Cerebral Palsy (CP) is the leading cause of childhood disability in the United States. It is a permanent and acquired neurodevelopmental condition that affects the central nervous system. CP may be the result of an abnormality in fetal brain development or may be acquired due to brain injury before, during or after birth and is irreversible. CP is not progressive, however, meaning the condition itself does not worsen, though symptoms or impairments may have a greater impact on an individual as they grow and age. Some individuals with CP may experience only minor signs and symptoms and will carry out an independent life and career while others may require part or full-time caregiver support.

There are several types of CP and each is named by the location of symptoms and the dominant movement type. The term diplegia is used to describe symptoms that occur more so in the legs than the arms. Quadriplegia indicates all four limbs are affected whereas hemiplegia indicates one half of the body (right or left side) is affected. Types of CP are further classified by their primary movement pattern:

• Spastic CP: caused by injury to or abnormal development of the motor cortex of the brain. Causes spasticity or abnormal tightness in the muscles which affects voluntary movement.
• Dyskinetic CP: also known as “athetoid CP,” is caused by damage to or abnormal development of the basal ganglia area of the brain. It is characterized by involuntary and often writhing movements.
• Ataxic CP: caused by injury to or abnormal development of the cerebellum which causes shaky movements in the head, trunk or extremities and can impact balance and coordination.
• Mixed CP: a mixture of the above movement patterns is experienced due to injury to or abnormal development of multiple areas of the brain.

• Spastic, dyskinetic or ataxic movements of the head, trunk and extremities
• Changes in muscle length, joint range of motion or contractures
• Weakness in one or more limbs or the neck or trunk
• Difficulty coordinating movement of the limbs for tasks like walking, changing positions, feeding oneself, writing and more
• Impaired posture
• Impaired balance
• Pain
• A need for assistance with self-care, mobility and activities of daily living
• Delays in the acquisition of gross and fine motor skills and language

• Seizures
• Intellectual disability
• Incontinence
• Impaired vision
• Impaired hearing
• Impaired growth and development
• Dental problems
• Social emotional impacts
• Reduced bone health

If you decide to work with a physical therapist to help with cerebral palsy issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions to start that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

ROLE OF PHYSICAL THERAPY IN MANAGING CP

Children and adults with CP will often benefit from physical therapy throughout their lifetime as the impairments and symptoms of CP will impact them differently throughout their life. Children 0-3yo will often qualify for PT through Early Intervention followed by either privately funded or state funded therapy until 21 years old. Even as adults many with CP can benefit from working with a physical therapist intermittently. Some of the goals of physical therapy for children, teens and adults with cerebral palsy include:

• Reduce sensations of pain and discomfort
• Maintain or improve joint and muscle flexibility
• Improve posture
• Acquire equipment and orthotics
• Increase overall health and fitness through physical activity such as aerobic, strength, endurance, balance and flexibility training
• Preserve or improve the ability to sit, stand and move about
• Preserve or improve the ability to participate in daily activities at home and in the community
• Acquire age-appropriate gross and fine motor skills
• Improve balance