- Posted by Rim Boulos
- On December 7, 2020
- 0 Comments
- cerebral palsy, Paediatric Physiotherapy, Therasuit, Treatment
We specialize in the treatment of Cerebral Palsy – one of the most common physical disabilities diagnosed in children. But what is Cerebral Palsy and how can it be treated? How do we treat CP at All About Kids Rehabilitation Centre? Let’s take a look at the diagnosis, treatment, and the 5 ways that are most effective in achieving your child’s goals.
What is Cerebral Palsy?
You might have heard of Cerebral Palsy, more commonly called CP for short, but what does this diagnosis really mean to you?
Cerebral Palsy is an “umbrella term“, meaning it covers a variety of unique conditions with common, related symptoms. CP is characterized as a group of permanent, non-progressive neurological disorders that impact movement and posture, which is caused by damage to the developing brain. To simplify, it’s a group of disorders that affect the brain and are not curable but don’t get worse over time. It’s one of the most common conditions treated in pediatric physiotherapy – and one we at All About Kids Rehab have years of experience with. The brain damage that defines a diagnosis of CP can occur prior to birth (prenatal), at the time of birth (perinatal), or after birth (postnatal) as a result of an injury or illness in the first 2 years of life.
Each child with Cerebral Palsy has a unique combination of symptoms and will present differently depending on the degree and location of the damage. Some children will have their lower body most heavily affected (diplegia), while others will have one whole side of their body affected (hemiplegia). In severe cases, both the upper and lower body are affected (quadriplegia). Some people may think of it as which arms and legs are affected, but it’s important to remember that the trunk of the body is in some way affected in all cases.
What are the Common Signs of Cerebral Palsy?
Cerebral Palsy can have a wide variety of symptoms – here are just a few of the most common ways CP presents itself.
Abnormal Muscle Tone
When you hear the term “higher than normal muscle tone” or “low tone“, what is the first thing that pops into your head?
For many, they immediately think of strength. But tone actually refers to how hard or how “on” a muscle is when it’s resting. Hypotonia (low tone) and hypertonia (high tone) can present in different parts of the body. This is a neurological symptom, which cannot be cured, but with the right treatment plan, it can be compensated for.
The amount of muscle weakness a child with Cerebral Palsy has depends on the damage they’ve suffered. As a way to make up for this weakness, children can learn poor patterns of movement, which then leads to other problems that are NOT neurological. These problems are preventable! They may never learn how to activate certain muscles on their own.
It is especially important for these kiddos to HELP and TEACH the activation of certain muscles and correct patterns of movement. The problem with the neurological weakness is not that it can’t be helped through training – because it CAN! The problem is that it leads to habits and postures that are counter-productive to these kids achieving functional goals. Frequent strengthening and practicing functional movements in alignment with appropriate assistance can make HUGE differences for these kids!
Spasticity is characterized by a ‘catch’ or ‘stop’ muscle reaction when quickly moving the affected arm or leg. To the typical person, this can come across as jerky or stiff movements. This is different from high or low muscle tone and can often be worse when muscles aren’t functionally strengthened.
Muscle Tightness or Stiffness
This happens over time as children spend too much time in certain postures and not enough time in a variety of postures. It can happen to anyone – for instance, think about how stiff you feel after staying in the same position for an extended period of time! For children with CP, who often struggle to move in different ways, this is an aspect of CP that can increase over time. It also happens as a result of using dysfunctional motor patterns as an attempt to be strong against gravity. The right physiotherapy interventions can help to prevent this.
Reflexes are meant to help babies practice movements during development and to then be integrated into normal, voluntary movements. What often happens in children with Cerebral Palsy is the retention of some reflexes. These can then hinder movement or provoke a startle which disrupts their balance.
Sensory, Visual or Vestibular Issues
These issues can occur as a result of neurological damage, or from missing movement milestones such as crawling or being unable to sit or stand upright in good alignment. These issues can also result from a combination of neurological damage and lack of typical movement during development and growth.
Do you want to know more about CP, the science behind it, and the newest techniques? Follow these links!
5 Effective ways to Treat Cerebral Palsy in Children
Parents will often ask me “Will strengthening increase spasticity?” This is one of the biggest misconceptions about strengthening spastic muscles. Spasticity does not equate to strength.
