NDT - Bobath koncept kod cerebralne paralize

Cerebralna paraliza je neprogresivni razvojni motorički poremećaj kretanja i položaja uzrokovan bolestima ili ozljedama centralnog motornog neurona. Klinička slika cerebralne paralize različita je kod svakog pacijenta, a simptomi ovise o dijelu mozga koji je zahvaćen, vremenu nastanka, a nešto manje o samom uzroku. Glavno obilježje svake kliničke slike je poremećaj motorike. S obzirom na simptomatologiju cerebralna paraliza može imati spastičnu, hipotoničnu ili ekstrapiramidalnu prirodu. Uz poremećaj kretanja javljaju se i poremećaji tonusa, ravnoteže, motoričke kontrole, usporen razvoj motorike i mišićna slabost. Za rano uočavanje odstupanja izuzetno je bitno poznavanje normalnog psihomotoričkog razvoja djeteta. Promatranjem psihomotoričkog razvoja, potrebno je obratiti pažnju na zahvaćenost tijela i njegovu asimetriju. Promatra se koja strana tijela je zahvaćena, položaj ruku, nogu, glave i trupa. Dijagnostika cerebralne paralize temelji se na dijagnostičkim pretragama, laboratorijskim testovima i dodatnim pretragama za sluh, vid, govor i intelektualne sposobnosti. Liječenje cerebralne paralize provodi se na multidisciplinaran način koji obuhvaća operacijsko i medikamentozno liječenje, fizioterapiju, radnu terapiju i logopedski tretman. U fizioterapiji koriste se specifične tehnike poput Bobath koncepta, Vojta terapije, Halliwick koncepta i hipoterapije. Primjena Bobath koncepta u fizioterapiji oboljelih jedan je od najpoznatijih pristupa u liječenju cerebralne paralize. Osnovni cilj primjene koncepta je poboljšanje motoričke kontrole oboljelih u aktivnostima svakodnevnog života, č̌ ime se poboljšava funkcija i sudjelovanje pacijenta u svakodnevnim životnim aktivnostima. Bobath koncept koristi se u evaluaciji i liječenju svih pacijenata s poremećajima kretanja i posturalne kontrole bez obzira na težinu njihove kliničke slike. Glavna načela koncepta su inhibicija, facilitacija i stimulacija pokreta te se na temelju navedenih načela provodi fizioterapijska intervencija. Bitno je terapiju započeti što ranije kako bi njezin ishod bio što kvalitetniji za pacijenta i njegovu obitelj. Cerebral palsy is a non-progressive developmental motor disorder of movement and position caused by diseases or injuries of the central motor neuron. The clinical manifestation of cerebral palsy is different for each patient, and the symptoms depend on the part of the brain that is affected, the time of onset, and somewhat less on the cause itself. The main feature of each clinical manifestation is a motility disorder. Regarding the symptomatology, cerebral palsy can be spastic, hypotonic or extrapyramidal in nature. Along with the movement disorder, there are also disorders of muscle tonus, balance, motor control, slow development of motor skills and muscle weakness. Knowledge of the child's normal psychomotor development is extremely important for early detection of deviations. When observing psychomotor development, it is necessary to pay attention to the involvement of the body and its asymmetry. It is observed which side of the body is affected, the position of the arms, legs, head and trunk. Diagnosis of cerebral palsy is based on diagnostic tests, laboratory tests and additional tests for hearing, vision, speech and intellectual abilities. The treatment of cerebral palsy is carried out in a multidisciplinary manner, which includes surgical and medicinal treatment, physiotherapy, occupational therapy and speech therapy. Physiotherapy uses specific techniques such as the Bobath concept, Vojta therapy, Halliwick concept and hippotherapy. The application of the Bobath concept in the physiotherapy of patients is one of the most well-known approaches in the treatment of cerebral palsy. The basic goal of applying the concept is to improve motor control of patients in activities of daily life, thereby improving the patient's function and participation in daily life activities. The Bobath concept is used in the evaluation and treatment of all patients with disorders of movement and postural control, regardless of the severity of their clinical picture. The main principles of the concept are inhibition, facilitation and stimulation of movement, and physiotherapy intervention is carried out on the basis of these principles. It is important to start therapy as early as possible so that its outcome is as good as possible for the patient and his family.