| Abstract | 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. |
| Abstract (english) | 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. |
