Comprehensive Cerebral Palsy Treatment for Adults & Children

Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. It affects muscle tone, posture, and movement, and is caused by damage to the immature brain as it develops, most often before birth. Treatment for cerebral palsy aims to enhance the quality of life for those affected by this condition. This includes addressing physical limitations, managing medical complications, and improving independence. Let’s explore the treatment strategies for children and adults with cerebral palsy, using the keywords provided.

Understanding Cerebral Palsy

Cerebral palsy refers to a group of neurological disorders that affect movement, muscle tone, coordination, and motor skills caused by damage or abnormalities in the developing brain. It is a non-progressive condition that arises out of damage to the brain tissue incurred during pregnancy, childbirth, or early infancy.

Some children may even acquire CP later on, as a result of an accident, neglect, or abuse.
Cerebral palsy in children presents with a wide range of symptoms, including spasticity (muscle stiffness), ataxia (lack of muscle coordination), and dyskinesia (involuntary movements). Early diagnosis and intervention are essential. Treatment for children often involves a multidisciplinary approach, including physical therapy, occupational therapy, speech therapy, and sometimes medications or surgical interventions.

While CP is typically diagnosed in childhood, individuals with the condition continue to experience challenges throughout their lives. Cerebral palsy in adults can present unique difficulties, such as premature aging, increased risk of musculoskeletal complications, and chronic pain. The transition from pediatric to adult care requires a comprehensive plan that addresses the evolving needs of the individual.

Symptoms of Cerebral Palsy

Typical cerebral palsy symptoms include:

Exaggerated and involuntary movements
Rigid or floppy limbs
Awkward gait
Poor balance
Partial paralysis
Speech and swallowing difficulty

Intellectual impairments, vision problems, and seizures are other symptoms that may also arise.

There are several types of Cerebral Palsy depending on which part of the brain was damaged and the severity of the damage. For the same reason, the nature and extent of Cerebral Palsy symptoms tend to differ widely from patient to patient, although signs of physical impairment will likely be visible in all of them.

You can read about the different types of cerebral palsy here.

Physiotherapy Treatment for Individuals with Cerebral Palsy

The earlier a patient commences Cerebral Palsy treatment, the better their results. The benefits of physiotherapy intervention for Cerebral Palsy are manifold, and can help improve mobility as well as physical development in young children, making it easier for them to walk, sit, and crawl. The sooner the patient starts a physiotherapy regime, the sooner motor problems can be addressed and prevented from getting worse.

Physiotherapy for children with Cerebral Palsy will typically take the form of a customized plan to decrease muscle tightness, improve muscle mobility, and encourage physical development through daily activities and games. As the child grows up, they will still require intervention to enhance their functional abilities. Physiotherapy for adults with Cerebral Palsy usually focuses on minimising abnormal movement patterns, improving mobility and balance, improving sensory abilities, reducing muscle spasms, and enhancing the individual’s quality of life. For both adults and children, physiotherapy intervention for Cerebral Palsy aims to improve their physical, mental, and emotional well-being in different environments, both at home and outside.

The type of Cerebral Palsy treatment plan followed depends on how severe the patient’s Cerebral Palsy symptoms are. Some may only have mild tremors and muscle stiffness and can overcome symptoms with physiotherapy. Others may be more severely affected to the point of being unable to move. Such children will need lifelong care and assistive devices in addition to physiotherapy.

There are several types of physiotherapy treatment approaches that can be incorporated into Cerebral Palsy treatment for children. Some of the commonly prescribed types include:

Neurodevelopmental Treatment

Reflexes play a significant role in the diagnosis and treatment of cerebral palsy. In children with cerebral palsy, primitive reflexes, such as the Moro reflex or the palmar grasp reflex, may persist beyond the age at which they typically disappear. These persistent reflexes can interfere with normal movement and development. For instance, the tonic labyrinthine reflex (TLR) can cause increased muscle tone when the child’s head moves backward. Early intervention and physical therapy are crucial in managing these abnormal reflexes to promote more natural movement patterns.

The Bobath Approach or neurodevelopmental treatment (NDT) is a form of cerebral palsy treatment that was developed by Karl and Berta Bobath in the 1940s. Based on their own experiences with children who had cerebral palsy, the Bobaths postulated that motor abnormalities are a result of atypical development of the child’s reflexes and posture because of the underlying damage to the nervous system. NDT aims to enable typical motor development that will help the child function better. It also reduces the risk of secondary injuries, joint and limb deformities, and muscle contractures.

Electrical Stimulation

An effective form of physiotherapy for children with Cerebral Palsy that increases motor function and muscle strength is through the application of electrical stimulation. It involves the use of a Transcutaneous Electrical Nerve Stimulation (TENS) Unit, which applies currents that stimulate muscle contraction. Neuromuscular electrical stimulation as a form of Cerebral Palsy treatment enhances muscle strength by recruiting the type 2 muscle fibers and increasing the muscle’s cross-sectional area.

