Introduction: Cerebral palsy refers to a group of non-progressive neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination. Cerebral palsy (CP) is caused by damage to or abnormalities inside the developing brain that disrupt the brain`s ability to control movement and maintain posture and balance. CP is often accompanied by seizures and/or im-pairment in perception, cognition, behavior as well as other medical disorders. The majority of the therapeutic approaches for cerebral palsy aim at optimization of the movements. Neuroplasticity theory is based on the idea of continuous development and remodeling of the nervous system. Application of the Feldenkrais method for patients with cerebral palsy contributes to the reorganization of the motor elements and helps the patients to control their movements better.
Aim: The present study is aimed to evaluate the improvement in the clinical condition of a patient diagnosed with CP through application of basic principles of the neuroplasticity theory.
Materials and Methods: We present clinical case of an 18-year-old patient with CP (spastic diplegia), who had undergone classical rehabilitation, including physical therapy and physiotherapy for 16 years. For this patient we applied neuroplasticity approach with two methods included: neuromuscular therapy (deep tissue massage) and Feldenkrais method (awareness through movement) for a period of 6 months.
Results and Discussion: Deep tissue massage and Feldenkrais method as parts of the neuroplasticity ap-proach, applied for a period of 6 months, showed significant improvement of the clinical condition of the patient, relaxation of the spastic muscles of the lower limbs, better control of the abnormal reflexes, correction of the posture and gait, as well as improvement of the performance of self-service activities.
Conclusion: The neuroplasticity approach in the therapeutic management of cerebral palsy showed very good effects in improving the functional capacity of the muscles, the phycho-emotional tonus and the self-esteem of the patient, as well as independence and stamina in everyday basic self-service activities.
Нормално развитие и някои отклонения на нервно-психичното развитие в детска възраст. С. Цеков ред., Варна, Зограф, 2015
Boudreau, S.A., Farina, D., Falla, D. The role of motorlearning and neuroplasticity in designing rehabilitation approaches for musculoskeletal pain disorders. Man. Ther. 2010; 15 (5),410e414
Cyriax J. Deep massage. Physiotherapy. 1977; Feb;63(2):60-1.
Eileen Bach-y-Rita. Neuroplasticity and the Feldenkrais Method® (in press)
Flor, H., Cortical reorganization and chronic pain: implications for rehabilitation. J.Rehabil. Med. 2003; 41 (Suppl.), 66e72.
Ginsburg, C. The Intelligence of Moving Bodies: a SomaticView of Life and its Consequences. AWAREing Press, Santa Fe,NM. 2010
Hillier, S., Worley, A. The effectiveness of the Feldenkraismethod: a systematic review of the evidence. Hindawi Publishing Corporation Evid.-Based Complement. Altern. Med.2015; http://dx.doi. org/10.1155/2015/752160.
Kleim, J.A., Jones, T.A. Principles of experience-dependentneural plasticity: implications for rehabilitation after braindamage. J. Speech Lang. Hear. Res. 2008; 51 (1), S225eS239.
Mathias S, Nayak USL, Isaacs B. Balance in elderly patients: the “get-up and go”test. Arch Phys Med Rehabil. 1986;67:387-389.
Pascual-Leone, A., AmediAFregni, F., Merabet, L.B. Theplastic human brain cortex. Annu. Rev. Neurosci. 2005; 28, 377e401.
Snodgrass, S.J., Heneghan, N.R., Tsao, H., Stanwell, P.T., Rivett, D.A., van Vliet, P.M. Recognising neuroplasticityin musculoskeletal rehabilitation: a basis for greater collaboration between musculoskeletal and neurological physiotherapists. Man. Ther. 2014; 19 (6), 614e617.
van Vliet, P.M., Heneghan, N.R. Motor control and themanagement of musculoskeletal dysfunction. Man. Ther. 2006; 11 (3), 208-213.
Young, J.A., Tolentino, M. Neuroplasticity and its applications for rehabilitation. Am. J. Ther. 2011; 18 (1), 70e80.
Zemach-Bersin, D., Foreword. In: Feldenkrais, M. (Ed.), Embodied Wisdom: the Collected Papers of Moshe Feldenkrais. Somatic Resources. 2010; San Diego and North Atlantic Books, Berkeley, pp. xiexix.
