Cerebral palsy is a neurological disorder that affects movement and posture, causing activity limitation attributed to a static disturbance in the developing brain. Physiotherapy is an important part of the treatment of cerebral palsy. It can help individuals with cerebral palsy improve their motor skills and prevent movement problems from getting worse over time.
In this article, we’ll explore why physiotherapy is important for cerebral palsy and how it can help individuals with this condition.
What is cerebral palsy?
Cerebral palsy is a neurological disorder that affects movement and posture, causing activity limitation attributed to a static disturbance in the developing brain. CP is the most common motor disability in childhood, affecting about 1 in 323 children in the United States.
Causes of cerebral palsy
Cerebral palsy is caused by damage or abnormal development in the parts of the brain that control movement. The causes can be before, during, or after birth, or in the first few years of life. Some examples are infections, stroke, head injury, and low blood pressure. The exact cause is not known for many children with cerebral palsy.
Symptoms of cerebral palsy
Cerebral palsy (CP) is a group of neurological disorders affecting movement and coordination. It occurs due to damage to the developing brain, often before birth or shortly after. While the severity and specific symptoms vary greatly among individuals, there are some common signs and symptoms that can alert parents and caregivers to the possibility of CP.
- Delayed development milestones: This may include late reaching, rolling over, sitting, standing, or walking.
- Stiff or floppy muscles: This can manifest as either increased resistance to movement (spasticity) or decreased muscle tone (hypotonia).
- Tremors or involuntary movements: These may be jerky, writhing, or choreiform (dance-like).
- Feeding difficulties: This can involve problems sucking, swallowing, or coordinating tongue movements.
- Abnormal posture or gait: This may include scissoring gait, tiptoeing, or difficulty maintaining balance.
- Muscle weakness or spasticity: This can affect one or both sides of the body and can lead to difficulty with movement, coordination, and balance.
- Involuntary movements: Tremors, athetosis (slow, writhing movements), and dystonia (sustained muscle contractions) are common.
- Abnormal reflexes: Hyperreflexia (exaggerated reflexes) can cause involuntary kicking, scissoring of legs, or other reactions.
- Balance and coordination problems: This can lead to difficulty with walking, running, climbing stairs, and other activities requiring coordination.
- Speech and language difficulties: This can range from mild articulation problems to complete inability to speak.
- Sensory processing difficulties: Individuals with CP may be hypersensitive or hypersensitive to certain stimuli such as touch, sound, or light.
- Learning disabilities: This can range from mild difficulties with reading and writing to more severe intellectual disabilities.
- Vision and hearing problems: These can occur in some individuals with CP.
It is important to note that not all individuals with CP will experience all of these symptoms.
Treatment for CP is based on the child’s individual needs and may include:
- Physical therapy to help improve movement and muscle function
- Occupational therapy to help children learn to perform everyday tasks
- Speech therapy to help children develop their speech and language skills
- Medications to control seizures or other symptoms
- Surgery to improve movement or function
physical therapy helps with stress fractures
What are coordination issues in cerebral palsy?
CP arises from damage to the developing brain, affecting how the brain signals muscles to move. This can manifest in various coordination issues, including:
- Dyspraxia: Difficulty planning and executing purposeful movements
- Ataxia: Lack of balance and coordination
- Intention tremor: Shaking or trembling when attempting precise movements
How does physiotherapy help individuals with cerebral palsy?
Physiotherapy is an important part of the treatment of cerebral palsy. It can help individuals with cerebral palsy improve their motor skills and prevent movement problems from getting worse over time. Physiotherapy focuses on function, movement, and optimal use of the child’s potential and uses physical approaches to promote, maintain, and restore physical, psychological, and social well-being within all environments of the child including home, school, recreation, and community environments.
Goals of physiotherapy for cerebral palsy
The goals of physiotherapy for cerebral palsy are to improve the child’s functional abilities, prevent secondary complications, and promote participation in activities of daily living. Physiotherapists work on areas such as gross motor skills, functional mobility in the management of motor deficits, positioning, sitting, the transition from sitting to standing, walking with or without assistive devices and orthoses, wheelchair use, and transfers, using a wide range of physiotherapeutic approaches to influence the functional ability of the child.
