2. Management of orthopedic problem:
The
deformities and contractures, which are not managed by the regular
stretching exercise and physiotherapy, are treated surgically.
3. Rehabilitation:
An
infant with spina bifida and hydrocephalus will usually have delay
in development. This may be present from birth. It is due to several
reasons
- Long
periods of time in hospital after birth
- Parent’s
concerns about having infant with spina bifida and knowing how
to handle the child
- The
infant’s heavy head due to hydrocephalus making it difficult
to gain head control.
- The
infant’s difficulty in learning to move due to muscle paralysis,
contractures and deformities.
AIDS
used in rehabilitation
All
children should be given opportunity to stand and walk. The child
can be stood as soon as he has sufficient head control and balance
in his body. Standing encourages the muscles that hold the body
up to walk. It prevents contractures and strengthens leg bones.
If the child does not have muscle strength in the legs, aids such
as gaiters, forward lean standers or an upright stander may be
used.
Learning
to walk should be fun and not a task. The child needs to gain
confidence slowly. Special aids such as splints or calipers may
be necessary to support the legs during walking. As the balance
and confidence with walking improves; the child may be able to
use crutches or walking sticks for support. For some children
the effort of walking is too great. This may be difficult for
the family to understand and accept. They may need to talk about
it and not push the child to walk. These children may use a wheelchair
or trolley for all or part of the body.
SCHOOL
ISSUE:
School
is an important place for learning, developing skills and social
interaction. Children with spina bifida can enjoy the usual range
of school activities. Some children with spina bifida are usually
mentally normal but majority of the children will have learning
difficulties. The children may be good at some activities and
have difficulties with other activities. Given appropriate help
and guidance children with learning difficulties will be able
to benefit from going to school. So schooling is a very important
issue in children with spina bifida and parents must be encouraged
to send their children with spina bifida to school.
Last updated on 30-10-2001
