Comprehensive Management of People with Cerebral Palsy: An Indian Perspective

Abstract

Purpose: Guidelines for the management of people with cerebral palsy are available from many countries. However, these cannot be adopted in their entirety in other countries due to socio-cultural differences and varied health systems. This study set out to develop guidelines for the management of people with cerebral palsy, throughout their lifetime, in India. Methods:A mixed methodology with a multiphasic approach was used. The first phase involved an extensive literature review to compile current evidence about the management of people with cerebral palsy. In the second phase, a questionnaire was given to stakeholders in order to explore current practices. The third phase consisted of consensus-building meetings with stakeholders, to develop resolutions that incorporate global best-practice recommendations for India. Results:Responses from the second phase were compiled and categorised based on discipline. Proceedings of the consensus meetings were transcribed verbatim and best evidence was synthesised to understand current global practice guidelines. Resolutions were formed within the framework of the results of phases I and II. These were ratified by experts and then formalised. Conclusion:Sixty-four resolutions were formed, detailing a framework for multidisciplinary management of persons with cerebral palsy throughout their lifetime. A card with guidelines was developed to document all aspects of rehabilitation, development and care. However, the utilisation and application of these guidelines have not been explored as yet.

Efficacy of neuromuscular electrical stimulation and interrupted serial casting in children with spastic diplegia

“…Various therapies and procedures, including medications, injections, orthoses, exercise programs, surgery, and casting, are combined to correct deformities and improve standing and walking. 6 Non-surgical methods for treating hypertonia in CP are particularly important before motor patterns mature, typically between the ages of 8 and 10 years. 7 …”