Another method is to use functional electrical stimulation, where the current is applied during a specific task to the muscle that is expected to contract during the performance of that task. Studies have shown that electrical stimulation is particularly effective for ambulatory diplegic children, who may have trouble with certain types of resistive strength training.

Hippotherapy

As a form of physiotherapy for children with Cerebral Palsy, hippotherapy (therapeutic horse riding) can improve the child’s gross motor coordination, balance, coordination, and overall range of motion. Hippotherapy is also one of the most enjoyable Cerebral Palsy exercises for children and can have cognitive and emotional benefits. It involves guided horseback rides as well as sessions where the child pets and feeds the horse in a safe environment and in the presence of the horse trainer.

Hippotherapy is usually recommended as part of a broader program of Cerebral Palsy treatment. It is important to talk to your child’s therapist about any special equipment that may be needed for therapy, such as a specific type of saddle.

Constraint-Induced Movement Therapy

This is a type of physiotherapy intervention for Cerebral Palsy that specifically helps patients with hemiplegic Cerebral Palsy to improve their muscle strength and range of motion in the affected upper limb(s). It involves immobilizing the non-affected limb during the exercise, so as to force the patient to use their other limb. It helps to address inequalities in limb and muscle development and thus enhances the patient’s overall speed and dexterity in completing tasks that require both hands.

Reflex Integration Therapy

Reflexes are the neurological building blocks of all the daily activities that humans perform. Children with Cerebral Palsy often do not have these reflexes, and reflex integration therapy is the ideal physiotherapy intervention for Cerebral Palsy in this case. It can train the brain to perform essential cognitive and motor tasks through a structured pattern of hands-on Cerebral Palsy exercises for children that stimulate the appropriate nerve responses. These exercises are designed to enhance motor control, boost core strength and coordination, and help the nervous system ‘learn’ the expected reflex.

Another option is called Quantum Reflex Integration, which uses sounds and cold lasers to target specific points on the child’s body and is an effective form of Cerebral Palsy treatment for repairing nerve damage. The therapist will design and modify the reflex integration therapy program based on how the child’s Cerebral Palsy symptoms are progressing.

Goals of Physiotherapy Intervention for Cerebral Palsy

At our centers in Bangalore and Hyderabad, we offer physiotherapy interventions for cerebral palsy that are diverse and tailored to the individual needs of each patient. Physiotherapy plays a crucial role in the management and treatment of cerebral palsy, aiming to enhance the physical capabilities and overall quality of life of those affected. Our programs have the following goals:

Improve Motor Function and Mobility

One of the main goals of physiotherapy is to enhance the gross and fine motor skills of individuals with CP. This includes:

Strengthening muscles
Enhancing coordination
Increasing range of motion
Promoting ambulation (facilitating walking and the use of mobility aids if necessary)

Prevent and Manage Contractures and Deformities

Contractures (permanent muscle shortening) and deformities are common complications in CP. Physiotherapy aims to:

Stretch tight muscles
Use of orthoses (orthotic devices to support proper alignment and prevent deformities)
Postural management

Improve Balance and Coordination

Balance and coordination are often impaired in individuals with CP. Physiotherapy interventions target:

Balance training
Coordination exercises
Vestibular stimulation (to improve the body’s ability to balance and orient itself in space)

Pain Management

Pain can significantly impact the quality of life of individuals with CP. Physiotherapy aims to:

Alleviate pain (techniques like massage, heat therapy, etc.)
Manage spasticity
Educate on pain management

Facilitate Social Participation and Interaction

Promoting social inclusion and interaction is another important goal. This includes:

Encouraging participation in activities
Promoting self-confidence
Family and caregiver support

Promote Overall Health and Well-Being

Physiotherapy not only addresses physical impairments but also promotes general health. This includes:

Cardiovascular fitness
Healthy lifestyle education
Mental health support

Our physiotherapists always encourage self-initiated movements. By engaging in a variety of task-oriented cerebral palsy exercises that cover a variety of environments (such as soft and hard surfaces) and postures (such as sitting, kneeling, and standing), the child’s brain can reinforce and strengthen the relevant neural connections that will enable them to perform daily activities with greater ease.

Over time, physiotherapy for children with cerebral palsy can improve cardiovascular fitness, enhance muscle strength and control, improve the child’s range of motion and flexibility, and preserve joint and muscle health.

Benefits of Physiotherapy for Cerebral Palsy

Physiotherapy plays a considerable role in easing cerebral palsy symptoms in children. Through a combination of exercise and assistive devices, children become stronger and more flexible overall and have a better sense of balance. They can also develop better stamina, posture, and coordination, and improve their general physical health.

