Apport de la transdisciplinarité sans perdre sa spécificité de kinésithérapeute dans la rééducation d’un enfant polyhandicapé : étude de cas

This paper presents the case study of Julie, a 5-year-old child presenting a cerebral palsy. Her motor function level is rated V on the Gross Motor Function Classification System for cerebral palsy (GMFCS) and her manual ability is rated V on the Manual Ability Classification Scale (MACS). Her communication level is rated IV on the Système de classification des fonction de communication (SCFC). Our work focuses on the major hypertonia observed with this child and which massively alter her voluntary motor skills. The analysis was led through an interdisciplinary re-education team and enabled us to consider the different roots for these contractions. Not only is the neuromotor function altered by the brain injury leading to an inflated basal state of contraction, but the sensory, psychological and emotional dimensions were also taken into account to understand Julie's behavior in relation to her exaggerated contractions. Based on this multidimensional diagnosis, a collective process led to a physiological and educative therapy in order to allow this young girl with multiple disabilities to achieve a certain level of control over her contractions. The installations, the organization of her environment and an adapted educational framework were the three areas chosen to answer the three identified dimensions of pathological contraction. Regulating her state of contraction appears as a necessary step towards optimizing her expression and accessing an improved state of relaxation and comfort – a key element to support her general development.