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Sample text

Physicians and health professionals who work with patients with CP need to be aware of the implications of the diagnosis, the hardships these children undergo, and the value of each step gained towards function, no matter how small. A thorough knowledge of all the aspects of CP including the timing of diagnosis, the probable natural history, the prognosis and outcome is absolutely necessary in order to be able to help these children become part of the normal world. The ultimate goal in the management is to minimize disability while promoting independence and full participation in society.

An allegory can be made with sports: even with the best coaching, an athlete cannot compete in the Olympics if he does not have the potential. Similarly, even with the best physiotherapy, the child with CP cannot walk [H,I] if he does not have the neurological capacity. The treatment team must be careful therefore not to raise any false hopes about the outcome of physiotherapy in children. The efficacy of neurofacilitation techniques in improving the neurological impairment is controversial. Meta-analyses of neurodevelopmental therapy (Bobath) have shown that the functional status of the children at school age are the same regardless of having received therapy or not.

The competitive aspects of involvement in sports and games is basic to human nature, however many physically handicapped individuals frequently do not have the physical attributes to participate fully in different sport activities. Therefore most of the modern games and sports are modified for handicapped persons. The rules of the sport or the game are modified to meet the needs of disabled person (wheelchair tennis), or specially designed adapted devices are used for physically disabled to compensate or substitute the loss of muscle strength or function (downhill skiing) [E].

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