Kule meko, "isenzo" sithetha amandla anokufumana kwinkqubo yobomi ukucwangcisa nokufezekisa ukuhamba okuhambelanayo. Umntwana onokukhubazeka kwe-cerebral uhlangabezana nobunzima ekwenzeni okuqhelekileyo kwinqanaba lemisebenzi yophuhliso - umzekelo, ukuhlanganisa iintambo, ukukhwela ibhasiki okanye ukubhala iileta. Iinkcukacha oza kuzifumana kwinqaku ethi "Ukulungiswa ngokwenyama kwabantwana abane-cerebral palsy".
Indlela yanamhlanje
Kuze kube kutshanje, aba bantwana babecatshangwa nje banobuqili, bakhawuleza kwaye bakhawuleza. Oku kwakudla ngokukhokelela ekungathandweni kweengxaki kunye nokungabi nonyango olwaneleyo. Ngenxa yoko, umntwana unokuhlakulela ubuninzi beengxaki zokuziphatha ezinxulumene nokukhungatheka, kuba akunakwenzeka ukuba umzimba wakho wenze ukuhamba okufunekayo ngexesha elifanelekileyo. Okwangoku, kucatshangelwa ukuba aba bantwana baneengxaki ezithile zentshukumo ephezulu (kunye nokungabikho okupheleleyo okanye okukhethiweyo kwezinto eziphambukayo kwinkqubo yesistim, umsebenzi we-musculoskeletal okanye i-reflexes), ekhokelela ekunciphiseni ukukwazi ukubala nokufeza ukunyakaza okujoliswe kuyo. Akukho nxu lumano phakathi kwe-cerebral palsy nokuhla kwengqondo.
Ukuxhatshazwa
Ngokomlinganiselo oqikelelwayo, ukuya kwi-10% yabemi abaxhamla kwiifom ezinobumba bepheney. Kwi-2-5%, iifom ezininzi zesifo ziyabonwa. I-70% yezi zi gulane zikwabelana ngesondo. Kucatshulwa ukuba imbangela yokukhubazeka kwe-cerebral kuyinto yokuphuhliswa kwe-system ye-nervous. Ngaloo ndlela, oku kungakho ngenxa yesiphene se-neurologic okanye i-hypoxia (i-oxygen starvation) yengqondo ngexesha lokubeletha. Intshukumo yokuqala ye-fetus iyenzeka ngexesha lokubeleka ngenxa yeengcamango ezingabandakanyekanga. Kwinkqubo yokuphuhliswa kwabantwana, ezi ngcamango zizaliseka ngokuthe ngcembe, ziba zichaneke ngakumbi, kwaye zilawulwa yimiqathango yokulawula, yokulawulwa kwemimiselo. Ukuvuthwa okupheleleyo kwazo zonke iistim e-motor kuya ekupheleni kokukhula. Umbutho wokunyakaza okungahambisani nokuxhomekeka kuxhomekeke kwizinto ezininzi. Ngokuqhelekileyo umntwana ufumana ulwazi oluchanileyo malunga nokusingqongileyo, ngomsebenzi wecandelo le-vestibular kanye ne-proprioception (ukuvakalelwa kwesimo kwindawo). Ukusebenza ngokubanzi kwalolu lwazi kukuvumela ukuba ubale ngokuchanekileyo kwaye ufeze intshukumo efunwayo. I-Cerebral Palsy ingadibana nokungaqhelekanga kwinto nayiphi na okanye yonke imithombo emithathu yolwazi. Kule nkalo, ukubonakaliswa kwepheneyalalal infalty in children ezahlukeneyo kuyahluka: umntwana omnye uthola nzima ukwenza inkinobho, kunye nomnye-ukucacisa ngokucacileyo nangokucacileyo amagama.