Moreover, children with cerebral palsy experience a significant increase in their confidence when they successfully perform daily tasks on their own.

How Our Physiotherapists Assess Patients for Cerebral Palsy

Prior to recommending cerebral palsy exercises to patients, the therapist will assess the patient to determine the current degree of spasticity and any musculoskeletal deformities that might be present. They will also check if the patient has any gait, balance or trunk impairment, along with their overall physical fitness. This is essential to determining which types of cerebral palsy exercises to focus on for maximum improvement. For instance, while physiotherapy is generally sufficient for mild cases of spasticity, in more severe cases the patient may need surgery or other kinds of medical interventions.

There are several scales and benchmarks available to assess patients on different parameters of fitness and muscle function.

A CP physiotherapy assessment is crucial for children prior to starting any form of physiotherapy, to determine their current level of gross motor function. Many therapists will also assess infants with cerebral palsy symptoms to predict the kinds of motor impairment that are most likely to occur and accordingly begin early physiotherapy intervention for CP.

Exercises for Cerebral Palsy Patients

Physiotherapists will recommend a variety of Cerebral Palsy exercises that focus on muscle stretching and strengthening. These are particularly recommended for children with Cerebral Palsy in order to correct muscle imbalances and enhance strength as the child grows. A schedule of exercises for Cerebral Palsy patients will usually include some, or all, of the following:

Manual stretching: Prolonged manual stretches are one of the best cerebral palsy exercises to passively lengthen the affected muscle and improve hypertonicity. The stretch can rely on body weight or make use of a machine or splint. Stretching is one of the most effective forms of cerebral palsy exercises for children to improve soft tissue tightness and reduce spasticity
Splinting: Splints and casts distribute forces in a controlled manner to perform basic body functions and avoid tissue damage. They are extremely useful aids for CP exercises focused on improving gait, posture, and range of motion. They can also reduce swelling, spasticity, and hypertonicity
Serial casting: This is a specialized form of CP treatment that enhances the range of joint motion with the help of a padded, semi-rigid cast. This technique usually involves the repeated application of casts every few weeks as the patient’s range of motion improves. It is a highly effective form of treatment to manage spasticity-related muscle contractures
Static weight bearing: Static weight-bearing exercises like Standing Frame and Tilt-Table are effective cerebral palsy exercises at home that have been demonstrated to reduce contracture in the lower limbs by means of prolonged stretches. It is essential to perform weight-bearing exercises at the right angle to ensure that the knees stay extended during the prolonged stretch, as the force exerted on the knees is quite considerable
Functional exercises: For children who have higher ambulatory capacity, functional cerebral palsy exercises that combine strength training with cardio activity can significantly improve overall fitness and enhance their quality of life. While training on static treadmills or bikes is good for gross motor development, plyometric exercises help improve walking ability and muscle strength, particularly in children with unilateral cerebral palsy symptoms
Bodyweight-supported treadmill training: The stepping reflex is what encourages young children to walk. In this type of training, the child is placed on a slow-moving treadmill with the support of a harness to limit load-bearing and encouraged to take slow stepping motions
Muscle strengthening: These exercises focus on weak antagonist muscles as well as the corresponding spastic agonist muscles to enhance overall strength. Under a therapist’s guidance, patient’s can perform these with their own body weight or with strength-training equipment

Cerebral Palsy is non-life-threatening, and most young children experiencing its symptoms are expected to enjoy the same lifespan as anyone else. Moreover, with the right Cerebral Palsy treatment patients can significantly improve their ability to function independently and live a complete, fulfilling life.

To know more about how our customized rehabilitation program can help you or your dear one, reach out to Team Plexus today.

WhatsApp +91 89048 42087

Call +91 78159 64668 (Hyderabad) | +91 82299 99888 (Bangalore)

FAQs

What are the treatments for cerebral palsy?

At Plexus, we offer physical therapy, occupational therapy, speech therapy, and other interventions and assistive devices as deemed necessary by the severity of the symptoms. The treatment plan is tailored to the individual’s specific needs and symptoms.

What is cerebral palsy in adults?

Adults with cerebral palsy may face challenges such as muscle stiffness, pain, fatigue, and mobility issues. Managing these symptoms typically involves ongoing therapy and medical care. Cerebral palsy does not surface in adulthood. These are individuals who have grown up with the condition after being diagnosed in infancy or childhood.

What is the newest treatment for cerebral palsy?

At Plexus, we offer only the best treatment for your child with Cerebral Palsy. Under the care of Dr Na’eem Sadiq, and his team of experienced, skilled, and empathetic cerebral palsy specialists, your child will be able to lead a life of purpose, quality, and dignity.

Plexus offers a holistic rehabilitation program for CP that consists of –