Both children's, and the adult organism permanently adapts to an environment. The interaction with an environment and reaction of organism occurs on a reflex principle.
The complex of signals from receptors is analyzed by CNS, the commands to the executive organs are formed. After finishing of the commands the information on results of their executes comes to CNS and, if it is necessary, after the analysis of this information the adjusting commands are sent. By definition, the reflex is an organism's reaction on any external influence. For executing of each reflex the certain combination of neuron connections is formed.

The reflexes are divided into two kinds - unconditioned (inborn) and conditioned (acquired reactions of an organism on external influences). For example, a unconditioned reflex is drawing back of a hand, if you have pricked. But yogi lies on a board with a prominent nails, and receives a pleasure from this. It is already a conditioned reflex produced as a result of the analysis of consequences from such procedure. Or classical example - you are snatched a hot subject and, protecting hands from a burn, immediately let it out of hands. It is an unconditioned protective reflex. But if this subject is an expensive porcelain teapot for tea, that, sacrifices slightly by hands, you will try accurately to put it for not to break. It is too conditioned reflex.

It is possible to tell, that the external influence has three basic components - complex of signals causing a unconditioned reflex, complex of signals, which provides fulfillment of the conditioned reflex on the basis of the given unconditioned ones, and the additional information, which modifies a reaction.
The unconditioned reflexes are steady. The conditioned reflexes can be weakened and disappeared with time. On the conditioned reflex the new conditioned reflexes of the second, third orders can be produced.

Let's assume, that we have developed a conditioned reflex.
If the conditions have changed and an external information influence is enough strong and long, then an inhibition of the earlier developed reflex can occur and the new one will be developed, more suitable for new conditions of life. I.e. the new information flow should exceed some adaptive threshold that are determined by the information, available in memory, about an earlier developed reflex. A local changing of functional connections of CNS occurs at this.
A number of mechanisms explaining in what way a fixing of a conditioned reflex (temporary neuron connections) occurs are offered now. It can be axons germination in the necessary direction, or myelinization of endings of reserve neurons, after what they can conduct nervous pulses, or formation of new synaptic connections. Not concerning the specific mechanism, for us it is important, that there are mechanisms, which at a level of morphology of a brain are capable to fix the produced reflex.

Let's discussed a little bit more in detail an execution of a reflex movement.

At execution of movement a transition from one pose of a body to another ones occurs. Thus, in each moment of time the brain (CNS) processes an instant image of a body as set of nervous pulses and neurons connections involved in the given moment.
In other words, the reflex is the certain spatial - temporary pattern in a CNS of neuron connections and flows of nervous pulses, which varies in a process of fulfillment of reflex movement. Instant a reflex image is like a photo of city from altitude of the bird's flight, where streets are the nerves, through which nervous pulses - people, machine - are moved.

The movement is carried out as a transition from one instant reflex image to another one. This instant reflex image of all body consists of elementary components. Essentially important is that fact, that the brain analyzes not a condition of separate muscle fibers or muscles, but a position of a joint in a space. It receives a three-dimensional picture in the form of signals from proprioceptors of all muscles that fix the given joint and, accordingly, sends a complex of commands for change its position.

In other words in a motor system the individual image is a whole complex of nervous pulses from set of motor units - muscles fibers that fix one joint. And it is analyzed not only spatial position of a joint, but also a degree of a muscles strain and speed of transition from the given position to the next one. To the information from proprioceptors the information from tendon receptors, joint, skin receptors, etc is added. Therefore, even with closing eyes we nevertheless have a complete idea about a position of a body we can fulfill any movement, to touch a nose by the finger-tip.
Now we shall do a fancy experiment. By closing eyes let's imagine, that you are going to jump through a ditch. If you from the beginning can precisely imagine its width, that it will be discovered, that you can imagine that you have jumped the ditch of some width, but for greater width you will fall down, cannot jump that far.

