Cerebral Palsy (CP)-what does it mean?

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 info@therapystars.co.uk or 07813764938.

 

Baby walkers-why don’t physiotherapists like them?

Lots of parents choose to put their baby into a baby walker. These activity centre style walkers tend to be advertised as being for babies as young as 6 months old and are often marketed to parents as a way of encouraging a child’s mobility. So….why don’t paediatric physiotherapists recommend them?

A baby in a baby walker

An example of a baby walker activity centre.

 

There are 2 main reasons why we would not recommend a baby walker: The first is due to safety and the second because of development.

Safety: Any parent’s first priority is to keep their child safe. However every year there are many reports of babies being injured whilst in a baby walker. These accidents include trapping arms/legs, head injuries and burns/scalds. Some studies have shown that just under half of the babies that are put into a baby walker will experience some form of injury whilst using it. If you do use or decide to use a walker, never leave your child unattended.

Development: A baby will walk when a baby is developmentally ready. In order to get to the point of walking, a baby has to learn so many other things. The timescales for a baby to walk will also depend on their body shape, motivation, personality and many other factors.

Various studies carried out have shown that not only do baby walkers NOT encourage a child’s development but they can actually cause a delay in a baby’s motor development milestones. Spending lots of time in a walker limits the amount of time spent in other positions like lying on the floor. Here your baby will learn skills that are crucial to their motor development like rolling, sitting and using their arms and hands to lean on. Walkers also alter a baby’s ability to see their legs and feet. At such a young age babies are learning where their bodies parts are, relative to themselves and to their environment…again a skill that is essential for a developing baby. There is also evidence that suggests that the use of baby walkers can cause a child to walk on their toes. This may be because their muscles and joints are not ready to take their own body weight at such a young age. The toe walking may also continue once your child is walking independently.

It is for these reasons that baby walkers are not recommended. However if you do decide to use one with your baby, the APCP (Association of Paediatric Chartered Physiotherapists) have published a parent leaflet that advises that your child is ALWAYS under close supervision and that they use a walker for no longer than 20 minutes at a time. Also ensure your child’s feet are flat on the floor, not up on their toes. This can be found at http://apcp.csp.org.uk/publications/parent-leaflets

If you require any further advice or information about the use of baby walkers or your baby’s development, please contact Therapy Stars on 07813 764938 or info@therapystars.co.uk

 

Why is “Tummy Time” important?

Those of you who have recently had a baby or have young children have probably heard about “Tummy Time”. This is where you are told to encourage your baby to spend time playing or lying on their front. But why…?

Evidence has now shown that the safest position for our babies to sleep in is on their back. This is to reduce the risk of Sudden Infant Death Syndrome (SIDS) or cot death. However it is still vitally important for developing babies to spend quality time on their tummies. If a baby is always on their back, they not only miss out on a different perspective of the world, but they may develop flat spots or changes of head shape and/or poor development of their motor skills.

When a baby is positioned on their front, they are encouraged to lift their head and therefore strengthen their back and neck muscles. They also go on to learn to turn their heads from side to side in reaction to what is going on around them. As they get older and stronger, they then start to use their arms to lean on, and strengthen the muscles around their shoulders. This all helps as your baby continues to develop and learn new skills. These muscles are then used as your baby learns to roll, sit, crawl and walk.

You can start to position your baby on their front from birth, but many wait for the first few weeks due to the umbilical cord stump. But once this has come away, your baby needs to start to experience “Tummy Time”. The easiest way to start may be to position your baby tummy down but on your front. This way you can feel that you can monitor them closely. Many babies will find the position hard work, especially at first, so little and often is usually the key! There is no set time so do what works for your baby.

Please remember that the accepted advice is now that babies should only be place on their tummies when awake and supervised. It is not advised for your baby to sleep on their fronts.

If you have any concerns about your baby, or need any advice regarding “Tummy Time” please feel free to contact us on info@therapystars.co.uk or Sian on 07813 764938.

Prone

What is Paediatric Physiotherapy?

Therapy-Stars-header-logoTherapy Stars offers Paediatric Physiotherapy…but what is it?

Paediatric physiotherapists are physiotherapists who have experience and training to specifically treat children and teenagers. All physiotherapists have general training during their degree, and can then specialise in different areas, dependent on their interests, experience and developing skills.

Physiotherapists who work with children can be found in hospitals, in the community and in private practice. They can help children with a variety of symptoms, injuries, conditions and illnesses.

Paediatric physiotherapists will have a solid understanding of child development and growth, as this is a major difference between treating adults and children. They will also have knowledge of treatment methods that aim to maximise a child’s function and potential, whilst appreciating that childhood is a time for fun and enjoyment.

If you are unsure if your child may benefit from paediatric physiotherapy, please contact us at info@therapystars.co.uk or Sian on 07813 764938.