الفهرس 
Cerebral palsyOnly 14 pages are availabe for public view
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Abstract
Cerebral palsy refers to a group of non-progressive brain disorders secondary to lesions or anomalies of the brain during the early stages of development. CP is a major cause of childhood motor disability. However, many children with CP have additional disabilities, such as cognitive deficits, visual, hearing, speech and language disorders and epilepsy. CP is more prevalent in the low socio-economically populations of the world. This disorder results from insult or injury to the brain before birth or in early childhood that causes neural connections to be formed in aberrant ways and leads to persistent abnormal limb strength, control, or both. Clinical diagnosis of CP has traditionally been based on neurological examination and detection of developmental delay and its stable course. The neurological deficits correlate to some degree with the location of structural damage. Causes of CP include prematurity, asphyxia, trauma, severe jaundice, hypoglycemia, intrauterine virus infection, neonatal meningitis, genetic factors, malformations and vascular complications. The above etiological factors are classified as prenatal, perinatal and postnatal. Cerebral palsy cannot be cured, but early treatment will often improve the child’s capabilities, functions and his ability to enjoy as normal adult lives if their disabilities are properly managed. Early intervention for a young child with CP make a difference in optimizing the health and quality of life of that child. Early intervention not only improve functional outcomes, but it will improve the psychological and emotional well-being of both the child and family. HBOT involves inhaling 100% oxygen at greater than one atmosphere absolute (ATA) in a pressurized chamber. HBOT has been used successfully in humans at varying pressures to treat a range of conditions, many clinical applications of hyperbaric oxygen therapy are including treatment of decompression sickness, arterial gas embolism, carbon monoxide poisoning, amyotrophic lateral sclerosis, and diabetic foot etc. However, HBOT has also been used at lower pressures (1.5 ATA or less) equal to 18 psi with clinical success in conditions including ischemic brain injury and CP. There are a lot of debate about effectiveness of HBOT on CP so that none of the international health insurance plans to include cerebral palsy as one of the medical conditions for HBOT. The aim of our study was: • To identify the efficacy of the hyperbaric oxygen therapy in rehabilitation of CP children. • To assess and compare between combined treatment (hyperbaric oxygen therapy and conventional rehabilitation program) with (conventional rehabilitation program only) for rehabilitation of CP children. Our study was done at 60 children with CP that divided into two groups randomly according to line of treatment: group 1 received HBOT 40 sessions with in mono chamber at 1.3 to 1.5 ATA one hour for each session 5 days consequently each week with 2-days holiday in addition to the conventional rehabilitation therapy. group 2 received the conventional rehabilitation program only in the form of: 1- Heat therapy such as: - infra-red rays and hot packs. 2- Massage to affected limbs. 3- Exercise such as: - (active, assisted active or passive) according to state of child. 4- Stretching exercises. 5- Functional exercises using assisting devices as ball and wedge. 6- Functional movement exercise of hands. Each child in this study was functionally assessed at the start of treatment ,3 and 6 months follow up. Functional assessment of children was done by: • Gross motor function classification Scale. (GMFCS) • Gurdon and Duff hand function assessment. • Modified Ashworth scale. (MAS) • Communication function classification system (CFCS). The results of this study was summated as following: • There was insignificant difference between both groups according to GMFCS, MAS and Gurdon and Duff upper limb function assessment as both groups as minimal improvement at 3 and 6 months in comparison to start of treatment slightly more at group 1. • There was significant difference between both groups in speech and communication assessment as group 1 show improvement in 3 and 6 months in comparison to start of study which is not in group2. • There was difference related to effect of HBOT in different age group as improvement in younger group more than older one. • There was difference in reduction of complication associated with CP as cognitive problems, drooling and disturbed sleep. • The effect and benefits of HBOT is better when received 5 days each week consequently with regular course by child without interruption. • CP children of mild degree of functional impairment respond better to HBOT sessions.