Paedriatician's Report -

History and condition before starting G Therapy:

He was examined by me on 9.11.98 He is the third child of a non consanguinous marriage, born prematurely (34wks.) with B.W. of 2.0 kg. No neonatal problems. Convulsions occurred at 5 years of age. He is on Valproate and Baclofen.

He has started recognizing parents by voice at the age of 4 years, also neck holding during that time. On pulled to sit neck holding is good, when made to sit in the corner, tends to slip. Can turn prone but cannot get back to supine position. Moves forward in the supine position. In prone position raises head slightly. When held in axillae, refuses to bear weight and bends right knee and equinus of feet, no voluntary grasp nor reaching possible. Does not understand spoken language - just learnt to recognize parent. Speech 2-3 syllables, gurgling present. No sphincter control.

On examination :

He has head circumference of 39 cm. Squint, mild scoliosis, drooling. Moves head in direction of light and sound. Spasticity in all four limbs, more on right side than left. Moderate adductor spasm of hip and T.A. tightness of both ankles. Deep jerks exaggerated, plantars up going, no clonus. The child was not receiving any physiotherapy till date.

After taking G Therapy for 1 month :

He was re-examined by me on 9th December 98. Following changes noted.

• Head circumference 41.8 cm.
• More responsive to parents-saying two more syllables.
• Trying to rise to sitting position from supine by lifting head.
• Corner sitting for 5 minutes possible.
• Spasticity overall slightly reduced.
• Adductor spasm still bad, weight bearing poor and no steps forward (walking) when supported in standing position.

Comments :

The child seems to be progressing mentally and in motor milestones with a notable increase in head circumference.

Dr. Sabiha A. Sayed
(M.B.B.S.,D.C.H)
Date: 16-12-98

Occupational Therapist's Report -

Observations before G-therapy:

• Was able to roll on either sides but unable to come to prone position.
• No weight bearing on elbows in prone position.
• No weight bearing on outstretched arms in sitting position; poor balance. Very uncooperative.
• Pallor of distal portion of extremities.

Observations after 1 month of G-Therapy :

• Can maintain the prone position and independent transfer from supine to prone is possible now.
• Now bears the weight on his elbows with relative ease along with good neck control.
• Co-operates during activities.
• Improved blood circulation through out the whole body.
• Reduction in hip abductors spasticity.

Further Assessment by O.T. on February 9, 1999 (3 months after G-Therapy) :

• Slight reduction in hip abductor spasticity.
• Fair to good neck control.
• Comes to sitting position on his own from side-line position (Lt. >Rt.) Sitting balance without support for 5-10 minutes.
• Brings both hands in mild line.
• Supported standing possible now.
• Indication for food/water/undressing activities present now.
• Co-operates during physiotherapy activity.

Dharma Prakash Jha
Occupational Therapist
Date: 9-2-99