PHYSICAL THERAPY BASED INTERVENTION ON MOTOR FUNCTIONS PERFORMANCE IN INFANTILE CEREBRAL PALSY

After cognitive and reasoning abilities, one of the most basic function which defines an individual as human being is the ability to control and move the body in space. Some of us, focus most of their attention on cognitive activity and on the other hand, some individuals focus most of their activity on motor skills. Probably the more significant aspect is that, even if we are engaged in cognitive activity we still depend on motor functions to relate and transmit our cognitive achievements. So palsy? Their childhood is characterized by lost motor function which is a major part of the disability with a large variety of motor impairments (all of which are secondary to the encephalopathy), including lower extremity function, upper extremity function, mobility, swallowing or speech. However, even with this anatomical problems, children with cerebral palsy, may succeed as contributing members of society. The goal for these children is not “to find someone to blame”, is to grow up and develop to their maximum capabilities with their own resourses. The study examined effectiveness of therapeutic physical exercises in achieving motor control in five dimensions of motor ability (lying and rolling, sitting, crawling and kneeling, standing, walking, running and jumping). The assessment tool was a specific indicator designed to measure changes in gross motor function over time in children with cerebral palsy, GMFM (Gross Motor Function Measure).

that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication, and behaviour, by epilepsy, and by secondary musculoskeletal problems'' [2].
The complexity of cause has been extensively discussed in the medical literature. With cerebral palsy, the structural and functional maturation of the Central Nervous Systems (CNS) gets compromised. This can happen due to prenatal conditions ( prematurity, less than 36 weeks, low birth weight, less than 2500 g, bleeding in the third trimester, severe toxemia, trauma or placental insufficiency) perinatal conditions (premature rupture of membranes, presentation anomalies, bradycardia or hypoxia) or postnatal conditions (0-2 years-CNS infection, encephalitis, meningitis, hypoxia neonatal hyperbilirubinemia or head trauma) [3].
The consequences of a lesion for the developing brain depend on development stage of the infant at the time of insult, place and size of the lesion that may compromising the process of skill acquisition. The topographical classification of the cerebral palsies are: [4]: Tetraplegia (quadriplegia). Involvement of all limbs and body. Arm are equally or more affected than the legs (many are asymmetrical).
Diplegia. Involvement of limbs, with arm much less affected than legs (again, asymmetry may be present).
Hemiplegia. Limbs and body on one side are affected. By type, the classication of the cerebral palsies is: [3,4,5]: Spastic cerebral palsy ( lesion site-cortex with main motor characteristics: hypertonus, abnormal postures, changes in spasticity and postures, voluntary movement).
Mixed cerebral palsy ( lesion site-diffuse with main motor caracteristics: mix of two or more of the above).
Physical therapy plays a large role in the development of a child with cerebral palsy. The therapist has to develop a treatment plan (always individualized) to allow the child to function as independently and efficiently as possible delivering with time, maximum independence of the individual child.

Material and method
Hypotheses of the research: we hypothesized that an individualized and specific set of exercices will work towards two important goals: first, to improve motor functions, for example, sitting, standing, using a form of locomotion or using hands, increase muscle ROM, flexibility and strength, improve balance, stability and posture/alignment, improve gait, and second, to prevent impairements that may affect performance such as limited range of motion, weakness, postural malalignments, pain and fatigue wherever possible.

Conclusions and discussions
The framework for all assessments is outlined to synthesis in previously graphics. The framework consists of the following assessments: The motor functions, for example sitting, standing or using a form of locomotion were increasing with contribution of physical therapy treatment. Physical therapy has a positive attributes in the development of a child with cerebral palsy. Althought the brain damage is not progressive, the motor and musculoskeletal problems may increase. Physical therapy is needed to prevent or minimise these impairments.
The main roles for therapists for ,,grow-up'' a child with cerebral palsy to his maximum independence may be the following: -minimising hypertonicity and involuntary movements; -improving postural alignments and patterns of gait; -minimising impairments within the functions; -improving ROM of muscles, joints, and soft tissues; -improving postural mechanism of stability and balance; -prevent deformities; -strengthening for weakness of various kinds; -promoting positive motor experiences as key for motivating the child with cerebral palsy and of their family.
Psysical therapy has a significant role in promoting the neurological development of the child and teaching the child to use his existing potential in the best possible way.