Cerebral Palsy (CP) is now a widely used diagnosis given to many children. It is a term that can cover a wide spectrum of varying degrees of disability-it may include a mild impairment that only minimally affects a child’s everyday function, or a child may present with full body involvement and use a wheelchair as their permanent mobility. Obviously a blog post couldn’t possibly cover such a complex subject, but I’ve written this basic guide as a start….:
So what does CP actually mean? It is widely accepted that CP refers to a non-progressive, neurological disorder that is caused by a brain injury or developmental malformation of the brain. It is primarily a motor function disorder that affects muscle movements, posture and co-ordination. This can obviously present in many different ways and each individual is unique.
So to simplify that further…CP affects the way an individual can move and control some of their muscles. This can be often due to fluctuations in the tone of their muscles. Tone (in a basic explanation) refers to the amount of resistance that occurs when you try to move a limb or muscle. For most people with normal muscle tone, when relaxed, someone could easily bend their elbow so that their hand is close to their shoulder. This is because in a relaxed state the main muscles around our joints are not rigid so can be passively moved (moved by someone else). For a child with CP this may be slightly different: they may have high tone (hypertonia or spasticity) which would mean there is excessive resistance to any movement of certain muscles. They could also have some muscles which are low tone (hypotonic) and appear more “floppy” than you would expect. This will then affect their ability to move and control any of these muscles groups.
Cerebral Palsy is often broken down and classified even further, depending on how or where a child is affected. For example, if CP only affects one side, it can be referred to as being hemiplegic CP. If only the lower limbs are affected, this is known as diplegic CP and if all 4 limbs are affected quadriplegic CP. These all involve some degree of high tone (spasticity). There are also children who have CP that have lots of unwanted movements. This can generally be classed as either athetoid CP, where the child has constant unwanted movements, even when trying to sit still, or ataxic CP, which involves poorly controlled and co-ordinated or awkward movements. However, like many disorders, it is not easily “labelled” and even within each classification, every child will present very differently.
From a physiotherapy perspective, a full assessment can provide us with vital information about which main muscle groups are most affected. Rigid, high tone muscles can often lead to joints becoming stiff and even having reduced range of movement, which then affects function further. Unwanted movements and/or low tone can make mobility and simple tasks such a sitting on a school chair very difficult. It is our job to try to help a child to fulfil their full potential and to minimise any limits to their everyday function. Plus the key is…to make therapy FUN for every child. That way they don’t even realise that they are working hard!
If you would like more information, or think that Therapy Stars can help your child, please contact me on firstname.lastname@example.org or 07813764938.