A physiotherapist can develop patient specific training programs to optimize postural control, in order to increase balance and safety. To protect against postural asymmetries the use of supportive and protective devices may be necessary. Physical therapists might use neuromuscular/sensory stimulation techniques such as quick stretch, resistance, joint approximation, and tapping to increase tone by facilitating or enhancing muscle contraction in patients with hypotonia. For patients who demonstrate muscle weakness in addition to hypotonia strengthening exercises that do not overload the muscles are indicated. Electrical Muscle Stimulation, also known as Neuromuscular Electrical Stimulation (NMES) can also be used to “activate hypotonic muscles, improve strength, and generate movement in paralyzed limbs while preventing disuse atrophy (p.498).”  When using NMES it is important to have the patient focus on attempting to contract the muscle(s) being stimulated. Without such concentration on movement attempts, carryover to volitional movement is not feasible. NMES should ideally be combined with functional training activities to improve outcomes. Occupational therapy can assist the patient with increasing independence with daily tasks through improvement of motor skills, strength, and functional endurance. Speech-language therapy can help with any breathing, speech, and/or swallowing difficulties the patient may be having. Therapy for infants and young children may also include sensory stimulation programs. A physical therapist may recommend an ankle/foot orthosis to help the patient compensate for weak lower leg muscles. Toddlers and children with speech difficulties may benefit greatly by using sign language.
Screening
Although the chance of having kids with CHB in anti Ro/La positive mothers is relatively low (1-5%), it is recommended that all mothers with autoimmune disease to be screened and seek consultation when decide to get pregnant.For mothers with at least one CHB-affected pregnancy, with 16 - 18% recurrence chance for the directly following pregnancy and an overall 9% chance in following ones, monitoring both the mother and the fetus is crucial. Treatment
Due to the rarity of this disease, there is a lack of comprehensive and high quality research about the different treatment options, and therefore, no specific treatment plan is followed globally. However, some studies have attempted to outline the most widely accepted approaches in dealing with CHB. Fluorinated steroids
There is no agreement on using fluorinated steroids in treating CHB, and the results of the different studies are contradictory. These steroids (such as dexamethasone) are used when the disease is diagnosed in utero as they can cross the placenta without being deactivated. The main goal of using corticosteroids is to mitigate the inflammation by decreasing the amount of anti Ro/La autoantibodies in the fetal serum. Therefore, they are used in the autoimmune-mediated CHB. Both the mother and the fetus might suffer from their side effects which can include growth problems and adrenal insufficiency. Beta-adrenergic agonist
Trebutaline and Sulbutamol are among the medications that have been used to treat CHB. They are used mainly to increase the heart rate in fetuses suffering from bradycardia. Although they showed positive results, some patients showed intolerance to their side effects.