Izitho zengqondo
Umntwana onokukhubazeka kwe-cerebral ngokuqhelekileyo akakwazi ukuqonda ngokwaneleyo kwaye asebenzise le nkcazelo elandelayo:
• Thintela - ukungakwazi ukuqonda into ngokuvakalayo xa uyichukumisa (umzobo);
• i-vestibular device-organ of balance in ear ear, inganika ulwazi olungenakulinganiswa malunga nokuhamba, ukunyakaza, ukulinganisela kunye nesimo somzimba kwisithuba;
• Ama-Proprioceptors aphelile ekupheleni kweentsimbi ezikhoyo kuzo zonke izihlunu, iintambo kunye namalungu kunye nokuhambisa ulwazi malunga nesimo sabo kwisithuba kwingqondo. Ukusebenzisana namalungu ombono kunye nokuva, banikezela ukulungelelaniswa kweminyango kunye nokugcina imilinganiselo. Ukubonakaliswa kwe-cerebral palsy kungabangelwa kukungabikho kwenkqubo yokuziphatha. Kwiimeko ezininzi, abazali baqala ukukhupha abazali, baqaphele ukuba umntwana unempawu ezithile okanye i-lag kwizibonakalisi ezithile zokuphuhliswa kwexesha elifanayo. Kubalulekile ukuba umntwana onjalo ahlolwe ngexesha elifanelekileyo ngodokotela wezingane kunye nengcali yengqondo yengqondo, engcono ngaphambi kokuba angene esikolweni esiprayimari. Oku akuyikuqinisekisa kuphela ukuqaliswa kokonyango kwangaphambili kunye nokuphuhliswa kweendlela ezizimeleyo eziza kusebenza ngayo isikolo ekusebenzisaneni nomntwana, kodwa kuya kunceda ukunciphisa ukuhlukaniswa kwezentlalo, ukunyeliswa yontanga nokunciphisa ukuzithemba.
Iifom zokukhubazeka kwamagciwane
Ingcali yengqondo yengqondo iqhuba uchungechunge lweemvavanyo ezizodwa ukuvavanya izinga lokukhubazeka kwengqondo, kunye nokuchonga amacala emisebenzi yansuku zonke ekuchaphazela ngayo. Ngokwahlulo lweendlela zokukhubazeka kwe-cerebral ephawulwe ebuntwaneni, iimpawu zokuqala ezine ezikhethiweyo zixhomekeke, kuxhomekeke kubukhulu bokhubazeko bezakhono ezahlukeneyo zezithuthi (nangona zonke iindawo zihlala zichaphazelekayo kwiimilinganiselo ezihlukeneyo). Amaqela ezakhono angaphuliwe kwi-cerebral palsy zibandakanya:
• izakhono ezinkulu zemoto-ukulawula umsebenzi we-muscular, ukulungelelaniswa kweminyango kunye nokulinganisela okufunekayo ukwenza ukuhamba okukhulu;
• izakhono eziphambili zezithuthi-eziyimfuneko ekwenzeni ukuhamba okuncinci, umzekelo ukuhlanganisa ama-shoelaces;
• izakhono zomlomo - ubunzima ekuqondeni imiyalelo yezenzi kunye neengcaciso;
• Izakhono zokuthetha - ubunzima ekukhuliseni amagama.
Ngokuxhomekeke kwindlela yokukhubazeka kwe-cerebral, ingqondo yengqondo yengane ingabhekisela umntwana kwingcebiso kunye neengcali ezifanelekileyo, umzekelo, ingcali yokuvuselela isifo, ingcali yomlomo okanye i-ergotherapist.
Ixesha elide unyango
Ukubona ngokukhawuleza iimpawu zokukhubazeka kwe-cerebral kumntwana kunye nokulungiswa kwazo kubaluleke kakhulu. Nangona kunjalo, kubaluleke kakhulu ukuba ungayigcini unyango olumiselweyo ngexesha lonke lexesha lokufunda, kwaye, ukuba kunokwenzeka, ixesha elide. Ingxenye yale nto yenziwa ngenxa yokuba njengoko ukhula, kufuneka ufunde ubunzulu obunzima obudinga izinga eliphezulu lokuququzelela ukuhamba. Ukongezelela, kukho ukutyekela ukubuyisela iingxaki ezindala kunye nokuvela kwabatsha ngexesha kunye nangemva kokutsala okulandelayo ekukhuleni. I-Cerebral Palsy iyakwazi ukuzibonakalisa kwinani leempawu ezahlukileyo ngokuxhomekeka kwimilo kunye nobukhulu bayo:
• ukunyuka okungahambi kakuhle, ukuxhamla;
• Ukunciphisa ingqalelo yengqondo - umntwana unokukhawuleza ukulibala oko akuve nje;
• ukungazinzi;
• Ukungahleleki ekudleni - umntwana uphethe i-spoon okanye ifoloki kwintonga;
• ungathandi ukudweba kunye nombala;
• Ukungakwazi ukubamba ibhola okanye ukukhaba;
• Ukungabi nomdla kwimidlalo kunye nabanye abantwana;
• Ukungakwazi ukugxuma emlenzeni omnye okanye emibini okanye ugxume phezu kwesithintelo;
• ukususela ekusaneni - ukungakwazi ukunqumla (umntwana uhamba, uhamba ngesisu);
• Umntwana uyisithambile, uhlala elahlekelwa izinto zakhe;
• Umntwana ugqoke iimpahla ixesha elide, akwazi ukubopha iinqabana okanye iqhosha lokuqhosha;
• Uhlala ephosa izinto, aguqe izinto.
