Hemiparesis in children is one of the forms of cerebral palsy, cerebral palsy. The prefix “hemi” indicates the right or left half of the body; “paresis” is incomplete damage to the nerves with partial loss of function. The term “hemiplegia” is complete paralysis of half the body. It must be said that this is not the most severe form of the disease, but it also depends on the severity of the brain damage. With a mild lesion, an adult child may not understand that he was given such a diagnosis. In severe cases, the child cannot use the right or left half of the body, i.e. the arm and leg are constrained by spasticity and movements in them are extremely limited. With such a diagnosis, there may be disturbances not only in the muscles of the limbs and torso, but also in the speech apparatus and intellect. Based on localization, left-sided and right-sided hemiparesis are distinguished. Causes of hemiparesis in children : usually this diagnosis is caused by brain injuries during childbirth through hemorrhage, prolonged or acute intrauterine hypoxia, asphyxia, ischemia, and combinations of these conditions. Often the cause may be infections, viruses, medical errors during childbirth, fetal development abnormalities, and brain underdevelopment. Extremely premature and low birth weight babies are at risk. The human brain is very sensitive to the lack of oxygen; if it is not supplied through the blood within 15-20 minutes, then the brain cells begin to die. Therefore, states of oxygen starvation are very dangerous for humans, and especially for the developing fetus. We can distinguish the main groups of factors leading to oxygen deficiency:
- mechanical, compression of the arteries by the umbilical cord when passing through the birth canal.
- hemorrhagic, with rupture of blood vessels in the brain.
How can you tell if your child has hemiparesis?
What symptoms may alert parents and become a reason to see a doctor? Upon examination, the specific posture of the child immediately attracts attention; on one side, the limbs are more tense, tucked in, brought closer to the body, less mobile, lagging behind the Moro reflex (this is when the child suddenly throws his arms to the sides and back, as if he was scared) Palpation and In passive movements of the limbs, tension and resistance from the muscles are felt. The child manipulates the tense half of the body much less. In such cases, you need to consult a doctor and explain the cause of your concern. It is the neurologist who makes such diagnoses; in other cases, these are only suspicions that need to be checked. Hemiparesis is similar to hemisyndrome, so the doctor will make this diagnosis last. Usually, a diagnosis of cerebral palsy is not made until one year of age; if the baby is at risk, then before the diagnosis is made, he is actively rehabilitated with medication, massage, exercise therapy, physiotherapy, etc. As a rule, specialists even before a year can already understand that making a diagnosis is a matter of time, but they write the threat of cerebral palsy as a type of hemiparesis. Experienced massage therapists can distinguish spasticity from tone, but according to the rules, you must first carry out therapeutic measures in order to eliminate the (so desired) error. At such moments, the doctor really wants to be wrong in his suspicions and the parents really hope for this.
Additional recommendations and useful tips
Both children and adults with hemiparesis should definitely develop fine motor skills. You can string beads or make mosaics, lace or fasten things. Play catch with the patient. Just use a tennis ball.
If possible, organize exercises for your patient in the pool. Such procedures have a beneficial effect on muscles and train the cardiovascular and respiratory systems. If a person is strong enough to walk, walk a short distance every day, gradually increasing the load.
Of course, recovering from serious neurological diseases is very difficult, and requires the guidance of experienced medical professionals and the support of loved ones. But hemiparesis is still much easier than tetraparesis, when all limbs are affected, or paralysis, when movements are completely absent. That is why the likelihood of an almost complete recovery is much higher. Study, don’t waste time and energy on it. And be healthy.
