- 1. Use of splints
- 2. Surgery for Congenital Multiple Arthrogryposis
- 3. Physiotherapy for Congenital Multiple Arthrogryposis
- Life expectancy
Treatment for Congenital Multiple Arthrogryposis includes orthopedic surgeries and physiotherapy sessions, and the use of sleeping splints, but in addition, the child's parents or caregivers should carefully manipulate the stiff joints to improve their movements.
Congenital Multiple Arthrogryposis is a disease characterized by the fusion of one or more joints, which does not allow the baby to bend his elbows, fingers or knees, for example. A characteristic and important sign is the loss of the normal contour of the limbs, which have a tubular appearance. The skin is usually shiny and the lack of folds is frequent. This disorder is sometimes accompanied by dislocations of the hips, knees, or elbows. Learn the causes and diagnosis of this disease here.
Thus, for treatment it may be recommended:
1. Use of splints
The pediatrician can recommend the use of splints to sleep, which can prevent the increase of contractures, improve the position of the affected joints, which can facilitate movement and mobilization in physiotherapy the next day.
2. Surgery for Congenital Multiple Arthrogryposis
Orthopedic surgery can be indicated to correct cases of congenital clubfoot, severe knee flexion, dislocation of the shoulder, hip or other situations in which it may be possible to improve joint flexibility, such as capsules, ligaments and muscles with fibrosis. In addition, in the case of scoliosis, it may be indicated to place a device to fix the spine up to the sacrum, when the scoliosis angle is greater than 40º.
The child with arthrogryposis may undergo more than 1 surgery in his lifetime, and it is always recommended to do physiotherapy sessions before and after surgery, with a minimum of 30 pre- and postoperative sessions.
3. Physiotherapy for Congenital Multiple Arthrogryposis
Physiotherapy should be performed especially before and shortly after surgery, but it is also indicated in other periods of life, and can be performed from birth to when the person desires.
Preferably physical therapy should be performed twice a week, with sessions of about 1 hour, but in addition, it is necessary that parents or caregivers do the passive and stimulation exercises at home, which have been guided by the physiotherapist during the consultation. Each baby or child must be personally assessed, as there is no protocol that will be suitable for all cases of arthrogriposis, but there are some treatments that are always indicated, such as:
- Passive mobilization of the affected joints; Muscle stretching of the affected tissues; Passive and muscle strengthening exercises; Techniques for preventing new contractures that may include the use of orthoses, splints or bandaging of certain joints; Use of laser after mobilizations to heal tissues in the correct position faster; use of apparatus and electrostimulation to strengthen weakened muscles; lymphatic drainage to reduce swelling of the affected arms and legs; strength exercises, with isometric contraction and breathing exercises to increase lung capacity; hydrokinesiotherapy, with exercises in water, it is also a good option because it helps to reduce pain and facilitate movement.
To perform these steps the physiotherapist must be very creative inventing many games that can fulfill these goals, in order to provide greater independence for personal care, such as teaching how to brush teeth and comb hair, and improving the child's relationship with others children, improving their self-esteem and quality of life.
Physiotherapy can reduce the need for orthopedic surgery called arthrodesis, which consists of permanently joining a joint, preventing its movement for life.
Life expectancy
Despite the movement limitations that the child may have, most have an apparently normal life. 75% of affected children are able to walk, even with crutches or a wheelchair, and they are subject to the same diseases as most of the population. However, as they have movement limitations, they must have a diet low in calories, sugars and fat to avoid being overweight, which can make their mobility even more difficult.
Arthrogryposis cannot be cured, but it is also not progressive, which is why the affected joints that the child presents at birth are exactly the same joints that will need lifelong treatments. However, healthy joints can also suffer due to the natural compensation that the child performs when saving the defective joint, and for this reason, there may be cases of pain and tendonitis in the joints not affected by arthrogriposis, for example.
