Therapeutic Approach to Spastic Tetraplegias
摘要
For each form of tetraplegia, the most justified, suitable, and effective reeducation treatments are proposed, clarifying boundaries between assistance and function recovery, i.e., between care and cure. In particular, for the most severe forms, the danger of “dividing the child into different pieces” in order to deal with each dysfunctional part through targeted interventions carried out by specialized technicians is underlined. Conceived in this way, reeducation can easily become an abuse. From a therapeutic point of view, problems of autonomic control and communication modality with caregivers (AAC) are addressed. In addition, the dangers of symbiosis, difficulties of oral feeding, reflux phenomena, hypersalivation with sialorrhea and respiratory infections, secondary deformities, especially hip dislocation and scoliosis, and the pain that accompanies them, visual and hearing problems, aids needed for sitting and transport, pharmacological measures required to control spasticity, and aspects related to manipulation are also explored. Special attention is given to the prevention and treatment of hip dislocation.