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Treatment of spastic hemiparesis in children
Therapeutic measures will be somewhat different in the early recovery period, late, and in the period of residual effects. The greatest intensity of treatment is in the first 2-3 years, hence the prognosis for future prospects. Many sources repeat that the earlier treatment is started, the greater the results. Of course this is true, but no less important is the correctly selected treatment methods and the quality of their implementation. You also need to understand that hemiparesis is not completely cured; it is only possible to partially restore lost functions. For most people, the diagnosis of cerebral palsy sounds scary, like a death sentence, in part this may be so, but I recommend that parents do not waste time and energy on despondency, but focus on the quality and regularity of treatment. Treatment of spastic hemiparesis in children is a long and expensive matter. The rehabilitation process is complex, usually in the first stages it is carried out in neurological hospitals, but after discharge it continues at home as prescribed by a doctor. Treatment is medicinal, massage, exercise therapy, physiotherapy, after 1.5-2 years speech therapists, psychologists, speech pathologists, orthopedic solutions are added.
Rules for performing exercises
Gymnastics is done with the help and under the supervision of healthy assistants. Any exercises are performed at a comfortable pace; there is no need to rush or strain too much.
Classes are held daily; consistency in this case is the key to recovery.
During the process, you can take short (no more than 5 minutes) breaks between 2-3 series of exercises. At first, each exercise should be done no more than 5 times; once you get used to the exercises, you can increase the load to 10 repetitions.
Massage and exercise therapy for hemiparesis in children
Massage for hemiparesis is done classically, has its own characteristics in plan, and the procedure also includes techniques from exercise therapy, passive ones aimed at stretching spastic muscle groups, and active ones aimed at strengthening the healthy half of the body and developing skills. The duration of the procedure depends on the age of the child. It is better to rely on the child’s patience, but even if the baby is able to endure a long procedure, I still do not recommend doing it for more than 40-50 minutes for children under one year old and 60-70 minutes for babies after one year. The massage is done every day, you can stop on weekends, the course is up to a maximum of 25 sessions, then a break for at least 2-3 weeks. Exercise therapy can be done every day without breaks. The massage can begin with the back and neck area, in order to work on the reflex zones and segments innervating the limbs. We use classic techniques. In tense areas such as the shoulder girdle, buttock area, the massage is done deeper and more slowly. We carefully process the paravertebral lines from bottom to top using spiral rubbing. The child should not be in pain, but the pressure must be strong to achieve the effect. In a position lying on his stomach, it is advisable for the child to lie supported on his elbows; if the baby does not succeed in this, then the mother sits and holds the child’s hands in this position. Reliance on the elbows is practiced for children up to 5 months old; older children, who can already lean on their elbows without support, can, if desired, place their heads on the table. Massage of the arms and legs for hemiparesis in children is done in a classic way, but passive movements in the joints are necessarily added in order to stretch tense muscles. Kneading at a slow pace and deeply in spastic areas. To improve the quality of kneading, the muscle can be stretched by movement in the joint through which it is thrown, and massaged in a stretched position. Physical therapy (physical therapy) for hemiparesis in children is of great importance in rehabilitation in all age groups. For infants there is a lot of passive and reflex gymnastics, but less active, due to the newborn’s inability to perform many active exercises. As they grow older, the emphasis and set of exercises gradually changes towards more complex ones that require the involvement and active participation of the child in the process.
Features of hemiparesis
When the disease occurs, the facial muscles usually suffer and the motor functions of the limbs are impaired. There is weakness and pain in the affected parts of the body. The level of limitation of movement depends on the degree of the disease.
In severe cases, the arms are bent at the elbows and the fingers are clenched into a fist. The movements are disproportionate, the person cannot move quickly and dexterously, and there is no smoothness characteristic of a healthy person. In some patients, the legs become entangled, the person is unable to maintain balance and sways from side to side.
What should be the result after massage and exercise therapy for hemiparesis?
Of course, these methods are not a panacea. The benefits of massage with gymnastics in the prevention of contractures, the consequences of congestion, atrophy, training and maintaining muscles, nerves, blood vessels, bones and ligaments. After all, without stress, muscles weaken, ligaments become thinner, bones become thinner and more fragile. The functions of the musculoskeletal system must be preserved at least until the child grows to an age when he will more consciously work with a physical therapy instructor and perform increasingly complex exercises that will form the skills necessary for life.