I.e., even mentally you can present only those movements, which is real practicable for a brain on the basis of the previous experience. And it means, that it is possible to make an inverse conclusion. In order to the man could carry out the certain movements, their image is must be previously "to writing down" in a memory. It is impossible to imagine movements, which you are not capable really to fulfill, which image is not present.

Thus, in each moment of the person's life in his memory is stored the certain quantity of reflex images. Each of them consists of elementary images describing a position of joints, direction and speed of change of their mutual position. And to each individual image the certain quantity of neurons (functional) connections corresponds.

And what condition will be at CP with similar destruction of nerves bond?
The absence of mobility complicates foots in the initial period of development preservation of balance. The child is not able to not balance yet with case and hands, therefore there is a proof stereotype of fear to lose balance and to fall. It is natural, that thus the process of training to walking is strongly complicated. In result, are not formed not only bonds directly caused by development of a complex of movements with participation foots, but also majority of bonds necessary for other phases of walking, as they are included under condition of transition from a phase of unbend of foots. As the period of training to walking is missed, the formation of bonds on preservation of balance without participation foots etc is complicated. The impellent activity is sharply reduced, the child does not go, does not try to study jumping at all... Practically are excluded fast, large amplitude of movement by hands and legs, as they can result in loss of balance.

There is a stereotype more slow movements and less amplitude of them. The part of synergistic muscles is switched off from work and gradually will atrophy. The quantity fast muscle fibers ensuring pulse development of a large muscle efforts, decreases, as in daily life volume of fast movements is reduced. Gradually there is a formation of some deformed volume of impellent activity and accordingly, abnormal bonds of CNS. Parasitic bonds, as reaction for fear are developed. For example, the pose, in which the child can fall, results in a convulsive stressing of all muscles, the control above a body is lost etc. Thus, the part of bonds is not formed, and part of bonds - are abnormal (shaded part between curves in the field of communications(connections) ensuring movement).

Let's present, that we managed to involve reserve communications and completely to compensate destroyed neurons. For the adult who has transferred stroke, it will mean, that he should again generate small quantity of communications lost because of destruction of nervous crates, then there will come complete rehabilitation. For the child it means, that he had an opportunity normally to operate by foot, but communications ensuring, for example, walking at him still is not present. Therefore, now he should develop impellent stereotypes, which would be formed at him within the first several years of life. Thus it is necessary to mean, that at the healthy child from the moment of the first step before time of free walking passes some months, he is normal to run and to jump is trained by 3-5 years of life and the process this occurs rather actively. At this time he is in constant movement, moving in tens times more adults. The same intensity should be and impellent activity for formation of new functional system in a case, considered by us.

Consider now situation, when at once after birth by special system of trainings the child with CP (spasticity of a foot in our example) realizes necessary volume of various movements approached to volume of movements of the healthy child. It will result that despite of some absence of inherent functional communications his condition will be not worse, and most likely it is better, than the adult who has transferred stroke with consequences, considered in the given model, as due to higher ability of a brain to development (plasticity of a brain) in children's age has indemnification of the broken departments much easier. It is clear, that the later to begin to the given trainings, the more difficult is to receive significant effect, as the formation of wrong communications occurs continuously.

Thus, even without indemnification of concrete communications formed (educated) by defective sites of a brain, in a case of CP the rather fast and significant progress is possible (probable) if to know how quickly "to write down" in memory of movement, which are not forbidden by existing defect of CNS. Or by constructing process of training and trainings so that to force CNS purposefully select and to remember the necessary information.

And what with restoration the consequence of a stroke? And accordingly, with an opportunity of therapy of a source of a Cerebral Palsy?

