Physiotherapy for Cerebral Palsy - An overview

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Understanding Cerebral Palsy

• Cerebral Palsy (CP) is an umbrella term that
  defines a group of disorders that impacts
  coordination, movement, muscle strength, and
  gait. It is caused by abnormal brain development
  or irreparable damage to the immature and
  developing brain (during pregnancy or shortly
  after birth).
• CP can affect the whole body, be limited to one
  or two limbs, or one side of the body. CP is not
  a degenerative disorder. This means its symptoms
  will not get worse with time. However, timely
  diagnosis and immediate treatment can better the
  persons ability to be as independently mobile as
  possible.

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How does Cerebral Palsy affect mobility?

• CP affects that part of the brain that is
  responsible for muscle movement. It can lead to
  flaccid muscles, poor motor coordination,
  impaired reflexes, impaired balance, incorrect
  posture, involuntary movements, etc. The extent
  of mobility issues depends on the type of CP.

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The Gross Motor Function Classification System
(GMFCS)

• The Gross Motor Function Classification System
  (GMFCS) is a system of classifying the severity
  of CP that further helps in describing the
  individuals abilities and challenges when it
  comes to mobility. The GMFCS has ascertained the
  five levels of mobility as follows
• Level 1 Walking without limitations
• Level 2 Walking with some limitations
• Level 3 Walking with the help of assistive
  devices like cane or a walker
• Level 4 Mobility with self-operated wheelchair
• Level 5 Mobility with wheelchair operated by
  another person
• In order to evaluate the degree of difficulty in
  mobility, the above classification can help
  greatly.

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Benefits of physiotherapy for Cerebral Palsy

• Physical therapy will help
• Reduce muscle contractures
• Improve strength and flexibility
• Better coordination and sense of balance
• Increase flexibility
• Physical therapy introduced early can also avoid
  many bone and joint deformities, as well as help
  children become more independent. It will also
  help them improve their social and communication
  skills, participate better at home and school,
  and boost their psychological well-being.

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Benefits of physiotherapy for Cerebral Palsy

• Physiotherapy can be tailored to suit the
  individual needs of the child and based on the
  type of CP they have been diagnosed with. It can
  benefit different types of CP in different ways,
  like
• SPASTIC CEREBRAL PALSY Reduce muscle tension and
  jerky movements relieve stiffness (through
  stretching)
• ATHETOID CEREBRAL PALSY Increase muscle tone,
  gain control over voluntary movements
• ATAXIC CEREBRAL PALSY Improve gait, balance, and
  mobility
• Physiotherapy has also proved to be beneficial
  for other symptoms of CP like scoliosis, lumbar
  lordosis, knee/hand deformities, pelvic
  inclination, and shortened Achilles tendon.

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Types of physiotherapy for Cerebral Palsy

• Exercise, stretching, special equipment, and
  muscle relaxation techniques are all part of
  physiotherapy for Cerebral Palsy that address
  specific needs and limitations.
• Lets take a look at some of the most prescribed
  physiotherapy activities
• Passive stretching eases soft tissue tightness,
  relieves spasticity, enables easier walking,
  enhances range of motion
• Manual stretching use full body weight to induce
  a good stretch can help overcome hypertonia
• Weight-bearing exercises targets tight muscles
  in the lower body
• Splints improves resting posture, reduces
  spasticity, improves flexibility enables
  long-duration, low-force stretching
• Static weight-bearing exercises uses devices
  like tilt-tables and standing frames to guide
  children through load-bearing activities
  improves muscle tone and strength

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Types of physiotherapy for Cerebral Palsy

• Functional exercises combination of aerobics and
  strength training to improve functionality and
  fitness in children who can walk
• Apart from being beneficial, these kinds of
  activities, like static biking, plyometric
  exercises are thoroughly enjoyed by children.
• Bimanual training improves coordination of the
  upper body through play and functional activities
  that employ both arms

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Types of physiotherapy for Cerebral Palsy

• Body weight supported treadmill training
  develops stepping reflex that is essential for
  regular perambulation
• Electric stimulation improves muscle strength
  and nerve function through stimulation these are
  safe and non-invasive techniques can be done at
  home (guided by the therapist)
• Massage therapy relaxes muscles and gives the
  child a break from physical strain also helps
  with pain relief

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Things parents and caregivers should keep in mind

• 1. Choose a physiotherapist who has worked with
  children who have CP
• 2. Cover slippery floors and remove sharp objects
  from to make a safe environment for your child
• 3. Start slow with new exercises and equipment,
  gradually increase intensity
• 4. Use assistive devices like brace, guard rails,
  anti-slip gloves, etc. wherever necessary
• 5. Always supervise therapy sessions.
• 6. Encourage your little one to speak up if
  theyre uncomfortable. Stop the exercise
  immediately if theres any pain or discomfort.
• 7. Ensure you have a stretching routine before
  beginning physical therapy.
• 8. Encourage and motivate small wins.
• 9. Speak with your doctor about corrective
  surgeries that could fix bone or joint
  deformities.

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Play is a childs work

• Children learn through play too. You do not have
  to always follow an exercise program, per se. You
  can incorporate physical activity into your
  childs daily routine through simple play and
  games.

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Treatment and care

• At Plexus, we offer the best treatment for CP
  through our rehabilitation program that helps
  children learn suitable coping mechanisms, and
  live their best lives. The earlier a
  rehabilitation program begins, the greater the
  physical, cognitive, and psychological benefits
  will be
• Treatment for CP includes
• Physiotherapy
• Occupational therapy
• Speech and language therapy
• Cognitive therapy
• Developmental therapy
• Reflex integration therapy
• Early intervention therapy
• Postural training
• Gait training
• Activities for daily living training

• Pre-academic skills training
• Hand function training
• Stem cell therapy
• Medication and/or surgery
• Mirror therapy
• Contracture release therapy
• Constraint-induced movement therapy
• Corrective splinting
• Mobility aids