Forecasts
So far, no supermethods or specialists have cured a single child from cerebral palsy with deep damage and, as a consequence, central spasticity. The diagnosis can be removed, but if the child had a mild degree of brain damage, in which many functions are preserved. If we are talking about deep and extensive damage to the brain tissue, then nothing can be done to force the brain to restore dead cells again, too many of them die, the structure is complex, and besides, the body quickly replaces the dead areas with connective tissue. Therefore, everything that can be restored bypassing the lost areas in childhood will be the result of treatment for hemiparesis. But with this form, one half of the body is working and this means a lot for the future formation of skills.
Kinds
There are right-sided and left-sided hemiparesis, depending on which half of the body movements are limited. You should know that the right side of the brain is responsible for the actions of the left side of the body and vice versa.
Right-sided hemiparesis is typical for adult patients and occurs as a result of injury or disease. Right-sided hemiparesis, with the help of a complex of exercise therapy and other procedures, is often eliminated with virtually no consequences. Diseases that can lead to hemiparesis:
- stroke;
- encephalitis;
- diabetes;
- traumatic brain injuries (bruises, concussions);
- complications of epilepsy;
- multiple sclerosis.
Left-sided hemiparesis occurs more often in children; it can be caused by pathologies of intrauterine development, birth injuries, or the cause may be prematurity of the baby.
If the left side of the brain is damaged, disturbances are observed:
- speeches;
- ability to analyze;
- perform operations with numbers;
- logic and linear representations.
When the function of the right side is impaired, the speech of adult patients usually does not suffer, unless, of course, the person is left-handed. In children, speech problems can occur if any part of the brain is affected.
When the right side of the brain is damaged, the following is disrupted:
- the ability to dream;
- sense of rhythm;
- ability for holistic and three-dimensional perception;
- the ability to imagine and perceive colors.
It follows from this that the left hemisphere is responsible for the ability to think logically and draw conclusions, and the right hemisphere helps to navigate in space.
With left-sided hemiparesis, the exercise therapy complex and treatment in general are more complex, since its consequences are much more difficult to correct.
How to select specialists for the rehabilitation of a child with hemiparesis?
Usually the parents of such children are ready to do anything and believe everything in order to restore their children’s health. Unfortunately, there are unscrupulous people who try to sell useless services to parents who find themselves in difficult life situations. We have accumulated some experience in interacting with such children and their parents. Based on this, we would like to give advice to parents: for medical rehabilitation, select specialists with medical education, massage therapists, exercise therapy instructors, etc. From time to time it is advisable to undergo complex treatment and rehabilitation in specialized medical facilities. centers, hospitals. During the break between such courses of treatment, you can work with the child by inviting specialists to your home. If it so happens that your baby has hemiparesis and you don’t know anything about it, don’t hesitate to ask mothers who already have experience in the rehabilitation, care and education of such children. They can be found on the Internet on forums and social networks. Children with the same diagnosis are still individual and have their own characteristics. But in general, information exchange with such parents will help you choose suitable correctional teachers-speech pathologists for your child, a feeding system, a diet, developmental activities, gradually trying what was useful for others, you will select for your baby the most effective activities, methods, and methods in your case. etc. It is better to look for speech pathologists and other teachers in specialized institutions where such children are cared for. For questions about massage and exercise therapy for children with hemiparesis, write to me on WhatsApp +79266057470 Alexey. The author of the article is massage therapist Alexey Matrosov.
Treatment methods
Successful treatment requires a set of measures to help identify and eliminate the causes of the pathology. Surgery may be necessary if there is, for example, a tumor or inflammation of the brain or spinal cord. Drugs that improve cerebral circulation are used.
To restore motor functions the following is prescribed:
- drugs that reduce muscle spasticity;
- courses of various physiotherapeutic procedures;
- massage and exercise therapy.
The importance of exercise therapy in this case is especially great; in combination with massage, physical therapy allows you to expand, and sometimes almost completely restore, the ability to move normally.