The citation from the site http://www.stroke.org about statistics of restoration the consequence of a stroke is given below:
There's still so much we don't know about how the brain compensates for the damage caused by stroke. Some brain cells may be only temporarily damaged, not killed, and may resume functioning. In some cases, the brain can reorganize its own functioning. Sometimes, a region of the brain "takes over" for a region damaged by the stroke. Stroke survivors sometimes experience remarkable and unanticipated recoveries that can't be explained. General recovery guidelines show:
10 percent of stroke survivors recover almost completely
25 percent recover with minor impairments
40 percent experience moderate to severe impairments requiring special care

The statistics does not specify, as far as the degrees of a defeat of a brain those differ who has got in 10 % restored practically completely and 40 % with serious consequences. But it speaks that the elimination of consequences is possible. Probably it and for those 40 %, at which gross infringement.
The answer to a question, as it occurs, is possible to find in a technique of restoration the consequences of a stroke under the name "immobilization therapy".

" Immobilization therapy is a therapy in which the good arm is immobilized - that is, put in a splint, in a cast so it can't move, forcing the patient to be able to use their bad arm in various activities intensively, somewhere around six to seven hours per day for a two week period. "
(All text is on site http://www.stroke.org/rehabcast.cfm )

By that frequently have begun this method rather to describe in the various publications, it gives quite good results.

Analyzing it is possible to make some important conclusions.
- The essence of a method consists that it changes orientation of work ЦНС from search of optimum ways to adapt to life with functional by a disabled hand to the decision of a task of restoration of its functions.
- At fixing healthy hand or leg the life turns to a continuous circuit of attempts to force struck them to carry out purposeful movements, i.e., in the basic movement are carried out with use of the 4-th level - level core of a head brain (see: 4-level system managing of a movements). And it is an obligatory condition for formation of new impellent reflexes
- The method is rather intensive - 6-7 hours per day and during two weeks
- The results of therapy are caused by own efforts of the man!!!

Thus, the man consciously goes on essential complication of the life, tries with rather large difficulties to carry out probably even the elementary actions, which he with ease could do with use of a healthy hand. But is gives result!
In the example, considered by us, with spasticity of foot such man with a guarantee would get in those 10 % restored the consequences of a stroke practically completely, as the method of immobilization therapy works here automatically. If, certainly, he from the very beginning will not plant in a carriage in order to he could " more sure and faster " to move.

The child, unfortunately, on such feats is not capable. The conscious restriction is actually inaccessible to him (however, as well as many adult, which rather quickly adapt to new style of life). It simply is not interesting to him. You see for reception of result it is necessary to do hundreds same, purposeful movements. And not one day. During game - it is possible, if there was a set of such games.

In result in real life with a help of wheelchair, drugs, walkers, surgeries the vector of his development is displaced and instead of attempts to restore the generically given movements the child forces CNS most effectively to adapt to performance of tasks, required on life, with the limited opportunities. And environmental, and also the every possible technical adaptations, maximum promote him in it.

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PS
From the letter
Sent: Wednesday, March 27, 2002 11:47 AM
To: PED-PT@LISTSERV.TEMPLE.EDU
>>> Subject: CONSTRAINT-INDUCED MOVEMENT THERAPY IN CHILDREN WITH CEREBRAL PALSY
We are currently RECRUITING children with HEMIPLEGIC CEREBRAL PALSY between the ages of 4-18 YEARS to participate in a study that will test the effects of Constraint-Induced Therapy on affected hand and arm use in children with hemiplegic Cerebral Palsy. This study will be taking place in the Movement Science Program at Teachers College, Columbia University located in New York, NY. Therefore, residence in the Greater Metropolitan area is preferred.

Constraint-Induced Movement Therapy is a recent therapeutic intervention involving restraint of the "less affected" extremity and extensive functional task practice with the more affected extremity that has been developed for adults sustaining hemiplegic stroke. This intervention has been found to be extremely effective in overcoming nonuse of the more affected extremity in these patients. These results have compelled us to test the efficacy of this intervention in children with hemiplegic CP.

If you are interested or would like more information, please contact:
Jeanne Charles MSW PT, Project Manager at 212-678-3332 or
jrc44@columbia.edu