64 chapter 7
REHABILITATION OF THE CHILD WITH PARALYSIS
All children paralyzed by polio can be helped by certain
basic rehabilitation measures—such as exercise to keep a
full range of motion in the affected limbs.
However, each child will have a different combination
and severity of paralyzed muscles, and therefore will have
his own special needs.
For some children, normal exercise and play may be all
that are needed. Others may require special exercises and
playthings. Still others may need braces or other aids to
help them move about better, do things more easily, or keep
their bodies in healthier, more useful positions. Those who
are severely paralyzed may be helped most by a wheelboard
(trolley) or wheelchair.
For this child, walking provides
exercise that stretches his
legs and feet, and prevents
contractures. (Tilonia, India}
Every child needs to be carefully examined and evaluated in order to best meet his or
her particular needs. The earlier you evaluate a child’s needs, and take steps to meet
them, the better.
Unfortunately, in most
areas where polio is
still common, village
rehabilitation programs
do not exist or are just
beginning. Many children
(and adults) who have
been paralyzed for a long
time already have severe
deformities or joint
contractures. Often these
must be corrected before
a child can use braces or
begin to walk.
This child, who had polio as
a baby, already had severe
contractures in the hips, knees,
and feet. (PROJIMO)
It took several months of
exercises at home and then
a series of plaster casts in the
village rehabilitation center to
straighten the contractures so
he could walk with braces.
Because contractures are such a common problem, not only with polio but with many
other disabilities, we discuss them separately in the next chapter. Before evaluating a child
with polio, we strongly suggest you read Chapter 8 on contractures.
WARNING: Before deciding on any aid or procedure, carefully consider
its advantages and disadvantages. For example, some deformities may
be best left uncorrected because they actually help the paralyzed child
stand straighter or walk better (see p. 530). And some aids or braces
may prevent a child from developing strength to walk without aids (see
p. 526). Before deciding what aid or procedure to use, we suggest
you read Chapter 56, “Making Sure Aids and Procedures Do More
Good Than Harm.”
Disabled village Children