The child's brain has a remarkable capacity for reorganization. This means that even after significant injury, there is the ability for uninjured parts of the brain to take over the function of the damaged parts. Since neurons do not generally re-grow, reorganization or "plasticity" is probably the major mechanism by which children improve or recover after brain injury. Even in progressive or degenerative diseases, it is likely that plasticity plays an important role in maximizing the child's abilities.
|Therapy is important to help the brain relearn and adapt to its injury.|
Although there is not yet conclusive evidence, it is likely that plasticity mechanisms are significantly enhanced by appropriate exercise. This means that physical therapy, occupational therapy, and schooling are important not only to improve strength and teach skills, but also to help the brain relearn and adapt to its injury. This is likely to be particularly true with movement disorders, since a child may be able to learn alternative strategies for movement that make use of residual neurological and musculoskeletal function. At the very least, by maintaining joint mobility and preventing muscle contracture, physical and occupational therapy preserve the ability for a child to possibly use these muscles and joints in the future.
Evidence from research in animals and humans shows that the brain can adapt rapidly (e.g., over a period of a few weeks) to changes in the use of the limbs. The significance of this observation for childhood movement disorders is not known; however, it suggests that training in the appropriate use of the limbs as early as possible may have significant long-term benefits. In particular, it is hoped that early and continuing physical and occupational therapy may delay or prevent future worsening of symptoms.
The success of the techniques that are suggested during a physical or occupational therapy evaluations depends upon repeated practice of these techniques. The most important therapists are the parents, who have to repeat the exercises with their children on a daily basis.
|The most important therapists are the parents.|
They must also observe children for improvement or changes that may be needed. There are programs that encourage extremely intense home therapy programs, with many hours of therapy each day. Thus far, evidence that this approach is helpful is not conclusive; some therapists believe that the results do not justify the ongoing stress and strain on families. However, most children receive tremendous benefit from a stimulating home environment that includes both active therapy as well as engaging play activities, thus encouraging the development of motor skills.
Many alternative therapies have been proposed to treat children with movement disorder, including chiropractic, homeopathy, hyperbaric oxygen, acupuncture, and other elements of holistic medicine.
|It is difficult to scientifically prove that alternative therapies are beneficial for children with movement disorders.|
There are anecdotal reports of some children receiving benefit from these treatments. However, it is difficult to scientifically prove that these therapies are benefical for children with movement disorders. When a large population of affected children is studied, on the average, there is no benefit. This does not mean that no child benefits; it means that it is not possible to recommend the treatment for every child. Most of these therapies are harmless, but they are often expensive and time consuming. It is important to be aware of the likelihood of success before engaging in such treatments.
Kids Move is WE MOVE's Web site devoted to pediatric movement disorders. Healthcare professionals and parents may access up-to-date information about the recognition, assessment, treatment, and avenues of support that are available for individuals concerned with childhood movement disorders.