GIS pédiatrie

CP is a consequence of a brain injury, definitive, non-evolutive, occurring during the perinatal period. The location and extent of the lesion in the brain determine the clinical picture, which can therefore be very varied.

The motor problem is characterized by a disorder of muscle tone regulation. Muscle tone allows the adjustment of posture and voluntary movement. The motor problem is often accompanied by sensory disorders, of varying importance:

• vision disorders
• hearing disorders
• feeding disorders
• intellectual disorders.

In terms of clinical pictures, the main ones are distinguished:

• Hemiplegia: involvement of one hemibody, i.e., one side of the body. It is characterized by asymmetry.
• Diplegia: global involvement with a marked predominance of motor and spastic involvement in the lower limbs.
• Quadriplegia: global involvement, affecting the whole body.

The management of CP is always carried out by a multidisciplinary team (specialist doctor, physiotherapist, occupational therapist, speech therapist, psychologist).

A baby is considered premature if born before 37 weeks of amenorrhea (completed weeks of pregnancy) (before eight months of pregnancy), but after 22 weeks of gestation, regardless of weight, but at least 500 g. However, in practice, the gestational age may be missing, hence the importance of its determination.

The neurological examination allows to quantify the term with quite good precision. It evaluates the cerebral maturation of the child on different criteria: passive tone (extension of the four limbs in very premature babies, flexion of the upper limbs from 34 weeks of gestation, quadri-flexion at 40 weeks of gestation), spontaneous movements, archaic reflexes and ocular reflexes. However, this neurological examination is only slightly contributory as soon as there is a pathology interfering with the examination itself or a neurological involvement.

The management of the premature child can be ensured according to the concepts described above.

Spina bifida is a congenital malformation linked to a defect in the closure of the neural tube during embryonic life. This results in the absence of one or more vertebral arches of the spinal cord, causing a protrusion of the spinal cord. These malformations are of varying severity. Folic acid has proven its usefulness in the prevention of spina bifida.

Spina bifida will be mainly rehabilitated according to the Bobath concept.

In the case of a trisomy, at least one of the pairs of chromosomes is in fact a triplet, hence the name trisomy. In trisomy 21, it is chromosome 21 that appears as a triplet. It is also known as Down syndrome.

RESPIRATORY PHYSIOTHERAPY is characterized by:

• the method of accelerating respiratory flow.
• Clearing the upper airways is done using the retrograde rhinopharyngeal technique.
• Bronchial clearance is achieved through the technique of accelerating expiratory flow.
• The technique of induced coughing is applied to children up to the age of 2-3 years. After this age, we will try to obtain a cough on demand.

Respiratory physiotherapy plays an important role in the therapy of myopathies and in respiratory diseases (such as cystic fibrosis). Cystic fibrosis (mucus + viscosity) is a genetic disease affecting all organs lined with glandular epithelium. It is the lethal genetic disease with autosomal recessive transmission. The symptoms of the disease are digestive and respiratory abnormalities as well as infertility in men.