IPLin

... life with Individual Physical Loading Inc

Print E-mail

Published in Cerebral Palsy

Social sharing

Cerebral Palsy

The term cerebral palsy refers to any one of a number of neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination but don’t worsen over time. Even though cerebral palsy affects muscle movement, it isn’t caused by problems in the muscles or nerves. It is caused by abnormalities in parts of the brain that control muscle movements. The majority of children with cerebral palsy are born with it, although it may not be detected until months or years later. The early signs of cerebral palsy usually appear before a child reaches 3 years of age. The most common are a lack of muscle coordination when performing voluntary movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes, a crouched gait, or a “scissored” gait; and muscle tone that is either too stiff or too floppy. A small number of children have cerebral palsy as the result of brain damage in the first few months or years of life, brain infections such as bacterial meningitis or viral encephalitis, or head injury from a motor vehicle accident, a fall, or child abuse.

Cerebral Palsy Symptoms

The signs of cerebral palsy are usually not noticeable in early infancy but become more obvious as the child’s nervous system matures. Early signs include the following:

· Delayed milestones such as controlling head, rolling over, reaching with one hand, sitting without support, crawling, or walking

· Persistence of “infantile” or “primitive” reflexes, which normally disappear 3-6 months after birth

· Developing handedness before age 18 months: This indicates weakness or abnormal muscle tone on one side, which may be an early sign of CP.

Problems and disabilities related to CP range from very mild to very severe. Their severity is related to the severity of the brain damage. They may be very subtle, noticeable only to medical professionals, or may be obvious to the parents and other caregivers.

· Abnormal muscle tone: Muscles may be very stiff (spastic) or unusually relaxed and “floppy.” Limbs may be held in unusual or awkward positions. For example, spasticleg muscles may cause legs to cross in a scissor-like position.

· Abnormal movements: Movements may be unusually jerky or abrupt, or slow and writhing. They may appear uncontrolled or without purpose.

· Skeletal deformities: People who have cerebral palsy on only one side may have shortened limbs on the affected side. If not corrected by surgery or a device, this can lead to tilting of the pelvic bones and scoliosis (curvature of the spine).

· Joint contractures: People with spastic cerebral palsy may develop severe stiffening of the joints because of unequal pressures on the joints exerted by muscles of differing tone or strength.

· Mental retardation: Some, although not all, children with cerebral palsy are affected by mental retardation. Generally, the more severe the retardation, the more severe the disability overall.

· Seizures: About one third of people with cerebral palsy have seizures. Seizures may appear early in life or years after the brain damage that causes cerebral palsy. The physical signs of a seizure may be partly masked by the abnormal movements of a person with cerebral palsy.

· Speech problems: Speech is partly controlled by movements of muscles of the tongue, mouth, and throat. Some individuals with cerebral palsy are unable to control these muscles and thus cannot speak normally.

· Swallowing problems: Swallowing is a very complex function that requires precise interaction of many groups of muscles. People with cerebral palsy who are unable to control these muscles will have problems sucking, eating, drinking, and controlling their saliva. They may drool. An even greater risk isaspiration, the inhalation into the lungs of food or fluids from the mouth ornose. This can cause infection or even suffocation.

· Hearing loss: Partial hearing loss is not unusual in people with cerebral palsy. The child may not respond to sounds or may have delayed speech.

· Vision problems: Three quarters of people with cerebral palsy havestrabismus, which is the turning in or out of one eye. This is due to weakness of the muscles that control eye movement. These people are often nearsighted. If not corrected, strabismus can lead to more severe vision problems over time.

· Dental problems: People with cerebral palsy tend to have more cavities than usual. This results from both defects in tooth enamel and difficulties brushing the teeth.

· Bowel and/or bladder control problems: These are caused by lack of muscle control.

Physical Therapy

Physical therapy is one of the most important aspects of cerebral palsy therapy. The referral to the physical therapist is often the first referral made in a cerebral palsied child’s treatment and is usually started soon after a diagnosis of cerebral palsy is made. Physical therapy consists of activities and education to improve flexibility, strength, mobility, and function. A physical therapist also designs, modifies, and orders adaptive equipment. Physical therapy may be carried out in clinics, hospitals, and schools -- and through a home exercise program. Physical therapy will not be successful without an ongoing daily home program.

Aquatic-based rehabilitation uses the physical properties of water to resist or assist in the performance of exercises. Cerebral palsy patients experience muscle shortening in most of their involved extremities and it becomes a difficult task to lengthen the affected musculature with regular stretching while having to deal with the affects that gravity has on the spastic arm or leg. In the past, there was clinical prejudice against strengthening activities for this population. However, recent research findings are revealing that children with cerebral palsy can benefit from strengthening programs and that strength is directly related to motor function. Some of the documented benefits are optimization of neuromuscular responses, improved motor unit contraction synchrony and facilitation of maximal muscle contraction along a joint's available range of motion.

Physical therapy for cerebral palsy patients does not cure spasticity but can improve impairments and limitations. Physical therapy for cerebral palsy patients is an important step towards an independent lifestyle. If these changes happen only in the therapy gym, the disability remains unchanged. Therapy must improve abilities to perform meaningful tasks in everyday life. Changing the level of disability is the ultimate goal of physical therapy for cerebral palsy