Top Health Tips on Living with Cerebral Palsy

Cerebral palsy refers to a medical condition where a child suffers from certain disabilities as a result of damage caused to his or her brain during or before birth. If a child is diagnosed with cerebral palsy then he or she may experience problem with body movement and brain development may also get affected. Along with difficulties in body movements, there are many other problems that he or she may encounter, such as difficulties in hearing or vision, intellectual disabilities, learning disorder, impaired speech and seizure problems, etc.

There are many causes responsible for cerebral palsy; they are stated as follows

If the brain of the child is deprived of oxygen during birth
Premature birth
Severe head injury
A brain infection
Regular exercises and physiotherapy can help the child to cope up with the condition better. Following are few exercises which may prove to be helpful:

Joint exercises: Joint exercises will help a C.P. child to increase flexibility.
Muscle exercises: Muscle exercises can help to get rid of muscle tightness which is a common disorder seen in a C.P. child.
Stretching exercises: Stretching exercises can prove to be very helpful in dealing with the problem of body movement which is one of the most potent symptoms observed in a C.P child.
Balancing exercises: Balancing exercises can help the C.P. child to improve his or her balance.
Spine stabilization exercises: Exercising the upper and lower part of the spine can help the C.P. child to strengthen his or her spine which will in turn, help him or her to improve balance.
Wrist and knee exercises: Wrist and knee exercises work on the affected wrists and knees, thus improving flexibility and bettering body motions.
Swimming exercise: Swimming, as an exercise, involves the movement of many muscles and joints. It can thus help to improve body movement disorder.
Exercises with proper assistance can prove to be very beneficial for a child suffering from cerebral palsy.

What do we mean by the term cerebral palsy?
A cerebral palsy is a group of permanent movement disorders which occur in early childhood. It is a neurological disorder which can occur due to many causes, such as hypoxia, injury, infection, hypoglycemia, or any other cause.

What are the symptoms of cerebral palsy?
Stiffness; tightness in the muscles of the extremities either upper or lower extremity; exaggerated movements; limited movements; abnormal gait; crossed knees; and abnormal reflexes are the common presentations of this disease.

How does physiotherapy help in cerebral palsy?
Physiotherapy is one of the best methods to assist patients with cerebral palsy. It helps in following ways:

By reducing the exaggerated tone of the muscle
By enhancing the development of milestones
By maintaining the muscle length
By correcting the posture
By improving activities of daily living
What are the goals of the physiotherapy in patients with cerebral palsy?
The main goals of the physiotherapy are as follows:

To make the patient independent by improving functional mobility
To strengthen and stimulate the growth of muscles
To improve the ability to move parts of the body
To prevent the joint stiffness and muscle atrophy (wasting of the muscles) of the limbs
To improve the balance and joint stability
What methods are used in physiotherapy for the patients with cerebral palsy?
It includes following methods:

Stretching exercises to improve the mobility of joints and soft tissues
Use of toys and games to make the therapy enjoyable for the child
Use of special positions, exercises, and cushions to maintain the natural position
Use of braces, casts, and splints to straighten the joint, support the joint, and to manage uncontrolled limb movements
Use of a special plastic jacket to prevent exaggerated curvature of joints
Use of equipment for constraint-induced movement therapy, to improve movements through presenting interesting activities, and giving praise and rewards when a child makes attempts to use the less-functioning muscles
Use of tilt-tables and standing frames
Serial casting to increase the range of joint motion and repeated applications of casts, typically every one to two weeks to restore it
Passive stretching or prolonged manual stretching by using the effect of body weight and gravity or mechanically with a machine or splints
Use of exercise balls, resistance bands, free weights, swimming pools, and hot and cold packs
Electric stimulation to improve gait and upper limb function
Hyperbaric oxygen therapy to improve the oxygen supply to the surrounding neurons
Use of an ankle-foot orthosis (AFO) in foot drop to prevent tripping over the toes
Use of walkers also may be prescribed to enhance mobility

What are fine motor skills?
Motor skills are movements and actions carried out by the proper coordination of the brain, nervous system, and muscles working together. These motions are divided into two types fine motor skills and gross motor skills. Acquiring and mastering motor skills or control helps you explore the world around you and also helps with your cognitive development.

