gms | German Medical Science

Background: Cerebral palsy is one of the most common physical disabilities in children. In addition to developmental disorders of movement and posture, children with cerebral palsy (CP) also have deficits in sensory perception, cognition and behavior, which leads to activity restrictions. This leads to difficulties in motor learning and overall physical development. Early intervention programs are necessary to prevent complications, promote neuroplasticity and provide early support to affected children and their families. Most children with CP live in low- and middle-income countries.

Project description: The physiotherapy team at Zomba Hospital in Malawi has set itself the goal of contributing to improving the care of children with disabilities through interdisciplinary cooperation. Among other things, they carry out Physiotherapy Pediatric Outreach Programs in which various medical disciplines are involved (e.g. physiotherapists, social workers and nutritionists). They travel to a village for three consecutive days to assess children with motor abnormalities, advise families and give workshops.

The lead physiotherapist and his team run workshops on the construction of assistive devices in order to have a lasting effect. APT (Appropriate paper-based technology) is a technique with which small aids such as chairs can be produced inexpensively for children with motor disabilities. Adapted to the child’s measurements, a sturdy chair is built from a mixture of flour and water using old cardboard, waste paper and paste.

Results/findings: The various measures carried out that there are already specialized personnel, facilities and structures for children with CP and their families. Access and, in some cases, implementation, particularly in remote regions, appears to be very difficult.

Discussion: Due to cultural differences, individual assessments or therapeutic measures such as early verticalization using aids cannot be implemented in Malawi. There is therefore a need to revise physiotherapy standards for the treatment of children with cerebral palsy in Malawi. In addition, educational material for families is needed, as is already available on the subject of spina bifida in Malawi. Interdisciplinary cooperation in the context of the International Classification of Function and Health is necessary.

Conclusion: Increased cooperation between specialized personnel from various professional groups in Germany and the therapists at Zomba Hospital will take place in the future. This includes the pillars: skills and knowledge, parent education and physiotherapy pediatric outreach. An association to promote these measures is currently in the founding phase.