Ukukhethwa kwonyango olufanelekileyo kubalulekile ukucacisa uhlobo lokuphulwa. Ngenxa yale njongo, uninzi lweemvavanyo ezizodwa zisetyenziselwa ukuvavanya amakhono omzimba omzimba. Ngaphambi kokuvavanywa, umvuseleli uya kubuza abazali ukuba bazalise i-questionnaire ebonisa ulwazi malunga nokubunjwa kwentsapho, ubukho bobazalwana kunye noodade, izifo ezithwalwe ngumntwana, ukusebenza kwakhe kwezemfundo kunye nokuziphatha esikolweni, izakhono zentlalo, ubungane, iimfuno kunye nokwesaba.
Uvavanyo lokuphuhliswa kwabantwana
Uvavanyo lithatha malunga neyure kwaye luqhutyelwa ngabanye ngomntwana, ngokungabikho kwabazali. Ngokusekelwe kwingcaciso kwiphepha lemibuzo kunye neziphumo zokwenza imisebenzi eyahlukeneyo, umlungiseleli wokulungisa ubuchule wenza isigqibo malunga nesantya sokuphuhliswa komzimba.
Imigangatho yophuhliso
Ukuphuhliswa kwezakhono ezithile kubantwana kubakho malunga nomyalelo ofanayo kwaye malunga nexesha elifanayo. Ukutshintshela ekufundeni izakhono ezilandelayo kuxhomekeke kwinqanaba elithile ekuqondeni iziganeko zangaphambili. Ngokomzekelo, ukunyuka kokuqala komntwana kubetha kwisisu esisemva nasemva; kamva kamva uqala ukuhlala, ukukrazula, ngoko-vuka ngamadolo, ekugqibeleni, ume. Ukufunda ukuma, uthatha amanyathelo okuqala. Ikhono lokuhamba linika amandla ekuphuhliseni izakhono ezintsha - umntwana ufunda ukugijima, gxuma kwimilenze enye kunye nemibini, gxuma izithintelo. Kwinkqubo yokuphuhlisa ezo zakhono, umntwana ufezekisa ngokufanelekileyo ukunyakaza kwezitho, ezivumela ukuba aqonde izakhono eziyinkimbinkimbi - umzekelo, ukuphosa nokubamba izinto, ukudweba neekrayoni okanye ukutya i-spoon. Ukungaphumeleli "ukuphuma" nawaphi na amanyathelo okuphuhlisa ngokomzimba okudweliswe ngasentla kwenza kube nzima ukufumana nokudibanisa izakhono eziyinkimbinkimbi ezenza inxalenye ebalulekileyo yokukhula. Kungenxa yoko ukufumanisa ngexesha elifanelekileyo le-cerebral palsy kubaluleke kakhulu. Ugqirha-we-rehabilitologist wenza uchungechunge lweemvavanyo, okuvumela ukuba uqikelele:
• imeko ye-muscular system - abantwana abane-cerebral palsy benza kakubi kunye nokusebenza kwamanyathelo athile, okusoloko ekhokelela ekungeneni kwemithwalo yemisipha kunye nokuncipha kwabo. Uvavanyo lusebenzisa iimvavanyo zamandla emisipha; Ingqwalasela ekhethekileyo ihlawulwa kwimeko yemisipha yegxala kunye nebhinqa le-pelvic, kunye neetoni (postural). Ukunyakaza okuqhutyelwa yizihlunu kubumba isiseko sawo onke amanye amanyathelo, umzekelo, ukulinganisana ngexesha lokulinganisa;
• imeko edibeneyo - kwabanye abantwana abane-cerebral palsy, amajoyina "akhululiwe" - ubuninzi obuninzi bokunyakaza, okukhokelela ekunciphiseni ukulawula kwabo. Oku kuhambelana nokuphulwa kwekhono lokwenza izenzo ezichanekileyo, umzekelo, ngokubhala;