Gross motor skills: They are the movements and actions of the larger groups of muscles of the arms, legs and other body parts to see visible actions like running, swimming, crawling etc
Fine motor skills or dexterity: They are the movements and actions of the larger groups of muscles of the wrists, hands, fingers, and the feet and toes to see visible actions like picking up objects between the thumb and finger, writing, etc
Fine motor skills will keep developing with your age, practice and the increased use of muscles. This happens while you are playing sports or playing an instrument. Activities like writing, coloring and using the computer also help in acquiring and mastering them.

Reasons behind fine motor skill issues
As all motor skills require proper coordination of the brain, nervous system, muscles, joints along with good eyesight; issues with any of them can have an effect on dexterity and decrease control. Some common causes affecting the fine motor skills are

Stroke: The frontal lobe controls your movement, and the cerebellum fine-tunes them. As the cerebellum controls fine motor movement, balance, and the brain's ability to determine limb position, a stroke in the cerebellum leads to paralysis or "jerky" muscle movements.
Dyspraxia or DCD: This condition affects co-ordination of gross motor skills requiring balance, kicking and throwing a ball and fine motor skills too such as writing or using small objects carefully in children and adults.
Apart from stroke or DCD any major injury, illness, congenital deformities, cerebral palsy, and developmental disabilities can hamper the fine motor skills development too.

Occupational therapy for improving fine motor skills
All fine motor skills are imperative for your own self-care and maintaining self-dependence for the different activates carried out throughout your life, any dexterity issues can severely bring down your self-esteem and quality of life. Occupational therapy can help improve overall fine motor skills. It involves the use of particular activities as an aid to recuperation from physical or mental illness. An Occupational therapist can practice in different settings, like: hospitals, long-term care facilities, schools, outpatient clinics, and the assisted living communities too.

So, depending on how soon the fine motor skill issues are diagnosed and their severity one can approach the Occupational therapist for their improvement. He or she would then follow an assessment process allowing them to identify the nature of your difficulties with fine motor skills, and the reasons for them. Once identified, they work with you to put in place a plan to address them. Depending on each individual case the therapy would involve a practice of different movements on a regular basis to help you improve and master the fine motor skills.

Sometimes children suffer from conditions where their feet may not be in proper shape or size which can affect their posture. Most of the times the disorders correct themselves as they grow up but certainly there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment.

Some of the common orthopedic disorders found in children include:

1. Flatfeet

While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.

2. Toe Walking

Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.

3. Pigeon Toes

In toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when upper part of the leg bends more than it naturally should causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually the condition corrects on its own with age and does not interfere with sport activities which involve running.

4. Knock-Knees

It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum), since their bodies go through natural shift in alignment. Usually treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10.

Cerebral palsy and occupational therapy

In order to recover the skills that are required for leading an independent and a satisfying life after any injury or disease, an occupational therapist is required. The word occupation refers to the tasks which one has to perform everyday not to one s profession. Muscle and joint coordination issues can be fixed with the help of occupational therapy in case if kids .These include the daily activities like eating, brushing using the toilet. With the help of OT your cognitive and social abilities and even your motor skills will improve at a very good rate.

How is this beneficial for children with cerebral palsy?

Occupational therapy will be helpful to the children who are specially suffering from cerebral palsy. These benefits includes:

- It will increase the chances of making your child more independent.
- It will boost their ability to play as well as to learn.
- The self esteem and the confidence of your child will readily increase.
- They ll have a sense of accomplishment.
- Their quality of life will improve as well.
- This is also beneficial for the parents as well. It will reduce your stress and will provide you with a sense of security.

What to expect?

Occupational therapy is different for different children who have cerebral palsy. It depends on one s physical, intellectual and social emotional abilities .The first session is basically done for evaluation where your child s fine motor and will be observed how your child responds to touch or any kind of movement. The parents are also interviewed in order to find out about the strengths and the weaknesses of your child. For children with cerebral palsy, a revaluation should be done in every 7-8 months in order to see the progress and change the treatment plan accordingly as per the improvement .The operational therapist will use some specific techniques which will help your child to improve very quickly and reach their destination.

These techniques are :

Paediatric constraint induced Movement therapy: This therapy helps your child to move the weaker parts of the body by restraining the stronger counterpart. If you child has a difficulty in moving one of the arms then the stronger arm will be restrained and the weaker arm will be trained in order to gain the strength.

Sensory integration therapy: This type of therapy will help your child to improve the ability bro receive , interpret and act on the information and situations that comes in your child s brain with the help of sensory receptors .

