Cerebral palsy describes a group of permanent disorder of the development of movement and posture, causing physical limitation, which is non progressive and is caused by damage to brain or around birth. Its damage won’t worsen but remains constant.
Causes of Cerebral Palsy
- Antenatal causes – genetic, hypoglycaemia
- Neonatal causes – prematurity, trauma
- Postnatal causes – delayed cry, jaundice
How Physiotherapy helps
A Physiotherapist designs a rehabilitation program and sets some goals and outcome that includes:
- Tolerance to position
- Weight bearing status is improved
- Joint integrity and mobility is maintained
- Trunk control and balance are improved
- Strength, power and endurance are increased
- Functional independence in ADLs are increased
Various Type of Interventions during Physiotherapy Treatment
1. Motor learning strategies
- Feedback by using mirror
- Proprioception weight bearing
- Repetition of desired task
- Distractions should be progressed and challenged with task variation or a new task as soon as the previous has been mastered or almost mastered
3. Remediation/facilitation approach
- NDT initially developed by bobath. Identifies the task of the patient and works on the movement pattern and widespread abnormal tone reflex activity
- NDT techniques and it view development as dynamic, sequential, cephalocaudal, proximal distal movements
4. PNF techniques
- Include slow reversal timing for emphasis with repeated contraction, hold -relax, agonistic reversals.
5. Positioning strategies
- Correct positions encourage proper joint alignment, symmetry and comfort
- Prolonged static positioning in any one posture should be avoided
- Mobilization technique and exercises are important.
6. Range of motion exercises
- Soft tissue /joint mobilization and daily range of motion exercises
- Sustain stretching for muscles
- Splinting techniques
7. Sensory integration
- SI is the ability to recognise various sensation, organise them so that they can be used in functional activities. Objects of different kinds can be given to the child can be given in this therapy.
8. Strategies to re-establish postural control and improve functional mobility
- Sit to stand movement transition
- Early weight bearing exercise
9. Normalising tone of the muscles
- For hypotonicty slow passive movements, sustain stretch, cryotherapy over the vibration can be used 10 to 20 min.
10. Oromotor control training
- Oromotor function depends upon on good head control. Problems like drooling,suckling inadequate Tongue movement can be done with this therapy.This therapy gives good control of neck and trunk.
11. Occupational therapy
- Child helps to adapt to their limitation and live as independently as possible.
12. Developing rapport with parents and patients
- Developing rapport with patient is very important as goal will be difficult to achieve without the cooperation of patient and relatives
- Regular motivation to gain confidence
Lastly, as treatment for cerebral palsy child is life long process, along with the therapist, the support of family and relatives is very high. The therapy should be carried out at home so that child get used to it and does it functionally.