Cerebral palsy (CP) is a disorder that affects; muscle tone, movement, and motor skills (the ability to move in a coordinated and purposeful way). Cerebral palsy is one of the most common congenital (existing at or before birth) disorders of childhood.
Brain damage that happens before or during a baby birth usually causes CP. Or may occur during the first 3 to 5 years of a child’s life. This brain damage also can lead to other health issues, including vision, hearing, and speech problems; and learning disabilities.
Benefits of Physical Therapy for Cerebral Palsy
Beginning physical therapy as early as possible usually gives children the best chances at improvement.
There are many benefits of physical therapy, from improving mobility to preventing future issues such as contractures and joint dislocations by keeping the body strong and flexible. However Many children with CP increase their level of self-reliance through physical therapy.
The main goal of physical therapy is to make everyday movements easier for children with cerebral palsy.
Physical therapy can improve:
- Coordination
- Balance
- Strength
- Flexibility
- Endurance
- Pain management
- Posture
- Gait
- Overall health
Benefits Of Cerebral Palsy
The types of exercises used vary and have specific benefits for each types of cerebral palsy. Some of the benefits by cerebral palsy type include:
- spastic cerebral palsy — causes stiffness and movement difficulties . However Physical therapy can reduce the muscle tension and jerky movements associated with spastic cerebral palsy. Exercises such as stretching can even relieve stiffness over time
- athetoid cerebral palsy — leads to involuntary and uncontrolled movements . However people with athetoid cerebral palsy use physical therapy to increase muscle tone and gain more control over their movements.
- ataxic cerebral palsy — causes a problem with balance and depth perception. But there are exercises that can improve balance problems faced by those with ataxic cerebral palsy.
Physical Therapist
Physical therapists also tailor treatment based on the location of movement issues. However movement issues in children with cerebral palsy can be limited to one half of the body (hemiplegia), the legs (diplegia) or in the torso and all four limbs (quadriplegia). Therefore therapists prescribe special exercises and routines for hemiplegia, diplegia and quadriplegia that may help the child regain movement in the affected area over time.
Physical therapy can also treat a range of other issues experienced by children with CP, including:
- Scoliosis – an abnormal curvature in the spine, common in up to 30 percent of children with cerebral palsy
- Lumbar lordosis – a contortion of the lower spine
- Pelvic inclination – a protrusion of the pelvis either in the front or rear
- Thoracic kyphosis – a contortion of the upper spine
- Pelvic rotation – a horizontal contortion of the pelvis
- Pelvic obliquity – a contortion of the pelvis at angle
- Knee deformity- Pelvic deformities that causes abnormally straight or bent knees.
- Shortened Achilles tendon – a shortened tendon that causes issues with walking and standing
- Hand and wrist deformities – abnormal flexing in the hand and wrist that prevents development of fine motor skills
What to Expect in Physical Therapy
Physical therapy is different for every child with cerebral palsy. Firstly, the therapist has to evaluate the child’s movement problems to create a treatment plan. Then, generally, a combination of exercises, muscle relaxing techniques and special equipment is used to improve movement. The degree to which physical therapy can improve a child’s specific issues depends on the severity of the condition.
Exercises
Exercises for cerebral palsy are geared toward treating either high or low muscle tone. High muscle tone causes stiffness and spasticity, whereas low muscle tone causes too much flexibility and weakness.
Improving muscle tone
Flexibility exercises and massages are often used for children with spastic cerebral palsy; these exercises not only help improve mobility, but also can prevent painful muscle tightening that could require surgical correction. Strength training exercises are used to increase muscle tone in children with athetoid cerebral palsy.
Assisting posture and walking
Special exercises are also used to help with walking, posture, transitional movements and sensory impairments like touch and balance. Exercises that emphasize sitting, knealing, and standing improves posture. Transitional movements are those used by infants that lead to walking, such as rolling over and sitting up.
Equipment
Physical therapists use a range of mobility aids to make therapy more effective. Braces, casts, splints and shoe inserts are types of orthotic equipment used to help with walking, posture and joint mobility.
Physical therapy also often includes the following tools:
- Exercise balls
- Resistance bands
- Free weights
- Swimming pools
- Hot and cold packs
- Electric muscle stimulation
In some cases, electric stimulation is used to improve gait and upper limb function. This therapy uses small electrodes to stimulate certain muscles.
Physical Therapy by Age
As children get older, their physical therapy needs change. Physical therapists have to adjust and adapt treatments at different stages in development. The most important stages are when the child is a toddler and in the early school years.
- Toddlers – Therapy for toddlers tends to focus on playtime. Children in early developmental stages learn and experience a lot through play, making it an important aspect of early therapy. Toddlers with CP are often reluctant to touch their face or practice certain movements that are necessary for learning and physical development. A therapist can help children overcome this reluctance.
- Young children – During school age, roughly ages 5 to 12, children with cerebral palsy experience new movement issues in part because their bodies are growing. Physical therapy can help ensure children grow in a way that is conducive to their motor function. Exercises and orthotics are most commonly used at this age. Therapy also helps instill healthy habits and a proactive mindset.
Finding a Physical Therapist
Parents looking for a therapist need to find someone who has experience treating children with cerebral palsy. Physical therapists with experience treating CP understand the unique needs of these children and can tailor an individualized treatment regimen.
Physical therapists use observation and a series of standardized tests to measure motor function. They look for specific postures and movements that could be corrected, and develop a physical therapy plan for your child. It can be hard to find a physical therapist that has experience treating children with cerebral palsy. However, parents should never settle for an inexperienced therapist.
Jemimah Kamau
Physical Therapist
C & P Health Centre
