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Tightness and Contractures in Cerebral Palsy: An Overview

Tightness and Contractures in Cerebral Palsy: An Overview

Cerebral Palsy is a non-progressive motor disorder that occurs in about 2 to 3 live births per 1000. Patients will experience a variety of motor symptoms over their lifespan, as well as difficulties with speaking and swallowing. In particular, several children experience tightness and contractures in their limb muscles, which requires special treatment for Cerebral Palsy, to restore functionality. Here’s a quick guide as to what that may look like.

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. Children with Cerebral Palsy will usually display symptoms within the first year. Treatment for Cerebral Palsy such as stem cell therapy, physiotherapy, occupational therapy, and speech and language therapy can improve functionality and enable a more independent way of life.

Understanding the difference between contractures and tightness

About 75% of Cerebral Palsy cases are spastic in nature. Spasticity is formally defined as a velocity-dependent resistance to stretching. Children with Cerebral Palsy may have spasticity in two or more limbs. It may be mild, moderate, or severe. Spasticity makes it difficult to move from one position to another and to perform activities that engage specific muscle groups, such as picking things up.
On the other hand, contractures refer to a fixed shortening in muscle length. They are often a result of muscle tightness or spasticity, wherein the muscle becomes so short over time that the child cannot straighten their limb even when the muscle is relaxed. Muscle contractures may become more evident as the child grows and displays an inability to fully extend joints.
Both tightness and contractures can cause problems with limb movement and gait. It is important however, not to confuse the two. When a therapist examines your child, they will determine whether your child is experiencing muscle tightness, contractures, or both. The treatment plan will then be tailored accordingly, for maximum benefit.

Treatment for tightness and contractures

Physiotherapy and occupational therapy are essential for children with Cerebral Palsy to ease muscle pain and regain functionality in the affected limbs. Some of the elements that a therapist might choose to include in your child’s physiotherapy plan, are as follows.

  • Stretching: Guided stretching helps relax the muscles, reduce spasticity, increase range of motion, and lengthen the soft tissue for better joint mobility. Studies have demonstrated that stretching can improve agility in children with Cerebral Palsy. Ideally, your child should perform stretches every day, and especially after periods of physical activity.
  • Positioning and Splinting: Children with Cerebral Palsy may require postural support to attain different positions or what is otherwise known as positioning. Using supportive devices, like splints, would help your child in keeping their limbs straight and immobile. These practices are meant to enable your child to experience and develop more ways of movement and prevent secondary complications.
  • Assistive devices: Your child’s therapist may recommend the use of a brace to support the joint and enable correct movement. Braces also help prevent joint injury. Your child could also need a walker or a wheelchair to get around.

While muscle tightness and contractures can severely impede movement, it doesn’t necessarily mean that your child will never be able to walk. With the right treatment and the use of assistive devices as needed, your child can regain mobility over the years, and even walk independently. It is crucial therefore, to intervene at an early stage so that your child can be relieved of pain, and reap the benefits as soon as possible.

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