Cerebral Palsy PEDS
What is Cerebral Palsy ?
Cerebral Palsy is a group of congenital neurologic disorders (Meaning from birth and involving the nervous system), which affects the muscle tone, and coordination of movement, balance, and posture. Breaking down the name gives us more insight into this condition, as cerebral means related to the brain, and palsy means weakness. CP- is the most common motor disability among children as approximately 1 in 343 kids has CP. It is more common in males versus females, and is typically caused by damage to the brain as it is developing or during birth.
The name Cerebral Palsy is an umbrella term, meaning that it refers to a group of symptoms and disabilities. Individuals who are affected with CP will experience an array of symptoms that can range from minor to severe disability. That is to say that every person with CP will have their own unique experience and individual presentation of symptoms.
There are four classifications of CP: Spastic, Dyskinetic, Ataxic, and Mixed.
- Most common and affects approximately 75% of people with a diagnosis of CP (80% of children with CP)
- Marked by increased muscle tone
- Can affect one or both upper extremities, lower extremities, and/or trunk
- Delayed developmental milestones (Especially with gross motor movements)
- Abnormal movement and difficulties controlling muscle movement
- Movement inhibition and difficulties changing positions
- Stiff and spastic muscles
- The second most common form
- Dystonia (Involuntary muscle contractions that causes repetitive and twisting movements)
- Athetosis (Involuntary writhing movements)
- Chorea (Quick and unpredictable movement)
- Decreased postural control
- Painful movement
- Difficulty swallowing or talking
Ataxic CP is the least common and causes of tremors, balance abnormalities, poor coordination, and depth perception.
Mixed CP occurs when a person exhibits symptoms that are characteristic of two or three of the different types. The most common type of mixed CP is spastic-dyskinesia.
How Is Cerebral Palsy Diagnosed?
Cerebral Palsy requires a medical diagnosis by a Pediatrician, or a specialist and is confirmed with brain imaging. However, it is commonly first noticed when a parent or caretaker notices developmental delays. During an evaluation, the healthcare provider will request for a complete medical history and will ask questions about pregnancy and birth, developmental milestones, fine and gross motor skills, speech, and comprehension, among other things. The physical or objective examination will include a thorough neurological examination and assessment for improper muscle tone, abnormal reflexes, stiff or involuntary motions, poor coordination, difficulty with postural control and/or balance, decreased independence and difficulty with movement and transfers, muscle weakness, impaired fine motor control, and impaired oral motor function. Not every individual with CP will exhibit all of these symptoms, but the presence of some or all of them, with no other identifiable cause, may warrant a doctor to investigate further for the possibility of CP. An individual’s specific symptoms will be dependent on the type of CP that they have and what muscle groups are affected.
Individuals with CP will commonly have other conditions such as:
- Epilepsy or seizure disorders
- Learning disabilities
- Cognitive impairments
- Hearing, vision, or speech impairments
- Feeding problems or nutritional deficiencies
- Emotional and behavioral challenges
- Sleep disorders.
How can a Therapist Help with Cerebral Palsy?
A Physical Therapist can help improve the overall quality of life for individuals with CP by managing their symptoms and preventing a secondary conditions from developing, or worsening. Physical therapy treatment and symptom management would include:
- Pain reduction through manual techniques
- Passive range of motion to maintain or improve joint health
- Strengthening of weak muscles to improve tone
- Stretching of tight muscles to improve flexibility
- Increasing mobility and independence with movement
- Balance training
- Coordination and motor control
- Functional strengthening specific to desired tasks
- Aquatic therapy
Physical Therapists can also assist individuals with CP by performing specific movement assessments and assessing their need for adaptive equipment. This may be performed in a physical therapy clinic or in a person’s home. A home evaluation may be performed to assess the safety and conduciveness of an individual’s environment.
The frequency or type of treatment for an individual with CP may vary over time in order to accommodate any changes in their condition or abilities. Long-term treatment will include physical and other therapies, medications, and sometimes surgery. It is important to remember that although, there is currently no cure for CP, it is not progressive and proper physical therapy treatment can significantly improve symptoms and quality of life. Early intervention and good medical care are very important for optimal outcomes, especially for those with severe forms.
Other therapies that can be beneficial for individuals with CP include:
- Occupational Therapy
- Speech Therapy
- Hippo therapy
- Music/Art Therapy
- Behavioral Therapy
- Bowel/Bladder Programs.
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