Management of Celebral Palsy

MANAGEMENT OF CEREBRAL PALSY .

1. Constraint Induced Movement Therapy (CIMT) _Used where non-impaired upper limb is immobilised for a variable duration in order to force use of the impaired upper limb over time.

2.Passive Stretches _This is a manual application for spastic muscles to relieve the soft tissue tightness. Manual stretching may increase range of motion ,reduce spasticity or improve walking efficiency in children with spasticity. Different stretches are used in relation to the set goal. When we look at the use of stretch to normalize tone and maintain soft tissue length, we employ  a slow prolonged stretch to maintain or prevent loss of range of motion through different mechanisms such as splinting ,weight bearing (static weight bearing ), and manual stretches.

3. Bimanual Training _This training focuses on improving of both arms using structured tasks such as lifting light objects using both arms .

4. Muscle Strengthening exercises _ This aims at increasing the power of weak antagonist muscles and of the corresponding spastic agonists to provide the functional benefits of strengthening in children with cerebral palsy.

5. Functional Exercises _ Training related to specific functional activities aiming at intensity of activities and quality of life.

6. Balancing exercises such as balancing in sitting with hip flexed and balancing the body of the feet in standing.

7.Positioning _ Most children with cerebral palsy do not easily move into or stay in positions for activities such as eating ,dressing or even washing .They often  have poor control of their muscles . Sometimes your child’s muscles pull her into a certain position(s) and then she  may  struggle to change these positions by herself. Positioning a child with cerebral palsy can be very difficult and frustrating but whenever this child is placed in helpful position makes it easier for him/her to be more involved with everyday activities .She/he may be able to look around and watch what is happening in the room, may become easier to communicate with others, may help the child use his/her arms more easily during activities and also makes it easier for you to take care of him/her.

8a.Weight bearing through feet such as assisted standing ,sit – stand ,squatting.

8b.Weight bearing through hands equally such as putting hands on the floor, wall or mirror.(mirror Therapy)

9.Use of adaptive equipment – These are used to enable a child with cerebral palsy to maintain a stable ,symmetrical posture when lying ,sitting or standing so that he/she can practice and develop newly acquired gross and fine motor skills. The type of equipment prescribed will depend on the child’s age , specific pattern of posture and movement, child’s stage of development and whether there is deformities or not

10.Use of Orthotics – These are devices used during physical therapy to train on major muscle groups which includes Splints, Braces ,AFO’s and casts .

 

 

N.B ; In order to maximize learning ,the movement performed by the child should be self initiating to allow problem solving in line with the set goal(s).

-The movement should be repetitive to strengthen neural connections .They should be carried out in varied condition and contexts.

-The type of management needed can depend on ;- The type of C.P ,level of impairment, co-occuring conditions and location of impairment problems.

 

 

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