26/11/2022
Cerebral Palsy
Cerebral palsy (CP) is a disorder of movement and posture that appears during infancy or early childhood resulting from permanent and non-progressive damage to the developing brain. It is characterized by deficits in muscle movement, coordination, and balance. In many cases, hearing, vision, and sensation are also affected. This condition is the most common motor disability in childhood and the prevalence is about 1-5/1000 babies.
Signs and symptoms
The symptoms vary among individuals and range from mild to severe. Some of the signs and symptoms include
• Lack of coordination or ataxia
• Muscle stiffness or spasticity
• Delays in motor milestone
• Abnormal muscle tone
• Difficulty speaking
• Difficulty walking
• Involuntary movements
• Excessive drooling and difficulty swallowing
• Intellectual disabilities and so on
Classification of cerebral palsy
Cerebral palsy can be classified into 3 major categories, namely:
• Spastic CP
• Dyskinetic CP
• Ataxic CP
Risk Factors
There are different risk factors for developing cerebral palsy. These include
• Prematurity
• Maternal infection
• Trauma
• Placenta insufficiency
• Neonatal hyperbilirubinemia
• Birth asphyxia
• Central nervous system infection
Diagnosis
The diagnosis is carried out by taking a complete medical history, performing a physical exam that includes a detailed neurological exam, and evaluating the symptoms. The classification of gross motor, fine motor, and communication will help medical professionals to better understand the abilities of the child and what to focus on for interventions.
Treatment
The goal of treatment is to improve limitations and prevent complications. The treatment includes assistive aids, medications, physical therapy, and surgery.
Physiotherapy management
The goal of physiotherapy is to improve mobility, prevent deformity, teach daily living skills, and educate the parent.
Methods of physiotherapy
• Active and passive ROM exercises, weight-bearing exercises, and positioning to maintain soft tissue length and joint integrity
• Cryotherapy is used as an adjunct to reduce spasticity. Ice is also used with static stretch to overcome hyperactive stretch reflexes
• Bobath Neurodevelopmental Therapy is an approach to normalize muscle tone, inhibit abnormal primitive reflexes, and stimulate normal muscle movement.
• Bracing can be used to stabilize the trunk and extremities, improve function, keep joints in a functional position, and facilitate selective motor control.
• Mobility aids such as standers and walkers are used to train standing and walking, as well as improve posture.
