Treatment of Pediatric Movement Disorders
The child's brain has a remarkable capacity for reorganization. This means that even after significant injury, there is the ability for uninjured parts of the brain to take over the function of the damaged parts. Since neurons do not generally re-grow, reorganization or "plasticity" is probably the major mechanism by which children improve or recover after brain injury. Even in progressive or degenerative diseases, it is likely that plasticity plays an important role in maximizing the child's abilities.
Although there is not yet conclusive evidence, it is likely that plasticity mechanisms are significantly enhanced by appropriate exercise. This means that physical therapy, occupational therapy, and schooling are important not only to improve strength and teach skills, but also to help the brain relearn and adapt to its injury. This is likely to be particularly true with movement disorders, since a child may be able to learn alternative strategies for movement that make use of residual neurological and musculoskeletal function. At the very least, by maintaining joint mobility and preventing muscle contracture, physical and occupational therapy preserve the ability for a child to possibly use these muscles and joints in the future.
Evidence from research in animals and humans shows that the brain can adapt rapidly (over a period of a few weeks) to changes in the use of the limbs. The significance of this observation for childhood movement disorders is not known; however, it suggests that training in the appropriate use of the limbs as early as possible may have significant long-term benefits. In particular, it is hoped that early and continuing physical and occupational therapy may delay or prevent future worsening of symptoms.