16 VM2G – Therapy of Children Affected by CP (Cerebral Palsy)

The therapy of children who have been already affected by completed CP syndrome at the time of admission to our care is significantly more complicated compared to children at risk of CCD. The older the children are and the severer the affection is, the less successful the effort to improve their condition could be. It’s not possible to perform as intensive therapy with older children as with infants. The infants are stimulated by VMG mostly four times a day. In older children, we have to get by with therapy implemented once a day in most cases. Ossification of pathological stereotypical movements and the corresponding gradual increase in joint subluxations and deviations of bone axes makes the achievement of the therapeutic goals significantly more difficult. Still, in preschool children and children of younger school age, the long-term and carefully led VM2G can achieve incredible results. The engagement of “home therapists”, who help to bring some relief to the families of afflicted children, proved to significantly ease the implementation of the therapeutic process as the daily VM2G stimulations lead the children to the improvement of the condition of their locomotive apparatus.

Economic and Social Aspects of Practical Implementation of VM2G

CP belongs among the most expensive diseases of musculoskeletal apparatus in children. Multiple expenses consist of direct medical expenses, concerning also social and transportation expenses, the costs of medical aids. Other indirect financial impacts include the reduced labour productivity of the family, expenses of the family and the relatives, the costs of psychological care of the patient and his family and also in the upcoming reduced or the non-existent labour productivity of the patient.

Intangible costs are difficult to quantify because they do not cause any measurable impact on the resources. They include the feeling of pain and torment as well as the following decreased quality of life. Compared to direct costs, it is very difficult to measure indirect and intangible costs with money.

Real costs connected with the illness concern all the costs incurred by society, regardless where they occurred or who bears the economic impact. In terms of social economic policy, they constitute the expenses that are decisive because they provide a complete image of the overall cost of the disease that the economy must bear.

According to a study from 2001 by Bode,1 the costs on one handicapped patient acquired during his whole life were more than 500 thousand dollars. The incidence of CP is relatively stable statistically. In developed countries, it is 2 – 3 children per 1,000 live births. The conclusion of the study “Costs of Disorders of the Brain in Europe” was implemented in 2011 and published by The European Brain Council in 2012. The study focused on the estimated prevalence of the wide spectrum of brain diseases and on the estimated expenses related to them in various aspects – predominantly in healthcare, social services and within the loss of productivity.

The non-economic benefit of VM2G therapy mainly consists of the change of the angle of view. The attention focuses on the family itself, particularly the effort to maintain quality family background for the care of the handicapped child. Home care of a child with health impairment (predominantly the long-term care) significantly influences the conditions of the family life. In particular, the rehabilitation of the child, which completely depends on the parents, becomes even more demanding in later childhood. It often leads to the decomposition of the family environment marked by long-term exhaustion of the parents. The development of the relationships within the family and the quality of the family background involves the children, particularly – siblings of the patient and the handicapped child. The therapy focuses on the possibility for the families that care for the handicapped child to live a high quality life with all its joys. Thanks to home therapists, who regularly visit the children, the parents can divide their time between their ill and healthy children and live together more as family. The main achievement of social innovation brought by VM2G therapy is the interconnection of the healthcare with a key social aspect.

Kateřina

It saves time for the family and children when the therapy is implemented at home, school or school club. The current model of travelling to rehabilitation outpatient offices is often a great loss of time for the child and for the care providers; time that couldn’t be used for leisure activities and with the rest of the child and its parents as well.

Implementation of the home therapy of handicapped children at schools and school facilities leads to recognising the reality of such care by other healthy children. Right at the kindergarten or the basic school, they can experience the acuteness of the necessary care of their classmates. They are being naturally educated how to behave toward physically challenged people and how to communicate with them and what their needs are. Home therapy performed in the child’s natural environment provides direct experience as how to non-forcibly help the handicapped ones, healthy children and adolescents in mutual integration.

The continuity of the educational process is often broken by the long-term absence of handicapped children. This is the result of necessary treatment stays at spas or sanatoriums. The stay usually lasts 4 or more weeks. The transport to remote rehabilitation outpatient offices is another problem. Conversely, home therapy excludes such breaks in education. It prevents a deficit in the quality of education. It brings the young people closer to reaching the apprenticeship certificate, graduation or completion of the university. Good education is an essential prerequisite for a good job and the fulfilment of a high-quality life. Our experience proves that continuous systematic and supervised rehabilitative care is a fundamental precondition for gradual improvement of the status of the patient, particularly in building and maintenance of the stable status of the musculoskeletal apparatus. The mental condition of the handicapped child is usually more fragile than in healthy children. The help and support provided by the home therapist gradually confirms the patient’s quality of self-acceptance and the acceptance of others in their surroundings. The child is naturally and not forcibly led to acquiring the adequate position within the collective of children, without frustrations and inferiority complex. The long-term forged, strengthened and supervised relationships: home therapist – child; the parent – home therapist creates a valuable bond and an instrument that could help the families and the individuals to get over their difficulties and problems that usually occur in the life of handicapped children.

Adéla