• Ukulingana - umlungiseleli uvavanya amandla omntwana wokugcina umlinganiso xa imisebenzi yemoto efanelekile kwiminyaka yakhe idibeneyo (umzekelo, ukulinganisa emlenzeni omnye okanye ukuhamba ngokukhawuleza kwibhentshini lokuzivocavoca). Kukho ukunyuka okwedlulele kunceda umntwana ukuba agcine ibhalansi yakhe (umzekelo, ukubetha izandla);
• Ukulungelelaniswa kwemisipha - imidlalo yebhola isetyenziselwa ukuhlola ukubonisana okubonakalayo kokuhamba kweengalo nemilenze. Kubantwana abancinci, bangathatha indawo ngokudlala ukuze bafake izinto zeentlobo ezahlukeneyo kwiimingxuma ezifanelekileyo ngobukhulu kunye nomlo;
• Umsebenzi we-intermistration - abantwana abaninzi abane-cerebral palsy "bayagqitha" isiteji sokukhahlela, beshukunyiswa ngokuswela kwisisu. Nangona kunjalo, izilwanyana zinyusa ubuchopho bokudlulisa ulwazi ukusuka kwelinye ilizwe ukuya kwelinye, elidlala indima ebalulekileyo, umzekelo, ekuhambeni okuhambelanayo kunye nezandla okanye iinyawo. Ukukwazi ukwenza izinto ezinjalo kuyimfuneko kwiintlobo ezininzi zomsebenzi wokwenyama. I-rehabilististist ihlola ubunzulu bokuhamba kwezandla ezihambelana nomgca womzimba xa "ukudweba" amanani emoyeni;
• Ukukwazi ukuthobela imiyalelo - ugqirha uhlola ikhono lomntwana lokuqonda nokuyenza imiyalelo elula yomlomo (ihlolwe ukuba ngaba kucaciswe ngakumbi okanye ukubonakaliswa kwezenzo kufuneka).
Ukukhethwa kweendlela zokuvuselela ngokwenyama kuxhomekeke kwiimfuno zomntwana ngamnye. Unyango lusekelwe kwimimiselo kunye nemidlalo, ekhuthaza ukuba asebenzise ngokupheleleyo amandla akhe omzimba. Uqeqesho olunjalo luyisiseko somsebenzi oxhasayo kunye nomntwana, ukuba kunyanzelekile, kubandakanye noncedo lo-ergotherapist, umlomo weengcali, inkxaso evela kubazali, ootitshala kunye nabasebenzi bezempilo. Injongo yonyango kukunyusa ukuzithemba kwesigulane esincinci ngokwenza imisebenzi elula ngaphambi kokuba uqhube phambili ekusebenzeni izakhono eziyinkimbinkimbi. Le ndlela isekelwe kwingcinga yokuba umsebenzi osebenzayo uphucula umsebenzi weendlela ezikhoyo kwiingqondo kunye nokwakhiwa kwezinto ezintsha. Ngokuqhelekileyo umntwana uhambela igumbi lokuvuselela ngokomzimba 1-2 ngamaxesha ngeveki kwiinyanga eziliqela. Ngelo xesha, kufuneka afunde imihla ngemihla kwiprogram ecetyiswayo ekhaya. Iiklasi ziqhubeka emva kokugqitywa kokutyelela kwiingcali zokuvuselela. Ukulawula impumelelo yomntwana kukuxanduva lwabazali. Ukuba imeko ibuhlungu okanye isiphumo asikwazi, umjikelo omtsha weyeza lokulungisa uphakanyiswa.
Jikelele uya kumanyango
Inani leendlela eziqhelekileyo zisebenza ngendlela yokonyangwa kwengqondo yokukhubazeka.
