Therapies for Cerebral Palsy

Sunday, November 30, 2008

Article on Osteopathy

I found this short article and thought it was relevant and a good overview of osteopathy. An excerpt of the article is below.

What is Osteopathy?
"Former U.S. presidents and important political figures FDR, Eisenhower, and JFK all relied on osteopathic services for their health needs among many other famous figures then and now, and even though breaking the cycle of relying on doctors to heal us instead of listening to our bodies takes time, at least we are not solely looking to leeches for help. To find a DO in your area, look to The Cranial Academy to help your body heal itself through mental and physical osteopathic techniques."

Sunday, November 23, 2008

ACQUIRE Therapy (Pediatric Constraint Induced Therapy)

ACQUIRE Therapy is a new therapy to assist children with neuromotor disorders. It is based on Constraint Induced (CI) Therapy, also called Taub Therapy after its founder.

ACQUIRE is an acronym for:

Acquisition of new motor skills through
Continuous practice and shaping to produce
Quality movement of the
Upper extremity through
Intensive therapy and
Reinforcement in
Everyday patterns and places

The following is taken directly from the UAB Pediatric Neuromotor Research Clinic web site:

"ACQUIRE Therapy begins by casting the child's less-affected arm. A full-length, lightweight fiberglass cast is applied from the upper arm to the tips of the fingers. Then the cast is uninvolved so it can be removed by the staff once a week to check for skin integrity, clean the arm, and offer the child a few minutes of movement. The cast is then immediately placed back on the arm. The reason for applying the cast is to restrain the use of the less-affected arm allowing concentrated facilitation of the more-affected arm.

ACQUIRE Therapy begins the day after casting and includes play-based and functional activities to encourage your child to use the more affected arm. An ACQUIREc trained therapist will establish a close working relationship with your child in his/her typical environment. The therapist will provide intensive treatment for 6 hours a day for 21 days (some weekend days are included) over a 26-day period. The procedures are designed to elicit, facilitate, and refine voluntary control of the upper extremity. We will engage your child in many fun games and activities, with both familiar and new objects. We especially seek to have your child ACQUIRE useful movements and motor skills, and also to develop new confidence and independence in a variety of everyday situations."

Read more about ACQUIRE Therapy by downloding the ACQUIRE Therapy Brochure.

Friday, November 14, 2008

News Story about Hyperbarics

NBC 15 in Madison, WI published a story yesterday about a family doing hyperbarics at the same clinic we treated our son, the Wisconsin Interactive Hyperbaric Center.

http://www.nbc15.com/home/headlines/34422984.html

Tuesday, November 4, 2008

Article Conclusion: Children Should be Allowed Access to HBOT

The Journal of American Physicians and Surgeons published a great article in Volume 12 Number 4 - Winter 2007 reviewing and comparing the currently accepted therapies with HBOT in the treatment of cerebral palsy. I really appreciated the conclusion of the article, which is quoted below.

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"Hyperbaric Oxygenation Therapy in the Treatment of Cerebral Palsy: A Review and Comparison to Currently Accepted Therapies"
Carole Sénéchal, Ph.D.; Serge Larivée, Ph.D.; Engelbert Richard; Pierre Marois, M.D.
Download article in PDF format

Conclusions
"Previous studies of HBOT in CP have shown noteworthy favorable results, but to produce conclusive evidence, additional, more systematic trials are needed.

Much is at stake. Improvement in the function, independence, and comfort of persons with a severely disabling neurologic conditioncould lead to significant improvements in health and quality of life as well as to significant cost savings in the long term. While other treatment modalities are paid for by government programs, parents must bear the cost of HBOT as the controversies continue.

In the meantime, given the very low risk of adverse effects and the promising results, children should be allowed access to HBOT."

The Institutes for the Achievement of Human Potential

According to their website, The Institutes for the Achievement of Human Potential is a nonprofit educational organization that serves children by introducing parents to the field of early child development. They offer courses for parents at their campus.

I read "What to Do About Your Brain-injured Child", written by Glen Doman who founded "The Institutes" in 1955. I found some of the concepts in the book useful, such as patterning. The program they typically recommend is very time and energy intensive, which isn't for everyone.

http://en.wikipedia.org/wiki/The_Institutes_for_the_Achievement_of_Human_Potential

Olympic Cool-Cap System

The Olympic Cool-Cap System is the only FDA approved device for the treatment of hypoxic-ischemic encephalopathy (HIE) in term infants. It works by utilizing a unique cooling cap to provide selective brain cooling while maintaining core temperature at safe levels through the use of a radiant warmer.

Studies have shown that if used in the first six hours of life, the system can prevent or significantly reduce the severity of neurologic injury associated with HIE.

Monday, November 3, 2008

Harnessing The Power Of The Brain

Human beings driving wheelchairs and operating computers with only their thoughts...impossible, right?

Harnessing the Power Of The Brain

"People who are completely paralyzed due to illness or trauma are getting help communicating with a new technology that connects their brains to a computer."

Saturday, November 1, 2008

Advanced BioMechanical Rehabilitation (ABR)

ABR is a unique biomechanically based hands-on rehabilitation approach created by Leonid Blyum for children and young adults with brain injury. The therapy claims to bring about predictable recovery of musculoskeletal structure and motor functions.