Many children with cerebral palsy will present with significant muscle weakness as a result of their abnormal muscle tone (i.e. spasticity, low tone, or fluctuating tone). One of the best ways to improve muscle tone in your child is strengthening muscles in a functional manner. This is one of the major focuses of pediatric physiotherapy.
This means performing exercises that they would require in their day to day life, such as transitions, squatting, sit to stand, kneeling, reaching, etc. In this way, they are able to simultaneously strengthen their muscles while also building skills that can transfer into their own lives outside of the clinic.
The Therasuit Method
Based on an intensive model of therapy, the Therasuit Method enables your child to achieve specific goals in a short period of time. Children usually attend therapy for 3 hours per day, 5 days per week for 4 weeks. A targeted strengthening plan is designed and customized to your child’s unique needs. The program consists of a strengthening protocol that targets specific muscles. It then utilizes a pulley system, followed by functional strengthening in the spider unit. The Therasuit is a wearable type of orthotic device that we use during the intensive session. The Therasuit will help align your child and helps to recruit specific targeted muscle groups. This has been one of my favourite interventions in my over 25 years of practice. The gains that can be made using this methodology are truly incredible!
Functional Electrical Stimulation (FES) / Task-Specific Electrical Stimulation (TASES)
Remember how muscle weakness can drive a child to use poor motor patterns? Or they can have a really hard time activating certain muscles at all? The purpose of FES or TASES is to teach your child how to activate a specific muscle for a specific functional task. For example, sitting, walking, running, reaching. Your physiotherapist should find the combination of muscles to stimulate during a specific activity that brings on an immediate in-session change, and a carry-over for the next 1-2 days. If it is very effective, it may be an option to continue at home for a permanent effect! There is no shame in needing to continue to exercise or use an intervention to maintain your child’s’ function – don’t we all have something we must continue every day? We don’t stop brushing our teeth and expect no cavities! Athletes don’t stop training and expect to win!
One of the first things parents will answer when asked, “What is your #1 goal for your child?” is “I want my child to walk”. Depending on the severity of condition, children with cerebral palsy can present with a variety of walking abilities. While some children are able to walk independently, others may not have taken their first steps yet, or are able to walk with some form of mobility aid. Pediatric physiotherapy will help reach your child’s major milestone of walking through hands on facilitation and a daily strengthening program. Perfect practice makes perfect!
The Key is Alignment
As physiotherapists, we develop a keen eye for postural alignment. We can explain how it affects development and movement in children with AND without a physical disability.
When alignment is optimal, muscles are their strongest! With optimal alignment, breathing and core activation are easiest! When alignment is optimal, your balance and your reactions are better!
Your vision, your vestibular system (balance), your joints, your body awareness (proprioception) are all better with optimal alignment!
Our Therasuit Method setup makes it much easier to help position your child in optimal alignment – without the need for 4 different sets of hands. It also allows your child to feel more independent in their movements. As they get stronger and better able to maintain optimal alignment on their own, we can gradually reduce the assistance we are giving until it is fully independent – which is the ultimate goal.
Having a diagnosis of Cerebral Palsy can be daunting and overwhelming, for both the child and their family. But with a care team invested in helping your child achieve their goals, there is nothing these little warriors can’t do.
Does your child have CP, or do you have concerns regarding their mobility? Click the link below – we would be happy to meet with you and work with you and your child to reach their full potential!
Cerebral Palsy is caused by damage or abnormal development to the brain, typically to the part of the brain which controls movement. This brain damage can happen during pregnancy, at the time of birth, or in early childhood in some cases. In many diagnoses, the exact cause of CP is unknown.
The life expectancy for children with CP is as unique as their symptoms. Depending on their level of severity, adults living with CP can be anywhere from 30 – 70. The more involved and severe a child’s CP is, the lower their life expectancy can be. A child with a mild case of CP can live a completely typical lifespan.
As children with Cerebral Palsy age, the brain damage they’ve suffered will not get worse. However, growing and aging can cause symptoms to get worse in some cases, including muscle stiffness and pain.
The tough answer to that is no, Cerebral Palsy has no cure and is a permanent disability. But CP does not get worse – the brain damage remains consistent. Symptoms can worsen in some cases, but with the help of treatment, the symptoms of CP as well as the overall quality of life can be improved.