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针对一名患有交通性脑积水且因斜颈继发发育迟缓的1.5岁儿童的物理治疗干预:病例报告

Physiotherapy Intervention for a 1.5-Year-Old Child With Communicating Hydrocephalus and Developmental Delay Secondary to Torticollis: A Case Report.

作者信息

Dethe Shivani R, Sharath H V, Warghat Pratiksha A, Raghuveer Raghumahanti

机构信息

Department of Pediatric Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Sep 26;16(9):e70260. doi: 10.7759/cureus.70260. eCollection 2024 Sep.

Abstract

This report presents the case of a 1.5-year-old female child diagnosed with communicating hydrocephalus and developmental delay, who received physical therapy as part of her treatment. Hydrocephalus refers to the formation of excess fluid in the deep brain cavities. The excess fluid makes the ventricles enlarged, which increases the pressure inside the brain. Excessive cerebrospinal fluid (CSF) pressure caused by hydrocephalus, on the other hand, can harm brain tissue and cause a variety of neurological problems and developmental delays. After taking a thorough history in this case, it was discovered that the patient had a history of one-month NICU admissions due to frequent episodes of vomiting, fever, and low birth weight. After repeated delays, medical consultations were requested, and a magnetic resonance imaging (MRI) showing signs of communicating hypertension led to a referral for physiotherapy. The child shows delays in reaching developmental milestones, such as having difficulty controlling her head and trunk and having a history of consequent birth complications. The goals of the physiotherapy intervention were to develop total body coordination and balance, improve awareness of sensations, and attain head and trunk control. Different approaches were used to target developmental milestones and functional abilities, such as myofascial release techniques, neurodevelopmental approaches, sensory stimulation, and integration therapy. The patient's outcome measures were evaluated both before and after the intervention using the Hammersmith infant neurological examination, Face, Legs, Activity, Cry, and Consolability scale, and infant neurological international battery. All outcome measures indicated significant improvements after receiving physiotherapy rehabilitation. Significant improvements were achieved through progressive treatments, demonstrating the importance of combining early therapy and parental engagement in assisting patients in achieving their goals. To investigate additional therapy methods and evidence of long-term prognosis for this patient population, more study is required.

摘要

本报告介绍了一名1.5岁女童的病例,该女童被诊断为交通性脑积水和发育迟缓,接受了物理治疗作为其治疗的一部分。脑积水是指在脑深部腔隙中形成过多的液体。过多的液体使脑室扩大,从而增加脑内压力。另一方面,脑积水引起的脑脊液(CSF)压力过高会损害脑组织,并导致各种神经问题和发育迟缓。在对该病例进行全面病史采集后,发现患者因频繁呕吐、发热和低出生体重在新生儿重症监护病房住院一个月。经过多次延误后,寻求了医学咨询,磁共振成像(MRI)显示交通性高血压迹象,随后转诊接受物理治疗。该儿童在达到发育里程碑方面存在延迟,例如难以控制头部和躯干,并有出生并发症史。物理治疗干预的目标是发展全身协调和平衡,提高感觉意识,并实现头部和躯干控制。采用了不同的方法来针对发育里程碑和功能能力,如肌筋膜放松技术、神经发育方法、感觉刺激和整合疗法。使用哈默史密斯婴儿神经学检查、面部、腿部、活动、哭声和安慰量表以及婴儿神经学国际成套测验在干预前后对患者的结果指标进行了评估。所有结果指标均表明接受物理治疗康复后有显著改善。通过逐步治疗取得了显著改善,这表明早期治疗和家长参与相结合对于帮助患者实现目标的重要性。为了研究针对该患者群体的其他治疗方法和长期预后证据,还需要更多的研究。

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