How can physiotherapy help after hydrocephalus?

Excessive pressure on the brain can result in physical problems in babies or children
which may affect their physical development, achievement of milestones, balance,
coordination or mobility. Our team of specialist paediatric physiotherapists can
provide treatment of a childs physical problems in order to maximise their potential
and quality of life. Aims of treatment will vary according to the childs needs and
age but may include:

Promoting achievement of physical milestones such as sitting, standing, crawling

Maximising independence in mobility

Exercises to improve balance and coordination

Exercises to stretch or strengthen tight or weak muscles

Improving confidence and quality of life

Improving tolerance and stamina

Evaluation:

Physical Therapy is an integral part of the hydrocephalus multi-disciplinary team.

The physical therapist performs testing of function, balance, and gait disturbances
typical of a patient with hydrocephalus.

Treatment:

Physical Therapy will address common secondary difficulties associated with

hydrocephalus such as strengthening, stretching, neuromuscular re-education,
balance training, development of gross motor skills such as walking, and increased
independence with functional daily tasks.

Specific treatment procedures are numerous, functional training for activities of

daily living; therapeutic exercise; manual techniques such as mobilization and
stretching; and therapeutic modalities.

Motor control, development, and learning theories focus on the idea that several
factors contribute to emergence of motor behavior. These factors include not only
the central nervous system (CNS) as the driving force, but also biomechanical,
psychological, social, and environmental components. Teaching and practice of skills
under these theories is task-oriented and intermittent versus rote and repetitive.
Higher-level learning takes place through problem-solving by the child rather than
by the therapist's hands-on facilitation. Emphasis has also been placed on the
importance of family-centered care, transdisciplinary service, and treatment in
natural environments.

The common goal usually is that functional activity increases and that disability
decreases.

What is the prognosis for hydrocephalus?

The prognosis for individuals diagnosed with hydrocephalus is difficult to predict,

although there is some correlation between the specific cause of the hydrocephalus
and the outcome. Prognosis is further complicated by the presence of associated
disorders, the timeliness of diagnosis, and the success of treatment. The degree to
which relief of CSF pressure following shunt surgery can minimize or reverse
damage to the brain is not well understood.

Affected individuals and their families should be aware that hydrocephalus poses
risks to both cognitive and physical development. However, many children
diagnosed with the disorder benefit from rehabilitation therapies and educational
interventions and go on to lead normal lives with few limitations. Treatment by an
interdisciplinary team of medical professionals, rehabilitation specialists, and
educational experts is critical to a positive outcome. Left untreated, progressive
hydrocephalus may be fatal.

The symptoms of normal pressure hydrocephalus usually get worse over time if the
condition is not treated, although some people may experience temporary
improvements. While the success of treatment with shunts varies from person to
person, some people recover almost completely after treatment and have a good
quality of life. Early diagnosis and treatment improves the chance of a good
recovery.

Preventive measures

Prenatal care:

Hemorrhaging, traumatic brain injury, and infection are seen in some premature
births; premature births may, therefore, be a risk factor for hydrocephalus.
Pregnant women can reduce the risk of hydrocephalus in their unborn child by

taking appropriate precautions to reduce the likelihood of a premature birth, for

example, by establishing appropriate prenatal care

Women should ensure adequate intake of folic acid prior to and in weeks following
conception to reduce the risk of NTDs

Foods that are naturally high in folic acid include spinach (130 g/half cup), navy
beans (125 g/cup), wheat germ (80 g/cup), avocados (55 g/cup), and oranges
(45 g/cup)

Infection:

Seeking prompt treatment for infections such as meningitis and other diseases that
are associated with hydrocephalus

Physical activity:

Measures should be taken to reduce the risk of post-traumatic hydrocephalus.

Infants and children can be protected from head injury by careful handling and by
ensuring that a helmet is worn during activities such as cycling, skateboarding, and
rollerblading

Environment:

Ensure that environment in the home is safe and is geared toward prevention of
falls