberate the different techniques mentioned by u.
thank u.

[anujajoshi]

i read ur question.i think to regain muscle tone roods approch is very effective.its basically stimulation of muscle by icing or by brushing,just brush the muscle from proximal to distal site te relax the muscle and to gain normal tone.but contact should be 2-3 strokes per sec.wid slow speed u gain the relaxation and fast speed increases the tone

[PamVersfeld]

Hi Gokul

The best place to start is always with what the child can do. Children learn through actively engaging with their physical and social environment - and all we can do as therapists is encourage the child to expand his/her repertoire of actions.

What can this baby baby do? What does he do when he lies on his back - does he look and follow objects, is he interested in looking at you, at toys, can he move his arms and legs? Does he reach for toys?

If you can give a detailed description of everything this child does when lying on his back, then I will make suggestions about how you can expand his repertoire of actions in this position. Start by just observing the baby for some time and noting what happens.

Best wishes

Pam