• Ukuthambisa
Ukubhukuda kunconywa kubo bonke abantwana abane-cerebral palsy. Inceda ukuqinisa imisipha. Ukuhambela emanzini kuphuza, oku kunika umntwana ixesha lokubala izenzo. Ukukwazi ukugcina ukulinganisela emanzini kubaluleke kakhulu, ngoko unokuzibandakanya kwimisebenzi yontanga, eyandisa ukuzithemba kwakhe.
• Uphuhliso oluphambili
Emva kokufunda iiklasi zakhono ezilandelayo zijolise ekufezeni okulandelayo. Ngokomzekelo, ekuqaleni umntwana ufunda ukugqithisa umtya oza kufakelwa phansi, ngoko-ke uqhube umthamo omncinci, uze uqhube ngebhola elikhulu, ngoko-ukuhambisa iingalo kwisimo esifanelekileyo esiswini. Emva koko umntwana ufunda ukuhlala ehleli, ngokuxhaswa kweenyawo zakhe ebhentshini, umzekelo, ukudweba (ngokunyuka ngokukhawuleza ngexesha leeklasi).
• Ukuqeqesha umsebenzi wokusebenzisana
Ingqwalasela ekhethekileyo ihlawulwa ekuphuculeni imisebenzi yokusebenzisana kwezifundo. Ukuziqhelanisa kweli qela kubandakanya ukukhahlela ngepayipi, ukuphula udonga lwaseSweden kunye nokugqithiswa kwezandla, umzenzelo apho umntwana ehamba khona kuzo zonke ezine, eqhutyelwa ibhola ye-tennis ehamba phambi kwakhe, ehamba ngokungafaniyo nokuphakamisa izinto ezingafani neengalo nemilenze.
• Uqeqesho lokulinganisela
Njengoko umsebenzi we-intermedium interaction uphucula, baqhubela phambili ukusebenza kulungelelaniso lokuhamba kunye nokulinganisela. Qalisa ngemizamo yokubamba isikhundla esimi emilenzeni emibini kwi "ibhodi yokuguqula" ngesiseko esikhulu, ngoko-ngomlenze owodwa. Emva koko, hamba ukuhamba ngokukhawuleza.
Ukulungiswa kweengxaki zeemoto ezinxulumene nokukhubazeka kwe-cerebral kusekelwe ekusebenziseni imisebenzi ekhethekileyo. Ngethuba elifanayo, isicwangciso sonyango sonyango senziwa ngamnye kumntwana ngamnye. Ukuzivocavoca ngokulinganisela, ukulungelelaniswa kwezinto ezihambayo kunye nokuqhelaniswa kwendawo kujoliswe ikakhulu ekuphuculeni izakhono zamanqanaba onke. Iindlela ze-ergotherapy zisetyenziselwa ukulungisa izifo ezincinci zeemoto. Izindlela zokwenyama zonyango lobuchopho bunyango
• Ukuzivocavoca - ukuhamba ngokukhawuleza kwibhentshini yokuzivocavoca; ukulinganisa emlenzeni omnye kwi "bhodi yokuguqula"; ukubamba ibhola okanye iipokethi ezinobumba ezizaliswe ngeebhola zeplastiki, zimi kwi "bhodi yokuguqula"; intambo yokuqaqa; ukudlala "kwiiklasi" okanye i-leapfrog;
• Ukusebenzisa ukulungelelanisa ukunyakaza - ukuqhuba ngokubamba ngentambo; "Ukudweba izinto eziphezulu" emoyeni ngezandla zakho; usebenze "kwindawo yokuhlala eTurkey"; ukukhahlela; sebenzisa "ibharba" (ukuhamba ngezandla kunye nenkxaso yemilenze); kubhukuda; udlala nebhola kunye ne-racket; ukudlala "kwiiklasi" okanye kwi-leapfrog; ukuxhuma "inkwenkwezi";
• Ukusebenzisa isiqhelo kwi-space - usebenzisa "i-tunnels", udlala nebhola elikhulu kumatshini; ukubamba iibhola zobukhulu obuhlukeneyo okanye iibhola ngevava;
• ukuqhuba ukuphuhlisa izakhono ezifanelekileyo zezithuthi - ukuqokelela iintonga; imifanekiso; umdlalo we "fleas". Ngoku uyazi ukuba ukulungiswa ngokwenyama kwabantwana abane-cerebral palsy.