ABR focuses on strengthening smooth muscles to restore the mechanical structure of the musculoskeletal system. Strengthening of the smooth muscles is suppose to induce gradual growth of internal pneumatic capacity, which in a cascade effect helps to re-establish - unit-by-unit - proper skeletal and muscular structure.

We have not done this therapy for our son because we don't feel it's necessary at this time. It's something we may consider in the future.

Check out http://blyum.com/ for more information.

Monday, October 27, 2008

Hyperbaric Oxygen Therapy (HBOT)

I have contacted many subject matter experts in the field of hyperbaric medicine over the last several months and have received an overall positive response regarding the use of lower pressure (mild) HBOT to treat brain injury. I found this explanation of HBOT posted to an online support group by a medical doctor, some of which I’ve edited for clarity.

"There are two components to hyperbaric oxygen: increased ambient pressure and increased inspired oxygen concentration. The physics of hyperbaric oxygen in a nutshell is that under increased atmospheric pressure, more gas goes into substances.

This increased oxygenation, or hyperoxia, has several beneficial effects. First, the high level of oxygen in the blood allows improved oxygen delivery to tissues that are not getting enough oxygen at baseline (i.e. hypoxic tissues). Second, having times of alternating hyperoxia and hypoxia (as occurs during a series of HBO treatments) promotes the growth of new blood vessels into the hypoxic tissues, a process known as neovascularization.

In the case of a brain injury, whether from a traumatic brain injury, a stroke, a near-drowning, cerebral palsy, or any incident which causes lack of oxygen to part of the brain, there are some cells that have died.

It is thought that around the area of the dead cells or the "umbra" there is a surrounding area of damaged and dormant nerve cells--the "penumbra"--which can heal over time.

The theory--and there does seem to be considerable evidence to support it--is that when a patient is in a hyperbaric oxygen chamber and given 100% oxygen under increased atmospheric pressure, the oxygen dissolves not only into the red blood cells (as happens normally when we breathe) but also in much higher concentration into the blood plasma, the cerebral spinal fluid, the lymphatic system and all of the body's fluids, bathing all of the body's cells with increased oxygen levels.

The result is high levels of oxygen carried to the brain, bypassing the normal way the brain gets oxygen; by the circulation of the blood stream bringing oxygen rich red blood cells.

At least one study was conducted comparing the use of air, which has about 21 percent oxygen, to the use of 100 percent oxygen. The patients given room air were intended to be the "control" group, and they did as well as those with 100 percent oxygen. The conclusion, erroneously, I think, was that because there was no difference in outcome between the two groups, that hyperbaric oxygen was ineffective.

However, importantly BOTH groups improved. So the conclusion I believe is that the use of hyperbaric pressure does significantly help in healing injured tissue--in this case, the brain.

The KEY is the use of increased atmospheric pressure, so that increased oxygen dissolves into the cerebral spinal fluid to be delivered to the damaged brain tissue to speed up healing.

Dr. Harch and some of the other hyperbaric medicine physicians have found 1.5 ATA with 100 percent oxygen given either once or twice a day to be safe.

It appears--although it would be nice to have better studies--that any amount of oxygen from room air to 100 percent oxygen has a beneficial effect. We know that for prolonged periods, using 100 percent oxygen can be toxic, but those are under conditions of using 100 percent oxygen over days or weeks. The short periods of time used for hyperbaric oxygen chamber treatment don't carry that risk--the exposure is much shorter.

It is way past time for the US government to sponsor controlled studies using a variety of protocols, with careful assessments using SPECT scanning. It is clear to many of us that there is a very great benefit from hyperbaric oxygen in treating a variety of brain injuries and many studies as well as individual case reports which prove this is true."

Our son suffered from lack of oxygen at birth (hypoxic ischemic encephalopathy (HIE)), along with seizures shortly after birth. He has cerebral palsy, developmental delay and cortical vision impairment (CVI), as well as secondary microcephly (small head size) due to this lack of oxygen at birth.

I read The Oxygen Revolution by Paul G. Harch, M.D. and found it to be a well organized text and a good overview of the use of hyperbaric oxygen for off-label indications.

I spoke with a nurse who has been closely involved with clinical trials for many years using HBOT to treat acute traumatic brain injury. She told me in so many words that as a mother; she would be doing what we’re doing.

I also spoke with a clinical research nurse involved in an ongoing clinical trial in Ohio sponsored by the Department of Defense involving 80 some children with cerebral palsy. She informed me of many initial positive results from the study An Evaluation of Hyperbaric Treatments for Children With Cerebral Palsy. Many children see a decrease in spasticity and increased attention span.

Based on this research and the experts I spoke with we completed 40 sessions lasting 60 minutes each, twice a day (at least 4 hours apart). We observed a definite decrease in the spasticity of our son, as did his Physical and Occupational Therapists. His vision and attentiveness have also improved.

In conclusion, the use of HBOT (1.5 ATA) to treat brain injury has minimal negative side-effects and great potential for positive results. HBOT is certainly not a miracle cure, but it is a valuable therapy to ensure the most complete recovery possible.

The OxyHealth Fortius 420 Hyperbaric Chamber