In Cp, spasticity is one of the most common problems we encounter. It is difficult to solve and negatively affects the treatment process. Modified asworth and modified tardieu scales are generally used in the evaluation.
The most obvious difference that distinguishes pediatric rehabilitation from others is to teach the individual the unknown activity with simulation and regulation (For example: removing shoes, taking his/her hand to his/her mouth, etc.)  The individuals at the beginning of life are a major obstacle to gaining  them.

Spasity solution : “Techniques designed according to the developmental level of the Bobath motor,  Sensory integration,  Electrotherapy  , stretching and PNF techniques”
Electrotherapy : ES with contraction to the antagonist of the spastic muscle for 15 minutes will increase mobility and control.
Stretching: Isolated muscle Passive stretching for at least 30 seconds should be 8- 10 repetitions.  This will give a long-term relief. In addition, the use of only night or full-day orthosis can be recommended to maintain mobility and increase the ambulatory.  Agonist taping can be done and this is a very effective method.  While the spastic muscle is passively stretched, the anagonist provides tactile and visual biofeedback within the muscle.

PNF:

Rhythmic stabilization and opposite stabilization

Muscle-relaxation

Synergistic muscle pattern AA muscle work

Apraximation, traction , massage (may increase spasness if spastic muscle is performed) , tactile stimuli can be added to the techniques.

BOBATH :
It’s very important. In this technique, the motor development step is done one by one (It continues as catching the moon,sitting, rotating , crawling and walking.)

Weight transfers

Antispace Positioning

SENSORY INTEGRATION
It is used to educate the child to the next step by  using simulationand regulations.

Stretching , massage, push-pull,  weight lifting for processive input

Swing for vestibular input and thrombolin

Brush for tactile stimulation, fabrics with different textures, etc.

By helpingthem, visual and auditory enrichment is very important.

CASE EXAMPLE

7 years old

Diplegic boy

There are 3(0-4) spasities in gastrosoleus,  hamstring  and QF muscles compared to MA.  Spastic muscles controlled muscle activation Vas 6 (0-10) . Antagonist-controlled muscle activation of spastic muscles Vas 2 ( 0-10) There is
sitting and above-knee balance, standing balance is present for 3 seconds. The patient can walk with CAFO and Tripod. KMFSS is 3 according to 6- 12 years of age.
What should be the purpose and practices of treatment here?