Cerebral Palsy and How Physiotherapists Can Make a Difference
About Cerebral Palsy
Cerebral Palsy is a permanent disorder that impacts an individual’s ability to move due to a lack of muscle control and coordination. This condition often occurs during pregnancy or shortly after birth. C.P. does not worsen over time, instead the symptoms can be improved.
- The term cerebral palsy, broken down means brain and lack of muscle control.
Types:
Cerebral Palsy is categorised by the main movement disorder someone has. It is common for an individual to fall under one or more of these categories.
1. Spasticity: The most common type, it’s characteristics include stiffness and exaggerated reflexes. Also appears to have weakness or paralysis of the body.
2. Dyskinetic: Characterised by difficulty in controlling voluntary movement.
3. Ataxic: Characterised by difficulty maintaining balance and coordination.
Causes
- Injury to the developing brain of a foetus during pregnancy
- Infection during pregnancy such as Rubella or Zika virus
- Genetic mutations
- Internal bleeding
- Stroke
- Damage to the brain’s movement control centre (white matter)
- Traumatic brain injuries
Diagnosis
Children around 1-2 years old and often younger can be diagnosed with C.P. by a General Practitioner or Paediatrician. When children go for regular check ups symptoms can be monitored to ensure the child is developing at the rate they should and hitting all necessary milestones.
- Further clarification can be made by conducting brain scans to identify any injury to the grey or white matter.
Symptoms
- Lack of muscle coordination
- Decreased muscle tone
- Poor balance and difficulty maintaining posture
- Difficulty with fine motor skills such as using utensils, holding a pen, and buttoning shirt
- Limited range of motion
- Stiff muscles
- Tremors
Signs
- First 3-6 months post birth: floppy or rigid limbs, head falls back when being picked up, stiff or crossed legs.
- 6-9 months: unable to roll over, doesn’t bring both hands together, reaching out with one hand.
- 10+ months: scooting on bottom or knees, unable to crawl or a lopsided crawl, favouring one side.
Treatment
- Improve daily function
- Early intervention results in better management of symptoms as neuroplasticity can be optimised when the child is developing.
- It requires a whole team of health professionals including Doctors, O.T, Speech Pathologists, Support Workers, and Dietitians.
What can Physios Do?
- Increase Strength: Using body weight or dumbbells to increase the strength of upper and lower limbs to make daily tasks easier.
- Increase Range of motion: Encouraging movement in joints and muscles to alleviate stiffness.
- Gait Training: Focusing on having a proper walking cycle, targeting any adaptive strategies and practice walking independently.
- Improve Functional Mobility: Sit to stand, bed mobility, crawling and stairs.
- Target Balance and Coordination: Training how to control posture and maintain balance for daily activities such as walking and reaching.
- Education on assistive devices, pain management, hydrotherapy and other.
