Treatment with VIBRA - AperCrescereOnlus
PATIENT OF YEARS 4
DIAGNOSIS: HEMIPLEGIA SN, resulting from cerebral hemorrhage due to aneurysm rupture at the age of 2 years. Widespread cerebral flooding and neurosurgical intervention of emptying and suturing aneurysm.
Taken in charge by our service for about 15 months: acquired static standing and path and autonomy in all postural steps; marked reduction of the flexural pattern of the upper limb.
In the phase under examination of the rehabilitation program, the upper limb is regaining motor function and the component of agnosia and inattention is clearly reducing.
OBJECTIVE OF TREATMENT WITH VIBRA: reduction of the spastic flexor scheme; favor the greater perception and cortical representation of the segment.
We have done a first cycle of 6 sessions at the rate of 2 times a week: we are currently proceeding with recall sessions every two weeks.
We use the frequency of 100hz, stopping for 5 to 10 minutes per district (also in relation to the collaboration of the little patient). We obtain more evident results using the technique on the antagonist muscles to the hypertonic groups, and inserting the treatment in a work in mobilization and support of the upper limb to offer a better representation of the segment. The progression of treatment occurs in the proximal-distal sense. However, we choose to never combine the use of vibrations and a subsequent session of neuromotor rehabilitation during the same session: in this case it is difficult to draw up an excessive amount of stimuli, demonstrating an evident feeling of tiredness on the part of the child . Currently the optimal response is highlighted by the session of Vibra every two weeks and two sessions of weekly neuromotor rehabilitation.
FIXATORS OF THE SCAPOLA
Treatment of the scapula fixators, to correct the abducted position due to the flexion-intra-rotation of the scapulo-humeral. At the same time, we try to make the girl perceive the correct positioning of the shoulder and the support of the upper limb to stimulate the functional tightness of the joint. Clearly, every moment of treatment must be adapted to the child's collaboration.
TREATMENT OF TRICIPITE
Proceeding in the treatment of the upper limb, we choose the triceps brachial as antagonist to the hypertonic flexors: we require a contraction of the same muscle by placing the hand in support, thus promoting the inhibition of the pathological pattern and the functional integration of the stimulus.
TREATMENT OF WRIST EXTENSORS
Treatment of the extensors of the wrist, keeping the hand in support and in load, so as to offer the vibration in the functional context: here too, the extenders represent the antagonists in the spastic scheme in flexion.
In the case of the hand, the choice of starting from the flexors, even if they represent the agonists of the spastic pattern, arises from the need to provide better adherence of the instrument in a reduced surface: it is obviously always fundamental to adapt the use of the technique to the specific characteristics of every patient.
For this we begin the work from the palmar surface to obtain an evident relaxation, then going to the treatment of the extensors of the fingers in wrist extension, so as to favor the reconstruction of the correct motor solution in the approach to the object for the subsequent prehension.