Occupational therapy has been a very important part in improving the physical and the mental discomfort faced by your child when he or she is suffering from cerebral palsy. The therapist may even provide your child with some gadgets in order to make his /her daily life easier and more independent. This helps your child to improve and gradually get better at it without any sort of negativity. While you re looking for a OT make sure the person has enough experience and knowledge, just to ensure that your child gets the right treatment.

Cerebral palsy is the term for a group of neurological disorders that affects one s muscle movement and motor skills.

In most cases, the condition is caused due to a brain impairment that develops while the baby is still in the womb. Cerebral palsy may also occur shortly after or during birth.

Symptoms of Cerebral Palsy:

The signs and symptoms of the condition vary from one individual to another, ranging from mild to severe. The commonly observed ones in children are-

Difficulty walking
Difficulty holding on to objects
Delay in developing motor skills- sitting up straight, rolling over, crawling
Variation in the muscle tone- too stiff or too floppy
Delay in development of speech
Spasticity
Lack of coordination of the muscles
Difficulty swallowing and excessive drooling
Functioning of only one side of the body
Neurological ailments such as intellectual disabilities, seizures, and others

Types of Cerebral Palsy:

Cerebral palsy can occur in the following forms-

Spastic cerebral palsy - Causes exaggerated reflexes and muscle stiffness. This is the most common type of cerebral palsy, affecting nearly 80% of the population.
Dyskinetic cerebral palsy - Causes abnormal, involuntary movement of the legs, arms, and hands. It may also affect the movement of the tongue and face, thereby making it difficult to talk or swallow.
Hypotonic cerebral palsy - Causes overly relaxed muscles and reduces muscle tone. The legs and arms are easily moveable and appear saggy.
Ataxic cerebral palsy - This is the least common type. People living with this form of the condition have problems with coordination and balance.

Diagnosis and treatment of cerebral palsy

Cerebral palsy can be diagnosed with the help of the following-

CT scan
MRI
Ultrasound
Electroencephalogram

Treatment of the condition depends on its severity. Long-term treatment includes physiotherapy, medications and surgery.

Physiotherapy and occupational therapy helps restore muscle strength and improves muscle tone. You can try stretching exercises to improve flexibility.
Usually, the doctor prescribes medications in the form of muscle relaxants and sedatives. Muscle relaxants reduce muscle tension, helps relieve discomfort and muscle pain.
You may need to undergo an orthopaedic surgery in case medications and therapy does not yield positive results. The surgery will aim to release tight muscles and repair bone abnormalities caused due to spasticity.

The specialist as a last resort may recommend SDR or Selective Dorsal Rhizotomy to reduce spasticity and chronic pain. This involves operating the nerves at the base of your spinal column.

There is no permanent cure for cerebral palsy. However, the condition is manageable with the help of drugs, therapy and surgery. The kind of treatment required depends on your overall condition. While some may be able to live with the condition without much assistance, others may require immediate medical intervention. Therefore, it is best to consult an orthopaedic and get help if the symptoms deteriorate over time.

Some babies learn to walk by the age of nine to ten months, and others may take longer, much longer to start walking properly. By the age of 15 months, people may start asking you if your little munchkin is able to walk yet. These constant questions can eventually irk you off, and keep you wondering if truly your baby is facing any sort of disability or not. In most cases, you will probably find your baby was too lazy to start walking all along, and he has mastered the art of toddling a couple of months later. Other times, when your baby has not started walking in over 17 months, you may want to give your paediatrician a visit.

When should you not worry?

If your baby is an active child and is playing around normally, you may not worry about him or her too much. If you find your child able to move around crawling or rapidly kicking his legs around, then your child is probably a late bloomer when it comes to walking. Other factors that will indicate that your baby is not going through any developmental issues are when he or she is able to communicate with sounds or broken speech. Other thing that you must keep in your mind is the relative age of your baby if it is born premature. If your toddler was born two months prematurely, then you must consider his developmental age by adding two months to his actual birth. Also notice if your child is able to move positions on his own, like if he is able to change positions when he is sitting down or lying down. As such, inability to walk is not really a solid indicative of a developmental disorder.

When is it of concern?

When you go to your paediatrician with your child regarding his inability to walk, your doctor will firstly take a note of the general movement of your baby. Thus the quality of movement is what matters the most. If your baby is showing signs of rigidity or flaccidity in his limbs, it may concern your doctor, as it is the primary symptom of cerebral palsy. Nothing can be concluded unless your get proper reports of scans like MRIs which your doctor will recommend you to get.

