This little girl has mild hemiplegia, and is practicing balancing on her weaker leg.
Cerebral palsy (CP) describes a range of movement or postural disorders caused by damage to the developing brain, before or at the time of birth. "Cerebral" refers to the brain and "palsy" refers to a physical disorder. Cerebral palsy is caused by faulty development of or damage to motor areas in the brain, causing disruption of the brain's ability to control movement and posture.
Cerebral palsy affects approximately one in four hundred people in the UK. A diagnosis of "Cerebral Palsy" covers a wide range of disability, with no two people having the same difficulties. The movement problems vary from barely noticeable to severe.
Cerebral palsy can be classified in several ways. One way corresponds to the muscle tone or control:
- Children with spastic cerebral palsy have increased muscle tone causing ‘stiff’ muscles. Because the stiffness is caused by problems in the brain, it tends to increase with effort or excitement. Children with spastic cp need physiotherapy to help stop their joints and muscles becoming stiff or ‘contracted’.
- Children with athetoid, dyskinetic or dystonic cerebral palsy have difficulty controlling their muscles and posture. The brain causes the limbs of a child affected by athetoid or dyskinetic CP make unwanted movements. In dystonia, the trunk is more affected by unwanted movements than the limbs. Children with athetoid, dyskinetic or dystonic cerebral palsy need physiotherapy to help improve their balance, stability, symmetry and control of movement.
- Children with ataxic cerebral palsy usually have problems with balance and the control and selectivity of movements. Physiotherapy can help children with ataxic cp improve the quality of their movements.
Cerebral palsy can also be classified by the parts of the body affected:
- Children with quadriplegia have movement difficulties with all their limbs.
- Children with hemiplegia have problems with the movement of one side of their bodies.
- Children with diplegia have difficulties with the movements in their legs. Often they also have difficulty with fine, dextrous movements of their hands.
- Children with monoplegia have problems with just one limb.
Many children with CP are hardly affected, whilst others have problems with any movements, feeding and talking. Some children manage all activities independently and others are unable to sit up without support and need help with all aspects of daily living. Cerebral palsy can be classified by function using the Gross Motor Function Classification System. This system looks at abilities at different ages and classifies on a scale of 1 to 5. Briefly, in relation to mobility:
- GMFCS Level I: walks without limitations.
- GMFCS Level II: walks with limitations, such as distances and difficult terrain.
- GMFCS Level III: walks with adaptive equipment assistance, (eg walking frame) indoors, but may need a wheelchair for use outside.
- GMFCS Level IV: may be able to walk with assistance and self-propel a wheelchair short distances.
- GMFCS Level V: May be able to learn to operate a powered wheelchair, but will predominantly be transported in a manual wheelchair.
How can KidsPhysio help?
Ryan has spastic quadriplegia. He is practicing holding his head up when sitting.
It has been shown that specialised Paediatric Physiotherapy can help babies and children with cerebral palsy to learn how to move, maximising their abilities and preventing stiffness and tightness in their joints and muscles.
Kids Physio can provide a flexible approach to your child’s physiotherapy management to suit your and your child’s needs.
Many Health Authorities have waiting lists for Paediatric Physiotherapy and babies have to wait a long time for treatment. KidsPhysio can offer early intervention, and are experienced in the Physiotherapy treatment of very young babies. It may be that you would like a couple of physiotherapy sessions to help you learn some activities to assist your child until they are seen by the NHS physiotherapists, or you may prefer your child to have regular Physiotherapy treatment sessions. Some families have extra private physiotherapy to supplement the treatment offered by their NHS Physiotherapist.
Many children need additional physiotherapy when they reach adolescence, for muscle tightening and joint contractures. A combination of growth spurts, school commitments making NHS appointment attendance difficult and teenage rebellion make this is a high risk time. KidsPhysio can provide after school appointments at your convenience to help manage joint and muscle contractures and maintain your child’s function.