Rehabilitation of children with arthrogryposis

Abstract

Arthrogryposis is a congenital, multiple and non-progressive deformation of the joints, which is characterized by a multiple contractures of the joints at the child's birth. Stiff joints are cylindrical in shape, retaining usual contours, with partially erased muscle and skin outlines. The classic form of arthrogryposis is usually referred to as amyoplasia in the current literature. The case presented here is of a female child aged 17, with the diagnosis of Arthrogryposis multiplex, categorized as mildly mentally disabled, semi-mobile and using wheelchair. The female subject is with deformities of both upper and lower extremities and is completely dependent on the help of another person in matters of usual daily activities, such as maintaining her personal hygiene and satisfying her basic living needs, also in practicing her basic skills. The rehabilitation plan is grounded upon the diagnosis of disease, as well as on the results based on a functional assessment. The rehabilitation plan included daily exercises, passive exercises for lengthening of the soft tissue structures, active sustained exercises, active exercises and those with load on all joints according to the estimation made by the manual muscle test. The plan was being implemented during the research over the course of one whole month. The patient cooperated greatly and was motivated to work. Treating children with arthrogryposis requires cooperation between physiatrists, surgeons, physiotherapists, occupational therapists, social workers, orthotics, with early and complete engagement of parents. Therefore, the treatment of arthrogryposis necessitates to be approached by all aforementioned experts as a team.