CEREBRAL PALSY- WHAT ARE THE BENEFITS OF EXERCISES AND PHYSIOTHERAPY IN CHILDREN?

Cerebral palsy is a disorder of movement and posture caused by a non- progressive lesion in immature brain.

 

CAUSES

There are various causes of Cerebral palsy. It can be pre-natal, Natal and Post -natal period.

Various causes can be-

  1. Maternal diabetes.
  2. Birth trauma.
  3. Rubella infection.
  4. Anoxia.
  5. Prematurity.
  6. Trauma.
  7. Meningitis.
  8. Mutations in genes leading to Abnormal brain development.
  9. Delayed labour(leads to asphyxia of brain) .
  10. RH Incompatibility.
  11. Premature birth.

CLINICAL FEATURES

Clinical features depends on the location  of  the  lesions of the Brain. Some of the signs of CP can be-

*Impairment of muscle tone.

*Delayed milestones.

*Impairment of gross motor and fine motor functions.

*Difficulty in  swallowing (oral motor dysfunction).

*Loss of co-ordination and control.

 

PEOPLE WITH CEREBRAL PALSY  MAY ALSO HAVE

*Seizures.

*Low IQ.

*Difficulty in vision.

*Urinary incontinence.

 

WHAT ARE THE DEFORMITIES ASSOSIATED WITH CEREBRAL PALSY?

UPPER LIMB-    Swan neck deformity, Thumb in palm deformity.

FOREARM –   Pronation contracture.

WRIST AND FINGERS-    Flexion deformities

SHOULDER-       Adduction and internal rotation deformity.

LOWER LIMB-   Adduction deformity(most common)

Flexion and internal rotation deformity.

Dislocated hip.

Pelvic  obliquity

SPINE

Scoliosis

Kyphoscoliosis

KNEE – Genu valgum, Genu recurvatum, Patella Alta,

Knee flexion contracture, Subluxation/Dislocation      Patella.

FOOT – Equinus deformity, Talipes equinovarus, Calcaneous deformity, Talipes Cavus.

WHAT ARE THE BENEFITS OF PHYSIOTHERAPY IN CEREBRAL PALSY?

Exercises helps in benefitting health of every child.Kids with cerebral palsy benefit  greatly from exercises.Circulation and lung function are also found to increase. Cerebral palsy exercises improve muscle tone, flexibility and strength.

 

EXERCISES RECOMMENDED FOR CEREBRAL PALSY           

There are various list of  exercises recommended for cerebral palsy .Kids have found to benefit greatly from these exercises.

  • SWIMMING -Water is itself very soothing and buoyancy helps in exercising  and also relieves pain.

  • STRETCHING –Babies benefit from simple  stretching techniques given by physiotherapist.
  • SOFT TISSUE MOBILIZATION – STM has been found to be effective in reducing tightness of muscles.Studies have shown that STM(Soft tissue mobilization) and heat  both  are effective  for people with CP, especially  for spastic CP.
  • THERABAND EXERCISES – Theraband exercises helps in resisted exercises of muscles. Strengthening interventions is one of the most important interventions to achieve long term functional goals. Resisted exercises has been found to increase muscle volume. The most common exercise being the resisted plantar-flexion and heel raises.
  • TUMMY TIME – Tummy time is important because lying in the wheelchair can cause tight hips knees and tummy muscles. Patients are prone to develop scoliosis or kyphosis. Shoulders  are often rounded or in forward  position.

Tummy down position is found to provide a stretch in front of hips. There is improvement in knee flexion position as the knees get straighten due to the effect of gravity. Back muscles also get a stretch in lying position.

# Tummy time is found to be effective in improving head control and balance.

# Use pillows for support if needed.

  • Balance exercises- Balance and co-ordination exercises are very important in maintaining posture of the patient.

 




#Head lifting in a modified bridge position  activates neck flexor muscles and abdominal muscles.

 

ADVANTAGES OF USING ORTHOSES IN CP CHILD

The most common orthoses is AFO. It limits unwanted ankle movements specially ankle plantarflexion(foot pointed towards  ground). AFO has been found to improve walking efficiency in children. However children who are able to stand on a flat foot did not benefit much from AFO as it tended to slow them down n sit to stand position.{1}

 

HOW DOES OCCUPATIONAL THERAPY BENEFITS THE CHILD ?

Occupational therapy plays an important role in improving everyday activities like eating dressing and using bathroom.

It also helps in improvement of motor function.

The advantages include-

#Boosting the confidence of child.

#Makes the child independent.

#Improves child’s ability in day to day activities and also during play.

  •  DISCUSSION

It is found that stretching followed by passive exercises reduce hyperactive stretch reflexes. Slowly sustained stretch manages painful contracture in spastic children.{2}

Passive stretching decreases muscle tightness and makes easier to put on orthotics before gait training.

Studies have also suggested that strength training can improve motor activity in people with CP without adverse effects.{3}

  •  REFERENCES

1.Management of spasticity in children with Cerebral palsy:-

Alireza Shamsoddini,PhD, Susan  Amirsalari,M.D,[…],and Amideddin  Khatioi-Agnda,M.D.

2.Functional stretching exercise submitted for spastic Diplegic children:- A Randomized control study

Mohamed Ali Elshafey, Adel Abd-Elaziem, and Rana Elmarzouki Gouda.

  1. A Systematic review of the effectiveness of strength training programs for people with cerebral palsy.

Karen J. Dodd, PhD ,Nicholas F.Taylor,PhD, Diane L.Damiano,PhD

 

AUTHOR- INDIRA SHIVANI. G. , M.P.T

PICS COURTESY-   GOOGLE

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NOTE-THE CONTENT ON PHYSIOHEALS IS NOT RECOMMENDED AS A SUBSTITUTE FOR TREATMENT AND MEDICAL ADVICE.ALWAYS CONSULT  PHYSIOTHERAPIST OR ADVICE OF YOUR PHYSICIAN REGARDING QUESTIONS AND CONDITIONS.

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