Benefits of physiotherapy for cerebral palsy
There are several benefits to physiotherapy for cerebral palsy. First, physiotherapy can help improve the child’s motor skills and prevent movement problems from getting worse over time. Second, physiotherapy can help prevent secondary complications such as contractures, scoliosis, and pressure sores. Third, physiotherapy can help improve the child’s quality of life by promoting participation in activities of daily living.
Types of physiotherapy for cerebral palsy
There are several types of physiotherapy for cerebral palsy. Some of the most common types include:
- Neurodevelopmental treatment (NDT): This approach focuses on the child’s movement patterns and aims to improve their ability to move and function in daily life.
- Constraint-induced movement therapy (CIMT): This approach involves restricting the use of the child’s unaffected limb to encourage the use of their affected limb.
- Functional electrical stimulation (FES): This approach uses electrical impulses to stimulate the child’s muscles and improve their movement.
- Aquatic therapy: This approach involves exercises and activities in water to improve the child’s strength, flexibility, and balance.
- Orthotics: This approach involves the use of braces, splints, or other devices to support the child’s joints and improve their movement.
What to expect during a physiotherapy session for cerebral palsy?
During a physiotherapy session for cerebral palsy, you can expect the following:
- Initial assessment: The physiotherapist will conduct an initial assessment to evaluate the child’s physical abilities, including their range of motion, muscle strength, and balance. They will also assess the child’s functional abilities and identify any areas that need improvement.
- Goal setting: Based on the initial assessment, the physiotherapist will work with the child and their family to set goals for the physiotherapy sessions. These goals will be specific, measurable, achievable, relevant, and time-bound (SMART).
- Treatment plan: The physiotherapist will develop a treatment plan based on the child’s goals and needs. The treatment plan may include exercises to improve strength, flexibility, and balance, as well as activities to improve functional mobility and motor skills.
- Progress tracking: The physiotherapist will track the child’s progress throughout the treatment plan and adjust the plan as needed. They will also provide feedback to the child and their family on their progress and areas for improvement.
What is an exercise plan for cerebral palsy?
Several exercise plans for cerebral palsy can help improve motor skills and prevent movement problems from getting worse over time. The exercise plan should be tailored to the individual’s needs and abilities. Some exercises that may be included in an exercise plan for cerebral palsy include:
Upper body coordination exercises
- Finger taps: Tap each finger on a table, starting with your thumb and working your way down to your pinkie. Repeat with the other hand.
- Coin tapping: Use a coin or small object to tap on a table, alternating hands. Start slowly and gradually increase the speed.
- Buttoning and unbuttoning: Practice buttoning and unbuttoning a shirt or jacket. Use a larger button or object for easier grasping.
- Writing or drawing: Practice writing or drawing with a pencil or crayon. Start with simple shapes and lines, and gradually progress to more complex tasks.
Lower body coordination exercises
- Heel-to-toe walking: Walk a straight line, placing your heel directly in front of your toes with each step.
- Tandem walking: Walk a straight line, placing one foot directly in front of the other.
- Walking up and down stairs: Use a railing for support if needed.
- Jumping jacks: Start with small jumps and gradually increase the height and speed.
- Standing on one leg: Try to stand on one leg for as long as possible. Switch legs and repeat.
- Walking on a balance beam: Use a balance beam or a narrow line on the floor. Start slowly and hold onto a railing for support if needed.
- Using a wobble cushion: Stand on a wobble cushion and try to maintain your balance. Start with a small amount of wobble and gradually increase the difficulty.
- Yoga or tai chi: These mind-body exercises can help improve balance and coordination.
- Swimming: Swimming is a great way to exercise your whole body without putting stress on your joints.
- Horseback riding: Horseback riding can help improve balance, coordination, and core strength.
- Playing on an exercise ball: Bouncing on an exercise ball can help improve balance and coordination.
Physiotherapy is an important part of the treatment of cerebral palsy. It can help individuals with cerebral palsy improve their motor skills and prevent movement problems from getting worse over time. By understanding the benefits of physiotherapy for cerebral palsy and what to expect during a physiotherapy session, individuals with cerebral palsy can take an active role in their treatment and improve their quality of life.
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