Cererbral Palsy (CP) is a developmental disorder. Developmental Disability refers to an umbrella term that includes not only intellectual disability but also other neurological disabilities that are apparent during childhood.

What is Cerebral Palsy?

Cerebral palsy is defined as “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain“.#

  • Chronic developmental condition, not a disease
  • Associated impairments and
  • Secondary health conditions

#American Physical Therapy Association

Damage to the developing brain occurs either during pregnancy or shortly after birth. Cerebral means ‘of the brain’ and palsy refers to ‘a lack of muscle control’. It’s an umbrella term that refers to a group of disorders affecting a person’s ability to move.

  • Non progressive – brain lesion is a one-time brain injury that occurs while the child’s brain is still developing, during and after birth. No further lesion occurs.
  • Chronic developmental conditions refers to lifelong conditions.
  • Primary effect motor control, coordination, reflex, muscle tone, posture and balance. Gross motor, fine motor, and oral motor functioning are also considered primary conditions of Cerebral Palsy.
  • Secondary issues related to oromotor activities of chewing, swallowing, bowel control and communication related deficits.
  • Associated conditions that affect sensation, perception, cognition, communication behavior and EPILEPSY. Please note associated conditions may improve or worsen over time.

Interventions that are evidence based:

  • Trunk control facilitation
  • Intensive upper extremity training on bi-manual performance
  • Strength training to enhance muscle strength
  • Muscle symmetry and activities (balance board)
  • Reactive balance training

Not much evidence support for effectiveness for management of CP:

  • Neuro-development therapy – “the preponderance of results … did not confer any advantage to neurodevelopmental therapy over the alternatives to which it was compared”.
  • Adeli suit
  • Conductive education
  • HyperBaric Oxygen Therapy
  • Sensory integration therapy
  • Botox therapy

What can schools, home and Community do?

  • Promote Physical Access (Internal and External environment-Universal Access for ALL)
  • Home and community assessment & modifications
  • Equipments (standing, walking frames, plates/spoons/cups, hoists, seating systems etc.)
  • Lower & Upper limb orthoses
  • Wheelchair (home/community use)
  • School access – seating, toilets/sanitary fittings, communication tools, key board access etc

Make the environment Enriched (EE) so that exploration is facilitated so that it optimizes on motor challenges that are both novel and repetitive, fun and play based.

  • Brain plasticity
  • Learning – Behavior change
  • Memory and
  • Motor learning

Quick link: https://www.nice.org.uk/guidance/ng62/evidence/full-guideline-pdf-4357166226

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