Cerebral Palsy: PT assessment and Management

1. MANAGEMENT OF CEREBRAL PALSY: A
MULTI DISCIPLINARY APPROACH
BY
DR. C.S. UMEH
DEPT. OF
PSYCHIATRY, CMUL.

2. What is Cerebral Palsy?
 Cerebral Palsy (CP) is a group of non-inherited
neuromuscular disorders resulting from damage
primarily to the motor region of the brain, causing
impairment in control over voluntary muscles.
 It may occur through anoxia (lack of oxygen during
birth.
 It is one of the commonest neurodevelopmental
disorders seen in clinics.

3. What is CP Contn’d
The majority of children with
cerebral palsy are born with it,
although it may not be detected
until months or years later. The
early signs of cerebral palsy
usually appear before a child
reaches 3 years of age.

4. What is CP Contn’d
 The most common symptoms are:
 a lack of muscle coordination when
performing voluntary movements (ataxia);
 stiff or tight muscles and exaggerated
reflexes (spasticity);
 walking with one foot or leg dragging;
 walking on the toes, a crouched gait, or a
“scissor” gait;
 and muscle tone that is either too stiff or too
floppy.

5. What is CP Contn’d
A small number of children have
cerebral palsy as the result of:
brain damage in the first few months or
years of life,
brain infections such as bacterial
meningitis or viral encephalitis,
or head injury from a motor vehicle
accident, a fall, or child abuse.

6. What is CP Contn’d
 The brain damage that leads to cerebral
palsy can also lead to other health issues,
including:
 vision,
 hearing,
 speech problems,
 and learning disabilities.

7. Types of CP
 spastic cerebral palsy — causes stiffness and
movement difficulties
 Dyskinetic: which can be either athetoid
cerebral palsy — leads to involuntary and
uncontrolled movements or ataxic cerebral palsy
— causes a disturbed sense of balance and depth
perception
 Mixed: This is a mixture of different types of
cerebral palsy. A common combination is spastic
and athetoid

8. Causes of Cerebral Palsy
 The exact causes of most cases of CP are unknown,
but many are the result of problems during
pregnancy in which the brain is either damaged or
doesn't develop normally. This can be due to:
 infections,
 maternal health problems,
 a genetic disorder,
 or something else that interferes with normal brain
development.

9. Causes of CP contn’d
 Problems during labor and delivery can
cause CP in some cases, but this is the
exception.
 Premature babies — particularly those who
weigh less than 3.3 pounds (1,510 grams or
1.5kg) — have a higher risk of CP than
babies that are carried full-term.
 Falls and birth traumas

10. Treatment of CP
 Cerebral palsy can’t be cured, but treatment will
often improve a child's capabilities and quality of life.
 Many children go on to enjoy near-normal adult lives
if their disabilities are properly managed.
 In general, the earlier treatment begins the better
chance children have of overcoming developmental
disabilities or learning new ways to accomplish the
tasks that challenge them.

11. Treatment of CP contn’d
 CP usually affects several areas of
functioning, as a result, several disciplines
are involved in its management.
 The activities of the disciplines must be
coordinated in order to yield effective
treatment outcome.
 The disciplines usually involved in CP
management include:

12. Treatment of CP contn’d
 Pediatricians – they take care of
development, care and diseases of children
and are in the position to coordinate the
management of CP.
 Surgeons – they carryout surgeries to
correct anatomical abnormalities or release
tight muscles.
 Occupational therapists- they take care of
fine motor activities.

13. Treatment of CP contn’d
 Physiotherapists- they take care of gross
motor activities.
 Speech therapists -they apply remedies,
treatment, and counselling for the
improvement of speech functions.
 Clinical Psychologists- they provide
emotional wellbeing as well as cognitive
evaluation for school placement.

14. Treatment of CP contn’d
 Special need educators – the provide the
kind of education CP children with cognitive
impairment could benefit from.

15. Other CP treatment Aids
 The quality of life of CP clients could be
improved using the following aids:
 Prosthetic devices such as braces and other
orthotic devices;
 wheelchairs and rolling walkers;
 and communication aids such as computers
with attached voice synthesizers.

16. Prognosis
 Cerebral palsy doesn’t always cause profound
disabilities.
 While one child with severe cerebral palsy might be
unable to walk and need extensive, lifelong care,
another with mild cerebral palsy might be only
slightly awkward and require no special assistance.
 Supportive treatments, medications, and surgery can
help many individuals improve their motor skills and
ability to communicate with the world.

17. Conclusion
 CP is a non progressive brain disorder, meaning the
brain damage does not continue to worsen
throughout life, and usually develops by age 2 or 3.
 However, the symptoms due to the brain damage
often do change over time -- sometimes getting
better and sometimes getting worse.
 CP is one of the most common causes of chronic
childhood disability. It may not be curable but could
be managed.

18. Thanks for your attention