Trening siłowy w MPD.

Trening siłowy w mózgowym porażeniu dziecięcym, technika ćwiczeń zaadoptowanych do dzieci z poziomu GMFCS I, II, III.

dzieci niepelnosprawne na silowni

Trening siłowy w mózgowym porażeniu dziecięcym to być może coś co Cię dziwi?

Jak to pacjent ze spastycznością ma trenować siłę, po co?

Dla mnie osoby, która już od kilku lat zajmuje się rehabilitacją dzieci z mpd jest to coś co zakładam, iż wniesie wiele dobrego w procesie usprawniania chodu wielu dzieci. Mam na myśli głównie dzieci, które w jakimś stopniu się poruszają, ale mają wiele problemów i trudności.

Co może świadczyć o słabej sile mięśniowej:

-trudności w stawaniu

-podczas stania po chwili kolana i biodra uginają się

-podczas chodu : kolana w stawach kolanowych są nadmiernie zgięte

-dziecko nie może chodzić na długie dystanse

-problem z wchodzeniem i schodzeniem ze schodów.

Jako fizjoterapeutka obserwuję te cechy  u dzieci po operacjach, mamy teraz w naszym otoczeniu fizjoterapeutów napływ pacjentów będących po  Selektywnej Rizotomii Grzbietowej (SDR) i fibrotomii, którzy wydają się idealni do tego by ich wzmacniać.

Niedawno w ręce wpadł mi świetny artykuł z Neurologii Dziecięcej, który potwierdził to co podejrzewałam, że taki trening ma miejsce bytu i co najważniejsze odpowiednio dobrany i wykonany nie szkodzi dzieciom.

mózgowe porażenie artykuł

Autorzy tego artykułu („Trening siłowy w rehabilitacji dzieci i młodzieży z mózgowym porażeniem dziecięcym:przegląd piśmiennictwa” w Neurologia Dziecięca, Gąsior J., Pawłowski M., Bonikowski M., Jeleń P., Błaszczyk J.) przeanalizowali 19 publikacji w języku angielskim, gdyż brak jest jakichkolwiek badań dzieci w Polsce.

Przedstawione w artykule badania różniły się od siebie zarówno: kryterium włączania, prowadzeniem i nadzorem terapii,  czasem trwania itp. Zapewne z tego wynika to, iż wyniki tych badań różnią się od siebie, chociażby tym że w jednym badaniu poziom zadowolenia i samooceny uległ poprawie po kilkutygodniowym turnusie,a w innym badaniu zadowolenie pacjentów uległo pogorszeniu.

W wielu badaniach trening siłowy miał pozytywny wpływ na:

-spastyczność

-stanie

-chód (poprawie uległ wzorzec chodu np. faza podporu midstance oraz initial contact, zwiększyła się także prędkość chodu)

-objętość mięśnia brzuchatego łydki zwiększyła się .

Należy tylko podkreślić, że we wszystkich badaniach dzieci rozumiały polecenia i był z nimi możliwy kontakt słowny.

Problemowe jest jednak to, że brak na świecie wytycznych (protokołów treningowych) dla dzieci z mózgowym porażeniem dziecięcym. Autorzy jednego z badań uważają że protokół NSCA (National Strength and Conditioning Association) może służyć jako wzór, gdyż brak jest badań dotyczących szkodliwości treningu oporowego i adaptacji nerwowo-mięśniowej u dzieci i młodzieży z mpd.

To co mnie zdziwiło w tym artykule to to, że u pacjentów poruszających się we wzorcu zgięciowym (crouch) , którzy mieli określoną spastyczność w mięśniach kulszowo-goleniowych trening ten nie okazał się skuteczny. Nie ukrywam, że ten temat muszę drążyć dalej by odpowiedzieć sobie na pytanie dlaczego TS nie pomógł w tej grupie pacjentów?

Autorzy potwierdzają, że w TS u dzieci i młodzieży z mpd jest jeszcze wiele różnic, pytań, krytyki ze strony terapeutów koncepcji NDT Bobath.

Myślę że temat ważny i potrzebny, ja bardzo chętnie dowiem się więcej o treningu siły podczas szkolenia z holenderskimi fizjoterapeutami już w maju w Warszawie. Jeśli jesteś fizjoterapeutą, który widzi problem w sile mięśniowej swoich podopiecznych zapraszamy do udziału.

Informacje o szkoleniu:

Dla kogo?
Fizjoterapeuci, którzy pracują już z pacjentami z mózgowym porażeniem dziecięcym.
Studenci, którzy zamierzają pracować w neurologii dziecięcej i mają udokumentowane doświadczenie w ośrodkach, gabinetach oddziałach szpitalnych.

Co zyskasz?
Wiedzę i umiejętności do przeprowadzenia treningu, także w warunkach domowych.
Dołączysz do grona fizjoterapeutów zajmujących się treningiem siłowym i funkcjonalnym w Polsce.

Cel szkolenia
Nauka oceny stanu ruchowego pacjenta, planowanie i zorganizowanie terapii.
Zdobycie wiedzy dotyczącej holenderskiego modelu terapii, podejście do pacjenta w sposób funkcjonalny, mocny nacisk na współpracę rodzic-dziecko-terapeuta.

Tematy na szkoleniu:
– ocena siły mięśniowej
– ocena mocy
– krótka analiza chodu i funkcji (transfery)
– zasady treningu siłowego u dzieci z mpd
– zasady treningu mocy
– klasyfikacja do treningu
– trening siły i mocy po iniekcjach BTX
– trening siły i mocy po operacji SDR

Prelegenci 
Liesebeth van Vulpen i Eugene Remeckers, holenderscy fizjoterapeuci, którzy prowadzą naukową działalność związaną z treningiem funkcjonalnym, siły i mocy w mózgowym porażeniu dziecięcym.

Eugen Remeckers zaprzyjaźniony jest mocno z Polską, Wielokrotnie bywał w Polsce wraz z Fundacją Wandafonds przedstawiając holenderski model pracy z pacjentem.
Wspaniały człowiek, fizjoterapeuta z 25 letnim doświadczenie w pracy z mózgowym porażeniem dziecięcym. Wykładowca na Maastricht University w Holandii, swoje badania naukowe poświęca terapiom CIMT, BIMT, trening siły, mocy i funkcji.
Więcej o prelegentach znajdziecie tutaj:
https://www.researchgate.net/profile/Eugene_Rameckers
https://www.researchgate.net/profile/Liesbeth_Van_Vulpen2

Miejsce i data
Warszawa, ul. Skrzyneckiego 60
„Fizjograff”
18 -20 maj 2018r

Cena 
*800zł.
W tym zawarte jest:
-skrypt
-napoje & ciastka

Zaliczka 300zł ( 7 dni od zapisu)
reszta wpłaty 500zł najpóźniej do 18.04
nr konta
22 1240 1095 1111 0010 0817 0847
Fizjograff Kamil Graff
Tytułem: Szkolenie mpd

Liczba miejsc
20

Noclegi
we własnym zakresie.

Szkolenie odbywa się w języku angielskim, organizatorzy zapewniają tłumaczenie.

Więcej informacji dotyczących organizacji otrzymasz e-mailem:
kontakt@ortochodzi.pl

Rodzicu/pacjencie jeśli ten temat jest Ci bliski, masz ochotę poznać trening siłowy poinformuj innych o tym artykule lub szkoleniu!

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