If your child is not walking, avoid carrying him around too much to allow him to make movements on his own. Who knows, you may find yourself chasing him around all over in no time!

Cerebral palsy is a neurologic condition that occurs in children, and is due to brain injury that develops before, during, or after childbirth. The condition presents with motor impairment, and therefore there is generalized physical and mental dysfunction. The brain continues to develop for the first two years of life, and so conditions like premature birth, asphyxia at birth, and postnatal meningitis and encephalitis.

The diagnosis could be trigged by the slow motor development, poor muscle tone, and delayed response of the baby. One of the main noticeable feature that becomes evident is the spasticity of the limbs. The child may not be able to voice it out, but pain is a significant disabling factor too. While doctors would advise that physical movement is required to keep the spasticity at bay, the pain keeps the child away from most activities. This further adds to the spasticity and worsening of the condition.

Pain control therefore assumes a significant role and the modes can range from physical therapy to pain killers to injections to surgery. The idea, in addition to pain control, is also to:

Improve range of motion
Improve motor response
Promote good motor development
Reduce and control contractures
Improve overall lifestyle
Improve muscle strength
Improve exercise tolerance
Reduce spasticity
Some of the non-medical ways to control pain are listed below.

Of course, pain killers and injections are always used when immediate relief is required. A structured physical therapy program that includes medications and exercise is the best way to manage cerebral palsy pain. Though initially difficult, over a period of time, it improves range of motion and improves joint movement.

Acupuncture: Triggering specific points via needles is believed to stimulate the nerve endings and help in pain control
Alternating ice and heat therapy: This is also believed to improve pain control, blood circulation, and muscle movement.
Positioning in bed: A well-positioned child in bed may have less pain compared to another child who is not. Special equipment may be used also to keep the child in place, once the most comfortable situation is located.
Muscle massage: The affected muscles need to be massaged repeatedly so that blood flow improves, joint movement is better, and pain is controlled.
Botox is successfully used to pain control, as it paralyzes the specific muscles along with providing pain control.
Medications are used regularly, which are mainly anticholinergic and anti-spastic medications. They reduce stiffness, control pain, and help in pain control too.
Surgery is the last option and needs to be explored with the doctor.

Some babies learn to walk by the age of nine to ten months, and others may take longer, much longer to start walking properly. By the age of 15 months, people may start asking you if your little munchkin is able to walk yet. These constant questions can eventually irk you off, and keep you wondering if truly your baby is facing any sort of disability or not. In most cases, you will probably find your baby was too lazy to start walking all along, and he has mastered the art of toddling a couple of months later. Other times, when your baby has not started walking in over 17 months, you may want to give your paediatrician a visit.

When should you not worry?

If your baby is an active child and is playing around normally, you may not worry about him or her too much. If you find your child able to move around crawling or rapidly kicking his legs around, then your child is probably a late bloomer when it comes to walking. Other factors that will indicate that your baby is not going through any developmental issues are when he or she is able to communicate with sounds or broken speech. Other thing that you must keep in your mind is the relative age of your baby if it is born premature. If your toddler was born two months prematurely, then you must consider his developmental age by adding two months to his actual birth. Also notice if your child is able to move positions on his own, like if he is able to change positions when he is sitting down or lying down. As such, inability to walk is not really a solid indicative of a developmental disorder.

When is it of concern?

When you go to your paediatrician with your child regarding his inability to walk, your doctor will firstly take a note of the general movement of your baby. Thus the quality of movement is what matters the most. If your baby is showing signs of rigidity or flaccidity in his limbs, it may concern your doctor, as it is the primary symptom of cerebral palsy. Nothing can be concluded unless your get proper reports of scans like MRIs which your doctor will recommend you to get.

If your child is not walking, avoid carrying him around too much to allow him to make movements on his own. Who knows, you may find yourself chasing him around all over in no time!

Sometimes children suffer from conditions where their feet may not be in proper shape or size which can affect their posture. Most of the times the disorders correct themselves as they grow up but certainly there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment. Some of the common orthopedic disorders found in children include:

1. Flatfeet

While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.

2. Toe Walking

Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.

3. Pigeon Toes

In toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when upper part of the leg bends more than it naturally should causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually the condition corrects on its own with age and does not interfere with sport activities which involve running.

4. Knock-Knees

It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum), since their bodies go through natural shift in alignment. Usually treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10.