Thérapies corporelles et flexibilité tonique chez les enfants atteints de paralysie cérébrale. Une étude menée au Centre National de Réhabilitation des Personnes Handicapées (CNRPH)

Abstract

This work is titled "Body Therapies and Tonicity Flexibility in Children with Cerebral Palsy: A Study Conducted at the CNRPH." The main issue of this study is the management of the variation in tonicity in response to therapeutic interventions. The study is guided by the following research question: how do body therapies facilitate tonicity in children with CP? Its objective is to examine the effectiveness of body therapies on the tonicity of children with CP through progressive relaxation techniques, body mobilization (coordination and balance exercises), and therapeutic touch. To address this issue, we used three (03) theories: the sensory integration theory developed by Ayres (1972), the neurodevelopmental theory of Bobath (1985), and the motor control and learning theory developed by Schmidt (2005). The study employed a qualitative clinical research design, with a sample population consisting of five (05) children with CP obtained through purposive sampling at the CNRPH. To collect data, we conducted observations, followed by interviews, and finally administered the Tardieu scale to measure the degree of spasticity in the participants. The collected data underwent thematic content analysis. These data were analyzed and categorized based on the observations and interviews conducted. The results from the observations and interviews showed that therapeutic interventions such as progressive relaxation, body mobilization, and therapeutic touch had a significant influence on the tonic flexibility of these participants. Progressive relaxation helped the children better manage their muscle tension through deep breathing, while body mobilization was essential for encouraging movement and muscle fluidity. Finally, therapeutic touch promoted muscle relaxation and encouraged better blood circulation, contributing to increased tonic flexibility. The study suggested that for children whose results are not yet visible, psychoeducation for the entire family should be conducted, and strategies should be developed to involve families more in continuing these practices at home to maximize benefits and enhance autonomy. Additionally, an enriched environment should be used to stimulate various senses, etc. For those whose benefits are visible, further encouragement of activities that promote free movement is recommended. Following this work, we proposed an exercise called "The Sensory Journey on Sandy and Leafy Paths," which offers an innovative and locally grounded proach to improving tonic flexibility by focusing on gentle stimulation and movement.