Cerebral Palsy (CP) is a developmental disability that affects movement. It can result from damage or dysfunction in the developing brain, and may present before or at birth. It is estimated the approximately one child in 500 born in Australia will be diagnosed with CP. The effects of CP are different for each individual. The effects can include problems with movement, muscle control, muscle coordination, muscle tone, reflexes, balance and posture.
Types of Cerebral Palsy
Spastic Cerebral Palsy
Spastic Cerebral Palsy is the most common type of CP, accounting for 70% – 80% of cases. Spasticity is a form of hypertonia caused by damage to the motor cortex of the brain. Put another way, a person’s muscle tone is increased when they have spastic CP, because the part of their brain controlling their body movements is damaged. Children may have difficulty moving from one position to another and controlling individual muscles to perform a movement task.
Dyskinetic Cerebral Palsy
- Dystonic – twisting and repetitive
- Athetoid – slow movements / uncontrolled rhythmic writhing movement
- Chorea – dance like / unpredictable
Dyskinetic CP results from damage to the basal ganglia. The basal ganglia are responsible for regulating voluntary movements.
Ataxic Cerebral Palsy (least common)
Children with Ataxia have movement that can appear clumsy, unstable or imprecise. Their movements are not smooth and can appear jerky, an effect caused by damage to the cerebellum, which is the balance centre of the brain.
Mixed Cerebral Palsy
Children with CP can have a combination of all the above. This is called Mixed Cerebral Palsy.
Classification of Cerebral Palsy
In addition to the above Types of CP, CP is further classified by the region of the body affected. These include :
- Quadriplegia – all 4 limbs affected, sometimes including face and mouth.
- Diplegia – both legs are affected and sometimes mild involvement of upper limbs (often dyskinetic movement)
- Hemiplegia – one side of the body affected (arm and leg)
CP is also further classified using the Gross Motor Function Classification System (GMFCS).
GMFCS uses a 5 level system that corresponds to the extent of ability and impairment limitation. Each level is determined by an age range and a set of activities a child can achieve on his/her own. The GMFCS is a universal classification system applicable to all forms of CP.
GMFCS Classification Levels
- GMFCS Level I : Walks without limitations
- GMFCS Level II : Walks with limitations
- GMFCS Level III : Walks with adaptive equipment assistance
- GMFCS Level IV : Self mobility with use of powered mobility assistance
- GMFCS Level V : Transported in a manual wheelchair
What we do …
It is important for children to receive intensive intervention as early as possible to help assist them to have every opportunity to reach their full potential. At Therapies for Kids we have 3 senior paediatric physiotherapists who have extensive experience working with children with CP and other movement disorders.
Our physiotherapy techniques are aimed to assist your child with :
- normalisation of their muscle tone
- maintaining range in muscles affected by hypertonia
- improved balance and coordination
- development of gross motor skills
- strengthening of muscles
- experience of normal movement through play and functional activities
- splinting and advice on orthotics
- strengthening and stretching – post botox treatment
- intensive therapy – post surgical intervention (Single Event Multilevel Surgery (SEMLS) and involvement in rehab post- Dorsal Rhizotomy)
Benefits of regular physiotherapy include:
- Improved functional abilities
- Improved muscle strength
- Reduced muscle strength and joint range of movement
- Improved posture and positioning
- Improved balance and coordination
- Improved mobility and independence
- Improved quality of life
- Improved confidence
As cerebral palsy is a lifelong condition physiotherapy can be beneficial throughout a person’s life. Physiotherapists can provide advice regarding transition into school or working life, or assist if activities such as walking become more difficult in later life.
What you can do
Assisting a child with cerebral palsy can be a complex task for parents. Keeping a record of all clinic appointments, X-ray reports, medical reports etc is invaluable to assist in planning treatment and allowing preparation of reports as necessary. Build skill development into your child’s day which will allow them to take ownership of their therapy and become more independant. The praise and acceptance of all new skills is very important even if sometimes they are performed in very unique ways.