Cerebral palsy
Cerebral palsy (CP) refers to a group of disorders that affect muscle movement & coordination. In many cases, like vision, hearing, and sensation are also mostly affected.
The word “cerebral” says having to do with the brain. The word “palsy” denote weakness or problems with body movement.
Cerebral palsy is the most common cause of motor disabilities in childhood. According to the Centers for Disease Control and Prevention (CDC)Trusted Source, it affects at least 1.5 to 4 out of every 1,000 children worldwide.
How physiotherapy helps in cerebal palsy
Cerebral palsy is a term used to describe motor disability which is non – progressive and is caused by damage to brain at or around the birth. It is kind of incomplete form of brain paralysis. In cerebral palsy not whole brain is damaged , only some parts of it mainly those who controls movements are affected. The normal milestones of child are not achieved by the child during development period of life.
The main causes of cerebral palsy before birth includes problems such as diabetes , infection such as rubella , cytomegalovirus to the mother during her pregnancy , lack of oxygen in fetal brain , premature delivery , abnormal fetal position. Causes at the time of birth includes brain injuries, prematurity and forcep delivery. Postnatal causes includes jaundice, brain infection, head injuries, poisoning, brain tumour, blood clot in brain.
There are mainly four types of cerebral palsy
- Spastic
- Athetoid
- Ataxic
- Mixed type
Mainly a cerebral palsy affected child shows followings symptoms
- Floppy child
- slow movements
- feeding problem such as difficulties in sucking , swallowing and chewing
- communication difficulties
- speech defects
- mentally slow
- Vision and hearing difficulties
- Deformities such as lack of movements
- Overweight
- Tremors or involuntary movements
- Seizures
- Learning difficulties
- Slow, writing movements
- Mental health conditions
Risk factors for Cerebral palsy
- Breech birth
- low birth baby
- Premature birth
- Rh incompatibility
- being twin or triplet
Medical management
Medical management is necessary to diminish some symptoms of cerebral palsy.
- Diazepam
- Baclofen
- Botox toxins
- carbamazepine ( tegretol)
- glycopyrrolate ( robinul)
A physiotherapist plays an vital role in the treatment of cerebral palsy patient that usually begins soon after diagnosis . Some patients start taking physiotherapy sessions before diagnosis on the basis of their symptoms. Physiotherapy includes various methods of treatment that helps cerebral palsy child to live a normal life said by Dr Harmanpreet kaur PT on the world cerebral palsy day on 6-oct. which includes
- Phelps method ( massage, passive movement, assisted active movements, free active moments, resisted movements , conditional movements, automatic or confused movement , relaxation , movement from relaxed position , reach and grasp skills) for eg – if hemiplegia affected child cant do dorsiflexion of ankle, he is asked to do hip and knee flexion, then the child will be able to do dorsiflexion.
- Bobath method – It Is commonly known as NDT ( neurodevelopment techniques) aims to improve motar and functional deficits in children with cerebral palsy
- PNF techniques ( proprioceptive neuromuscular facilitation techniques)
- Rood techniques – This technique includes the prolonged iceing, prolonged weight bearing , painful stimuli.
- Temple fay
- Vojta’s Technique
- Conductive Education
- Integrated approach – The latest and most effective way of treating cerebral palsy child is integrated approach which includes
- Normalising tone of muscles
- Stretching and mobility
- Developing postural reaction
- Sensory integration
- Oromotor control training
- Reassurance and recreation
Mostly importantly therapist should be convincing and compassionate so as to make the parental education about condition of their children without letting them depressed & also told how they contribute in make the child’s life worth living , a successful one said Dr Harmanpreet.